Psychiatry has always been a mixed blessing. At its best it is humanistic and brings kindness and understanding to emotional suffering. At its worst, it can be coercive, controlling and damaging. What annoys me the most about current psychiatry with its overemphasis on medications is that it pretends to be scientific when it is not.
The pharmaceutical manufacturers do not submit their raw data when seeking FDA approval. Raw data would include the exact number of patients who started a clinical trial, the exact number who dropped out, the reasons why they dropped out and many other specific details concerning the clinical trial. Instead, data is manipulated and twisted to suit the needs of the manufacturer, and this manipulation is hidden from physicians and the FDA. The FDA has the ability to demand the raw data, but rarely does. Instead, the drug companies are free to reinterpret or exclude data that is not favorable to their product with no transparency.
Sometimes I am a reviewer for a professional psychology journal. When I review an article, I insist on the raw data, or the article is rejected for publication. The only raw data on a pharmaceutical that I have ever had the chance to review is the data on Paxil which was inadvertently made public in the trial of Lacuzong v. GlaxoSmithKline. http://www.breggin.com/index.php?option=com_content&task=view&id=160
The raw data reveals a shocking cover-up of information and indicates an extraordinarily high completed suicide rate of 7 subjects in a clinical trial of about 1400 people, mostly within a short period of time after stopping the drug.
As a physician, I seek to protect patients from this sort of danger. How am I to make a credible, scientific decision about a drug’s risks and benefits if I do not have the proper data? Professional, legal and scientific forums demand a ‘scientific’ discussion of drug effects, yet I am limited to data that has been manipulated for the benefit of pharmaceutical sales.
Sometimes I feel like I am wearing handcuffs in a boxing match. When I make an observation of adverse drug effects on my patients, my colleagues admonish me that I need to have controlled scientific data before I can draw a conclusion. I recall a decade ago when, in casual conversation with another psychiatrist, I mentioned that Paxil seemed to be addictive and that patients were unable to stop taking the drug. The response was a venomous assertion that I had no data to support my opinion. But did I even need data to support my opinion? And am I only limited to comments that are based on manipulated drug company data?
In 1990 when Harvard psychiatrist Martin Teicher reported six case studies of serious suicidality in six patients treated with Prozac, instead of prompting serious scientific study of Prozac-related suicide, Teicher was excluded from academic circles – despite the fact that Germany initially would not license Prozac for sale because of the possibility of suicide. Voicing professional opinion on adverse drug effects is hazardous to a person’s career.
Any observations or comments indicating side effects or adverse effects of psychiatric medications are met with indifference at best, but the doctor making the observation will more likely be labeled as “fringe” or as an “antipsychiatrist.” Any opinion that does not support the pharmaceutical industry is considered political opposition rather than professional and scientific observation. Given the lack of self regulation and lack of scientific scrutiny, the findings in Anatomy of an Epidemic that mental illness increases in proportion to the amount of medication prescribed is not surprising.
Not too long ago I saw a young man who had tardive akathisia – a sense of almost intolerable restlessness – for a second opinion. I felt the condition related to taking SSRI antidepressants. He was the son of an academic psychiatrist. After my opinion that the patient had tardive akathisia he went for another opinion from a prominent academic psychiatrist, who concurred with me. The young man’s father commented that he also agreed, but could never voice this opinion in public because his peers would be highly disapproving.
What is to stop the drug manufacturers from deliberately making drugs that are ultimately damaging to the patient if a physician is not free to discuss observations and findings?
In the late 70’s, before the invention of CT scanners or MRI scanners, I practiced emergency medicine. Without these sophisticated tools, I had to diagnose potentially fatal problems such as internal bleeding from head trauma or abdominal trauma on the basis of history and examination. A doctor had to look at a patient and make a decision about whether or not they appeared ill or in distress. A doctor had to examine the patient; smell the patient, touch the patient, talk to the patient; this was crucial to the decision making process of diagnosis and treatment. With that sort of background, why do my observations and opinions somehow no longer matter?
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.