As I see it this website is about filling the gaping hole in the official literature on mental health problems and their treatment. Since these problems were declared to be diseases, ‘just like any other’, academic papers present them as if they were simply technical glitches in the way the brain or mind works. They can be identified by ticking a few boxes, and easily treated by tweaking the corresponding defect with a drug or a few sessions of quick-fix therapy.
What it is like to experience these problems and their treatments is nowhere to be found. Yet in post after post on this site among others, we hear about the harm produced by drugs that are prescribed for mental health problems. People report the horrible way some of these drugs make them feel, the negative impact on day to day functioning, the devastating things the drugs can do to the body, and the sometimes prolonged nature of withdrawal effects. We also hear about how the official literature inflates the benefits of drug treatments and minimises their dangers.
My latest book, The Bitterest Pills: The Troubling Story of Antipsychotic Drugs, is a contribution to this endeavour to present a more comprehensive picture of these drugs. Along with books by the likes of Bob Whitaker, David Healy, and Peter Gotzsche’s latest book: Deadly Medicines and Organised Crime: How Big Pharma has Corrupted Healthcare, it shows how the official picture of antipsychotics has been distorted by commercial, professional and political interests.
Peter Gotzsche concludes that the dangers of psychiatric drugs as they are currently used outweigh any benefits they might sometimes have for people who are seriously mentally disturbed. Doctors have not been able to resist big Pharma’s formidable marketing machine. “Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them” he says “ It is inescapable that their availability creates more harm than good.” This is an incredible indictment from a leading figure in the internationally respected Cochrane Collaboration.
Sadly, far from challenging Pharma, doctors and researchers set the scene for the pharmaceutical bonanza that atypical antipsychotics have become. Professional interests drove the transformation of antipsychotics from special sorts of tranquilisers into so-called ‘magic bullets’ back in the 1960s. It was this idea that antipsychotics constituted a sophisticated and targeted treatment, rather than a chemical suppressant, that obscured their unpleasant, mind-altering effects, thus enabling the pharmaceutical industry to expand their use over recent years. I believe that antipsychotics have their uses, but many people are currently exposed to all the risks these drugs pose in situations where their benefits remain limited and uncertain.
The early history of what are now called antipsychotic drugs illustrates the need for an alternative perspective. The French surgeon, Henri Laborit, who introduced chlorpromazine to psychiatrists in Paris in the 1950s, was awarded a share of the Lasker prize and is generally regarded as a medical hero. It transpires, however, that his use of the drug was based on bizarre and outdated theories about the origins of ‘shock’ in surgical patients. He used chlorpromazine in a highly dangerous procedure he devised called ‘artificial hibernation,’ which aimed to suppress the nervous system through sedation and cooling. American surgeons were not impressed. During his tour of the US to demonstrate the new procedure, most of the dogs he was trying it on died. French psychiatrists, on the other hand, embraced artificial hibernation because it resembled some of the dangerous interventions that psychiatry was already awash with at the time – things like insulin coma therapy and ‘deep sleep therapy.’ Eventually, however, they abandoned the cooling process (which consisted of surrounding patients with ice packs) and settled for the drug on its own.
Again and again the subsequent history of antipsychotics reveals attempts to whitewash the drugs. By the late 1960s it was reported that antipsychotics could produce a form of neurological damage, called tardive dyskinesia; a condition which could be irreversible. Over the next 20 years, however, psychiatric researchers tried to exonerate the drugs by attributing the damage to the underlying disease. Influential publications claimed that it was schizophrenia that caused tardive dyskinesia, even though the link to the drugs was well established.
A similar story played out with some of the new ‘atypical antipsychotics’ in the 1990s. Although it was plain that some of these drugs severely disrupted the body’s normal ability to regulate levels of sugar and fats, and could induce substantial weight gain and diabetes, psychiatrists and drug companies suggested that schizophrenia was to blame. There was no good evidence for this hypothesis, however, and eventually large sums were paid to settle claims from people who had suffered these effects.
Despite these dangers, massive legal and illegal marketing campaigns have resulted in increasing rates of prescribing of antipsychotics to people with depression, anxiety, sleep and anger problems and to the rising number of people who are being labelled as having ‘bipolar spectrum’ disorders. Many people are probably unaware that the drugs have not been properly tested in these situations, so we have no idea whether any benefits they might produce outweigh their dangers.
Antipsychotics do help some people suffering from psychosis. There is evidence that they reduce symptoms and levels of distress in the short-term. It is more difficult to judge whether they are beneficial in the long-term, and there is no evidence that starting antipsychotics early prevents brain damage, as was being claimed up until recently. In the long-term, some people who recover from a psychotic episode appear to do better without drug treatment. Others probably need it, but it is likely that too many people are currently being treated with a one-size-fits-all ‘stay on the medication’ approach.
Thanks to the internet and the survivor and consumer movement, we are all more informed about medical treatment than we were in the past, and better able to discuss and negotiate that treatment with our doctors. But it remains difficult to see the whole picture when it comes to psychiatric drugs. Such basic information as how each of the new atypical antipsychotics modify normal mental processes like thoughts and emotions, and how this impacts on behaviour for example, is simply not available. No one has done, or at least published, the research because of a systemic reluctance to admit that these drugs are mind-altering substance. By uncovering some of the untold story of antipsychotics, I hope The Bitterest Pills will enable patients and professionals to make better informed decisions about the use of these drugs.
Of further interest:
