The passing of each year brings further evidence of the dangers and failings of psychiatric drug treatments. Peter Breggin, David Cohen, David Healy, Bob Whitaker and Joanna Moncrieff have all made substantial contributions to unmasking the shameful deceits and pseudoscience that masquerade as theory and evidence as far as psychiatric treatment is concerned. Yet despite this, drugs continue to dominate psychiatric practice.
If the blimp that is psychiatric treatment were a passenger aircraft, the authorities would have grounded it many years ago, but still it continues to inflict harm on countless thousands of people. I read Joanna Moncrieff’s latest book with a growing sense of anger and shame. The roots of drug treatment in psychiatry are thoroughly rotten. They sustain the decaying trunk of psychiatric theory and practice through misrepresentations and untruths; it is snake oil peddled by quackery.
She picks up the narrative she started in The Myth of the Chemical Cure (Moncrieff, 2008), but The Bitterest Pills is concerned primarily with neuroleptic drugs. She describes in detail how they came to be seen as a ‘specific’ treatment for schizophrenia and, increasingly, other psychoses. Starting with the transformation of chlorpromazine into psychiatry’s first wonder drug, she describes the origins of the dopamine theory of schizophrenia as a post-hoc rationalisation, based in the observation that the drug, which appeared to damp down acute psychosis, was subsequently discovered to block dopamine transmission in the brain. She dismantles the evidence for the effectiveness of these drugs with the precision of a Swiss watchmaker. As she points out in chapter six; despite all the claims made for the effectiveness of neuroleptics in schizophrenia, no placebo-controlled study of their use in first-episode psychosis has ever been conducted.
In her earlier work (Moncrieff and Cohen, 2005; Moncrieff, 2008) Joanna Moncrieff has set out the distinction between drug-centred and disease-centred models of psychotropic drug action. The latter holds that neuroleptics are effective because they have the specific property of rectifying a biochemical ‘abnormality’ (an excess of dopamine activity in certain brain areas) believed to be responsible for the symptoms of acute schizophrenia. The difficulty, as she indicates in chapter four, is that there is no evidence to link excessive dopamine activity to schizophrenia. In contrast, the drug-centred model maintains that psychotropic drugs may help some people because they induce abnormal brain states. In the case of neuroleptics this arises through the complex effects they have on consciousness (inducing indifference) and motor activity (reducing it).
I found that one of the most significant achievements of her book is the light it casts on why the disease-centred model is so attractive to psychiatrists. Chlorpromazine was introduced barely ten years after penicillin revolutionised the treatment of infections, saving countless lives in the Second World War. In the guise of Largactil it became psychiatry’s ‘magic bullet’, reaffirming its medical credentials just as the medical profession more generally was becoming increasingly identified with drug treatment.
This appeal to a medical identity also helps us to understand why so many psychiatrists are reluctant to face up to the implications of serious critiques of the scientific basis of psychiatric practice. To accept these critiques would result in a crisis of legitimacy for the role of doctors in mental health. I have a different view of this. Dr Moncrieff’s work is a threat to the role of the doctor if you believe that the medical role is restricted to prescribing medication and checking for concurrent physical illness. I don’t subscribe to that view, and have more to say about how doctors can work without drugs and physical treatments, with people who experience madness and distress, in my forthcoming book about the future of psychiatry.
Chapter seven deals with the subjective experiences reported by people who take neuroleptics, which has potential as the starting point for a systematic investigation of the drug-centred model. Most of the evidence here comes from people who use psychiatric services, but I must confess a personal interest. Some years ago I was one of the subjects in David Healy’s study of droperidol referred to by Joanna Moncrieff. This experience served the purpose of reinforcing my determination to help as many of my patients as possible to reduce or come off these drugs. The coercive use of medication is the subject of chapter eight. In it she contrasts patients’ experiences of coercion, described as humiliating and degrading, with the presentation of coercion in the psychiatric literature (on the rare occasions it is addressed) as ‘therapeutic’.
Chapter nine examines the relationship between long-term neuroleptic use and brain atrophy. For years cerebral atrophy has been presented as an intrinsic part of the disease process of schizophrenia. The evidence implicating neuroleptics in this has met with indifference or denial in the profession. Indeed, her account of how the profession and the pharmaceutical industry have played down these serious consequences of long-term neuroleptic drug treatment is a shameful spectacle.
There is a much to admire about Joanna Moncrieff’s book, but treading the path of a critical psychiatrist can at times be a fine balancing act. If her message is to get through to the profession, its tone and positioning are of utmost importance. If the message is too strident the wagons will circle and the cowboys will start to let the Indians have it with everything they’ve got. This is how the profession responded to the attacks of so-called antipsychiatrists in the 1960s. For this reason I suspect that some may find her arguments too cautious, possibly to the point of ambivalence. There is evidence, however, that her carefully articulated tone is having an impact within the academic elites. The prominent British psychiatrist Robin Murray was very supportive of her systematic review written with Jonathan Leo about the effects of neuroleptics on brain volume, published in Psychological Medicine (Moncrieff and Leo, 2010)
There are two main criticisms I would make of this book. Given all that she has to say about the problems associated with the long-term use of neuroleptics, there is little in the way of practical guidance to psychiatrists about how these drugs might be used to help people in the short-term, whilst minimising their potential for harm. There is also little advice or guidance about reducing or coming off neuroleptics for those who are taking them.
True, there is a chapter on this topic in her short book about psychiatric drugs (Moncrieff, 2009), but perhaps more advice on the topic would have been valuable. That said, perhaps the greatest impact of her work is that it creates spaces for voices that are usually excluded from psychiatric discourse about drugs; those of service users/survivors and families. One important source of evidence about coping with coming off neuroleptics is to be found in the stories and testimony of service users and survivors. This can be seen in the recent post by Sera Davidow, Laura Delano and Sean Donovan on Moving Beyond the Medical Model. Here in England, Rachel Waddingham, Rob Allison, Adam Jughroo and I are in the early stages of collecting fifty stories of people’s experiences of reducing or coming off neuroleptics. Stories, whether in video or text, have the power to set free by opening up new possibilities for those who otherwise might never have countenanced the idea of coming off.
My other criticism concerns the prospect of mapping the subjective experiences of neuroleptics, and for that matter other psychiatric drugs, on to particular neurochemical mechanisms (chapter seven). This is another version of the problems of neuroscience in accounting for consciousness (see my earlier blog Why Neuroscience Cannot Explain Madness). The subjective experiences we have when we take a drug that affects consciousness arise not only from the effects of the drug on the central nervous system and the physical body. It is also the product of a wide range of contextual factors. Take as an example the consumption of alcohol. When I was a young man the subjective effects I experienced from alcohol when out drinking with friends after playing cricket depended amongst other things on the outcome of the game. Our excitement at winning, especially if I had taken a few wickets, would become elation fuelled and released by alcohol. In contrast two or three pints of beer tipped downheartedness at defeat into a miserable silence. The subjective effects of drugs, legal, illegal or therapeutic are contents of consciousness that are embodied and encultured, and thus saturated with meaning and values. For this reason I have serious doubts about the ability of neuroscience and psychopharmacology to generate anything like a comprehensive account of these aspects of consciousness, let alone one that might have some limited utility in psychiatry.
These minor quibbles should not mar the valuable contribution I hope this book will make towards a more rational, transparent and ethical approach to the use of neuroleptic drugs. By implication it also offers up a strong argument for much wider choice for people in crisis, particularly the provision of minimal drug/drug-free systems of help and support, such as Soteria-type facilities and Open Dialogue. It is a must-read for all psychiatrists and mental health professionals, and its accessibility means that many survivors/service users and carers will find it a valuable ally in their fight for more humane and less harmful alternatives to psychiatric drug treatment.
References
Moncrieff, J. & Cohen, D. (2005) Rethinking models of psychotropic drug action. Psychotherapy and Psychosomatics 74, 145 – 153.
Moncrieff, J. (2008) The Myth of the Chemical Cure. Basingstoke, Palgrave Macmillan.
Moncrieff, J. (2009) A Straight Talking Introduction to Psychiatric Drugs. Ross-on-Wye, PCCS Books.
Moncrieff, J. & Leo, J. (2010) A systematic review of the effects of antipsychotic drugs on brain volume. Psychological Medicine. 10, 1 – 14.
Excellent review, thank you
Very nice review… now I want to go read the book!
As a response to the following critique:
“there is little in the way of practical guidance to psychiatrists about how these drugs might be used to help people in the short-term, whilst minimising their potential for harm. There is also little advice or guidance about reducing or coming off neuroleptics for those who are taking them.”
I think that withdrawal discussions are a necessary part of guidance for using the drugs wisely in the short-term. Since this is such a huge topic, it seems ripe for another book!
I appreciate the forthrightness and thoughtfulness of Dr. Thomas’ review. I hope your position in your profession is solid enough that you don’t get drummed out of it. Remember, when Loren Mosher, my model of the kind of person a psychiatrist should be, established the original Soteria House, and insisted that people with severe emotional distress could heal through emotional support, not primarily drugs (which are the antithesis of healing anyway), he was driven out of his position in the National Institute of Mental Health.
Maybe things are better in the UK. You’re a more civilized country after all.
Ted I agree with you about Loren, he’s one of my hero’s, a truly decent man (like Phil), however our parliament (of all parties) is not remotely civilised!
In the absence of any ” medical professionals ” stepping up to the plate, we have Will Hall coming to speak with medical providers and all community members on Coming off psych meds, using his manual of Harm reduction. I asked Will to bring someone with an MD so that maybe, just maybe the local psychiatrists would actually Take in this training to promote a change in their current practices. We need more doctors to come out of the closet and take risks with us, to speak up, they too must be seeing the harm!
Good for you, Yana. Yes, I think any psychiatrists who are honest can see there is something seriously wrong with the way their profession functions. And yes, it sure does require taking risks. I will be down in Aptos for the event this coming Saturday, and maybe we can chat a bit.
Thank you for that excellent review! I have just this second downloaded it onto my kindle and will read it when I have finished reading Peter Gøtzsches book. He is not mincing his words! 😉
That those who use or are forced to use psychiatric drugs are and have been silenced, is sadly not new. For my thesis I tried to find research that specifically looked at people labeled ‘schizophrenic’ and their subjective experience of taking psychiatric drugs. I searched 5 databases from 1950 to 2012 and out of the 1000’s of articles looking at drugs and ‘schizophrenia’ I found only 14 articles that were interested in the subjectivity of being on them as a labeled ‘schizophrenic’.
This is disgraceful!
Not just regarding the lack of respect for those taking/being forced to take them but also in terms of serious scientific research. This has allowed and continues to allow for human rights breaches to thrive within orthodox psychiatry.
However I believe it also clearly indicates that the void between those who force it upon their patients or use the art ‘of peddling snake oil through psychiatric quackery’ is huge. Yet it is also incredibly dangerous for psychiatry should the silenced become heard as can be seen unfolding as our voices become louder and louder!
Btw we, the Danish Hearing Voices Network in conjunction with the organisation for users and survivors of psychiatry LAP, have translated Will Halls harm reduction guide and will be hopefully presenting it before the year is out! This along with Robert Whitakers Anatomy of an Epidemic being released in Danish 7th November and Peter Gøtszches book Deadly Medicines and Organized Crime having just having hit the market here in Denmark is creating waves and rocking the psychiatric boat. The reduction of psychiatric force is now a national priority… though lets see that in action before I say hip hip hurrah
Wow, Bob’s book has been translated into Danish? Awesome. And “Deadly Medicines and Organized Crime?” What a marvelous title. Does anyone know if it available here in the United States?
You may or may not think so, Olga, but I think there is a great advantage in being in a smaller country if you are trying to get the public to pay attention to our situation. I had the pleasure of visiting Jim and Mary Maddock a couple of years ago in Ireland, and I saw how they were able to reach the public there in ways we here in America can’t. As a result of their hard work, they are constantly on the radio, TV, and newspapers there. Denmark and Ireland are about the same population, and I wish I could live in either place and work in the movements there.
Hi Ted!
I agree there are advantages to being in a smaller country as our voices when they are heard are heard throughout the country. We too are being represented more and more in the media I was just the other day in a radio in a one to one debate with a psychiatrist. I have for a long time said I was willing to enter into such a debate but that has not happened before now. The reason it happened Is not because suddenly I am interesting to debate with but the pressure is on. My focus has been pretty much singleminded the drugs and human rights ever since someone I knew dropped dead from her drugs and help start up a new organization called Deaths in Psychiatry (translated)
Eg. Being a small country we were able to plan a countrywide campaign on the dangers of psychiatric drugs with go-cards in every cafe etc advertising our campaign. In fact if I can I will include a picture of our go-card which created a lot of discussion also I might add within our own ranks as too extreme 😉 I thought it was great. We chose not to try and ‘convert’ psychiatry or make them more ‘aware’ we went for the public. That has hit home and shaken the foundations which we continue to build on. Our campaign was viewed very negatively in the beginning but when we ended we had so many mucisians and bands wanting to play for us for free to support us that we had to apply for more time in the city square, Copenhagen!
When our campaign finished the newspapers became interested and have been regularly looking at conditions regarding psychiatric patients. Eg. There had long been rumors ie. complaints of overmedication from many of us but now it was of interest and one of the newspapers unraveled an extreme case of not just gross overmedication but also drugging with a non approved drug. This for the first time sent heads rolling and believe it or not a political decision again through us lobbying (us by the way is a mix of survivors, family members and some dedicated professionals) that psychiatrists medicating habits had to be monitored throughout the country. They are the only medical speciality to be put under such observation.
Importantly this focus on potential death has now opened the door to questioning the legitimacy of diagnosis and asking ‘so where is the evidence for mental illness’ that question, previously only heard among ourselves, is a really difficult one when it begins to be asked generally, and to avoid it psychiatry is for want of a better word trying to appease.
PsykoVision is translating or rather has translated Bobs book 🙂 and being closely affiliated with the Danish Hearing Voices Network we have been following the progress first hand 🙂 His book will be released at a big confence (interest is so great the venue has been moved to a bigger place) where he will be speaking along with Peter Gøtzsche who has written the book deadly medicine and organized crime along with a psychiatrist who has worked for Open Dialog in Denmark not easy. Gøtsche BTW is Director of The Nordic Cochrane Centre doctor and professor. His book can be bought through amazon
So yes there are advantages to smaller countries and also- I would love to have you by my side here working in our organizations!
Can’t figure out how to put picture of our go-card but here is a link to a very recent conference with Peter Gøtzsche it is in Danish but with english subtitles enjoy
http://www.youtube.com/watch?v=i1LQiow_ZIQ&feature=youtube_gdata_player
Wow! You all have achieved a lot. Hopefully we can find a way to emulate your success in North America.
Wow, Olga, I am really impressed with what you people are doing in Denmark. I especially appreciated what you said about “We chose not to try and ‘convert’ psychiatry or make them more ‘aware’ we went for the public.” I think our movement MUST do this. It is nonsense to think that psychiatry will “reform” itself if only we tell them how much we are suffering. Nothing will change until we take away their power. And the way to do that is to talk to the general public and make them see what is wrong. That is to me the only way to get change in democratic countries like Denmark or the United States.
I want to invite you to a project we are doing here in the US that will lead to the kind of public outreach you have discussed here. I will write you privately.
Many thanks for an excellent review of Joanna Moncrieff’s new book. It makes me want to run out and buy a copy.
David Healy has a different take on why psychiatry and pharma happily jumped into bed together after WWII. Antiobiotics, antipsychotics, etc. were now available by presciption only.
http://www.pharmapolitics.com/feb2healy.html
“The other thing that is happening stems from another war that began in 1914 – a War on Drugs. This began with the Harrison’s Narcotics Act, which made the opiates and cocaine available on prescription-only. In 1951, a Humphrey-Durham Amendment to the 1938 Foods Drugs and Cosmetics Act makes all the new drugs produced by the pharmaceutical revolution following the Second World War, the new antibiotics, antihypertensives, antipsychotics, antidepressants, anxiolytics and other drugs, available on prescription-only.
Not everybody is happy with the new arrangement. Many complain that a system designed for addicts is not appropriate for the citizens of a free country.
A combustible set of ingredients has been put in place that will lead to an explosion. It only took 16 years for the explosion to come.
In the next slide, you see the Tokyo University on fire. Tokyo sits at the apex of the Japanese hierarchy. The students have occupied the Department of Psychiatry in an occupation that continues for ten years. Psychiatric research in Tokyo is brought to a halt. The most powerful psychiatrist in Japan, the professor of psychiatry in Tokyo, Hiroshi Utena, is forced to retire (Slide 2).
Why is there such an extraordinary development? Only 16 years after the discovery of chlorpromazine, which liberated the insane from their straitjackets. The great boast of the advocates of chlorpromazine was that it had restored humanity to the asylums. Previously, lunatics had been guarded by jailers, who treated them brutally. Now it was possible for therapists to see the humanity of their patients and talk to them. The level of noise in the asylum has fallen.
However, the times have seen the emergence of antipsychiatry and the antipsychiatrists respond that real straitjackets have simply been replaced for chemical straitjackets, for the camisole chimique. That indeed there is silence within the walls of the asylums, but this is the silence of the cemetery.”
Dr. Thomas,
Thanks for this review. I was working on one myself! I enjoyed hearing you speak at IPS. I was there to present the results of my experience tapering neurolpetics. I wanted to say hello but you were surrounded by fans. In her last – and quite eloquent – chapter, she points out how many questions remain. She argues that we still have these questions because we have taken a disease centered approach. Perhaps, this is why she did not give many recommendations. More to follow when I do get around to writing more about my study and this important book.
Sandy
Of course they need the drugs to be paid as doctors. There’s no way insurance companies would pay them 160 thousand dollars a year to sit and talk to people about their problems. They’ve been clinging to these drugs and will continue to. There will be a day when it’s finally fully accepted within the medical science community that neuroleptic drugs cause permanent and serious brain damage that complicate a person’s life, and by then they’ll be 5 million children on them, and psychiatrists will say “Well, it’s not like we’re just giving it to them for kicks and giggles, bipolar disorder is a serious ilness, blah blah blah!”
It’s why I still, and will always, believe there ought to be criminal charges in the works. They’ve been ignoring the evidence of harm caused by their drugs for DECADES, and they have an obvious self-serving interest in doing so. That is, harming people for their own gain.
Criminal prosecutions, yes. While I consider giving drugs to small children long-term to be criminal, it would be hard t get prosecutors to act on that. But there are certain behaviors of psychiatrists, such as the drugging to death of four-year-old Rebecca Riley several years ago, that clearly reach the level of criminality. In that case, the authorities refused to prosecute the doctor who did it, and instead blamed it in the parents, who gave the child the drugs that the doctor prescribed. Jury members after the trial protested that it was the doctor who should have been prosecuted, and I think the public agreed.
It is egregious cases like this where our movement should have been calling for a criminal prosecution. Unfortunately, no one in our movement in the Boston area said a word, and we lost a great opportunity to educate the public. I hope the next time something like this happens, there will be groups in place that are not taking money from the mental illness system to defend it, and we will be prepared to raise the consciousness of the public. After all, with the DSM now calling almost all emotions “mental illness,” everyone is in danger, not just the mental cases like me.
I too wish there was some kind of justice. Unfortunately, society seems unwilling to convict people that it thinks are respectable.
I hang my hopes for justice on future generations. History will judge the people who commit egregious human rights violations, even if the judging doesn’t occur during the perpetrator’s lifetimes. This situation is has similarities to slavery in the US. Most of the slave-holders were never brought to justice. But, today, anyone who breaths a word of support for slavery or racism is hung in the court of public opinion.
Brilliant stuff, but you are right that a dedicated professional response is often needed but assumed to currently (and increasingly) available. And this is our bigger problem in so far as those deemed to be experts – and there are few enough like yourself Philip but more like Olga and Ted who have experientail expertise coupled with professional or academic skills. But the expert role requiring years of study really seems to ill-prepare folks for the task of sitting patiently in helplessness for the fog to lift. The sheer variety and ambiguity is very diffcult to deal with for professionals who must first face the frankly unedifying realisation that their current skill set is useless for the task at hand and actually what the need ar from being gained through a professional training program way well be the very attributes most valuable in responding sensitivly to persons experienceing prefound distrught 🙁
http://www.wormwoodgate.wordpress.com
Dr. Thomas,
I grew up in the Hill Country of Texas, where I learned, as a kid to shoot straight. Both with a rifle, and with my words.
I appreciate the fact that you’re a “straight shooter.”
Best,
Duane
Dr Thomas,
Thanks for your concise and insightful summary of Dr Moncrieff’s new book. I am looking forward to reading Joanna’s book. I read her 2008 book, and her articles here.I think her innovative and astute argument for a drug centered approach took the discourse beyond that of pioneer Peter Breggin–it provides a solid foundation for a harm-reduction approach. However I believe it is important to point out that there is a major inconsistency in Moncrieff’s work,to the point sometimes of absurdity. I previously attributed this inconsistency–on comments here on MIA– to the unconscious influence of the medical model. Before I elaborate let me give a quick but telling example of Joanna’s inconsistency–whether it is deliberate or unconscious. Dr Moncrieff makes a powerful argument for a drug centered approach, yet she consistently refers to neuroleptics as “antipsychotics.” The term obviously implies that the effect of the drug is upon the putative disease, or on the specific symptoms.
This may be a deliberate attempt to avoid alienating professionals, but it undermines her advocacy of a drug centered approach, and it reinforces the medical model. Language shapes people’s perception of reality. It’s not insignificant when one continually evokes an image that contradicts the model for which one is advocating. The public at large is convinced that neuroleptics ARE anti-psychotics and I cannot help but think Dr Moncrieff would be a more effective advocate if she began to refer–at least 75% of the time– to so-called anti-psychotics as neuroleptics.
I am led to genuinely wonder: Does Dr Moncrieff, an advocate for a drug centered approach, think that neuroleptics do not have any distinctive anti-psychotic properties? My impression is she is not completely sure.
I listened to her interview with Peter Breggin yesterday.At the beginning Joanna said she thought short-term use of “antipsychotics” is necessary. She thought Peter would agree but he responded, “I believe that if these drugs were given to anybody but mental patients they would have been off the market a long time ago.”He said that short term use of benzodiazepines could and should be used instead of neuroleptics. They then had a fascinating discussion. Every time Peter made a generalization she would give cite powerful evidence that backed it up, and vice versa. Towards the end of the hour, there was a pause and then Dr Moncrieff said out of the blue– as if she had not participated in the previous conversation:”My guess is that there are some people who do need antipsychotics and benefit from them.” There was a long pause. I imagine Peter was trying to overcome his confusion. Rather than pursue the point he tactfully changed the subject.
Now you write, Dr Thomas, “There is a much to admire about Joanna Moncrieff’s book, but treading the path of a critical psychiatrist can at times be a fine balancing act. If her message is to get through to the profession, its tone and positioning are of utmost importance….For this reason I suspect that some may find her arguments too cautious, possibly to the point of ambivalence.” Is her ambivalence then a pose, a move in a strategy designed to influence what you call the “academic elites.” I am convinced her ambivalence is genuine–after all she was talking to Breggin in a program that would in all probability be unheard by the academic elites. Does her ambivalence serve her goal nonetheless? I don’t put much stock in the academic elites, but I am wary whether such ambivalence serves the cause of educating her readers who includes professionals as well as clients.
There is no good evidence that long term use of psychiatric drugs is beneficial for anyone–and in fact Moncrieff is the first to point that out.If one takes into account the reduction in life expectancy and the 2/3’s incidence of TD after 20 years of use, along with numerous other indices of the deterioration in the quality of life…well I’m sure Joanna makes these very points in her book! THE APA in their mid 1990s report on tardive dyskinesia acknowledged the prevalence of the problem (this was before the myth of the atypicals) but said neuroleptics were necessary for the management of schizophrenia. What is Dr Moncrieff’s “guess” based upon? I stated that there was no good evidence. The “bad” evidence Dr Moncrieff might cite is the fact that many people she knows believe they were helped or saved by antipsychotics. Just as “psychotics” in other eras would have said they benefited from ECT and insulin coma therapy–let alone lobotomies. Of course. People trust psychiatrists. I think that is why 50% of depressed persons respond to placebos. (I am not aware of any cross-cultural studies on the placebo effect of anti-depressant drugs.)
As to short term benefit I think Dr Moncrieff is aware that there are studies that show benzodiazepines are just as effective, and she knows they don’t have the extremely adverse side effects,e.g., akathisia, EPS, emotional blunting.Most of the former patients I know who were put on neuroleptics in the hospital would argue that the administration of these drugs constitutes torture–physical and psychological– even when they took them willingly. Of course they were not permitted to stop taking them. Nor to switch to benzodiazepines. Why not? Because benzo’s are not “antipsychotics.” In other words there IS no good reason for the use of neuroleptics rather than more benign drugs.
I think Dr Moncrieff makes some pro-neuroleptic statements because she believes(some of the time, half-heartedly) that these drugs have specific and distinctive properties that make them usually well-suited for the “management”of “psychosis.” (Dr Sandra Steingard, who was probably influenced by Moncrieff, also believes this.)
Otherwise why support the uses of drugs that have the horrendous risk/benefit ratio of neroleptics when there are alternatives? I think her guess is based purely upon the hold that the medical model has upon the collective psyche,such that even dissidents do not escape its influence.
I have heard her online make an argument for the use of alternatives to SSRIs. She boldly contends that anti-depressants do not have an “anti-depressant” effect. But when it comes to schizophrenia, the “sacred symbol of psychiatry”(Szasz), even mavericks become timid. Even R.D. Laing became ambivalent.The fact that Tom Szasz was consistent, even with schizophrenics, throughout his life, is one reason he was held in such high esteem by activists in the survivors’ movement.
Dr Moncrieff described the Dutch follow-up study in one of her recent articles on this website, “This study provides tentative confirmation that long-term antipsychotic use impairs people’s ability to function, and this is exactly what we should expect from drugs that inhibit mental processes and nervous activity.”Yes,
indeed! And we should expect that drugs which “inhibit mental processes and nervous activity” would not be beneficial for anyone, even if many patients think that they are. In some activist circles these days it’s taboo to imply the patient could ever be wrong, whether she claims the drug is detrimental or helpful to her.
Every “mental health” professional and particularly every psychiatrist has to decide what they would say to clients who claim that neuroleptics are helping them. They have to decide how to respond to clients who wants to be en-couraged– who need the doctor’s confidence in them– to wean themselves off of neuroleptic drugs. They have to decide what to say to clients or colleagues who want to know if neuroleptics have specific anti-psychotics properties. And if they don’t, why call them antipsychotics?
Seth Farber, Ph.D.
http://www.sethHfarber.com
Yes, I had to be on a potent neuroleptic and found what Peter Breggin writes about them to be true. They are trainquilizers sometimes with a potent hypnotic. You haven’t solved a biochemical mystery by shutting down brain wave behaviors. They also create a highly suggestible subject and found that they are most often applied by bible belt parents, that truly believe the hippies go to the north west. Bizarre and wrong.