The FIAT (Financial Incentives for Adherence Trial) study, published last year, highlights the paradoxical nature of our current attitude to the use mind-altering drugs. In this randomised controlled trial people with ‘psychotic disorders’ were paid £15 a time to take an injection of an ‘antipsychotic’ drug(1). The payment increased rates of compliance only marginally, and had no effect on clinical outcomes, so the accompanying editorial suggested we need to pay people more(2).
We are now paying people to take drugs they don’t like and don’t want, while we continue to invest vast sums of public money in efforts to curb the use of drugs that people do like and do want. Prescription drugs like antidepressants, antipsychotics and so-called ‘mood stabilisers’ are widely promoted as good for your health. But the history of prescription and recreational drug use is more intimately intertwined than most people recognise. Attempts to disentangle the two have created a false dichotomy – with prescription drugs, at least some of them, set up as the ‘angels’ that can do no wrong, and recreational drugs cast as the ‘demons’(3).
Distinguishing drugs in this way makes no sense pharmacologically, and does not help us to understand what effects they actually have. The regulation of drugs is driven by political imperatives to produce a population that remains productive, diverted and obedient. The masses must have their opium, but must not be allowed to be so free with their drug use that they infringe public order or undermine the efficient operation of the economy.
As I have pointed out elsewhere, drugs prescribed for mental health problems are, without exception, psychoactive substances. In other words, they are drugs that alter the way people think, feel and act in various ways, depending on the chemical nature of the particular drug. The difference between drugs prescribed to people with mental health problems and recreational drugs is that the latter, by definition, make many people feel good, whereas most psychiatric drugs are disliked by the majority of people who take them, initially at least.
There is some overlap, of course, with prescribed drugs like benzodiazepines (and formerly barbiturates) being popular with some illicit drug users, and amphetamines, now predominantly associated with recreational use, retaining a niche in the treatment of ADHD (attention deficit hyperactivity disorder).
Psychoactive drugs have been a part of life in most societies and communities throughout history. They have been used for pleasure, to dull physical and emotional pain, to increase concentration and endurance and to induce states of religious ecstasy. Crucially for the current story, the recreational and medicinal use of such substances is often blurred. The intoxication produced by alcohol, for example, was much used for medicinal purposes before other drugs became available. Opiates (opium, morphine and heroin) effectively numb and neutralise both physical pain and emotional anguish. Benzodiazepines like Valium and Librium reduce anxiety by producing a pleasant state of relaxation, but where anxiety reduction stops and euphoria begins is difficult to pinpoint.
The Problematisation of Drug Use
In medieval and Tudor England, heavy drinking was an accepted part of rural life. Weak beer was consumed instead of water by all the family on a daily basis, but festivals and holidays, of which there were many, were occasions for drinking to inebriation. Drunkenness was not regarded as problematic in pre-industrial society, and the country people were left to enjoy their intoxicating habits.
It was only in the 18th century, when the increasing urban population took to drinking gin in large quantities, that concern about alcohol use emerged. Hogarth’s famous engraving, Gin Lane, indicates the moral outrage that had started to form around the drinking habits of the poor. Freed from the customs and obligations of rural life and displaced into the exploitative environment of early capitalist cities, the nascent working class turned to the instant oblivion provided by the newly imported, super-strength liquor. Gin was blamed for rocketing rates of crime, prostitution and debt, and the upper classes lived in fear of a breakdown of law and order, as well as bemoaning the decline in the nation’s productivity. The Gin Acts of the 18th century were the first legislative attempts to control the people’s use of mind-altering chemicals(4).
A similar same story played out with opium, which was widely used by all classes during the 19th century. The medicinal and recreational qualities of opiate drugs are particularly difficult to disentangle, and addiction to opium was likely common among working people who used it either to alleviate the pain of physical ailments, to relieve emotional strain or for enjoyment. Although the construction of the ‘opium problem’ had many drivers, including the professional aspirations of pharmacists and doctors, and pressure from the United States over the opium trade with China, concerns about non medicinal use leading to the dissipation of the working class fuelled public health campaigns against opium use and led to the beginnings of the legal regulation of its availability in the 1868 Pharmacy Act(5).
Similarly cocaine, initially promoted and widely marketed by companies like Coca-Cola as a performance enhancer for workers, was demonised when it became associated with use by black people in the US and ordinary British soldiers during the first world war(5,6).
The trend for regulating people’s use of mind-altering substances culminated in national Prohibition of the liquor trade in the United States, which came into effect in 1920 and lasted 13 years. Prohibition is widely acknowledged as a piece of class legislation. It was the result of a concerted campaign by the Anti-Saloon League and its aims were never to abolish the consumption of alcohol entirely, but to shut down the saloon, where working people went to drink. Possession and consumption of alcohol were not prohibited, only its commercial trade, and those with the foresight and the resources were free to drink alcohol they had stored before prohibition came into force. When the Great Depression hit, and the masses needed pacifying, prohibition was finally repealed(7).
The Modern ‘Drug Problem’
The modern recreational drug scene that started in the 1960s was preceded by an epidemic of prescription drug use involving barbiturates, amphetamines and later the benzodiazepines. The emergent and increasingly successful pharmaceutical industry played an important role in establishing the widespread use of these synthetic ‘psychopharmaceuticals.’
Barbiturate drugs first became available in 1903, and although they revolutionised anaesthesia and the treatment of epilepsy, they were most widely prescribed for anxiety and insomnia. Amphetamines, available as tablets from 1937, were prescribed for the treatment of mild depression or ‘neurosis’. They were issued to pilots during world war II, and soon started to be used as diet pills(8).
In the mid 20th century use of prescription uppers (amphetamines) and downers (barbiturates and later benzodiazepines) was rife, and far more common than the use of any illicit substance. In 1955, the quantity of barbiturates being used in the USA was sufficient for the treatment of 10 million people on a continuous basis for a whole year, representing 6% of the population of the time, or 8.6% of the adult population(9).
In the UK, a survey conducted in 1960 found that the quantities of amphetamine being prescribed were enough to supply 1% of the population with twice daily doses on a long-term basis. Eighty five per cent of prescriptions were issued to women, mostly those between the ages of 36 and 45. A third were issued for weight loss, a third for depression or anxiety and a third for a medley of vague complaints including tiredness, pain and psychosomatic complaints(10). By 1971, 5% of the US population were being prescribed amphetamines(11).
Many of these pills were sold on for profit and the majority of illicitly consumed substances during the 1960s and 1970s were of pharmaceutical origin. In the early 1970s, 80-90% of the stimulants sold on the street in the US were products of pharmaceutical firms (12).
The massive advertising campaigns that promoted these drugs played on the psychological insecurities of the age, and were mostly targeted at women. Advertisements for amphetamine paraded images of the competent and stylish state that women should aspire to, and others persuaded doctors that unmarried women, or men dominated by women, were good candidates for Valium.
In 1970, US senator Thomas Dodd complained that it was the pharmaceutical industry’s ‘multihundred million dollar advertising budgets, frequently the most costly ingredient in the price of a pill, have pill by pill, led, coaxed and seduced post world war 2 generations into the “freaked out” drug culture plaguing the nation’(12).
The Political Reaction
As drug use became increasingly associated with pleasure and expanding consciousness, rather than relieving distress, it became a symbol of rebellion. By the late 1960s, illicit drug use was strongly associated with the counter-culture — the hippy movement, the anti-Vietnam war protests, the 1968 student uprisings, etc. Drug use was part of the revolution against conservative mores and culture and against the regimented system of capitalist production and its associated war machine. In reaction, the degrading effects of drug use became a focus for social concern, whipped up by the media, which conveniently diverted attention from the political and economic problems of the 1970s.
In the early 1970s legislation was passed in the US and UK that attempted to put the genie back in the bottle. Amphetamines, along with other drugs like LSD and cannabis, became prohibited substances. Legitimate medical uses of amphetamines were restricted to narcolepsy and ADHD, and production quotas were applied. Prescription and diversion plummeted, but people turned to illicitly manufactured substances or imported drugs like heroin and cocaine(11). Meanwhile prescriptions for benzodiazepines continued to rise(13).
The Professional Reaction
The emerging drug scene presented a challenge to psychiatrists, whose drugs consisted entirely of psychoactive substances. To preserve the specialist aura of prescribing, and to avoid being seen as drug peddlers, the profession needed to present its practice as commensurate with the increasingly sophisticated use of drugs in other parts of medicine. It is no co-incidence that the ‘disease-centred’ model of drug action in psychiatry emerged alongside the illicit drug scene. By presenting psychiatric drugs as targeting underlying abnormalities, the disease-centred model helped to repackage the use of psychoactive substances as a bona fide medical treatment quite distinct from the use of drugs in other contexts.
It was particularly important to distinguish newly introduced psychiatric drugs from amphetamines, since the ubiquitous use of the latter was causing increasing concern. Some of the first drugs proposed to be ‘antidepressants’ in the late 1950s were in fact stimulant-type drugs (used in the treatment of tuberculosis) but their stimulant effects were downplayed(14). Discussants at a conference held in 1962 were keen to stress how the new ‘antidepressants’ were ‘much more specific’ than stimulants(15). The concept of an ‘antidepressant’ helped the process by defining the new drugs by their proposed effects on the presumed biological mechanism of depression, rather than their pharmacological properties (even though there was no evidence that they had such specific effects)
(See Joanna Moncrieff’s Why There’s no Such Thing as an ‘Antidepressant’)
The disease-centred model was undermined, however, by the continued prolific use of benzodiazepines. By the 1980s it was clear that however much they might be trumpeted as a specific treatment for anxiety, they were being used for their tranquilising properties, prescribed to many people, especially women, in order to numb the difficulties of daily life. The scandal over dependence and over-prescribing that erupted in the late 1980s forced the pharmaceutical industry to commit itself wholeheartedly to the disease-centred model for marketing its new drugs. The 1990s blockbuster ‘antidepressants’ such as Prozac and Paxil were advertised not for their tranquilising qualities (which in any case they do not possess), but for their ability to reverse an underlying chemical imbalance. In this situation it became as important to market the disease as the drug and companies funded campaigns to encourage people to think of themselves as ‘depressed’(16). Bipolar disorder has been promoted more recently using the same language and techniques(17).
Angels, Fallen Angels and Demons
So today we have the bizarre situation in which use of mind-altering substances is simultaneously prohibited and promoted. Taking heroin to numb the pain of life is demonised, but taking an ‘antidepressant’ or ‘mood stabiliser’ to combat your depressive tendencies or manage your mood swings is encouraged, and not just by the pharmaceutical industry, but by professional and governmental anti-stigma campaigns (18).
To take drugs for your own purposes, on your own initiative, is condemned, but taking them for a ‘medical’ reason, under medical supervision, is applauded. The pharmaceutical industry knows that what constitutes a medical indication for psychoactive drug use, however, is infinitely malleable, and that this malleability can be used to capitalise on the ancient human desire to alter one’s mental state. Large swathes of the population can be persuaded to view themselves as needing drug treatment for anxiety, depression, bipolar or whatever is the flavour of the decade. Just as governments of the mid 20th century tolerated the widespread use of barbiturates and amphetamines, governments of the 21st century have shown no concern about the rapidly rising use of antidepressants, antipsychotics and medically prescribed stimulants.
Benzodiazepines, by contrast, have fallen from grace because their euphoric effects make recreational and medicinal use hard to distinguish. General Practitioners in the United Kingdom are now penalised for prescribing these drugs on a long-term basis, while the absence of any disincentives for antipsychotic prescribing means that people may end up being prescribed much more toxic sedatives to achieve the same ends.
We need to be more honest and open about the nature of prescription drugs, in order to develop more rational policies towards drug use in general. At present we are stoking the desire for mind-altering effects with medically authorised substances, some of which may be just as harmful or worse than their illicit counterparts. We may also be missing opportunities to explore the therapeutic effects of some illicit substances, like the potential of opiates to suppress psychosis as noted anecdotally by people in the field of addictions.
The regulation of psychoactive substance use is not necessarily wrong in itself, and every society will wish to preserve order and prevent the ravages that excessive drug or alcohol use can entail. We should remember that among those at the forefront of the campaign for Prohibition were women, sick and tired of the abuse they suffered at the hands of drunken husbands(4). The irrationality of current drug policy, however, acts as an impediment to the development of informed and responsible attitudes towards the benefits and dangers of psychoactive substances.
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(1) Priebe S, Yeeles K, Bremner S, Lauber C, Eldridge S, Ashby D, et al. Effectiveness of financial incentives to improve adherence to maintenance treatment with antipsychotics: cluster randomised controlled trial. BMJ 2013;347:f5847.
(2) Kendall T. Paying patients with psychosis to improve adherence. BMJ 2013;347:f5782.
(3) DeGrandpre R. The Cult of Pharmcology. How America became the world’s most troubled drug culture. Durham, NC: Duke University Press; 2006.
(4) Gately I. Drink: a cultural history of alcohol. New York: Gotham Books; 2008.
(5) Berridge V. Opium and the historical perspective. Lancet 1977 Jul 9;2(8028):78-80.
(6) Cockburn A, St Claire J. Whiteout: The CIA, drugs and the press. New York: Verso; 1998.
(7) Burnham JC. New perspectives on the Prohibition “experiment” of the 1920’s. Journal of Social History 1968;2:51-68.
(8) Rasmussen N. Making the first amtidepressant; Amphetamine in American medicine 1929-1950. Journal of the History of Medicine and Allied Sciences 2006;61(3):288-323.
(9) Glatt M. The abuse of barbiturates in the United Kingdomk. Bulletin of the United Nations Office on Drus and Crime 1962. https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1962-01-01_2_page004.html
(10) Kiloh LG, Brandon S. Habituation and addiction to amphetamines. Br Med J 1962 Jul 7;2(5296):40-3.
(11) Rasmussen N. America’s first amphetamine epidemic 1929-1971: a quantitative and qualitative retrospective with implications for the present. Am J Public Health 2008 Jun;98(6):974-85.
(12) Graham JM. Amphetamine politics on Capitol Hill. Society 1972;9:14-22.
(13) Lader M. The history of benzodiazepine dependence. Journal of Substance Abuse Treatment 1991;8:53-9.
(14) Moncrieff J. The creation of the concept of the antidepressant: an historical analysis. Social Science and Medicine 2008;66:2346-55.
(15) Goldman D. Critical contrasts in psychopharmacology. In: Rinkel M, editor. Biological Treatment of Mental Illness.New York: L.C.Page & Co; 1966. p. 524-33.
(16) E.g. the Defeat Depression Campaign in the UK
(17) Healy D. The latest mania: selling bipolar disorder. PLoS Med 2006 Apr;3(4):e185.
(18) E.g. the Defeat Depression Campaign in the UK and Beyond Blue in Australia
These advertisements are great! It is great to see how pharmaceuticals were advertised to doctors when psychiatry was still predominantly organized around psychoanalytic theories. Do you have a link to higher quality images of the advertisements?
Thank you also for offering a thorough history of prescription drug use in the 20th century and making it clear that psychoactives have been used in cultures around the world long before modern medicine became the means to which to access them, and that people used them for all sorts of reasons (recreational, therapeutic, spiritual, temporary boosts in concentration, etc.).
My own experience is that Psychiatric withdrawal syndromes manufacture mental illness. I tried to come off the depot injections you mention and I wasn’t able, I ended up in hospital. But I was able to withdraw slowly and remain well. At about the same time I did gain some insight into my anxiety, and how it operated, and I found better ways of dealing with it.
Initially, I had been diagnosed with longterm mental illness, but the diagnosis was irrelevant, as I made full recovery. My anti psychotic disability cost the welfare state a few hundred thousand though.
Actually no there is a big difference between prescribed medications and street drugs. While the high gotten from street drugs is easy to see on drug users, as well as the lack of insight into their behaviors while high.
The effect of prescribed medication is much different. Prescribed medications, for the most part work by blurring the apparent effects of the drug, they usually have a much more profound effect on insight and emotional judgement. Allowing those prescribed to think they are all right, when in fact they are quite distressed emotionally. And unlike the street drug user who knows full well how “fucked up” they are the person on psych meds, won’t have a clue.
They will behave as if all is normal.. When in fact their mental state is way off. This maybe while psych meds can trigger shootings, which the shooter is at a loss to account for his behavior.
In many ways this is like a dissassociative anesthetic. I once treated a gang member who was shot several times in the stomach while high on PCP, and didn’t realize it until his girlfriend noticed, blood running out of the wounds.
This makes psychiatric medications much more problematical, when it comes to understanding their effects, once your prescribed. Because insight is necessary in almost all interactions between people.
Its true when ever a new drug is introduced into a population, you have the results like you described in Gin alley, because there was no experience of how to use the drug by the user and no tolerance to their effects.
With street drugs, eventually its likely that use patterns become less volatile as users become more experienced. However this is not the case with psychiatric medications, because of the powerful influence they have on insight.
I don’t think it is a matter of drugs themselves, I’d rather blame it on the fact that illicit drug users are paradoxically more informed about their effects. Patients in turn don’t expect that anything out of ordinary can happen from the medicine they get. Also many patients in fact notice these effects only to be told by the doctor that they’re imagining it, that’s why the “non-compliance” is so wide spread.
Dr. Moncrieff, You do a great job and especially never put on offer the mincing of words. Certainly, you invite opposition responses, and we can all see easily that most of the establishmentarians will stop thinking clearly when you mention their serious dislike of having any varieties of officialdom and professional authority questioned. However, I am glad that you let that serve as a starting point and keep telling the straight story. Thanks and I look forward to starting on your books.
I agree, Dr. Moncrieff, I am so grateful for your honest criticism of the use of “antidepressants” and “antipsychotics.” I felt your pain in trying to analyze what I saw as quite unscientific “scientific literature” in your first book. And I finally picked up a copy of “The Bitterest Pills” and was able to get a copy from my library of “The medicalization of ‘ups and downs:’ the marketing of bipolar” today. I look forward to reading them. Thank you so much for speaking sanity, in what I perceive as as world being driven crazy by an insanely greedy and egocentric psychiatric industry and their “cures” for fictitious “disorders.” You are one of my heroes.
I should clarify, fictitious or iatrogenic, “disorders.”
The ” marketers” have lots of money behind them to pay for all the public relations, and invention of clever arguments and whitewash that’s needed. So the prescribers don’t have to worry too much. The public relations machine can also be turned on anyone ‘asking questions’ or ‘getting clever’.
If people are making money out of something, and if the money is easy and guaranteed, they are not really too interested in criticism.
I know, Fiachra, and the people currently utilizing their money to perpetrate harm on and steal from the American people, and all people of the world, are evil. We seem to have the Sodomites and Nazi’s with the money now.
You can’t legally get psilocybin for depression cause its on the demon list but disabling “Abilify” is on the angel list. What a scam.
Marihuana is also an interesting case – it seems to have widespread therapeutic potential, aside from its ability to get you high but because it’s a schedule 1 drug it’s not reseachable in US. Here is a report on medical marihuana in Colorado helping kids with terrible seizures to regain normal lives after all the classical medicines not only failed but also caused more problems:
Personally, I think that there may be a legitimate place for many of the psych drugs, both legal and illegal in medicine, however, they have to be properly researched and prescribed for things they can really help you with rather than bullshit DSM disorders.
Though I agree that prohibition was stupid and counterproductive, many of the women who lobbied for it were attributing the problem behaviors of a lot of men to alcohol. It’s true that there is a relationship between violence and alcohol. At the time, there were also a lot of men abandoning their families, as well. It’s possible that there were social and economic reasons behind both the violent and irresponsible behavior of a large number of men and epidemic levels it, and that increased alcohol consumption was not causal but related.
As far as “bad drugs” that people suffering with mental/emotional difficulties and others use, nicotine is a “bad drug,” so its benefits as a mood altering drug are being ignored. Nicotine is both a stimulant and a depressant. When smoked, smokers unconsciously regulate their smoking in order to get the benefit they want. Most smokers don’t chain smoke, but smoke more when they drink because the alcohol makes them inhibit their behavior less. If you’ve ever been a smoker or know some well, you’ll notice them firing up when they’re angry or bored. On the whole, most smokers inhibit their smoking a lot, regularly, and have no problem doing so, for the most part, until they suffer obvious withdrawal symptoms. It’s a great drug for stuffing anger and other unwelcome emotions that are unwelcome because a person has to be “on” for their job or some other inhibiting cause. It’s so good at relieving boredom that it helps improve concentration on boring tasks.
Nicotine only stays active in the brain for seven minutes so its effects do not last long and can be controlled. As far as being a mood altering drug goes, the risks of cancer and emphysema are the most significant risks, and that isn’t about the nicotine. Nicotine has no longterm side-effects that effect brain function, other than withdrawal, and certainly doesn’t cause psychosis.
BigPharma is never going to make a more versatile and useful drug that works as quickly as it does and stops working as quickly as it does. I suspect that some electronic cigarettes allow the user to regulate whether or not the user gets the stimulative or depressive affect, but I’m guessing the one I use does, because I’m comfortable using it exclusively. I also suspect it gives bigger hits than smoking does. The patch does not, and I’m not sure the gum or lozenges does either.
There’s a reason why the poor and those with mental illness or “mental illness” are the most common smokers and it’s probably because nicotine can be a very useful drug, especially for people who are prohibited from showing their feelings but treated as if they didn’t have them.
smoking also affects the way major tranquilizers are metabolised, there have been some studies on this.
“Patients who smoke metabolize antipsychotics faster than nonsmoking patients.”
So it could be that people on psych drugs smoke a lot to help deal with their problems but also to counter the effects of the prescribed drugs
Well maybe I’m cynical, I think the connection between smoking and ‘schizophrenia’ emphasises lifestyle in people that die in middle age. I don’t smoke myself but I expect to pay the price for my anti psychotic drug use with an earlier passing.
That is true. All drugs people use have some beneficial properties, else we would not be suing them. Nicotine alleviates stress and helps to concentrate for many people alcohol in small amounts is beneficial for the cardiovascular system. Also the intoxicating effects of these drugs are not immediately a bad thing – it only becomes a problem when people abuse them and addiction seems now to be highly related to, lo and behold, social and personal factors:
So you’re spot on as usual :).
I know you don’t tend to comment on these blogs, but I’m reading through your book “The Bitterest Pill” now, and was hoping you’d confirm I am reading this correctly. On p. 87, you state, “Since the 1960s, it had been suggested that serotonin might be involved in the genesis of schizophrenia owing to the structural similarities between serotonin and lysergic acid diethylamide (LSD), … Paul Janssen became interested in this area, and set out to synthesize a serotonin antagonist.” So it make perfect sense a person would suffer from hallucinations on drugs chemically similar to LSD, like Risperdal and Seroquel, right?
I’m not a psychiatrist Someone Else so this may be way off – but I think from the quote you cited that the theory was there was too much serotonin present so they were trying to create a serotonin blocker (antagonist). Seroquel is a serotonin antagonist and Risperdal is what they call an inverse agonist for serotonin which apparently means it binds to the same receptor as an agonist but produces the opposite response as an agonist (quasi-Antagonist). This last bit is above my pay grade!
I’m not certain I understand yet. But another question, are the Selective Serotonin Reuptake Inhibiters “serotonin blockers (antagonists)”?
Hmm. SSRIs block the reuptake of serotonin leading to increased amounts of the neurotransmitter in the cleft. How they do that is a little more involved and outside my expertise! Again this gets back to the theory that an individual is somehow lacking enough serotonin so if they introduce a drug to disrupt the way the brain is working producing an increased amount of serotonin…well you’re just all better!
Except…that’s not what happens for many many people. As to your other question, in my opinion these dangerous drugs shouldn’t be given to adults let alone children with developing brains.
Serotonin re-uptake inhibitors increase and prolong the serotonin action. There are several ways in which one can affect the neurotransmitter signalling. In essence when you have to neurons connect in the brain they form a chemical synapse, which consists of the part of the 1st neuron, a space between and the part of the 2nd neuron. during the synaptic signalling neuron 1 releases the neurotransmitter into the space between and this neurotransmitter migrates to the 2nd neuron where it binds to a receptor. So in order to modify the signalling you can:
1) block the receptor in a way that inactivates it (antagonist) – that diminishes the signal
2) add a substance that binds to the receptor in a similar way to the real neurotransmitter and activates it (agonist) – it can also prolong the signalling if the substance is removed slower than the real neurotransmitter
3) block the re-uptake system (a system which allows the neuron 1 to take up excess neurotransmitter from the space in order to terminate the response and also save some of it for later) – blocking this system increases and prolongs signalling
So SSRI act to increase serotonin signalling but they also affect kinetics of the neuronal response – the timing of the neurotransmitter action is very important and changing the length of action itself can affect a lot. Moreover, the re-uptake system is very important to prevent toxicity and neuronal death (it’s well known that overactivation of neurons over a long time causes cell death) which can explain a lot of toxicity.
And if the Risperdal does the opposite of being a serotonin antagonist, does it mean it does essentially the same thing as LSD? I know I suffered from a frightening psychosis within 2 weeks of being put on Risperdal, and had no personal or family history of any mental illness issues, prior to being put on the Risperdal. Why are we putting little children on these drugs?
Someone Else, LSD is agonist at serotonin receptor 5-HT2A and Seroquel antagonist at the same serotonin receptor, so in a sense they work opposite ways in this receptor. But anyway, Seroquel binds to many other receptors as well, such as dopamine and histamine, and these also greatly contribute to its effects… etc.
I think that quote from Moncrieff’s book means reasoning such as that since LSD is agonist at those serotonin receptors and LSD causes symptoms that resemble psychosis, maybe a serotonin antagonist would help in treating psychosis.
I think you’re right about the quote, Hermes. Do you know how Rispedal effects the serotonin receptors? And, I know the neuroleptics affect many receptors and am amazed at the denial and lack of knowledge of a mainstream medical community that claims it knows “everything about the meds.” The amount of fraud and deceit by most within the psycho / pharmaceutical industries is staggering.
I gave Whitaker’s book to a guy who runs the largest children’s counseling service in my area a couple days ago, he knows my parents are effective leaders when it comes to good causes. I think he was a little embarrassed to learn my “cause” was trying to end the iatrogenic childhood bipolar epidemic. And ending the drugging of victims, to cover up child abuse. Hopefully, the book will get read by those in the trenches. You’ve got to hope most people’s intentions are good.
Risperdal is a strong antagonist at those serotonin receptors. Basically a similar set of receptors as quetiapine, different affinities. Especially at the time of their marketing, many places suggested that it’s this serotonin receptor (5-HT2A, etc) antagonism that makes “atypical” drugs better than than old drugs such as perphenazine. It’s quite hard to get any good data from the studies done at this period, since so many of them have been basically pharma-funded promotional studies! “Our drug is better than your drug, because…”
Thanks, Hermes. I guess I’m just concerned about all the children who are having ADRs and withdrawal effects from antidepressants misdiagnosed as bipolar, because that’s what happened to me. And I know antipsychotics DO NOT cure ADRs or withdrawal effects of antidepressants.
But Risperdal made me psychotic within two weeks, recorded as a “Foul up” in my medical records. I was taken off it, put on Seroquel and lithium, then lied to, and put back on the Risperdal again two weeks later (because the Seroquel and lithium made me sick, too). The very evening I was put back on the Risperdal in conjunction with the Seroquel and lithium, at exactly 6pm on 1.14.2002, I learned what “voices” in one’s head are.
When a healthy person, with no personal or family history of mental health problems, only suffering from withdrawal effects of a “safe smoking cessation med” / dangerous antidepressant, is given antipsychotics, the antipsychotics can and do CAUSE psychosis and “voices.” The psychiatrists are destroying millions of lives, and over a million little children were misdiagnosed (according to the DSM) exactly as I was. Wake up psychiatrists, stop creating “mental illnesses” in children for profit!
Thank you for this amazing article.
In fact what you’re writing about the use of legal vs illegal drugs can be corroborated by many of my friends who have wide experience in using both for often the same reason, be it recreational or against their distress. Bottomline, these drugs are useful for some people to deal with their emotional states over the short-term but in the long-term only meaningful changes in life circumstances make any difference and drugs can have a negative effect if only by distracting them from solving their problems. Also responses to different drugs by different persons are virtually unpredictable, when you can have 10 different people taking the same pill and some reacting with euphoria, others with withdrawal ad others yet with aggression.
Thanks for this article… very insightful. Now, here’s an experiment for everyone who reads or writes for Mad in America who has never been drugged or coerced by psychiatric force. Before writing another article or giving your next opinion about psychotropic drugs, spend a few months developing an addiction to your psychotropic drug of choice. It could be Prozac. It could be Zyprexa. It could be an old fashioned Benzo. Or maybe even try one of the newer drugs, just for kicks. It might be good, you know, for research purposes. Once you have developed an addiction to the drug, or drugs, try to withdraw from the drug or drugs rapidly, cold-turkey. Then, during this time of withdrawing from the drug, go to a psych ward and receive an injection of Haldol. After this, ask your psychiatrist if you can use a pen to write something down. Since the psychiatrist will not let you use a pen, you might have to dictate your thoughts. Since you won’t be allowed to talk with anyone, this won’t work either. On second thought, forget about the experiment. If you were lucky enough to survive it all, you could never write about such things with the cool, dispassionate voice of an academic. You would be, at that point, a true anti-psychiatrist. You would be a true psychiatric survivor.
You’re spot on.