Educating Psychiatrists and Patients Does Not Reduce Polypharmacy or Obesity

Rob Wipond
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Educating psychiatrists about appropriate prescribing guidelines for patients with schizophrenia did not reduce the incidence of inappropriate prescribing, according to a study in Therapeutic Advances in Psychopharmacology. In addition, educating the same psychiatrists and patients about healthy lifestyle habits did not reduce levels of obesity in the patients.

Conducted by psychiatric researchers in Denmark, the study involved 174 patients diagnosed with “severe mental illnesses” and staff across six different psychiatric facilities. Most of the patients were receiving multiple psychiatric medications, many known to cause obesity, and most of the patients were overweight.

Three of the facilities functioned as controls, and at the other three facilities, over the course of one year, independent experts conducted reviews and evaluated patients’ medications alongside staff relative to Danish National Board of Health guidelines. They also “provided training lectures to the staff about the use of antipsychotic medicine” according to the same guidelines. Simultaneously, the team provided regular training sessions on healthy eating and lifestyle habits to both staff and patients.

“The intervention showed no significant differences between the intervention and control group regarding psychotropic treatment,” the reseachers concluded. “We found both a high prevalence of obesity and that the patients received treatment with antipsychotic polypharmaceutics in high dosages. Active awareness did not change practice and we must think of other ways to restrict treatment with psychotropics in this group of patients.”

(Abstract) Reducing psychotropic pharmacotherapy in patients with severe mental illness: a cluster-randomized controlled intervention study (Hjorth, Peter et al. Therapeutic Advances in Psychopharmacology. Published online before print January 7, 2015. doi: 10.1177/2045125314565361)

12 COMMENTS

  1. Pretty discouraging Ted! Seems the facts are pouring out & assuming Denmark has created new guidelines and protocols that reflect these new studies, it’s really really disturbing that the prescribers aren’t changing their practice, but instead it’s business as usual. Big Sighs….
    That said, we can’t give up.

  2. It’s a huge double whammy.

    A ‘patient’ has to deal with :

    > huge amount of stigma and shattered expectations
    > basically an iron willed diet to remain at a healthy weight
    > in my experience the drugs block that feeling of connection and well being you get from exercise, it makes exercise a very difficult thing to actually do

    depending on the situation as well it’s most likely they’ll be dealing with people trained to basically not give a fuck, at all, the only thing they give a fuck about is not making things difficult for them and keeping a record of anything ‘clinically relevant’.

    • I wanted to to write pretty much the same thing. For patients it’s an impossible task of being drugged to their nostrils with substances that cause many issues including increased appetite and apathy (great motivation to eat less and exercise more) and force themselves to physical exercise and caloric restriction. With no evidence that it will help against diabetes anyway (there are reasons to believe that it’s not just an secondary effect of drug-induced overeating but a direct effect on sugar and fat metabolism).
      On the other hand there are psychiatrists who either don’t give a flying f*** or even if they did they don’t know what else to do but hand out pills.

    • It’s sick, isn’t it? Thanks for the link. I ended up here because I’d had the ADRs of a “safe smoking cessation med” (antidepressant) misdiagnosed as “bipolar.” I had no idea about the appalling magnitude of the psychiatric industry’s crimes against children, especially foster childen.

      It’s just disgusting today’s psychiatrists are so ignorant of the reality that their deluded beliefs in today’s “eugenics” theorized “mental illnesses,” are no more scientifically valid than the Nazi psychiatrists’ deluded eugenics beliefs.

      Wake up, psychiatrists, your drugs cause the symptoms of your “mental illnesses.” Stop drugging children.

  3. Seems “active awareness” there was something of a sluggard, or, to put it another way, very inactive, perhaps even asleep. I’ve talked to mental health workers who look aslant at me for being, in their eyes, “anti-medication”. There’s no dialogue in that kind of a situation. Their whole career revolves around the idea of seeing psych drugs as some sort of lifesaving (hack, hack) skeleton key to the hospital doors for some patients. I’m not surprised all textbooks look the same to them. Education winds up being a euphemism for something else. Think deprogramming might work, and you’re bound to be getting a whole lot warmer. Deprogramming or, even better, pink slips.

  4. I got my pdoc’s office notes and read how he was perplexed at me gaining 100 pounds when poly drugged. Thorazine/neuroleptic drugs made me so hungry I stuffed myself non-stop. Neuroleptics suppresses nausea so my stomach was numb to constantly eating. Besides being diagnosed as crazy I was also diagnosed as Morbidly Obese, double whammy for being targeted. As I tapered off the toxic drugs the weight fell off, every 2 weeks I went down 1-2 sizes without trying to diet. Unbelievable to be able to walk distances, my feet and ankles were no longer painfully swollen.

    Psychiatric drugs have been shown to cause dangerous weight gain, diabetes and high cholesterol numbers. My pdoc did not do blood labs on me which was breach of him being a prescribing physician. It’s been years since I had anything to do with psychiatry which I am extremely grateful of.