German Psychologists Declare “the Drugs Don’t Work”

Justin Karter
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Jürgen Margraf and Silvia Schneider, both well-known psychologists at the University of Bochum in Germany, claim that psychotropic drugs are no solution to mental health issues in an editorial for the latest issue of the journal EMBO Molecular Medicine. They argue that the effects of psychiatric drugs for depression, anxiety, and ‘ADHD’ are short-lived and may have negative long-term consequences.

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“There are now plenty of data and evidence that, in the long term, the drugs do not work,” the authors write in their commentary, From neuroleptics to neuroscience and from Pavlov to psychotherapy: more than just the ‘emperor’s new treatments’ for mental illnesses?

Margraf and Schneider begin by pointing out that the number of people in the industrialized world who are disabled because of mental health issues has been rapidly rising over the past fifty years. At the same time, they note, the common perception is that new antidepressant and anti-anxiety drugs and other new treatments have greatly improved mental health treatment.

Jürgen Margraf and Silvia Schneider, Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, University of Bochum, Bochum, Germany
Silvia Schneider and Jürgen Margraf, Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, University of Bochum, Bochum, Germany

If this “epidemic” of mental health issues causing disability is not due to an increase in overall incidence, they ask, “how can this apparent contradiction be explained?”

“Could it be,” they continue, “that therapeutic progress is much less than we think or are being told? Could it be that the course of depression, anxiety, schizophrenia, or ADHD has been altered for the worse? Could it be that we cannot make therapeutic progress because the concept of mental illness and its treatment is deeply flawed? There are strong reasons to assume that all three suspicions are in fact true.”

The researchers identify three conceptual mistakes that are preventing more successful treatments for mental health issues from being developed.

  • The “ill-advised biological notion of mental illnesses” and the “myth of the chemical imbalance”
  • The “reification of diagnostic constructs (‘depression’) as distinct illness categories” rather than as a dimension of human behavior occurring on a spectrum.
  • The emphasis on “bottom-up” causal pathways, like genetics, rather than “top down” social and psychological influences.

“After decades of proclaimed therapeutic breakthroughs and promises of imminent better treatments based on the translation of basic science into clinical practice, neither neurobiology nor neuroscience has led to measurably better long-term outcomes for any of the major mental disorders,” they write. “Although psychotropic drugs are by far the most often used treatment modality in industrialized countries, there is no compelling evidence for the long-term stability of their small to moderate short-term results.”

Margraf and Schneider suggest that psychologists work together to bring a renewed focus to all three levels of analysis, biological, psychological, and sociological, while pushing back against the “marketing power of Big Pharma.”

“A realistic assessment of our current treatment options and the close cooperation of clinicians and neuroscientists would help us to overcome the current stagnation and put us back on the track forward,” they conclude.

 

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Margraf, J., & Schneider, S. (2016). From neuroleptics to neuroscience and from Pavlov to psychotherapy: more than just the “emperor’s new treatments” for mental illnesses?. EMBO Molecular Medicine, e201606650. (Full Text)

36 COMMENTS

  1. It’s funny, I just had this conversation with my schizophrenic son.

    He went off of Zyprexa on his birthday due to the misadvised advice of his psychiatrist or perhaps my mistaken approval. Regardless it was a train wreck. It cost a lot of money, as any parent knows will happen. It cost some near misses that thankfully were avoided. Etc.

    Regardless as someone who was casually prescribed Zoloft years ago after a divorce, I know first hand how bad head meds are. And, frankly I think there should be a division in discussion between head meds and treatments for genetic disorders.

    He is back on 20 mg of Zyprexa and we avoided expensive hospitalization — and worse. But this medication DID indeed rescue him as a loving dad 1000 miles away. All it took was him getting his meds in this case.

    Last, I truly believe the leaps and bounds in the psychiatric profession over the next 20 years are going to be stunning, so I hope we can gather brilliant young minds to this much needed profession if pursued legitimately and for chronic, not so much acute patients. Give them a darn valium.

    • raproducer,

      Not saying this is what happened in your son’s case but sadly, many people go off of psych meds, including antipsychotics way too quickly which lead to withdrawal symptoms that look like a return of the illness but aren’t. Something to consider if your son decides to try getting off of meds in the future.

      Glad he is doing well.

      • raproducer,

        I’m very sorry to hear about your family’s experience.

        A maintenance dose of the MH drug Seroquel can be 450mg/day

        http://www.standard.co.uk/news/trainee-lawyer-ill-sue-over-depression-drug-that-gave-me-diabetes-6425652.html

        I was prescribed 25mg/day of Seroquel and consumed maybe 6mg/day of this.

        Stopping this drug years ago resulted in a long term excessive sleeping reduction – which has never completely resolved itself. Even stopping MH drugs very carefully can result in serious rebounds.

      • AA is correct, raproducer, and what he’s talking about is medically known as a drug withdrawal induced super sensitivity manic psychosis. And, just an FYI, there is no evidence that “schizophrenia” is a genetic disorder. That is just an unproven theory.

        And here is the medical proof that the antipsychotics / neuroleptic drugs are medically known to create the negative symptoms of “schizophrenia,” via NIDS:

        https://en.wikipedia.org/wiki/Neuroleptic-Induced_Deficit_Syndrome

        And they can also create the positive symptoms of “schizophrenia,” via what’s medically known as anticholinergic toxidrome:

        https://en.wikipedia.org/wiki/Toxidrome

        So, I do think it would be wise for you to encourage your son to slowly taper, if he so chooses. But you should understand that withdrawal from the neuroleptics does result in symptoms which are almost identical to the theorized disorder itself. Best of luck on your healing journeys.

        • Someone Else,

          Strangely enough it was a German Psychologist in 1983 in Ireland that told me all “schizophrenics” “manic depressives” and “others” could make full recovery through the psychological process – and he emphasised the “all”.

          I had tried to come off my medications ‘cold turkey’ in 1983, but didn’t last long.

          I became successful when I learnt how to carefully taper from the drugs and how to cope with the High
          Anxiety of Withdrawal Syndrome.

          • ….and the year before in 1982 I quit lithium ‘cold turkey’. I did experience a ‘Rebound’ High – but this Rebound levelled on its own, and I managed to stay off the Lithium.

    • As someone who has worked in mental health (health information) for 25 years and who has received treatment for depression and anxiety with medication for about 30 years, I see the system from both sides. Please note that your doctor may have prescribed Zoloft for you under inappropriate circumstances. Maybe you didn’t really need the medication. That doesn’t prove the medication is not effective when used and prescribed appropriately. I’ve tried to live with psych medication several times, but it just doesn’t work for me. Sooner or later, I start feeling so bad and start seeking it again. The medications don’t completely take away my symptoms, but they make the symptoms easier to live with, and I feel much better with my medication than I do without it. One time I had a doctor try to talk me into getting a cardiac catheterization; I didn’t think I needed it and I told him so. My regular physician agreed that I didn’t need it. If I let him do the procedure, I’m reasonably certain I would have been dead by now. But that doesn’t prove the procedure is no good when it is used appropriately. There are good doctors and bad doctors, and sometimes good doctors make bad decisions; they are just human beings like anyone else. The big trouble with psychiatric care is that it is very subjective; it can be really tough for the physician to make the right call based on observation and/or the patient’s description of symptoms alone–there still are no reliable technological diagnostic tests for psychiatric disorders. Talk therapy, counseling, etc., can be helpful for some but not for others. Currently, I’ve found the best thing for me is medication with additional support from Cognitive Behavior Therapy from time to time. I have taken different medications, some worked for me better than others. Right now, my medication regimen is Paxil, Buspar and Xanax once in a while when I’m having an especially bad day. I try to take the Xanax as little as possible because it is habit forming; once I had withdrawal symptoms from Xanax and it was horrible. Saint John’s Wort gave me agonizing stomach pains. Meditation, deep breathing, keeping busy and just having hobbies that I enjoy are also helpful. Some say there is no chemical or biological component of mental illness. I don’t buy it. There is far too much evidence that supports genetic predisposition of mental illness; as I see it, it is the result of a combination of genetic, physiological and situational or environmental causes. For example, my brother has bipolar disorder; some of my relatives have been treated for either depression, anxiety, ADHD
      or bipolar disorder. I hope you and your son are doing well, best wishes. Sorry about the long message, sometimes I get on a roll.

    • raproducer has only one post here on MIA.

      If you quit drugs, any drug too quickly you have withdrawal symptoms. When in withdrawal no one can tell if it is “mental illness” or drug withdrawal.

      If a person has not been taught skills to cope with life, they have no way to deal with their emotions. In my opinion, a chemical lobotomy for the rest of ones life is not the correct solution.
      http://www.nature.com/news/2010/100606/full/news.2010.281.html

      • Yes, Mark

        It appears that most of the posters supporting drugs on this thread are first time posters.

        I am hoping they will make the best use of this site’s resources to further investigate the thoroughly researched pros and cons of medications.

        Many people are never told honestly about the potential impacts of using psychiatric medications, either because their doctors have, like many others, been unable to penetrate the pharmaceutical companies’ largely false claims around the drugs’ safety and efficacy because the real data has remained hidden until legal action has forced its release.

        Only in very recent years has it become increasingly apparent that the drugs’ true risks have remained dangerously understated and the benefits have been very significantly exaggerated.

        It takes time for such research to filter into medical schools and down to doctors on the front line, especially when research and continuing education for doctors is largely funded by pharmaceutical companies intent on maximising profits.

        Meanwhile, patients are given one drug and when its side effects kick in, another drug is added to deal with those side effects, and then another is needed, so people end up on drug cocktails, some of which are deadly, if not in the short term, then in the longer term.

        …..and they are wrongly told they have a chemical imbalance when this theory has long since been debunked and is now widely accepted by the top psychiatrists in the world, and leaders in the American Psychiatric Association and NIMH have come out and said it was never more than an “urban myth”.

        Hopefully such messages will get through, and the drugs will be seen for what they are: dangerous, mind altering and mind damaging substances that hinder rather than promote recovery.

        • Been there. Done that! Took Anafranil due to anxiety from being homeless multiple times as a kid and sexually harassed for years in high school.

          That crap made me higher than a kite. No sleep for 3 weeks. And I mean none.

          They blamed me–said I was crazy and diseased or Anafranil would not have hurt me. Put me on megadoses of Haldol. This helped by causing daily seizures and OCD behaviors that drove those around me nuts. The shrink said I was non-compliant or I wouldn’t seize, have OCD or act like a zombie.

          Where would I be today without the help I received from the mental illness makers?

    • I think it is wise to continue to do what works for you, but the dreadful truth is that for the vast bulk of people these drugs are poison.

      In my case, since undertaking a very slow and difficult taper, I have now been off Olanzapine for more than six years and am far better now than I ever was on it. Actually, the only time I was ever psychotic was while I was taking Olanzapine as prescribed by a psychiatrist.

      Several people I know have had similar experiences. The effects of the meds have been devastating for them. Long term studies (Harrow and Wunderink, I think) have also shown poorer long term outcomes for this who are given the drugs – in those cases antipsychotics.

      The American Psychiatric Association’s leaders have come out and debunked the chemical imbalance myth of depression, and drug companies have had to pay billions of dollars as a result of false claims of efficacy and safety in well publicised law suits.

      It is extremely imporrtant that people who try to come off these meds do so very carefully indeed – this site has a wealth of information that can help.

      • I’ve had my own Harrow and Wonderlink experience.

        In 1983 I was advised by a “Mental Health” friend of mine that my continual restlessness was due to the (depot) medication I was consuming. So I approached my psychiatrist about this and he eventually offered me the option of discontinuation.

        In the next 5 months I had 4 hospitalizations 1 suicide attempt and at least 1 near miss; and I was given a more serious Diagnosis and Prognosis.

        I then switched to weaker oral medication and tapered carefully from there.

        As a result of this: – the restlessness stopped; I regained functioning; I became independent of the Irish Welfare State; and I have remained well for 30 years.

        I did suffer from “High Anxiety” on drug withdrawal, but I found effective solutions for this in the Talking Treatments, CBT, and Buddhism.

        Between 1980 and 1984 my Psychiatrist had continually criticised me over my inability to function and had expressed this to be my main Mental Health problem.

        Post 1984 my Former Psychiatrist went on to write promotional research papers on the drugs that disabled me.

    • Just not taking the meds is not the answer.

      Stopping them cold can induce severe withdrawal (which can be extremely dangerous) which is often misdiagnosed as a return of the “illness”, and hence proof that the meds work and are necessary.

      There is information on this site and there are numerous other sites that discuss how to withdraw slowly and safely from psychiatric medications, and even with assistance from a prescribing doctor (if you can find one willing to do it), it can be a very difficult and protracted process – believe me, I have been through it!

      Psychiatric medications are no easier to come off than illicit drugs, and sometimes are more problematic, especially when several different classes of drugs are involved, as is often the case.

      It needs be a gradual process and can take a year (or a lot more) to taper safely…generally people expect to be able to self-manage off the drugs in days, weeks or a couple of months, and predictably, they fail….and may well end up in hospital. Occasionally someone MAY manage it, but there are lots who don’t.

      Frequently, psychological support is also needed to address the underlying psycho-social and/or trauma issues that saw the person prescribed meds in the first place.

      If you decide to give it another go at some stage, research thoroughly, get support and be prepared for what may be a very challenging time!

  2. My experience as a pharmacist completely is contradictory to the claims of this article but there is a problem. Way too many unqualified and unethical prescribers. The treatment of mental illness with pharmaceuticals should be in the hands of a qualified psychiatrist who is ethical enough to not allow his prescribing practices be influenced by free stuff from pharmaceutical reps. There is a rumor there are a few of those still left and one was spotted in New Jersey.

    • The people who were among the first to warn me against taking psych drugs were pharmacists. As the first line of defense against overzealous prescribers, they know the harms that psych drugs can produce.

      I have a feeling this particular article will get a bunch of unverified anecdotes from those seeking to discredit the authors. If you need proof that these drugs have minimal to no use, look at the increasing rates of disability for those deemed “mentally ill”. Dismal, to say the least.

      This multi-billion dollar business depends on a massive professional class willing to look the other way while their patients suffer and die earlier than they should. All in the name of of preserving normalcy, another term for suppressing dissent.

      • Ace, I had been reading Glassner, Lynch, Whittaker, and others. One day in day treatment the question hit me, “Why are we doing this?” We were all morbidly obese, 90% diabetic as a “minor side effect” from the drugs. We couldn’t think straight and were mostly dumb as boxes of rocks. None of us had been gainfully employed in years. Almost none of us had any relationships outside the mental health center (I mean friendships, not just romances.) Despite med compliance suicide attempts and threats happened on a weekly basis. We were pretty miserable, tired, had no pleasure in anything, no hobbies aside from TV viewing, couldn’t do basic household chores or shower regularly.

        Finally I realized why we were there. To make other people money and a few incredibly rich. It was like realizing your church is a dangerous cult.

    • My cousin is a pharmacist who is deluded about the psych drugs, too. She didn’t even know that combining an antidepressant and a couple neuroleptics can make a person “psychotic” via anticholinergic toxidrome, and none of my pharmacists knew this either. It is a shame the pharmacists know so little about the drugs they sell.

  3. My SIL has been manic for nearly 35 years. She has lived with us for 6. I have seen her go through it ALL. She was like many who self-medicated with alcohol, especially in mania. She had an episode which caused her to give it up completely 11 years ago. Her stability is well maintained with Lithium, and Lamictal. In an episode, where her mania “makes her higher than God”, we can up the Li, but we add 50 mg Zyprexa (olanzipine), almost twice the highest therapeutic dose. THIS works. Safris, Seroquel and many others only prolong the manic state or cycle her up and it takes much longer to come down to a functioning level and her normal. We recognize the triggers and make every attempt to avoid them.

    Recently, she had an episode that required hospitalization…which has not happened in 15 years. The psychiatrist was not supportive at all in regard to the familial support and doing what we know worked. Her only concern was “stepping over the line.” Not only would she not give the 50 mg of Zyprexa, but she took away the meds that offered sleep support, which for her, is the key to coming down. Thus she ended up in the local psychiatric facility where they put her on Thorazine. A horrible med, really. She became paranoid, and had many side effects. She does not take an added antidepressant, but does taper off the Zyprexa. It causes weight gain and because she wears a prosthesis we taper off when she is re-stabilized. I cannot imagine where she would be without meds.
    In essence, although Big Pharma is an issue, the way psychiatric medicine is now practiced is disheartening. The MD’s only see a patient for medicating and then they go to a psychologist for counseling. I don’t like this but I don’t have a choice.

    • In my case my Bipolar2 was caused by the uppers and downers they gave. Now that I am off that funky cocktail I am much more mellow. I never was totally “manic” like your relative though. Getting drunk doesn’t help, even though alcohol is a depressant.

      Psychiatrists often disliked it when my family tried to help me too. Especially when Mom tearfully implored my shrink to take me off Anafranil.

  4. I’m torn. For this season of my life, I’m on the pharmaceuticals. I also do my own form of Orthomolecular. The combination seems to keep me going at a higher level than I ever experienced off meds or on just the meds, no Orthomolecular.

    I have experienced docs using the drugs–neuroleptics, in particular–as chemical restraints with me. That was mostly when I was younger, vulnerable, and my people weren’t as high status as they are now. Its funny…when you’re a down and out “loser” from a middle-middle class family, its all meds, all the time, no compassion. When you’re “mentally ill” from a “genteel” family, suddenly you have options, and the “experts” will talk to you about your problems.

    That’s the other thing…these psychologists talk a good game about tackling issues that lead to what is then labeled as “mental illness,” but in practice…most psychologists (and counselors) I’ve dealt with are just as elitist, misogynistic, and hyper-conventional as any psychiatrist. I’ve had counselors demand that I take an “atypical” to continue treatment, and then get angry because I walked out.

    I think the real “answer” is in non-professional people helping other people, no labels or power trips or expensive bills for the insurance company. I’ve got a friend now, an older, wiser woman, who has helped me more than any “professional…” for free. Because she’s an actual friend, and real friends are hard to come by for most of us in 21st century America.

  5. So the British psychologists have spoken out against the psychiatric drugs and DSM classification system, and now also the German psychologists are denouncing the psychiatric drugs. Wake up American Psychological Association! The ship is sinking!

    But we’re making progress, at least. Kudos to all the truth tellers here.

    • Mental Health, Inc. exists in a social context. American culture is changing, but even the “progressives” think that the solution is more treatment, maybe even bringing back state hospitals (I seem to recall reading an article in Mother Jones about this…).

      Its strange. More people in America are on pills and open about being on the pills and “in treatment,” etc., but there comes a point at which…you’re done. Because you’re on “those pills” and have “that diagnosis” and, often, because you’re un- or under-employed, maybe on disability. There’s a line in American culture, and once you’ve crossed it…you’re part of the underclass.

      So…we, the truth tellers who are in, were in, or are transitioning out of the underclass…here in the US, we’re so caked in labels and stigma that even the so-called “progressives” don’t want to listen to what we have to say. That leaves “experts” and those with credentials to speak for us…

      …and very few of them choose to do so, at least here in these United States.

      • Hi Someone Else, yeah_I_survived.

        It is possible to recover from so called “Schizophrenia” “Manic Depression” and “Schizoaffective disorder”.

        The Psychological Solutions exist and they work.

        I suffered severe anxiety when I cut psychiatric drugs but I received non drug help outside of the “Official System”, and this was successful in the long term.

        (I was psychiatrically disabled while I remained in the system).

        • thanks so much. I think…well, my life has improved dramatically (not because of Mental Health, Inc.), but I still get…pessimistic, I suppose.

          I’m happy to hear that you have moved beyond the (serious, stigmatizing) labels and on to real life, post-psychiatry.

          I’ve been burned by Mental Health, Inc. at all levels…the counselors, psychologists, psychiatrists, even the nurses. Such is life when one is labeled a “trouble maker,” etc.

          I’m beginning to see the fuzzy outlines of a life after psychiatry, and I like what I see. The question is…how do I get from Point A to Point B?

          Thanks again.