Critical Psychiatry Textbook, Chapter 16: Is There Any Future for Psychiatry? (Part One)


Editor’s Note: Over the next several months, Mad in America is publishing a serialized version of Peter Gøtzsche’s book, Critical Psychiatry Textbook. In this blog, he discusses the myths perpetuated by mainstream psychiatrists and the dishonest way they respond to critics. Each Monday, a new section of the book is published, and all chapters are archived here.

The industry has bought doctors, academics, journals, professional and patient organisations, university departments, journalists, regulators, and politicians. These are the methods of the mob.
—Richard Smith, previous editor of BMJ6:viii

What makes this book new and worth your attention? The answer is simple: the unique scientific abilities, research, integrity, truthfulness, and courage of the author. Gøtzsche’s experience is unequaled.
—Drummond Rennie, editor of JAMA6😡

These are extracts from the forewords to my 2013 book about organised crime in the drug industry.6 I have shown in this book that you cannot trust the randomised trials, the drug industry, or the psychiatric leaders. The editors say in their forewords to my 2013 book that I can be trusted but, more importantly, I have tried to document what I say so you can make up your own mind.

You cannot even trust the drug regulators. As David Healy has pointed out, in contrast to drug agencies, airline pilots are critically concerned with our safety because if we go down, they do too.617 There is widespread corruption in the FDA at the highest levels, including several commissioners,6 and in 2009, nine FDA scientists wrote to President Obama about this.618,619 In 2012, it was revealed that FDA management had installed spyware on the computers of five scientists who had alerted the FDA to safety problems to no avail and therefore had informed the politicians.620

Dark, vignetted black and white illustration: a lighthouse on an island. Below the water, the island becomes a skull.

It must be very tempting for drug companies to bribe officials at drug agencies. There is an enormous amount of money at stake and the approval of a new drug can be the difference between life and death for a company. In 2012, Danish Lundbeck and its Japanese partner Takeda submitted vortioxetine, an SSRI, for regulatory approval in the United States.621 Lundbeck’s blockbuster, escitalopram, was running out of patent, and the company would receive a $43 million milestone payment from Takeda if FDA accepted the drug.

It is paradoxical that, while drug firms don’t trust each other, drug agencies are supposed to trust the entire industry because they cannot review more than a tiny fraction of the mountains of documents they receive.622 The regulators don’t even check that everything is included. I have found numerous examples that whole appendices or many pages in the middle of a report were missing,279,326 and also of missing cases of suicidality,279 in clinical study reports of placebo-controlled trials submitted to European drug regulators for marketing approval.

Psychiatry’s narrative is that drugs are very often needed, both in the acute phase and long-term to prevent relapse; that specific drug treatments have been known for about 65 years;18:232 that the drugs are generally effective and safe; and that the new psychiatric drugs are highly beneficial.18:307

The truth is that none of the many psychiatric drugs have specific effects; the drugs rarely have clinically relevant effects and are therefore rarely needed, not even in the acute phase; an effect on relapse has not been demonstrated; and the drugs are far from being safe. There is an epidemic of overdiagnosis and overtreatment with psychiatric drugs to such an extent that, based on the most reliable research I could find, I estimated that psychiatric drugs are the third leading cause of death, after heart disease and cancer.7:12,7:307

The denial of the facts in the psychiatric profession is massive. In 2011, a group of prominent psychiatrists wrote:623

“Persistent, untreated depression produces a type of neurodegenerative disorder, associated with synaptic changes … Similar to poor control of blood sugar in diabetics, poor control of symptoms in Major Depression is associated with worse long-term outcome and greater overall disability … antidepressants prevent relapses … 53% of the placebo patients relapsed, whereas only 27% of drug-treated patients relapsed … After the FDA issued a black warning [sic] against antidepressants … there has been a concomitant increase in actual suicide … There have been concerns regarding whether certain antidepressants may cause suicides. We now know this is a myth largely fuelled by the media … Newer studies of children do not confirm an increase in suicidal ideation … Naturalistic studies show that the incidence of the suicide rate tends to go down as the incidence of antidepressant treatment goes up.”

I fail to understand how Stefan Leucht, who has published much good research and is an editor in the Cochrane Schizophrenia Group, could co-author this harmful nonsense. It shows that the collective delusions and denial in psychiatry hit even the best psychiatrists. It is very tragic for the patients, their relatives, and psychiatry itself.

A 2012 newspaper article written by four leading Danish psychiatrists called Behind the Myths About Antipsychotics was similarly tragic.624 They wrote that most patients suffering from schizophrenia have disturbances in the dopamine system; the genes are by far most important (about 70-80%); large international registry studies show that patients with schizophrenia who are not treated with psychosis drugs are at higher risk of dying prematurely than patients who are in treatment; numerous studies have documented that the risk of new psychotic episodes and a more severe course of the disease is increased if patients stop taking psychosis drugs; that they found no indications that polypharmacy with psychosis drugs increases mortality in their large study; and that large register-based studies in Denmark and Finland show that concomitant treatment with several psychosis drugs is not associated with increased mortality.

Leading psychiatrists constantly tell the public such nonsense, which is dangerous for their patients. They claim that psychosis pills reduce mortality when the truth is the opposite, and they happily continue their Titanic course towards the iceberg, which they refuse to see.

Here is a patient story from one of the psychiatrists’ university hospital in Copenhagen.7:277 A patient was admitted with mania, and although he asked not to be treated with drugs, he received forced treatment with olanzapine. In his own words: “At discharge, when I had been declared cured after my first-episode mania, I tried to behave well, fearing that I might not be released. The psychiatrist forcefully urged me to continue with olanzapine. I didn’t dare tell her that I had spat out most of the pills in the washbasin and therefore asked, for the sake of appearances, for how long she thought I should take the drug? For the rest of my life, she replied, because I had a chronic disease, with a great risk of relapse, and I should not be afraid of the harms.”

The reason why the patient didn’t take the drug was that he had read the newspaper article I published in January 2014 about ten harmful myths in psychiatry, which also exists in English,189 and he has been well ever since without drugs.

The same day my article about the ten myths appeared, Thomas Middelboe, chairman of the Danish Psychiatric Association declared in the same newspaper, on its website:625 “Antidepressant drugs protect against suicide.” A month later, 16 Danish professors in psychiatry responded to my article626 without mentioning my name, just like one was not supposed to mention the evil Voldemort’s name in Harry Potter. They wrote that a number of studies show that treatment with psychosis drugs increase longevity, compared with no treatment.

I have given many examples in this book that leading psychiatrists have no problem with claiming the exact opposite of the truth. In 2005, Steven Sharfstein, then president of the American Psychiatric Association, wrote that “Pharmaceutical companies have developed and brought to market medications that have transformed the lives of millions of psychiatric patients.”627 Sure, but not for the better. He added that “Big Pharma has helped reduce stigma associated with psychiatric treatment and with psychiatrists.”

Is there any hope for a specialty like this? I have heard critical psychiatrists say that their leaders suffer from cognitive dissonance, as what they see and hear doesn’t influence them. Many books have documented that the psychiatric leaders have given up rational thinking for the benefits they acquire themselves from supporting a totally sick system. Even psychiatrists who have used monstrous overdoses of psychosis pills are allowed to practice.8:143 Why don’t our politicians care that incompetent psychiatrists kill hundreds of thousands of their patients every year (see Chapters 7 and 8)? Or that the lives of many millions of children get destroyed?

Psychiatric drugging of children is a form of child abuse that should be prohibited, with rare exceptions. We are not allowed to beat our children but are allowed to destroy their brains with drugs. We medicalise the conflicts that arise between parents and children, and methylphenidate has become the modern version of the cane. This is a flagrant abuse of a faulty disease model.

Little has changed in recent years. If you google what causes ADHD, you can find this misinformation from the UK National Health Service, directed toward the public and last reviewed in December 2021:10:39,628

“ADHD tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition … Research has identified a number of possible differences in the brains of people with ADHD from those without the condition … Other studies have suggested that people with ADHD may have an imbalance in the level of neurotransmitters in the brain.”

The drugged child’s brain cannot develop in its intended manner but develops in response to a toxic internal environment. The stigmatisation and loss of self-esteem, which often follows psychiatric diagnosis and treatment, is especially ominous in children who have yet to shape their personalities, and it can hamper future opportunities even without considering the potential brain damage caused by the drugs. Children may learn to view themselves as physically or genetically disabled, with impaired self-determination and increased feelings of helplessness.526 This cruelty must be stopped.

Imagine if a virus suddenly appears that makes people sleep 12-14 hours a day and move around slowly and become emotionally disengaged.5:207 Some gain 30 kg of weight, their blood sugar and cholesterol go up, and they develop diabetes. People infected die substantially earlier than other people, some kill themselves, and parents panic over the thought that their children might also contract this horrible disease. Scientists find out that the virus blocks a multitude of receptors in the brain—dopaminergic, serotoninergic, muscarinic, adrenergic, and histaminergic—which lead to compromised brain function. MRI studies find that the virus shrinks the cerebral cortex, which is tied to cognitive decline. A terrified public clamours for a cure.

Such an illness has hit millions of children and adults. It is not a virus. It is Eli Lilly’s bestselling psychosis drug, olanzapine (Zyprexa). But since it is a drug, we do nothing. Drugs are taboo.

The only hope we have is if people protest so vigorously that it becomes an unstoppable revolution.

In 2017, a young Swedish psychiatrist, Joakim Börjesson, came to Copenhagen to do research with me.428 He became very impressed during his medical studies when a psychiatrist told the students that they knew so much about the brain and the drugs that they could use drugs that were specifically targeted to work on a disorder’s biological origin, the so-called chemical imbalance idea. He found it so fascinating that he decided to become a psychiatrist.

Joakim is cleverer than most of his colleagues. After having read books by Robert Whitaker and me, he realised that he had been totally fooled and considered leaving psychiatry.

In January 2018, he arranged a session in Göteborg during the annual conference for 150 Swedish psychiatrists in training where I debated with clinical pharmacologist and professor Elias Eriksson about SSRIs.8:147

During the session, I mentioned that Eriksson had entered a secret agreement with Lundbeck against his university’s rules, which meant that Lundbeck could prevent publication of his research if they didn’t like the results. I said this because Eriksson routinely “forgets” to declare his conflicts of interest, but I was immediately stopped by the chair. Later, the Ombudsman criticised the university for covering up the affair.629

What is typical for debates with people who try to defend a sick system also happened this time. Eriksson broke the rules for the debate, he lied, and he used dirty tricks in his attempts at convincing the audience that I could not be trusted. Joakim informed me that Eriksson had said before the session that he had the intention to “‘reveal that Peter Gøtzsche is a charlatan’ during his lecture. We then discussed this for about an hour and I fruitlessly tried to convince him to adhere to the rules for the debate with no success.”

Eriksson claimed that none of the harms of the pills were irreversible; that they were not addictive; that criticism of the pills was “ideologically founded”; and that their use according to the critics was the result of a worldwide conspiracy that included psychiatrists, researchers, authorities and drug companies. Five months earlier, when I debated with Eriksson on Swedish radio, he said the pills helped dramatically and prevented suicide.

After the meeting, I was told that many psychiatrists had not understood my explanations about depression pills causing suicide. When I present the same slides for a lay audience, they always understand them. The psychiatrists don’t want to understand what is too painful for them.

In 2013, when Robert Whitaker was invited to speak at a meeting in Malmö that child psychiatrists had arranged, other psychiatrists intervened and got control of the meeting. They requested that he should only speak about the dopamine supersensitivity theory and not present any data on long-term outcomes.

When he arrived, Bob was told that Eriksson would be his opponent, and he spent his time denouncing Bob in an unbelievably dishonest fashion. In Bob’s own words: “The whole thing was a disgusting setup that stands out for its complete dishonesty, from start to finish.” Eriksson declared that he considered Bob to be a “charlatan who tortures patients.”

I had planned on coming, but Eriksson declared that he would not participate if I showed up.

It is strange how psychiatry’s apologists constantly call their opponents charlatans or worse and use strawman arguments. None of us have ever postulated anything about a “conspiracy.”


To see the list of all references cited, click here.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Hopefully, Peter, there is NO FUTURE for the GENOCIDE that is the neuro-toxic drugged hell of the pseudoscience of psychiatry….a silly ecstasy-raved target of opportunity in the Negev, is MORE HUMANE than the carnage wrought by psychiatry’s fabricated & falsified insanity, of repeated traumatization and systemic, serialized abuse pretending to “medical” “care”….

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  2. You didn’t provide any sources for your information. I’m a psychologist and I am not thrilled with the side effects and low efficacy that psychiatric drugs often enjoy in comparison to medications available in other areas of medicine. However, you just come across as a person who was likely medicated as an adolescent and felt traumatized by it. Which many people have experienced, including myself. Nonetheless, you haven’t offered any evidence of what you’re saying and appear to only have antidotal evidence. Many patients, myself included, feel that medication assisted psychological treatment has saved our lives. Everyone in my opinion has a right to bodily autonomy and should have the right to refuse medication, there are those, however, that feel better on medication than off and they should have a right to that choice too. Even if the effect is purely a placebo if it help then people should have the right to try it if they wish with information about the potential benefits and side effects. Propaganda for or against helps no one

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    • The term “medication” in regard to concocted psychiatric “disorders” is a misnomer. Medications are used in treating verifiable (through rigorous testing) physical illnesses; the drugs employed in numbing or suppressing arbitrarily, subjectively defined “inappropriate” or “abnormal” thoughts and emotions should be more properly categorized as neurotoxins that have a brain-disabling effect. If you as an adult choose to rely on them after being informed accurately about their potential harms, you certainly ought to have the right to do so; however, administering these noxious substances to millions of children or elderly dementia patients who lack the capacity to make an objective judgment, solely to make them amenable to external control, is a gross abuse of authority if not outright sadism.

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    • Everyone in my opinion has a right to bodily autonomy and should have the right to refuse medication, there are those, however, that feel better on medication than off and they should have a right to that choice too.

      I agree with your statement. I can’t see where in this article he has written that those who want to voluntarily take psych drugs must be stopped from doing so. If he has, I disagree with that viewpoint.

      Under the article, it says “To see the list of all references cited, click here.”

      “Nonetheless, you haven’t offered any evidence of what you’re saying and appear to only have antidotal evidence.”

      I suppose you meant anecdotal evidence. After this you write:

      “Many patients, myself included, feel that medication assisted psychological treatment has saved our lives.”

      This is also anecdotal evidence. If I were to dismiss anecdotal evidence, I should also dismiss you and your patients.

      Anecdotal evidence is not right or wrong per se. Almost every form of evidence starts off as an anecdote. Some of them turn out to be false and some true. The only way to know is if you investigate it further.

      We criticise psychiatry a lot on this website, but we should not forget that there are suffering people everyday who go through everything from depression to hallucinations. If meds help some, they should have them. Personally, I’ve never had much of a problem with meds existing, more so the people in between the meds and the pharmacy existing and what they make you go through to procure those meds if needed.

      You’re a psychologist, so I want to ask you (and I’d appreciate it if you answered it pointwise in the same way it has been asked):

      i.) What do you think about psychiatric categorisations (ADD, MDD, BPD etc.)? Do you think they cause harm to the person they are applied to in any way?

      ii.) Do you tell your patients about “brain abnormailities found in psychiatric disorders via MRI, fMRI and PET scans”? If you do, do you make your patients, even if through a referring psychiatrist/neurologist, get such brain scans done and hand them the reports of observations on their brains?

      iii.) Do you take people who have experienced mania due to stimulants and antidepressants and label them as “bipolar” (or if the labelling is done by a psychiatrist, just continue to affirm it) and tell them that “the antidepressant induced mania just revealed an underlying problem which might have taken place anyway even without the drugs”?

      iv.) Do you have any cases where patients actively come in talking about psychiatric categorisations harming them or people (family, colleagues etc.) using it against them to gaslight them? What do you do for these people? When a person says something like “getting labelled as a borderline personality has destroyed my life”, what solution do you offer them?

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    • Nunya, I also think that people should have the right to take psychiatric drugs if they so choose. But that’s not the whole story; the fact is that psychiatry misrepresents the drugs they prescribe while believing they should have jurisdiction over patients’ bodies. And there’s plenty of evidence here on MIA to back up these claims.

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    • I agree both with you and Gotzche.

      With you I agree that people who derive benefit from an intervention, that feel better after it, should not be denied said intervention.

      With the caveat, that argument is actually the argument for illegal drugs, alcohol, tobacco, etc. And I always agreed to it’s legalization until fentanyl came along. Avoiding heroin, of course.

      As a side note, psychiatrists would be the professionals in charge of user illegal drug safety if at some point they became legal. They should be in charge of safe consumption sites, not volunteers with lived experience, IMO. I disagree with Gotzche and I thinkg Breggin that they should retrain as psychotherapists, they should train for what to my mind they actually, in part, do: increase the number of people dependent and even addicted to synthetic chemicals. And harmed by them…

      So, no, to me they should “retrain” as safe providers of now illegal drug consumption.

      With Gotzche my agreement is that all psychiatric medications cause more harm than good on the agreggate, and therefore on average.

      Beyond the placebo effect, it was common dictum during my medical training that some, many patients improved despite the treatment, because the treatment and independently of the treatment.

      I think PG has not argued strongly enough, or clear enough why he, like me, is for banning psychiatry, it’s diagnoses and treatments. I might be misspeaken for him though.

      But my point as a retired physician is that: on average and on the aggregate they bring more harm than good. It’s there in the numbers, the population statistics, concealed, behind the lingo, the propaganda, the persecution/violence against opponents, and the success cases narratives, and the anecdotal.

      Stating that somethings like alcohol, tobacco, illegal drugs, risky sports, risky investments and the like pose a conflict between public good, and personal choice. And in those cases the public is offered a minimum of legal protection when engaging in said activities, unlike psychiatry.

      So, as a compromise maybe treating psychiatric medications as those substances, with campaings to curtail it’s use in minors, restrictions on publicity, programs for recovery, etc., might cross the divide. The gap between those harmed and will be harmed by them, and those that could find a benefit, and therefore appreciate them and even fight for it’s use.

      And that would include acknowledging publicly that psychiatric medication cause more harm than good AND that for some it’s a personal choide, a freedom issue, not just a health issue. Which giving it’s diagnostic uncertainty and lack of grounding in physicial reality make using such diagnoses lacking at least validity.

      They become issues of belief, and in some cases as PG has stated of faith or creed. And therefore not of health, but of somehow preference, as ideology, religion and politics are.

      And those things are proscribed, banned, when they cause harm.

      It’s also not a health issue for me, because eventually those treatments will stop working and/or will bring complications. So, short term good, long term bad. And it could be very bad, even if in the short term for some, like in less than 4, four, weeks akathisia.

      Just like alcohol, tobacco, etc…

      As a final note, psychiatrists do really work beyond or outside the diagnoses, more like illegal drug providers: when the patient is down, bring an upper, when it’s up, bring a downer, when a “risk”, bring a suppressant. When victim/witness of a crime bring ECT.

      They cross and could use any and all diagnoses just to prescribe a drug. They treat, in their cuasi-honest mind, symptoms, not diseases.

      Just like an illegal drug prescriber, not dealer, since in illegal drugs collusion between and with authorities makes their illegal status a charade, in many cases. Just the availability on the streets, schools, churches, gyms, bars, legal drug stores, etc., makes them calling illegal at least improper.

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    • As for the sources, not trying to be offensive, the article at the bottom says:

      “To see the list of all references cited, click here.”

      Which links to:

      Which by the way, includes ALL the references supporting PGs book. Of which this is only part of a chapter.

      And there lots of books by Gotzche, Peter Breggin, Johana Montcrieff, Robert Whitaker, etc., that provide said sources. There are more on the corruption on the medical publishing industry, refered in other MIA articles, interviews, etc.

      It’s common knowledge among people who read MIA.

      But!, I prefer Thomas Szasz, even if it a little diffuse in his writings, and as far I understand, did not address medication harm as well as both Peters have done their books. And the references in there.

      And a lot of MIA articles provide links to the original research to support at least partialy PG’s point of view.

      Robert Whitaker has done several takes here on depression, psychosis, antidepressants and antipsychotics. Even in downloadable PDF format.

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  3. With all due respect, the ex-director of Cochrane South Asia who is a psychiatrist also used to talk all this stuff: “drug companies doing unethical things”, “ghost writing”, “research ethics” etc. That’s a public face.

    But in reality, when I would talk about the harms of psychiatric labelling, about psychiatry having become a weapon against me by an abusive parent to gaslight me, blackmail me and that I’m not an isolated case and this happens to others, I was met with nothing but invalidation, a stern attitude of being put in my place, and ultimately character assassination.

    They fundamentally believe that there’s nothing wrong with what they do, that there’s nothing horrible about what their patients go through as a result of their methods of help and if there’s anything wrong, it’s that academia is negatively influenced by money.

    What change will come if this is your fundamental precept and if you do not recognise the fundamental problems with what you, your colleagues, your profession do rather than drug companies and publications?

    I pay hardly any attention to all this stuff. I want to see them acknowledge and do something about ground level problems with their clients rather than public speeches on drug companies, systematic reviews etc. That’s a bunch of primarily self-serving public BS when you do not give an inch of space to ground level issues and real life cases of damage.

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