During the past twenty years, the American Foundation for Suicide Prevention and American psychiatry have adopted a "medicalized" approach to preventing suicide, claiming that antidepressants are protective against suicide. Yet, the suicide rate in the United States has increased 30% since 2000, a time of rising usage of antidepressants. A review of studies of the effects of mental health treatment and antidepressants on suicide reveals why this medicalized approach has not only failed, but pushed suicide rates higher.
With increasing evidence that psychiatric drugs do more harm than good over the long term, the field of psychiatry often seems focused on sifting through the mounds of research data it has collected, eager to at last sit up and cry, here’s a shiny speck of gold! Our drugs do work! One recently published study on withdrawal of antipsychotics tells of long-term benefits. A second tells of long-term harm. Which one is convincing?
After a meta-analysis of RCTs of antidepressants was published in Lancet, psychiatry stated that it proved that "antidepressants" work. However, effectiveness studies of real-world patients reveal the opposite: the medications increase the likelihood that patients will become chronically depressed, and disabled by the disorder.
A medical journal is expected to promote an open-minded discussion of treatments, even if findings—or criticisms—threaten conventional beliefs. But the American Journal of Psychiatry will not find space for criticism even if it comes from one of the best-known psychiatrists in the world.
I am a former Lieutenant in the US Navy, and on August 30, I sent a letter to the US Senate and House Committees on Armed Services, and their respective committees on Veterans' Affairs. I titled the letter "Concerning Mental Health Treatment and Suicide in the United States Armed Forces and the Veteran Community." Here is what I wrote:
In a recently published commentary in Psychiatric Times, Ronald Pies and Joseph Pierre made this assertion: Only clinicians, with an expertise in assessing the research literature, should be weighing in on the topic of the efficacy of psychiatric drugs. They wrote their commentary shortly after I had published on madinamerica “The Case Against Antipsychotics,” and it was clear they had me in their crosshairs.
In 2010, my 25-year old son was prescribed Prozac for depression. After a psychiatrist doubled his dose, my son became acutely psychotic and had to be admitted to the hospital. Over the next twelve months, during which time he was treated with antidepressants and neuroleptics, my son had five further psychotic experiences. I thought it might be that my son was having difficulty metabolising the drugs.
This review of the scientific literature, stretching across six decades, makes the case that antipsychotics, over the long-term, do more harm than good. The drugs lower recovery rates and worsen functional outcomes over longer periods of time.
The writings of Pies and his colleagues, I believe, provide a compelling case study of cognitive dissonance. Cognitive dissonance arises when people are presented with information that creates conflicted psychological states, challenging some belief they hold dear, and people typically resolve dissonant states by sifting through information in ways that protect their self-esteem and their financial interests. It is easy to see that process operating here.
In the past six years, I have had the opportunity to speak at several conferences or meetings that I felt had particular potential to stir some political activity that would challenge current psychiatric practices, and one of those events was the meeting convened in the U.K.’s Parliament on May 11th, which had this title for the day: Rising Prescriptions, Rising Mental Health Disability: Is There a Link?
In my wildest dreams, I could never have imagined being drawn into a story of intrigue involving my own government’s efforts to hide, from the public, reports of psychiatric drugs associated with cases of murder, including homicides committed by youth on the drugs. But that is precisely the intrigue I now find myself enmeshed in.
The hearing for Bill H4062: Informed Consent for Benzodiazepines and Non-benzodiazepine Hypnotics took place on Monday – in the middle of an April snowstorm! The discussion clarified some important points in the legislation and gave survivors an opportunity to tell their stories. I was so proud to be there and witness the courage, camaraderie, resilience, advocacy, and vulnerability of fellow survivors. This legislation is our chance to be heard. As one survivor said, through tears, to the committee, “Do not let my suffering be in vain. I beg you to pass this bill.”
On February 24th, 2016 Bill HD4554 - An Act relative to benzodiazepines and non-benzodiazepine hypnotics was filed by Representative Paul McMurtry in the Massachusetts State House. The bill received 47 co-sponsors during the seven-day open period in which legislators can co-sponsor. This is an impressive and promising turnout.
Over the past two months, Ronald Pies and Allen Frances, in response to a post I had written, wrote several blogs that were meant to serve as an “evidence-based” defense of the long-term use of antipsychotics. As I read their pieces, I initially focused on that core argument they were presenting, but second time through, the aha moment arrived for me. Their blogs, when carefully parsed, make a compelling case that their profession, in their use of antipsychotics as a treatment for multiple psychotic disorders, has done great harm, and continues to do so today.
Four weeks ago, after I wrote a blog about a study that concluded there was no good evidence that antipsychotics improved long-term outcomes for people diagnosed with schizophrenia, I was cc’d on an email that had been sent to a number of “thought leaders” about what I had written. At least as I read the email, it put me into the usual pigeonhole for critics of psychiatric drugs: I apparently was globally “against” medications, and I had displayed a type of simplistic “categorical” thinking. All of this led to my having an email exchange with Allen Frances, and his laying out, in his opinion, the considerable "collateral damage" my writings had done.
It can be difficult to pinpoint transitions. The Rubicon that led from a Medical Republic to a Pharmaceutical Empire was crossed in 1962 with the passage of the Amendments to the Food and Drugs Act. This act put in place an apparatus of controlled trials, prescription-only status and disease indications that laid the basis for a global pharmaceutical hegemony, although the drift to Empire could still have been stopped at this point.
On September 18th the one day "More Harm than Good Conference" brought together many of the leaders of the critical psychiatry movement. While the event has passed, the video and slides from the conference have been made available on the council for evidence-based psychiatry website.
Let’s face it, as our kids slowly developing brains wrestle with behavioral and maturity issues while also trying to juggle expectations related to academic and social challenges, some of the behaviors they display can be quite concerning. Understandably, after trying what seems like everything in the books plus the kitchen, bathroom and laundry room sinks, caring and often exhausted parents are actively looking for help, resources and answers. But guess what? Without any need for pharmaceutical intervention or “drug therapy,” for centuries parents have been quite capable of helping challenged children overcome semi-annoying and concerning behaviors that some “experts” want to label today as symptoms of a mental disorder. Behaviors that a billion kids worldwide display every day.
On his own website, clinical psychologist Kenneth Pope has summarized 60 meta-analyses of antidepressants published between 2013-2015. The studies contain information on antidepressants “uses,...
Writing for the Atlantic, David Dobbs examines how much harm has been done in the 14 years since Paxil was wrongly determined to be safe and effective. “Study 329, as it became known, helped spur a huge increase in Paxil prescriptions,” Dobbs writes. “In 2002 alone, over 2 million prescriptions were written for children and teens, and many more for adults.” “Thousands of children, teens, and young adults attempted or committed suicide while on Paxil,” and the reanalysis of Study 329 in BMJ makes it seem “more likely than ever” that many did because of the drug.
In May 2014, the RIAT team asked GSK what the children who became suicidal in the course of Study 329 have since been told. The consent form says that anyone entering the study would be treated just the way they would be in normal clinical practice. In Study 329, the children taking imipramine were by design force titrated upwards to doses of the order of 300 mg, which is close to double the dose of imipramine given in adult trials by GSK or in normal clinical practice. In normal clinical practice it would be usual to inform somebody who had become suicidal on an SSRI that the treatment had caused their problem.
People hassle me for being anti-medication, and I always tell them I am NOT anti-medication; I am pro-fully-informed choice. But people like things black-and-white. They see me as being against medications, and so I'm telling you why medications may have saved my life yesterday, or at least saved me a whole bunch more trouble.
The authors of Study 329 began recruiting adolescents for a comparative study of Paxil, imipramine and placebo in 1994 and finished their investigations in 1997. They dropped a large number of their original cohort, so the randomness element in the study must be open to question. Late in 1998, SmithKline Beecham, the marketers of Paxil, acknowledged in an internal document that the study had shown that Paxil didn’t work for adolescents in terms of the two primary and six secondary outcomes they had established at the start of the study. In a nutshell, Study 329 was negative for efficacy and positive for harm, contrary to their succinct upbeat conclusion.
I imagine that everybody on this side of the issue knows by now that the eminent psychiatrist Jeffrey Lieberman, MD, Chief Psychiatrist at Columbia, and past President of the APA, called Robert Whitaker "a menace to society." The grounds for Dr. Lieberman's vituperation were that Robert had dared to challenge some of psychiatry's most sacred tenets! But in all the furor, it was largely ignored that in the same interview Dr. Lieberman had said something else that warrants additional discussion.
Since the mid-1990s antipsychotic medications have been increasingly prescribed for children, adolescents, and adults. The most recent report finds an increase in use for older children from 2006 to 2008. Most of the prescriptions of antipsychotics for children reported by the study were for conditions which had not been approved by the FDA (called off-label use).
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