Blogs

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.

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.

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.

Medically-induced harm—affecting tens of millions of people worldwide—has taken the field decades to take seriously.

If academic psychiatry is evidence-based, why did it take two decades to recognize SSRI withdrawal as widespread and chronic among patients?

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.

‘I Don’t Believe in God, But I Believe in Lithium’ is the title of Jamie Lowe’s moving account of her manic depression in the New York Times. The piece reminds us how devastating and frightening this condition can be, so it is understandable that the author put her faith in the miracle cure psychiatrists have been recommending since the 1950s: lithium. The main problem is that there is no study in which people who have been started on lithium have been compared with people who haven’t.

The Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and Schizophrenia. The central theme of the paper is that the condition known as psychosis is better understood as a response to adverse life events rather than as a symptom of neurological pathology. The paper was wide-ranging and insightful and, predictably, drew support from most of us on this side of the issue and criticism from psychiatry.  Section 12 of the paper is headed "Medication" and under the subheading "Key Points" you'll find this quote: "[Antipsychotic] drugs appear to have a general rather than a specific effect: there is little evidence that they are correcting an underlying biochemical abnormality."

I thought I would make a small contribution to the discussion about how coverage of the recent airline tragedy focuses so much on the supposed ‘mental illness’ of the pilot and not so much on the possible role of antidepressants. Of course we will never know the answer to these questions but it is important, I think, to combat the simplistic nonsense wheeled out after most such tragedies, the nonsense that says the person had an illness that made them do awful things. So, just to confirm what many recipients of antidepressants, clinicians and researchers have been saying for a long time, here are some findings from our recent New Zealand survey of over 1,800 people taking anti-depressants, which we think is the largest survey to date.

Medicating children for a host of mental disorders has become very popular in some parts of the USA. More than 8 million kids from 6 months to 17 years of age are on pharmaceutical drugs in this wonderful country. We lead the world in drugging youth for behavioral, cognitive and attention issues. We are once again #1. But I would like to share with parents as well as adults working with children a few not so readily available facts related to medicating kids for behavior issues.

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.

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.

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.

The promotion of the chemical imbalance theory did occur, and continues to occur, and is a most shameful chapter in psychiatry's history.  It is arguably one of the most destructive, far-reaching, and profitable hoaxes in history. I could not begin to estimate the number of clients I've talked to over the years who told me that their psychiatrists had told them they had a chemical imbalance in their brains, and that they needed to take the pills for life to correct this imbalance. Even today, I regularly receive emails from readers contesting the assertions in my posts and telling me in no uncertain terms that they have chemical imbalances in their brains that cause their problems.

With 1 in 5 Americans taking a psychiatric medication, most of whom, long term, we should probably start to learn a bit more about them. In fact, it would have been in the service of true informed consent to have investigated long-term risks before the deluge of these meds seized our population over the past thirty years.

When I was researching Anatomy of an Epidemic and sought to track the number of people receiving a disability payment between 1987 and 2007 due to “mental illness,” I was frustrated by the lack of diagnostic clarity in the data. The Social Security Administration would list, in its annual reports on the Supplemental Security Income and Social Security Disability Insurance (SSDI) programs, the number of people receiving payment for “mental disorders,” which in turn was broken down into just two subcategories: “retardation,” and “other mental disorders.” Unfortunately, the “other mental disorders,” which was the category for those with psychiatric disorders, was not broken down into its diagnostic parts.

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.

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.

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?

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.

Depressed pregnant women need good care.  They should not be made to feel guilty for the choices they make concerning their depression or lectured to by those who don’t understand the area or lack compassion for them.  In that sense, Andrew Solomon does the public a service by turning his attention and writing talents to the topic of depression and pregnancy this week in the New York Times.  However, a crucial part of providing good care to depressed pregnant women is to give them accurate information on the topic.  In this sense, Andrew Solomon falls short.

What if I told you that, in 6 decades of research, the serotonin (or norepinephrine, or dopamine) theory of depression and anxiety - the claim that “Depression is a serious medical condition that may be due to a chemical imbalance, and Zoloft works to correct this imbalance” - has not achieved scientific credibility? You’d want some supporting arguments for this shocking claim. So, here you go:

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.”

This column is partly a report on the marketing of Abilify, the atypical antipsychotic that has become America’s best-selling drug.   It’s also an appeal for advice and feedback from the RxISK and Mad in America communities, and a call for some brainstorming about strategy.  The plans laid out by drugmakers Otsuka and Lundbeck for Abilify’s future, and the cooperation they’re getting from leading universities, are alarming enough to me that reporting on them seems inadequate.  We need action, although I’m not sure exactly what kind.