Blogs

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.

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

‘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.

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.

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.

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.

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

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.

There appears to be increasing acceptance of the idea that lithium prevents suicide, and even that it can reduce mortality rates. For a toxic drug that makes most people feel rather depressed, this seems curious. I did wonder whether it might be having this effect on suicide by sapping people of the will to act, but the proposed effect on mortality seems completely inexplicable. A closer look at the evidence, however, suggests the idea is simply not justified.

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.

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.

The Finnish Psychological Association held a meeting in Helsinki on 1 Sept 2014 titled “Mental Health and Medicalization.” I spoke at the meeting and four days later I sent a letter to another speaker, psychiatrist Erkki Isometsä. Professor Isometsä replied: “I will respond to it in detail within a few days..." As "Open Dialogue" is essential in science, I have published my letter to Isometsä here as well as on my own website, although I didn’t succeed in starting a dialogue.

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.

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.

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?

I’ve been teaching a course on substance abuse for about 30 years now. In this course, I cover a new drug class each week and always review the history of the drug. All of the drugs of abuse, cocaine, alcohol, marijuana, opiates are not new on the human scene. They date back to the Sumerians and the Greeks. The question for me is what accounts for epidemics? I have come to believe that epidemics are supplier driven rather than a function of consumer demand. For the current opiate epidemic, the suppliers were the pharmaceutical houses.

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.

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:

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.

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.

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).

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.

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.

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.

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.