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.
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."
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.
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.
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.
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.
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.
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.
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.
In November of last year, Schizophrenia Bulletin published a research study that, on the face of it, would seem to upset the notion that neuroleptic drugs are toxic and that their use markedly reduces life expectancy. There are, however, some problems with the study that need to be considered.
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).
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.
Alarming headlines, based on a recent study, declare that diagnosis with ADHD doubles the risk of early death. Psychiatrist Stephen Faraone, commenting on the original study published in the Lancet, concludes that: “for clinicians early diagnosis and treatment should become the rule rather than the exception.” This conclusion represents a false assumption that the deaths occurred in cases that were not treated.
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.
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:
‘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.
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.
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?
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.
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.
The first benzodiazepine – chlordiazepoxide – became available, from Hoffman-La Roche, in 1960. Benzodiazepines largely replaced the earlier barbiturates, which had received a great deal of negative publicity because of their much-publicized role in lethal overdoses, both accidental and intentional. Initially, there was a good measure of skepticism among the general public with regards to benzos, and indeed, with regards to psychotropic drugs generally. The dominant philosophy in those days was that transient, drug-induced states of consciousness were not only ineffective in addressing human problems, but were also dangerous. But pharma-psychiatry systematically, deliberately, and self-servingly undermined this skepticism.
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.
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.”
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.
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.
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