Foreign Correspondents

Dutch peer support education has changed dramatically over time since its inception. Peer support education has evolved over time from empowered and independent peer support education to institutionalized peer support education. In effect the (future) peer support workers in the Netherlands could become clinician-friendly peer support workers who merely represent peer support work in name but not in practice.

The controversy over “Study 329” on the effects of Paxil in teen depression has raised questions about the state of ALL medical research. I decided to look at the research for the most recent psychiatric drug approved by the FDA, a new antipsychotic called cariprazine or Vraylar.  I located twenty studies of Vraylar on www.ClinicalTrials.gov, the U.S. government-sponsored registry for clinical trials.  Three were still in process, and seventeen were completed.  Not one had shared its results on the government website, a supposedly mandatory step.

For several decades, since the days when I was a patient, I have seen and heard how an obsession with questions damages psychiatry. Many of us have been asked the same questions day after day, year after year: ‘Do your thoughts seem faster than normal?’, ‘Do you ever have thoughts in your mind which are not your own?’, ‘Do you feel anxious?’, and so on. Hearing only what a patient says under questioning when frozen by paralysis, or subject to the hyper-arousal of anxiety, the professional misses the opportunity to hear the threads of something new, the possibility of weaving with the patient a narrative of hope and recovery.

Some readers of Mad in America may be aware that Scientific American published a short blog by me on 17^th November 2014 - Why We Need to Abandon the Disease-Model of Mental Health Care. This blog was rather wonderfully (and slightly embarrassingly) described by Phil Hickey on his website, Behaviorism and Mental Health, as “an important milestone.” My blog attempts to summarise many of the key points of a perspective widely shared on Mad in America: 

Every year about this time I review my template file for new client notes. It has blank sections for name, presenting concern, history, plan, and a number of other categories. This year I found myself staring at it, considering whether a revision was in order. And the category that leapt out at me was “Diagnosis.” The truth is, I seldom use it any more.

When a pharmaceutical company discovers a potential new drug, they undertake a mammoth project. The aim is to amass sufficient evidence that national organizations such as the FDA will approve sale of the drug, and the type of disorders for which it can be openly prescribed – the so-called “on-label” uses. In order to encourage companies to undertake this risk, governments place a pot of gold at the end of the rainbow.

I just attended my first American Psychiatric Association (APA) meeting even though it has been going for 168 years. I was invited to join a symposium on vitamin-mineral combinations as primary treatment of psychiatric symptoms. There was one talk I decided to attend, not because I was particularly interested in the topic, but because it would give me an opportunity to ask Jeffrey Lieberman a question.

Access to data is more important than access to information about conflicts of interest. It is only when there is access to the data that we can see if interests are conflicting and take that into account. Problems don’t get solved unless someone is motivated for some reason. We need the bias that pharmaceutical companies bring to bear in their defense of a product, along with the bias of those who might have been injured by a treatment. Both of these biases can distort the picture but it’s when people with differing points of view agree on what is right in front of their noses that we can begin to have some confidence about what we have.

Today I paid a visit to the Managing Director of Mylan Pharmaceuticals, Lloyd Price. Mylan is the company that manufactured the antidepressant Fluox1 which, according to the NZ government, is the most likely cause of my son's suicide. My dealings with Mylan in the time since Toran died have not been entirely fruitful.

The Hearing Voices movement is a beautiful thing, and last year it was 25 years old. What has happened in 25 years? A confidence has grown in a different approach to hearing voices, listening and embracing rather than trying to control and silence voices. Key to this has been Hearing Voices groups and conferences, where people who hear voices are listened to with openness and curiosity. It’s not about telling people who hear voices to throw away their pills if they are taking them, its about creating spaces to listen deeply to what is happening.

Several of us involved in RxISK.org monitor other groups setting up to offer information on medicines. Some of these, like eHealthMe, offer useful information. As ever, though, pharmaceutical companies are in there early. The Brintellix website is a masterclass in how to appear patient-centered, and patient-friendly. How to move with the times and make the new way of doing things yours.

A Colorado based company, Sundance Diagnostics, contacted me a few months ago to tell me about work they are doing to develop a genetic test to predict suicide risk when patients are prescribed antidepressant drugs. Their plan is to sequence the entire human genome of about 360 patients and controls to see if antidepressant drug risk can definitively be predicted.

We want to start an international initiative to promote the writing of recovery stories in every country, with the ultimate goal of sharing at an international level the most compelling ones from each country. Our proposal is born from an awareness that recovery stories are necessary today in order to give back to mental sufferance its meaning and transparency, to fight the biographical opacity of biological theories (the broken brain) and to guarantee decisional power to those who are offered (or imposed) mono-dimensional or dehumanizing treatments.

My son is dead. He hanged himself at 17 but meh… whatever… that’s yesterday’s news and I’m totally over it now. I don’t long for...

A couple of days ago, after two years of fighting, I received Mylan Pharmaceuticals assessment of the causal link between their drug Fluox and my son's suicide. Their conclusion is identical to that of the New Zealand drug regulator Medsafe, that the SSRI antidepressant Fluoxetine is the probable cause of Toran's death. The rating of 'probable' includes an assessment that Toran's suicide was 'unlikely to be attributed to disease or other drugs.'

The marketing departments of pharmaceutical companies focus in on the ring-bearers just as the Eye of Sauron focused in on Gollum and later Frodo. Once the Eye fixes on a ring-bearer, it hypnotizes him into submission. If any demur, it directs its Black Riders (Medical Academics) to enforce compliance with its Will.

Pharmalot has just posted a piece - 'Controversial FDA official, Tom Laughren, retires.' This is a must read for anyone with anything to do with mental health - both the post and the comments afterwards where some have posted that they still believe the Black Box warnings on antidepressants arose because of pressure from the Church of Scientology rather than in response to the data.The post will likely seem boring to many. But the comments won't - they seethe with anger.

In June this year the BMJ published an article supposedly about how the Black Box Warning that antidepressants cause suicide had led to a drop in the use of the same antidepressants and an increase in suicides. The message was widely trumpeted in daily newspapers and other news outlets as well as the press office of Harvard University and the American Foundation for Suicide Prevention. In fact there had been no drop in the use of antidepressants and no increase in suicide rates or suicide act rates. The letters sent to the BMJ in response to the article wondering how such a shoddy piece of work could possibly have been published are worth reading – rarely is academic contempt so scathing.

I am proud and happy to announce that our webpage DrivingUsCrazy was launched today. It will help us to get the word out about the international film festival taking place in Gothenburg, 16-18 October, 2015, and also to highlight the issue of madness every day until then — and hopefully for many days afterwards.

This means that what ADHD proponents present as validation of a diagnosis of a real and treatable disorder is in fact a placebo effect caused by an ostensibly scientific label, which exists in synergy with an efficient, legal drug. The ADHD label produces this placebo effect because its diagnosis is based on behavior that in reality could be observed by anyone. What is observed sounds "scientific"; it is easily understandable and highly obvious. When the diagnosis is turned into an action plan, we forget that there is nothing scientific about it and that its evaluation is purely subjective and clinical; that it creates a great many false positives, and that a drug prescribed in half of the cases indeed does have serious side effects.

For a long time I have felt that there just isn’t a good enough and long enough study on the pros and cons of long-term antipsychotic treatment versus reduction and discontinuation in people who have psychotic disorders, including those who are classified as having schizophrenia. Moreover, there are increasing reasons to be worried about the effects of long-term treatment with antipsychotics. I put this case to the UK’s National Institute of Health Research recently, and proposed that they fund a trial to assess the long-term outcomes of a gradual programme of antipsychotic reduction compared with standard ‘maintenance treatment.’ The NIHR agreed that this was an important issue, and that a new trial was urgently needed. The RADAR (Research into Antipsychotic Discontinuation And Reduction) study officially started in January 2016.

At the 50th American Psychosomatic Society meeting in New York, Michael Shepherd was speaking. His topic - The Placebo. When the lecture finished, Lou Lasagna said "this paper is now open for questions." Nothing happened. Nobody said anything at all. Lasagna couldn't refrain from commenting: "There are 3 possible explanations. First, you were all asleep and therefore you heard nothing. Secondly, it was so bad that since this speaker has come 3,000 miles you didn't want to embarrass him. Third, it is genuinely so original and new that you don't quite know what to make of it. I'll leave you to decide which it was". What had Shepherd said?

Randomized controlled trials (RCTs) came into favor in the wake of thalidomide as a method to evaluate drugs and their risks. They were supposed to...

We are among an increasing number of people around the world who know the importance of holding on to a humanistic idea, and of keeping in mind that people need—first and foremost—other people. People who are willing to take part, to share with us the horror and confusion, to invite the telling of a narrative, and to keep the hope alive.

On 25 October 2013, the World Health Organization issued a press release promoting guidelines produced by the Patient-Reported Outcomes Safety Event Reporting (PROSPER) Consortium. The consortium aimed to “to improve [drug] safety reporting by better incorporating the perspective of the patient” with the aim of the guidance produced “to ensure that the patient ‘voice’ and perspective feed appropriately into collection of safety data.” Rather than 'quietly protecting the health of every person on this planet, every day' it seems clear that WHO is quietly protecting the interests of pharmaceutical companies and their advisors on planet 'profit from patients', every day.