Monday, February 24, 2020

Comments by Lois Achimovich

Showing 4 of 4 comments.

  • Hi Robert,

    This statement in the article (see below) appears to say that there’s something wrong with the brain before the first psychotic episode.

    “Lack of brain tissue found in schizophrenic patients

    ‘Scans from the patients’ first episode revealed that they had less brain tissue, compared with healthy individuals without the disorder.

    “The researchers say this finding suggests that something is affecting the brains of those with schizophrenia before they demonstrate obvious symptoms of the conditions.”

    Dr Andreasen implies that though meds cause damage to the brain, they may be caused by “pregnancy complications or exposure to viruses”. What about trauma in childhood? Perry has proven that trauma in children lasts long after the traumatic incidence(s) and others (eg Heim) have shown the persistence of psychological and neurodevelopmental conditions.(Read, Perry et al comment “As is often the case, women with a history of psychosis were not included in Heim’s study.’)

    The neglect of trauma in the causation of psychosis is extraordinary, given its prevalence in the inpatient histories of people with psychosis. Why is it being ignored by researchers? Read et al again: “In the last four decades (60s-90s), for every study on the relationship between child abuse/neglect and schizophrenia, there have been 30 on the biochemistry of schizophrenia and 46 on the genetics.”

    I applaud Dr Andreasen’s concerns around the use of antipsychotic medications. However, trauma is “the elephant in the room” which is still invisible in mainstream psychiatry.

    Lois Achimovich

  • I too greatly admire Brett Collins’ work. I also am against forced treatment. However, I wonder whether “Anonymous” and David have been in the situation where a person is throwing him/herself against walls, bashing his forehead over and over again or is out of her mind with methamphetamines.

    I have recently worked in an acute psychiatric unit. Having been away from acute work for 30 years. Short of putting someone in a straitjacket, I could see no other way for the staff to help the person than to medicate. Often midazelam is sufficient and avoids the use of antipsychotics, but there is no doubt that the latter is necessary in cases where drugs like Kronic and amphetamines are concerned.

    Sedation is also necessary when someone has to be airlifted to a hospital, as is frequent in Australia.

    The major danger is that people then get a label and be forced to take antipsychotic medication long term. That becomes a human rights issue, one that is rarely addressed by current psychiatric practice. Thomas Szasz was a voice in the wilderness for most of his career, but his books should be read by anyone who cares about the rights of the “mad” and the “bad”. Winnick’s book “The Right To Refuse Mental Health Treatment” is also useful.

    In prisons, the distress or aggression may be due to the treatment within the prison itself . It is rare for prisons to change their regimes to accommodate prisoners. It is also rare for prisons to allow minor tranquilisers to be used. Antipsychotics have many side-effects and should be used briefly and in the lowest dose possible.

  • Great presentation, Robert. Look forward to meeting you in Belgium in March.

    Re Stephen’s post re “why so few professionals in the mental health system have any knowledge of this information”, the first reason is that they are no longer taught anything but the neurobiological paradigm of psychosis. For instance I recently attended a presentation about the history of schizophrenia in which trauma as one cause of psychosis was not even mentioned. The second is the ascendency of Big Pharma, which has set the agenda for most research in the field, and which pays leaders in the profession to carry out research and promote antipsychotic drugs, not as cures for psychosis, but as “stabilisers” – forever.

    Re Markps2’s comment: You are quite right that in many cases, antipsychotic drugs are forced on the service user, not “given”. If they complain or resist, depot medication is “given’, often indefinitely. Sometimes, especially if the service user has been using amphetamines, it is hard to treat a psychosis without a major tranquiliser, though i agree with Robert that benzos are being used more frequently in acute situations. What I don’t agree with is long-term compulsory treatment – and in my experience, very few who are forced to take medication are able to work. Also, virtually no-one is told that it is possible to be drug-free, although there are now recovery programmes starting up in many parts of the world.

    Very few clinicians explain the side-effects of these drugs – and antipsychotics are now being given to children, which in my view has serious medicolegal ramifications.

    I’d like your reference, Robert, re the possible relationship of side-effects (eg akithesia, obesity, diabetes, liver damage, sun sensitivity) to suicidality in some patients.

    Best regards