Friday, December 14, 2018

Comments by Drtim

Showing 30 of 30 comments.

  • In 2008, Anne Anderman and colleagues reviewed the respected criteria for screening written by Wilson and Younger.
    Their final suggested update states: –

    “The overall benefits of benefits of screening should out-way the harms”.

    As the “Acceptable Treatment” is most likely to expose adolescents to the still poorly recognised,
    extensive, potentially life threatening harms to self and/or others of SSRI’s with very limited if any benefits, these wise words of caution should be taken very seriously indeed.

    Ref. Bull. World Health Organisation vol 86. n 4. Genebra April 2008.

  • Don’t we have duty of care to young doctors (some of whom we have taught , or used to teach ourselves) who may be considering entry into psychiatry training programs? How can we prevent the waste and sacrifice of their vocation if they are to be subjected to the type of propaganda illustrated by the “Stop Bashing Psychiatry” campaign launched in the UK earlier this year, and if they are to be used to perpetuate the current failed paradigm?
    They surely need to be aware of what catastrophic harms they will be coerced into inflicting upon their “patients” if their career decisions are to be informed and consented.
    If such awareness leaves a cadre of the committed to enter and revise with care, compassion and differentiation between science and science-fiction in psychiatry, then of course we should afford them our respect as well as all possible help and support. T.

  • Psychiatry not only destroys the people it arrogantly alleges to serve. This aberrant medical and allegedly scientific “speciality” destroys fellow human beings so brutally and relentlessly. It coercively and enforcedly drugs and damages physically, psychologically, emotionally, spiritually, socially, financially. The hopes, dreams and aspirations for future happiness and fulfilment are destroyed. Those so terribly injured and robbed of all self esteem may be too wounded to ever return to the society from which the hubris of psychiatry has exiled them. Their families and those who love them also have their lives and hopes destroyed in parallel.
    This more global human destruction is well conceptualised by reference to the words quoted by J. Robert Oppenheimer at the first atomic explosion in Los Alamos: –

    “FOR I AM BECOME DEATH, THE DESTROYER OF WORLDS”.

    It is that awful.
    Psychiatry has become medicine’s Enron and with it brought shame on my own profession.

  • Fiachra, – I share your concern that in addition to the appalling injuries and early death caused by “antipsychotics” (which in effect refers to “second generation antipsychotics”) a true broadly based, extended financial analysis of the all embracing economic cost of prescribing these grotesquely toxic drugs for months, years and lifetimes must identify a massive, avoidable financial burden on health care provision.

    In the U.K. this week –
    “New guidance from NHS England and the Royal College of General Practitioners encouraged
    GPs to review prescriptions for patients with learning disabilities or autism” –
    They are –

    “Urged to to cut the number of inappropriate prescriptions of psychotropic dugs ” –

    Surely that would provide a work load lasting their lifetime wouldn’t it?
    It is recognised however, that in many or most circumstances the initial prescribing would originate in psychiatry and not primary care.
    Antipsychotic tapered withdrawal is encouraged but I fear that GPs will not find it easy to deal with new antipsychotic induced injuries and toxicities which appear both during taper and after cessation. I have witnessed psychiatrists explaining such adverse drug reactions, including withdrawal induced akathisia, as an absolute demonstration that the patient
    “clearly needs the antipsychotic”.
    In some cases, the prolonged, extremely slow recovery from antipsychotic induced brain injury would be expected to leave the patient vulnerable to social isolation and profound loneliness in addition to recurrent nightmares and severe extended post traumatic distress (NOT DISORDER). This is in whole or in part caused by the returning memory increasing clarity of recollection and awareness of their incarceration and the institutional brutality they have experienced. This may have followed a psychiatric presentation originally, or a misdiagnosis, for example SSRI or other psychotropic medication induced akathisia, especially if they have a genomic CYP 450 variant metabolic vulnerability to delayed metabolism /detoxification.
    I have gained greater insight into these toxicities from Professor Gotzsche’s book and the extensive references provided.
    It causes me genuine concern that I misquoted the title which is:-
    DEADLY PSYCHIATRY and ORGANISED DENIAL. Peter C. Gotzche. 2015.
    Apologies to M.I.A. for my error.
    There is a BMJ on-line reference for the “inappropriate prescriptions of psychotropic drugs – -”

    BMJ 2016; 353; i3137.

    Tim.

  • This courageous and invaluable analysis of the marketing collaboration between drug manufacturers and those (allegedly) academic medical professionals with enormous influence on the prescribing decisions of doctors, is of fundamental importance in medical ethics.
    Is any patient in a position to provide valid, informed consent for an advised prescription medication program without their doctor advising whether or not they are receiving financial advantage from the manufacturer of the drugs which they advocate?
    What is surely needed is a “Conflict of Interest Patient Reference Website” –
    (A concept previously advocated By Professor Peter C. Gotzsche in his outstanding analysis: – “Dangerous Psychiatry and Organised Denial” -2015.)
    This must identify all pharmaceutical companies from whom money has been accepted, detail of amounts paid, when and by whom. This information should be available to every patient and their partner/family where appropriate.
    It would be recommended that such information should be considered in great detail before presenting any prescription for dispensing.
    Those doctors who, have no such conflicts of interest, will immediately and justifiably have patients trust in the integrity of their prescribing enhanced.
    Better still perhaps, every physician who considers that it is ethical and acceptable practice to receive pharmaceutical company payments should have every conflict of interest watermarked into each individual sheet of every prescription pad they use.
    Patients about to expose themselves to potential adverse drug reactions would then be able to ask themselves the pivotal question of medical integrity: –
    Who in fact is this individual doctor’s primary priority, their payer or their patient?

  • Mariel, your powerful and compelling writing, your generous gift of sharing your simply awful experiences are profoundly moving and important. When your words are related to our own experiences and/or observations of the institutionalised brutality that is marketed as a caring medical speciality, they combine to pierce the soul.
    I doubt many mainstream psychiatrists will have their souls pierced however. To comprehend the enormity of extreme adversity and unrelenting cruelty pelted upon you for so long and so mercilessly requires “compassion empathy and a conscience”. As you observe later, some people are completely devoid of these characteristics.
    It appears that medical graduates who are themselves devoid of these humanising qualities are not professionally disadvantaged. They are destined to rise to great professional heights in psychiatry.
    Thank you for moving me so deeply. I have taken a week or so to respond as the power and utterly compelling nature of your narrative deserved the most careful contemplation.

  • May be over-medicating?
    Is there some urgent, guild focused, buttock covering going on here?
    Maybe mainstream psychiatry’s long overdue tipping point is closer than those brutally abused and already dead, but bravely represented by their loved ones might hope?
    This now seems increasingly likely.
    Some perceive benefit. – How naive might this be?
    Growth retardation, alleged FDA cover up over suicidality and homicidality currently posted with strong evidence base and great courage. Brain stimulant medication of children followed by life destroying but psych-practioner-lucrative / pharma-mega-lucrative diagnosis of “bipolar disorder” ?
    This absurdity followed by enforced medication with some of the most poisonous and brain/ endocrine systems destroying drugs ever abused via the prescription pad. et al, – et al – et al!

  • The key differential diagnosis, most likely never recognised or probably never even considered, is AKATHISIA. Did the self harm and suicidality precede, – or did it follow introduction of SSRI / SNRI or other akathisia inducing prescription “medications”,
    – or changed dosages and/or components of psychiatric drugging?

    Please see: –

    Eikelboom-Schieveld SJM / Lucire Y. / Fogelman JC. *
    Journal of Forensic and Legal Medicine.
    2016 doi: 10 1016/j.jflm. 2016.04.003.

    *The Relevance of Cytochrome P450 Polymorphism in Forensic Medicine and Akathisia Related Violence and Suicide.

    The authors observe: –

    ” The combination of medication, fluctuating restlessness, suicidality, aggression and toxic hallucinations are pathognomonic of AKATHISIA”.
    “We cannot find any other diagnosis in medical taxonomy that combines suicidal and aggressive thoughts with medication, nor any other that recedes WHEN THE CULPRIT DRUG HAS BEEN TAKEN AWAY”.

    (My high-case emphasis).

    The need for UTMOST CAUTION and expert guidance in tapered withdrawal is
    STRESSED in view of the risk of decreased psychotropic drug levels inducing or exacerbating AKATHISIA. This is of PARAMOUNT importance.

    I share your sincere concern Kim, It is entirely possible that all of this young woman’s suffering is iatrogenic.

  • This compelling paper considers the personal catastrophe which follows the widespread failure of those prescribing SSRIs and SNRIs to consider AKATHISIA as the primary differential diagnostic possibility in someone who is suffering from a life threatening clinically recognisable, common ADVERSE DRUG REACTION due to prescription medication.
    The complex physical, psychological and behavioural changes are dominated by OVERWHELMING AGITATION rather than “restlessness”. They can be identified promptly, with attention to pre-akathisia status, awareness and knowledge that recent introduction, increased antidepressant dosing, change of antidepressant or insufficiently tapered withdrawal are critical features of this syndrome When fastidious clinical observation is combined with a precise history of the presenting complaint akathisia, and it’s secondary suicidality, violence and homicidality, together with it’s almost unbearable suffering can be diagnosed and managed promptly and effectively. This commonly mis-diagnosed condition is iatrogenic in origin. It is hard to consider that failure to diagnose and manage safely is anything other than the primary professional responsibility of the prescriber.
    To admit a severely dehydrated, acutely physically ill patient anywhere other than an acute general medical unit with access to intensive care facilities, and to fail to reverse the spiral of continuing and deteriorating biochemical imbalance in the acutely akathisic patient is the absolute antithesis of “safe” clinical management. The deterioration of this complex situation is aggravated by any delay in stabilising deteriorating body chemistry and physiology. This increases the very likely and catastrophic outcome which is misdiagnosis as a “serious mental illness” This psychiatric misdiagnosis is then followed by compulsory
    “treatment” with antipsychotics and changed antidepressants inducing further iatrogenic injury via overwhelmed, compromised and dysfunctional CYP P450 metabolism failing to break down and detoxify this additional and inappropriate drugging.
    Medicine and society MUST, via heightened awareness, recognise and report this devastating ADR in order to prevent the tragic sequalae and for the true and increasing frequency to be documented.

  • “I will keep telling about the bad, dangerous and inhuman conditions for people in treatment – and I do it in her spirit. It is if she sits on my shoulder all the time telling me what to do”.
    Dorrit, thank you for your wonderful, powerful, truthful and heart breaking book. Although I simply cannot keep a dry eye every time I pick it up, it is clear that your immense courage and the spirit of Luise on your shoulder have saved many people and their loved ones from being maimed and killed via the same grotesque fantasy of diagnostic infallibility and almost fanatical false belief that they are enforcing some meaningful drug therapy. Even though so many “patients” will have been emotionally and psychologically traumatised by abduction and cruelty beyond ever fully recovering, as well as suffering from multiple severe injuries to brain, metabolic, endocrine, integumentary and other systems; – they and their families have had a chance to learn to their terror, the reality of what was being done to them.
    Mainstream psychiatry’s institutionalised brutality, exercised by their endless misinterpretation of enforced adverse drug effects, and withdrawal syndromes, as an ever growing list of “serious mental illness” diagnostic labels followed by more and more ritual prescription drug poisoning cannot be fully comprehended without the incredible legacy of Dear Luise.
    That which you and Luise tragically experienced is indeed “the norm” rather than the exception.
    It is truly beyond belief.
    I would advocate that Dear Luise should become recommended reading for every medical student prior to graduation.

  • Thank you. As you know, I am not a psychiatrist but I would conceptualise that akathisia is vital to recognise and manage fastidiously as it may be the first presenting feature of a life threatening serotonin syndrome. Having seen intense akathisia “professionally DSM /ICD 10 diagnosed” as “psychotic depression”, with absolute refusal to reconsider a differential diagnosis, and insistence on compulsory “treatment” with fluoxetine and olanzapine – I am truly astonished at the apparent lack of medical awareness of this dreadful ADR.
    This seems relevant to both primary and secondary care physicians? Perhaps A + E specialists may be more diagnostically aware? That is an unknown to me, but it would seem possible,
    I find doctors receptive to my concerns in primary care.
    Perhaps the real medical educational issue is why this appears to be a “best kept secret” in our training?
    I am now a retired physician and have the time available to try to write and alert others to those concerns.

  • Thank you for clarifying the professional duty regarding medication disclosure. However, should this man have been suffering form severe psycholeptic prescription drug induced akathisia:-
    1) It would seem extremely unlikely that the prescriber would have warned him about the risk, nature of and potential consequences of akathisia.
    2) It is possible that he may ( or may not) have had a metabolic vulnerability to akathisia which may still be possible to identify or exclude within the limits of current CYP 450 genomic sequencing methodology.
    3) If this mans actions were determined not by choice but by prescription drug induced akathisia, then he may have been too intensely akathisic to be able to inform his employer of the medication he was (believed to be) taking.
    4) Just assume that 1) —-> 3) accurately define this pre “murder-suicide’ event, is it
    appropriate that the prescriber is exonerated from any contributory action/s?

    Finally, it might be argued that he could have told the employer before the onset of (possible) akathisia. Had there been extreme CYP 450 genomic variant vulnerability to serotonin and other neurotransmitter rapidly accumulating in the brain and other tissue with overwhelming toxicity, the onset may have occurred whilst not flying or expecting immediately to fly. Subsequent actions and decisions MAY not have been the choices which would have been made in the absence of (possible) intense ADR’s.
    I am uncomfortable speculating in a case where the scale, intensity and duration of suffering of all souls on board, and the suffering of all their loved ones is almost beyond comprehension.
    There does seem to be a question of accuracy and interpretation of coronial and/or other forms of inquiry into suicide, murder-suicide, and mass murder events where the person or persons responsible may not have acted in such a manner unless suffering from akathisia induced by prescription psychiatric medication. If their actions are entirely compelled by drug toxicity overwhelming any decision process, or their actions are entirely drug induced compulsions, then surely it is necessary to routinely apply all of the (real) science available to truly understand and to begin effective prevention?

  • Thank you Professor Healy and all colleagues for your intellectual rigour, fastidious attention to detail and determined adherence to defined scientific methodology. This crucially important re-introduction of academic integrity into clinical trial data analysis (via such objective and extensive re-analysis) is so greatly needed, and it is of unquestionable value for patient safety in psycho-pharmacology. Those compelled to dismiss and denigrate your vital work may perhaps be less focused on issues of safety? Deeply interested doctors outside your field who, in increasing numbers record their profound professional discomfort and concern regarding the apparently cavalier use of prescription drugs with life threatening and very serious ADR’s, recognise and applaud your courage and integrity.

  • Would it be relevant – (if still technically possible) – to undertake CYP 450 genomic sequencing on residual tissue?
    CYP 2C9, CYP2C19, CYP2D6, and possibly other genomic variants adversely affect the metabolic breakdown of SSRI’s – SNRI”s and other psycholeptic drugs. If the “Wings” tragedy might be further clarified by genomic sequencing, potentially identifying metabolic vulnerability to akathisia, then surely that forensic investigation should be mandatory?
    If there was an increased CYP 450 genetic predisposition to exacerbated prescription-drug induced suicidality and homicidality, via immediately preceding multiple psychiatric “medication”, this co-pilot may not have been in a position to exercise choice in the presumed “decision” to undertake those actions currently described as “murder- suicide”. Such forensic evidence may indicate that the crime could not or should not be attributed to the co-pilot. This comment fully acknowledges the indescribable terror and suffering of all those on board.

    Ref. Lucire Y. Crotty C. Antidepessant-induced akathisia-related homicides associated with diminishing mutations in the metabolising genes of the CYP 450 family.
    Pharmgenomics Pers Med 2011;4: 65 – 81.

  • Thank you.

    1) No they don’t.

    2) When prescribers of SSRI’s / SNRI’s can accurately recognise and adequately manage AKATHISIA, differentiating this very common psychotropic ADR from first episode psychosis, – then these “pseudo-bipolar disorders” can be saved from their imposed label-for-life, no longer “medically poisoned” for life, until wretched, premature death.

    3) Identify, and gradually detoxify from “psycho-pharmacology”, those thousands of – labelled-for-life “ADHD children” (and adults) whose stimulant “medications” cause features so easily labelled as “bipolar”. That includes the “non-stimulant” – nor-epinephrine increasing (i.e., stimulating drugs ) – as well as the “stimulant” stimulating ADHD “medication”.

    4) Avoid further generations of children labelled as suffering from autism being “therapeutically”driven into psychosis by psycholeptic “medication”used entirely for control of behaviour.

    What might be left?

    The real epidemiology of manic depressive psychosis can now be addressed.

    Now use whatever name those who are still labelled, and stigmatised by the brutality of “mainstream psychiatry” prefer,
    It will revert to the reality:- a rare condition.
    If managed by real doctors, with real empathy, and real science, with minimal medication, with guidelines driven by clinical and functional sociologic oriented measures – (as assessed by patients, families and loved ones) – the prognosis will be improved dramatically and the stigma reduced concomitantly.
    No label, real life?

  • When it comes to the fundamental failure of psychiatry, it is the inability to differentiate the injurious effects of their “prescription medications” – (upon which they have built their fantasies of specific “medication “efficacy) – from serious mental illness, which is the primary cause of growing contempt for the “mainstream”.
    It is from this abandonment of both the ethics and empathy of sincere medical practice that other physicians and “colleagues” may perceive a duty to alert potential psychiatry trainees to consider that the harms they will be called upon to inflict on fellow human beings are truly appalling.
    Might a wider commitment to critical self vigilance, a return to scientific credibility, and the re-discovery of humility within psychiatry contribute to a necessary conflict resolution?
    During 40 years of clinical and academic medicine I encouraged all trainees to believe: –
    “there are no non-prestigious specialities, only non-prestigious doctors”. – With the caveat: – Prestige may only be attributed by those (patients) whose care has been found to be acceptable, appropriate and of benefit to themselves and those who love and care for and about them.
    Bleating about “Bashing” beggars belief.
    Physician – (if indeed that is still what you aspire to be?) heal thyself.

  • I feel deeply for your anguish.
    A “duty of candour” is allegedly required of all medical practitioners in the UK.
    It is one of the G.M.C. “Duties of a Doctor”.
    Might it be that mainstream psychiatry is absolved from, and / or has opted out of this requirement? Elsewhere in medicine, this duty of candour is taken very seriously.
    When it comes to the fundamental failure of psychiatry – i.e. : – the inability to distinguish initial, and then cumulative psycholeptic drug toxicities from serious mental illness – (leading to undisclosed condemnation for life, via S.M.I registration) – then it appears that “Psychiatry means never having to say you’er sorry”.
    Akathisia following serial change of SSRI’s, and then exacerbated by increasing SSRI dosage, is vulnerable to misdiagnosis as psychotic depression or first episode psychosis.
    This is all that is required for the misfortune to be subsequently SMI – “labelled for life.”
    Surely this is unbelievable arrogance and brutality?
    This is the basis for the “life chances destruction” that I have mentioned in my post above.

  • So far removed from the BBC’s usual excellent and balanced approach to broadcasting.
    Little evidence of impartiality.
    These programs were in fact very powerful pharmaceutical marketing propaganda for medications which may suppress symptoms, albeit on occasion with appalling adverse effects. They are not specific “treatments” as portrayed, as for example by the term “anti-mania”.
    The reality is that some of these drugs are actually the cause of non-existent “mental health disorders.”
    Those injured by psychopharmacology have no NHS recognition of the true cause of their immense suffering, as with – for example, akathisia.
    The toxicity of akathisia was apparently well illustrated by the film crews??? – but was evidence of akathisia ignored by these “mainstream” psychiatrists????
    Worse still, those “patients” whose physical, psychological, emotional health; and social, economic, employment and relationship aspirations are destroyed by unrecognised (or denied) cumulative medication toxicities, have no appropriate rehabilitation services in which to recuperate.