Editorial note: We follow up the Guilty post last week with a piece written by Peter Gøtzsche that has caused a stir in Denmark and provoked some of the Danish professors he critiques to respond.
At the Nordic Cochrane Centre, we have researched antidepressants for several years and I have long wondered why leading professors of psychiatry base their practice on a number of erroneous myths. These myths are harmful to patients. Many psychiatrists are well aware that the myths do not hold and have told me so, but they don’t dare deviate from the official positions because of career concerns.
Being a specialist in internal medicine, I don’t risk ruining my career by incurring the professors’ wrath and I shall try here to come to the rescue of the many conscientious but oppressed psychiatrists and patients by listing the worst myths and explain why they are harmful.
Myth 1: Your disease is caused by a chemical imbalance in the brain
Most patients are told this but it is completely wrong. We have no idea about which interplay of psychosocial conditions, biochemical processes, receptors and neural pathways that lead to mental disorders and the theories that patients with depression lack serotonin and that patients with schizophrenia have too much dopamine have long been refuted. The truth is just the opposite. There is no chemical imbalance to begin with, but when treating mental illness with drugs, we create a chemical imbalance, an artificial condition that the brain tries to counteract.
This means that you get worse when you try to stop the medication. An alcoholic also gets worse when there is no more alcohol but this doesn’t mean that he lacked alcohol in the brain when he started drinking.
The vast majority of doctors harm their patients further by telling them that the withdrawal symptoms mean that they are still sick and still need the mediciation. In this way, the doctors turn people into chronic patients, including those who would have been fine even without any treatment at all. This is one of the main reasons that the number of patients with mental disorders is increasing, and that the number of patients who never come back into the labour market also increases. This is largely due to the drugs and not the disease.
Myth 2: It’s no problem to stop treatment with antidepressants
A Danish professor of psychiatry said this at a recent meeting for psychiatrists, just after I had explained that it was difficult for patients to quit. Fortunately, he was contradicted by two foreign professors also at the meeting. One of them had done a trial with patients suffering from panic disorder and agoraphobia and half of them found it difficult to stop even though they were slowly tapering off. It cannot be because the depression came back, as the patients were not depressed to begin with. The withdrawal symptoms are primarily due to the antidepressants and not the disease.
Myth 3: Psychotropic drugs for mental illness are like insulin for diabetes
Most patients with depression or schizophrenia have heard this falsehood over and over again, almost like a mantra, in TV, radio and newspapers. When you give insulin to a patient with diabetes, you give something the patient lacks, namely insulin. Since we’ve never been able to demonstrate that a patient with a mental disorder lacks something that people who are not sick don’t lack, it is wrong to use this analogy.
Patients with depression don’t lack serotonin, and there are actually drugs that work for depression although they lower serotonin. Moreover, in contrast to insulin, which just replaces what the patient is short of, and does nothing else, psychotropic drugs have a very wide range of effects throughout the body, many of which are harmful. So, also for this reason, the insulin analogy is extremely misleading.
Myth 4: Psychotropic drugs reduce the number of chronically ill patients
This is probably the worst myth of them all. US science journalist Robert Whitaker demonstrates convincingly in “Anatomy of an Epidemic” that the increasing use of drugs not only keeps patients stuck in the sick role, but also turns many problems that would have been transient into chronic diseases.
If there had been any truth in the insulin myth, we would have expected to see fewer patients who could not fend for themselves. However, the reverse has happened. The clearest evidence of this is also the most tragic, namely the fate of our children after we started treating them with drugs. In the United States, psychiatrists collect more money from drug makers than doctors in any other specialty and those who take most money tend to prescribe antipsychotics to children most often. This raises a suspicion of corruption of the academic judgement.
The consequences are damning. In 1987, just before the newer antidepressants (SSRIs or happy pills) came on the market, very few children in the United States were mentally disabled. Twenty years later it was over 500,000, which represents a 35-fold increase. The number of disabled mentally ill has exploded in all Western countries. One of the worst consequences is that the treatment with ADHD medications and happy pills has created an entirely new disease in about 10% of those treated – namely bipolar disorder – which we previously called manic depressive illness.
Leading psychiatrist have claimed that it is “very rare” that patients on antidepressants become bipolar. That’s not true. The number of children with bipolar increased 35-fold in the United States, which is a serious development, as we use antipsychotic drugs for this disorder. Antipsychotic drugs are very dangerous and one of the main reasons why patients with schizophrenia live 20 years shorter than others. I have estimated in my book, ‘Deadly Medicine and Organized Crime’, that just one of the many preparations, Zyprexa (olanzapine), has killed 200,000 patients worldwide.
Myth 5: Happy pills do not cause suicide in children and adolescents
Some professors are willing to admit that happy pills increase the incidence of suicidal behavior while denying that this necessarily leads to more suicides, although it is well documented that the two are closely related. Lundbeck’s CEO, Ulf Wiinberg, went even further in a radio programme in 2011 where he claimed that happy pills reduce the rate of suicide in children and adolescents. When the stunned reporter asked him why there then was a warning against this in the package inserts, he replied that he expected the leaflets would be changed by the authorities!
Suicides in healthy people, triggered by happy pills, have also been reported. The companies and the psychiatrists have consistently blamed the disease when patients commit suicide. It is true that depression increases the risk of suicide, but happy pills increase it even more, at least up to about age 40, according to a meta-analysis of 100,000 patients in randomized trials performed by the US Food and Drug Administration.
Myth 6: Happy pills have no side effects
At an international meeting on psychiatry in 2008, I criticized psychiatrists for wanting to screen many healthy people for depression. The recommended screening tests are so poor that one in three healthy people will be wrongly diagnosed as depressed. A professor replied that it didn’t matter that healthy people were treated as happy pills have no side effects!
Happy pills have many side effects. They remove both the top and the bottom of the emotions, which, according to some patients, feels like living under a cheese-dish cover. Patients care less about the consequences of their actions, lose empathy towards others, and can become very aggressive. In school shootings in the United States and elsewhere a striking number of people have been on antidepressants.
The companies tell us that only 5% get sexual problems with happy pills, but that’s not true. In a study designed to look at this problem, sexual disturbances developed in 59% of 1,022 patients who all had a normal sex life before they started an antidepressant. The symptoms include decreased libido, delayed or no orgasm or ejaculation, and erectile dysfunction, all at a high rate, and with a low tolerance among 40% of the patients. Happy pills should therefore not have been marketed for depression where the effect is rather small, but as pills that destroy your sex life.
Myth 7: Happy pills are not addictive
They surely are and it is no wonder because they are chemically related to and act like amphetamine. Happy pills are a kind of narcotic on prescription. The worst argument I have heard about the pills not causing dependency is that patients do not require higher doses. Shall we then also believe that cigarettes are not addictive? The vast majority of smokers consume the same number of cigarettes for years.
Myth 8: The prevalence of depression has increased a lot
A professor argued in a TV debate that the large consumption of happy pills wasn’t a problem because the incidence of depression had increased greatly in the last 50 years. I replied it was impossible to say much about this because the criteria for making the diagnosis had been lowered markedly during this period. If you wish to count elephants in Africa, you don’t lower the criteria for what constitutes an elephant and count all the wildebeest, too.
Myth 9: The main problem is not overtreatment, but undertreatment
Again, leading psychiatrists are completely out of touch with reality. In a 2007 survey, 51% of the 108 psychiatrists said that they used too much medicine and only 4 % said they used too little. In 2001–2003, 20% of the US population aged 18–54 years received treatment for emotional problems, and sales of happy pills are so high in Denmark that every one of us could be in treatment for 6 years of our lives. That is sick.
Myth 10: Antipsychotics prevent brain damage
Some professors say that schizophrenia causes brain damage and that it is therefore important to use antipsychotics. However, antipsychotics lead to shrinkage of the brain, and this effect is directly related to the dose and duration of the treatment. There is other good evidence to suggest that one should use antipsychotics as little as possible, as the patients then fare better in the long term. Indeed, one may completely avoid using antipsychotics in most patients with schizophrenia, which would significantly increase the chances that they will become healthy, and also increase life expectancy, as antipsychotics kill many patients.
How should we use psychotropic drugs?
I am not against using drugs, provided we know what we are doing and only use them in situations where they do more good than harm. Psychiatric drugs can be useful sometimes for some patients, especially in short-term treatment, in acute situations. But my studies in this area lead me to a very uncomfortable conclusion:
Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good. Psychiatrists should therefore do everything they can to treat as little as possible, in as short time as possible, or not at all, with psychotropic drugs.
Maria Bradshaw says
Thanks so much for posting this. A clear, concise refutation of the myths associated with psychiatric drugs which is easily understood by lay people is immensely valuable. I will be circulating it throughout my networks and particularly to the families I work with who are so often given antidepressants to deal with the grief they experience as a result of losing a loved one to suicide.
Sarah says
I will copy it for our GP who prescribed an SSRI for my daughter. Her grasp of the myths exactly matches those in Dr Healy’s post. My daughter’s suicide at 20 was “caused by depression not the medication”
mark slaney says
Your daughter would of faired much better with nutrition ,exercise and cognitive behavioural therapy .I was in terrible shape on those ssri s.This man is 100% correct .Gain more knowledge do your research and think outside the box .We were not meant to be filled with chemicals .Emotions can be worked on through positive thoughts .
Leah Burn says
Agreed thank you Mark Slaney
Claudia says
Dear Maria,
to me it looks rather weird or even zynical, if my doctor wants me to take Zoloft to deal with posttraumatic stress syndrome I’m suffering from since my daughter’s suicide while my daughter committed suicide after takting Zoloft for ten days.
Alison says
The number of times that me, or my family, has been offered psychiatric medication to deal with the normal grief and rage after my daughter’s iatrogenically caused death, borders on harassment.
Casey Forest says
Thank you for the truth. I sorry your daughter was a casualty of the good old boy’s network. Please get a new dr.that knows better.?
marie says
Its funny how easy GP’s will prescribe antidepressants. I went to see mine to tell him I have experienced tightening in my throat. He didnt even look at me twice he started typing and gave me a script for Lexapro. Lexapro made me so sick and instead of him realizing I had side effects he kept telling me the side effects were not from medication. Its funny how quick and easy it is to get them
Audrey says
What you have said makes me want to ask my Dr to hospitalize me, and remove all meds. If I had the opportunity, it would blow your mind what psychiatry has done to me. Right now, I’m on about six meds. They can’t seem to get me off them because it causes huge issues. I DOnt WANT TO TAKE ANY MORE MEDS. I’m going to be 50 in a month, I’ve been on these meds for 30 years. Think I got better????……..
Ellen says
Hello, Audrey.
I am desperate to connect with you and others like us who have a story like yours you described. Me, I was not “bipolar” until first being placed on Prozac. That was when I was 15, 25 years ago. I have never been allowed to NOT take these drugs, and my life has been a frightening, sad, and agonizing road of getting worse and worse with symptoms and ability to function. I am now 40, and have to live in an Adult Foster Care home, because of my attempts to end my life. I’m scared every day. Let us please get the word out about the facts that many are taken advantage of in the mental health system, especially if we ever had a manic episode. It seems to me that women are often the biggest victims.
Judy Gayton says
Sarah, I am so sorry for the loss of your young daughter.
Any dr who would prescribe the same kind of drugs that caused her demise to you, is an unethical, inhumane, obtuse danger to society and should be removed from their quacktise.
I see many Mothers across the internet speaking out about the unnecessary drugging and deaths of their children. One such group is Able Child. Dr. John Bredding and many others are speaking out against the false labeling and mistreatment for profit of their children (as young as 2.)
I hope that you can find others who can understand the depth of your loss and support you through your pain and grief.
There are just no adequate words.
Alison Rogerson says
I’m a fellow sufferer of hellish grief with my son taking his own life. Psychiatric drugs don’t work for grief. We have to let it all out & go to a specialist practitioner & talk. More importantly, I can say with the greatest certainty, that we all survive death & continue living on the other side. I’ve had ‘letters’; voice recordings & photographic images of my son in the higher frequency. He is very happy but feels tremendous guilt for our agonising anguish. He has to work on himself & face the mental problems he suffered whilst here. This is all connected to science, in particular, maths & physics. There is a supreme being expressed in the form of the light of love. Talk to your sons & daughters as they are at great pains to be acknowledged & to tell us they are just a breath away. You will be reunited ⭐️💫💛
Lee says
Thank you for speaking out. You Sir are a True Hero and an inspiration.
Annie says
Waiting for Godot?
Waiting for Godot is a play which “has achieved a theoretical impossibility—a play in which nothing happens, that yet keeps audiences glued to their seats. What’s more, since the second act is a subtly different reprise of the first, he has written a play in which nothing happens, twice.” (Irish Times)
Richard A. Lawhern, Ph.D. says
Doctor Healy: I would very much like to know how I might gain your authorization to cross-post a link to this BLOG entry to DxSummit.org, the Global Summit for Diagnostic Alternatives, sponsored by the Society for Humanistic Psychology. It seems to me that your piece is one of the more cogent arguments I have seen, against the mythologies routinely spouted by proponents for the medicalization of daily life.
I am also very interested to learn of your views concerning other bits of gross malpractice that have found their way into the Diagnostic and Statistical Manual. High on that list in my view would be psychosomatic medicine as a field, with its assertion of the self-evident nonsense that emotional distress can be “converted” into otherwise unexplainable medical symptoms.
I have talked with hundreds of medical patients who have been substantively harmed by such assertions, by being denied appropriate medical investigation and care after being labeled as having “somatoform” mental health disorders. There is also evidence that just by applying a label of “psychogenic pain”, a doctor will more than double the risk of suicide in patients whose medical symptoms have not otherwise been diagnosed and treated.
Sincerely,
Richard A. Lawhern, Ph.D.
Resident Research Analyst
David_Healy says
Richard – please feel free to cross post or link.
Ivony Santiago says
Thank you for this article in particular with the way you have written it for people like me to understand the effects of psychotropic drugs.
I am currently undertaking a research project of my choice – ‘Can the laid back attitude and over prescription of anti-depressants lead to psychosis?’
Your article has helped me a lot.
Thank you
Vanessa Schaffeler says
If you haven’t already read Robert Whitaker’s book “Anatomy of an Epidemic” maybe you will find some more information in there.
Denise Jones says
I was hospitalized for two weeks because I was having homicidal ideation against my daughter they put me on Zyprexa Depakote and Seroquel when I was released two weeks later I was fine for 3 days but now the medication does not work for me at all I’m still a g angry nervous and scared I don’t know what to do I do have anxiety attacks OCD add but nobody wants to correct that problem so I stay away from my daughter as much as I can in the people around me they want me to control my urges to not have these thoughts but it’s hard when you’re not getting the correct help don’t know if I should be committed again or I guess I should get a new psychiatrist tell me. What should I do I’m afraid
Marnie Woodcock says
A refreshing stance to see more psychiatrists willing to speak out about abuse and corruption which has hampered the psychiatric industry for a very long time and left millions of victims in its wake.
Question is- when will any government take the bull by the horns on this and many other abuses and make this public knowledge. My experience in the UK is that being labelled with a psychiatric condition, has become an alternative route to dis-crediting and silencing people, especially when they’ve blown the whistle regarding severe abuse and failings across several sectors.
Anne O'Beirne says
Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good. Psychiatrists should therefore do everything they can to treat as little as possible, in as short time as possible, or not at all, with psychotropic drugs” ~ Wow! Fairly profound coming from a Psychiatrist.
There have been times when I found major tranquilizers that I can tolerate or minor tranquilizers useful. But I never needed them long term and no one explained that to me in 2008! As a result I ended up heavily drugged for 3 yrs which was completely unnecessary. Not forgetting that my major issues started while on an SSRI (Citalopram). It led to extremes of “highs” and “lows” and a diagnosis of “Bipolar Affective Disorder”. I had to figure it out for myself. Now I spend time trying to create awareness for others even though I meet resistance. And it is great to have your work to refer to.
I am now at the stage of no drug use and do Yoga almost every day. I also listen to relaxation CDs, try to do mindfulness and sometimes do meditation. This requires daily work. I have also given up alcohol and try to watch my diet. As well as walking. Bibliotherapy is also something I find useful. And the idea of WRAP (Wellness Recovery Action Plan). The 5 key concepts of RECOVERY are: Hope, Personal Responsibility, Self-advocacy and Support. And also having good, honest doctors to refer to. Thank you.
My symptoms are slowly subsiding and going away. Officially losing the label may be that bit trickier. But that is the plan. The last thing left to come back is a full night’s sleep. Working on that.
Anne O'Beirne says
Correction ~ The 5 key concepts of RECOVERY are: Hope, Personal Responsibility, Education, Self-advocacy and Support.
Jake Eagleshield says
Psychiatry has no business in the treatment of alcoholism. It hangs mentally ill labels on people they do not deserve,then proceeds to treat the perceived mental illness,(which is a CAUSE of the mental problem,not a symptom) and forget about getting the alcoholic to stop drinking,which in most cases will cause the mental disorder to go away. I have yet to meet a shrink who told a patient,”you are fine,you do not need my help” They MUST find something wrong with everyone,to justify their existence,and all those little letters behind their names.
Deirdre Oliver says
And the money!
Sharon says
It seems to me that alcohol is a mood stabilizer. An alcholic drinks as a form of self medication. Sometimes, there is no underlying illness but surely there are times when there is one. Often enough, a mentally ill person cannot see they are ill and reaches for a bottle of alchol instead of for help.
Rachel Nichols says
Who deserves psychiatric labels, Jake? I was a naive young woman of 20 who thought doctors could be trusted. Had a HORRIBLE reaction to anafranil and wound up with a bipolar label. Between the damning label–a moral judgment of hopeless depravity and turpitude–and the massive quantities of drugs and quarterly lock ups my life is a shambles.
Sometimes I wonder why I bothered to come off my poisons. Suicide is morally wrong, but everyone hated me enough to want me drugged to the point of being comatose and seems happy with me dying at 52. Why did I go through withdrawal and prolong my misery (perhaps)?
Sarah P. Hancock says
The recovery model is a grassroots model developed by peers and not a theoretical one developed through research, the “principles” will vary depending on the source. In the US, SAMHSA decided thry would take the peer’s recovery model and define it for them–which as a peer, made me laugh because they complicated it in an effort to define it.
I like the principles you shared, but I really prefer the ones outlined by Recovery Innovations International because they encapulate what you stared and go beyond them: Hope, Choice (I always attach accountability to choice), empowerment, creating a recovery environment (which includes the education and self advocasy), and finding meaning and purpose in life (75% of peers stated that they initailly found meaning and purpose though connecting spiritually with life/universe).
Deirdre Oliver says
Anne, Peter Goetzsche is not a psychiatrist. He is a physician. He is a founder of the Nordic Cochrane Collaboration which has been investigating the pharmaceutical industry’s research since around 1992. His position on psychotropic drugs is taken because, that as a group, over many years, these emerged as the most damaging of all the drugs under investigation.
Richard says
And I’ll put money on it that as soon as we ban these drugs. You’ll see a drop In all gun violence. I’d love to see the stats of how may of these mass shooter were on had been on any of these drugs.
Jim straw says
http://www.naturalnews.com/039752_mass_shootings_psychiatric_drugs_antidepressants.html
Eileen says
You are so right! Psychotropic drugs are the real weapons, and of mass destruction…
Most of the shooters have been on psychotropic drugs or witdrawing from them.
And maybe some on a mind control program which utilizes mind altering drugs too.
June Moore says
Mindfulness training is definitely the way to go. I’m 67 years old and have taken every antidepressant since I was 20. Then in my 50s, diagnosed with ADD and put on adderral and xanax. Stayed on both of these for over 5 years, then my xanax was abruptly taken away. Suicide is always on my mind.
Elizabeth says
How did you recover from stop taking them after 30 years . I need help . I did a turkey withdraw 5 months ago and am loosing my mind . I have not slept in six months . I still use once in awhile Klonopin . My husband is going to leave me because he wants me on meds.
Rachel Nichols says
Oh dear, Elizabeth. Those drugs are more addictive than the kind you get off the street!
Slow and steady is the only way to go off those toxins or you’ll have horrible DTs and trauma galore.
Greg says
Elizabeth there are lots of natural products (especially ayurvedic) that can help you get over the bump (mountian!). Some of the best (all to be taken 3 times a day) are:
Ashwagandha (powder with warm milk and honey 3g at a time)
Gotu Kola (dried herb tea about 3g at a time with a dash of vinegar)
Kava (Capsules ok provided >60mg kavalactones)
Valerian (Kava or Valerian, not both) capsules recommended.
Rule #1 with most herbs. Forget about OTC capsules. You want the dried herb or powder and lots of it. 1 pound bags of the stuff.
You need to be taking Multi/Mega B 3x per time and zinc twice per day. Fishoil 3x per day. Ignore the labels.
Finally and very importantly you need to take ALCAR and NAC at least twice per day. In your case I would go 3x per day.
There is no magic bullet, but all of the above every day will help you a lot. Been to hell myself. This stuff works. It rebuilds and strengthens your nervous system.
Hope I’m not too late.
Arthur says
Taper slowly.. look up the Ashton manual.. taper one drug at a time and then taper the Benzo last.. find a dr that will do this correctly.. my dr took me off the lexipro I had been on for 3 hrs in three days.. it has left me extremely disabled.. eat right.. use cbd as it can help..
Mark says
Dr Healy I applaud you for this article.
Thankyou.
Millions worldwide including myself have been totally hoodwinked by so called academic giants (ie doctors) calling black white.
Julie Wood says
A great, direct summary of important themes. I think that the withdrawal point made under the “chemical imbalance” myth cannot be overemphasized. Dr. Gotzsche writes that “The vast majority of doctors harm their patients further by telling them that the withdrawal symptoms mean that they are still sick”. That is true, but the situation is even worse than that.
Symptoms that appear when psychoactive drugs are taken are interpreted as having “unmasked” inherent conditions, rather than being counted as the side effects they clearly are. The press enthusiastically blames acts of violence, that look a lot like withdrawal from SSRIs or other drugs when one reads the facts, on the failure of the perpetrator to take his meds.
This tendency to blame people for drug effects may be the single factor most responsible for perpetuating all the myths. Everyone sees the same situation, but psychiatrists too often add to the harm they have done by offering misleading, corrupt interpretations, which the public and the press accept.
Excellent blog, I would like SSRIstories to reference it.
GS says
As a parent of a 23 year old with schizoaffective disorder, we are very conflicted re. antipsychotics. We believe his disorder was triggered by heavy cannabis use.
After the first break, risperidone was tapered to zero after 10 weeks. We read Whittaker’s book at this time. Things settled, but after a “little” cannabis six months later, there was another break. Because of side effects, quetiapine was used. Things leveled out and after 6 months use, a very gradual (many months) taper was done.
The third break occurred 2 months later. Because the hospitalizations were so inhumane, we tried letting things run their course. The levels of psychosis varied from mild to moderate over a 10 month period. Eventually he was forcibly taken to the hospital from his university (not by our choice). He is now on olanzapine.
My point here is simple… if a person goes psychotic, there are no effective or accessible services to help families, even if you can afford to self-pay. There is no alternative for supportive professionals working in the home, this aint Finland! Second, the antipsychotics, for whatever reason, do eventually moderate the most overt symptoms. Lastly, mental health hospitals are little more than lock-down facilities that provide little more than medication in deplorable conditions.
While everyone involved recognizes the risks of long term antipsychotic use, there simply is not a well-developed body of literature or practitioners to guide families and patients through difficult times. After the first break, his doctor was Peter Breggin, the dean of anti-medication and he disowned our son as a patient when he came to the office in a psychotic state. What is a family to do?
Answers please, not a statement of problems and myths, Dr. Healy.
Johanna says
Dear GS – Trying to find humane & effective help can be a tough slog especially in the USA! I don’t think either David Healy or Peter Gotzsche would say never touch antipsychotics – just use the smallest dose for the shortest time possible.
I’m encouraged that your son was even allowed to taper off – most “shrinks” round my way insist the drugs have to be lifelong. He and you might enjoy a look at this online hub: http://www.madinamerica.com
Lots of good people searching for answers like yourself. MindFreedom also has some good resources. There’s also a network of “voice hearers” groups that seek to understand & live with their symptoms (some use meds, many don’t): http://www.hearingvoicesusa.org
Deirdre Oliver says
Was he treated with anti-psychotics as a knee-jerk reaction to his acute symptoms?Perhaps the `psychotic’ episode was simply a toxic reaction – and the ongoing `illness’ the consequence of the treatment! Back in the 1970s when I worked as a mental health professional in compared with with what I see now, seems a very advanced therapeutic environment, we did see young people coming in with acute psychotic symptoms. As we were wary of the `tranquillizers’ (similar to today’s anti-psychotics) very nasty side-effects and tended to be careful in their use. I recall seeing these kids get better and go on their way after a few weeks. Occasionally one would come back, but commonly they’d been using again- again, a few weeks and off they’d go. We provided safe harbour while their bodies recovered. In some other units they went on to become chronic `schizophrenics’, lost lives in the system. How come 40 years later it is worse, not better?
wendy shae says
Our 22 year old son has been through a similar experience to yours he’s now taking clozapine since January.We have found it so difficult as a family to deal with the confusion surrounding medication.Professionals seem to have different opinions on psychosis while the patient and family feel helpless .Any contact or knowledge from others in this possition would be so helpful .I am determined as a mother to find the safest recovery route for my son and will have to become an expert detective myself in this sea of confusion to empower him and our family. I need postive outlooks and useful treatments for him.Not a grim reaper. Which I feel a lot of mental health professionals come across as. Thank you for sharing your sons story I wish him a postive safe recovery and to know other people understand the struggle in a comfort
Deirdre Oliver says
Has anyone suggested the Open Dialogue approach. This is a Finnish initiative, now over 25 years in operation, where the person and their families are given support through as psychotherapy approach aimed a using no, or very little (and short term), medication. They have had extraordinary success with something like 70% of people having normal, drug free lives, and much reduced relapse rates for the other 30%. The program is being set up around the world. A study by Martin Harrow US, published in 2007 & 2012 found that those who had discontinued meds also had around a 60-70% full recovery rate over 20 years. A dutch study Lex Wunderink found the same after a 7 year study. The news is in that those who spend years on `anti-psychotics’ (tranquillizers) will lose 20 years off their life span & have marked brain shrinkage, & their recovery rate is around 16%. In fact the president of the NIMH, the biggest mental health organisation in the world, Thomas Insell, said, in 2012, `Perhaps we should re-think our use of these drugs.’ If these young men were my sons I would be looking very seriously at alternative options, and fast. As a former mental health professional I saw kids get better, and recently saw that one of the young men I had known then, who had at least two major psychotic breaks before he was 24, was retiring after 20 years in the post, from a very high-powered position in a very high powered organisation. What to do? 1st – understand that there is NOTHING final about ANY mental illness; 2nd, ask them what they really want from life; 3rd, you & they read everything; 4th, search for the psychotherapists & programs that believe psychosis is just another way of adapting and new ways can be learned. They DO exist. Good luck in saving your boys.
Anne O'Beirne says
Hi,
There was a 180 page report launched in November by British Psychological Society (BPS) ~ “Understanding Psychosis and ‘Schizophrenia'”. Not a fan of the label as it carries a lot of weight but very good document. I even flew over to London for the launch. Maybe it will be of some use. You can also ask for a hardcopy via BPS ~
http://www.bps.org.uk/system/files/Public%20files/rep03_understanding_psychosis.pdf
Best of luck,
Anne
Lucy Martin says
Thanks so much for posting this link, Anne. I’m currently in mental health services and am struggling to find a non-medicated resolution to ongoing psychosis. I’ve come a long way in terms of staying out of hospitals and hurting myself and others, but my experiences of paranoid and grandiose delusions and hallucinations really plague me, usually daily. Medication makes me very ill, so I’ve decided I can’t continue with it – despite the advice from my CMHT. I’m working my way through the document you posted and am getting a lot out of it so far. Best wishes
Sarah says
I have no answers- I just want to say that my son – and our family are in the same situation. Cannabis as a trigger and now no other option than the most powerful meds- I know what they could be doing to his brain- but the alternative is being locked in a box – in the criminal justice system – there is no limit on how many years a person can be locked up- if due to illness they are unable to comply.
People take extreme positions that give them the illusion of control over conditions that are beyond our current medical understanding. As if we would fail to right the right thing by our children – As if anyone knows what the right thing was/is
Miss Diagnosed says
Hi Sarah.
Sadly answers are steeped in the cryptic when it comes to medicinal therapy.
To say the only choice had is the drugs or caged, is a poor excuse for any actual choice if a choice at all!
There are further choices and that would be excessive work, effort and immense support in weaning off of the drugs and, finding a root cause as to the behaviours or situation that led to the use/diagnosing of these drugs initially?
The system sadly neglects help once drugged and in a condition of no fit state. It argues mental capacity and or right to freedom for the safety of self or others. Or a demand to be taken under pharmas profit wing of ‘Care’. Care can and will only come from those who do not profit and take a genuine interest in the welfare of the loved one.
Without arrogance nor judgement I ask why your son was ever medicated?
Sadly this last 30 years or so we have been led astray thinking any form of emotional disturbance (be it work related stress/ family loss/ family break down/ feeling lonely/ boredom/ fed up with our surroundings/ bullied/ excitableness… absolutely anything that can make us feel other than happy..) is a disorder or something that needs a Dr to investigate and tell us it’s a chemical issue that a drug can combat.
Truth is, common sense (after learning the hard way) it’s a realisation every situation is a situation that can be dealt with, walked away from, looked into, battled,… it is no disorder of a chemical problem….
Surroundings determine emotional responses to. Those emotive responses are natural and human. Root cause of why someone feels the way they do, be it anger, stress, upset, anxious….. remove the surroundings…. then the problem can be delved into to combat and get through.
Sadly too many also buy into having a disorder, it helps them feel normal to feel the way they do. This is the system again, or pharma rather, playing a very ugly game of mass profit at the expense of millions upon millions of people.
It’s not normal to feel so down, low, angry, stressed etc. Not on a continuum anyhow!
Try to see beyond what you are told is a choice. Not easy and certainly not an overnight answer – depending on the entirety of your sons situation? There is more to life for him than this and for you too!
DP says
Dr. Healy, thanks for going against the prevailing attitude in the medical profession and posting this. I went through a period of pretty severe depression several years ago at the same time I was being diagnosed with and going through a terrible period of Crohn’s Disease. I was prescribed antidepressants and filled the prescription but never could bring myself to take them. I read that there appeared to be a connection between Crohn’s and depression, and thought that maybe if my Crohn’s symptoms diminished that perhaps the depression would as well. I was concerned about messing around with my brain chemistry and wondering how I would ever get off antidepressants once I started them, particularly if they impaired my judgment. Thankfully, over 12-18 months my Crohn’s gradually went into remission and I came out of the depression. I have remained in remission on the Crohn’s and have had no episodes of depression in the several years since.
I suspect you could write largely the same article about statins which are overprescribed based on the successful lobbying efforts of the pharmaceutical industry to repeatedly lower the levels of cholesterol at which they’re prescribed. My father took these for years and became very weak with muscle fatigue in his 60’s. I suspect the statins played a role in that.
After much reading on these type of topics and understanding the incentives of the pharmaceutical industry and the medical community, my default position is to refuse a drug or medical screening unless there is an extremely compelling argument for it when considering the risks and potential benefits under both scenarios. And while I will consider the physician’s advice, I will also do my own research.
Vanessa says
There does seem to be a strong link between the gut and depression – see this:
http://www.anh-europe.org/Depression_Mental_condition_or_gut_disorder
truthman30 says
Thanks for sharing this Dr. Healy,
Maggie says
My son suffered from fairly severe school-related anxiety when he was very young. Every doctor insisted that I start him on Paxil or Prozac or Zoloft. I politely declined.
But it got to a point that I couldn’t get a doctor in our area to see him for treatable issues that he had. (He had extraordinarily MILD cerebral palsy–or something that mimicked very, very mild C.P.) I was labeled as non-compliant–and I guess I was “non-compliant.” I didn’t trust the medication; I thought it was a bad idea for my kid.
Meanwhile, I was very tired, I was gaining weight, easily fatigued, pale, out-of-breath during exercise, spent lots of time sitting and laying on our couch. So, every doctor I saw diagnosed me with depression and wrote me a prescription for Prozac, Paxil, or Zoloft. But I knew I wasn’t depressed. I didn’t TEND TOWARD depression–I was a generally happy person. Sorta born that way, I think. So I never filled the prescriptions for myself, either.
One day, I decided I would compromise. I decided I would get one of my prescriptions filled and see what effect the medication had on me.
I was given, supposedly a “baby dose,” and only took half of one one day.
I woke up the next morning with the worst sense of impending doom than I can describe. It was like a dark drapery was pulled down on my entire life. For the very first time in my life I felt deep, inexplicable sadness–I experienced utter despair. Out of nowhere!
This was 24 hours after having taken one half of one pill!
It terrified me that this medication was given to children and adolescents who may not make the connection between THAT pill and THAT feeling.
I became a member of 23andme and begged them to start asking their members if they had had any similar experiences. 23andme is currently studying this. Perhaps it is a medication that certain genetic profiles respond well to, and others do not.
(Sort of like statin meds, @DP–same experience with my dad and my husband following statin medication. Same medication–same symptoms. Symptoms that never relented.)
Anyway, I have met people who feel they have received a benefit from anti-depression medications–but they tend to be people who always tended toward depression.
But I think anti-depressant medication can be downright dangerous (particularly to children and adolescents) who do not tend toward depression; indeed I think it can trigger depression!
By the way–my fatigue, lack of energy, etc.,–I was severely, severely anemic, as it turns out. I wasn’t “depressed.”
I appreciate parents who are at the ends of their rope, and I am not saying that all such medication is bad for all children. But my child’s anxiety cleared up without medication. I was fortunate enough to be able to home school him until he seemed ready to overcome the anxiety for the payoff of spending time with peers. (About 5th-6th grade.) He’s a great kid, and a great student–4th year pre-med at UCLA. (Neuroscience major, ironically.) To this day–he’s never been medicated with a psychotropic medication.
I am just so relieved to see this issue discussed. And I am so relieved that I was an adult when I tried my one-half of a “baby dose” of Prozac.
Deirdre Oliver says
You are very lucky. On a friend’s suggestion I was given Prozac when I was extremely stressed with 4 major life changing projects maturing at the same time. I remember almost nothing of the next 20 months. Apparently, overnight, I had a gross suicidal reaction. I was admitted to a private clinic and given ECT the next day. For the next 20 months, after being diagnosed with bipolar which astonished everyone I knew, I had one drug after another and almost continuous ECT (66), mostly against my will. I lost the memories of my children growing up, my skills as a sculptor, I couldn’t recognise some of my own work, the ability to write (my third book was about a third finished), a planned movie series and a sitcom (optioned), all had to be abandoned. Frequently people would and still do, come up to me claiming friendship but I had no idea who they were. One was a gallery owner looking for more work. It was 3 years before I began to discover that huge sections of my memory was wiped out. Despite what David Healy says there is an enormous body of evidence that shows ECT severely affects memory & cognition. “It’s [memory loss] a nonissue. The idea that your memory is wiped out is a fiction.” British psychiatrist David Healy, MD, FRC.
Tests have shown significant deficits, particularly in my non verbal cognitive functions, similar to those found after any severe brain trauma. For 13 years I was trapped in the psychiatric system. Last February, (2013) I walked away after my doctor said all she could offer me was Closapine and/or ECT. I have had NO signs of ANY `mental illness’ whatsoever. I have even got my tennis game back. I knew that doctor for 10 years. I have tapered off the drugs and am now an advocate and activist against the excesses of psychiatry. Good luck for the future and congratulations for being a great Mum.
Nick says
Deidre,
Your experience is similar to mine I have been on the medication roulette wheel for 5 years and have just recieved a course of ECT im mentally scared and am just existing . The psychiatrist I saw over the course of this time just kept changing my medication stop start stop start and said withdrawel was not possible I now know different. ECT has caused severe memory loss and cognitive issues which im struggling to deal with. I have walked away from psychiatry. I have lost my marriage my home and my 7 year old son. I dont know whats next.
Elizabeth says
Please help !!! I have been on meds for depression , anxiety and insomnia for around 19 years . I did a cold turkey of Trazadone and klonopin and I am loosing my mind . I went to four new doctors given Seroquel which I only took for 9 days and stopped . My husband is leaving be because he can’t take it anymore . I have not slept for six months . I have tried all the natural meds in the market with no hope .
miss diagnosed says
Hi Elizabeth
The problem you are faced with is reduction of the drug and symptomatic responses together.
Cold turkey is the most dangerous and brutally futile way to go.
Your husband may not understand what’s going on and will sadly listen to the ‘expert’ who is no more than a prescriber –
You need do as much research as you can and ask for a reduction program of sorts – i strongly advocate liquid dose reduction because you can minimise the dose and decided when you are ready to lower that dose
i was 1ml a month to 6weeks
the support from family is indeed needed – it would be great if your husband sat and read this page here to see the difficulty and dangers associated with these drugs from first hand experiences.
i wish you all the best and hope you find the way through
miss diagnosed says
I meant….
i was reducing 1ml every month to 6weeks and this took me two years
Pierre Zarokian says
ECT has been endorsed by all the major health organizations, such as the National Institutes of Health (NIH), and National Alliance on Mental Illness (NAMI). As per the American Psychiatric Association (APA)’s findings, a significant enhancement is observed in 80 percent of patients who undergo ECT, in contrast to the effectiveness of antidepressant drugs which ranges between 60 to 70 percent for patients.
Gentian says
Yes there is indeed a connection between your genes and the medications you can metabolise. To be brief and very simple, the enzymes of the cytochrome p450 family are responsible for much drug metabolism (street and many pharmaceuticals).
If you have gene deletions or alterations, the medication will not be metabolised and will build up quickly to toxic levels, which shows up as psychiatric symptoms including the very dangerous akathisia, psychosis and various other side effects that look like mental illness to the untrained (which sadly, usually includes doctors and psychiatrists). Add to that polypharmacy (co-prescription of medications), stupidly (and unneccesarily) large doses and drugs with long-half-lives (prescribed to the averages dictated by ‘evidence based medicine’), and you have a perfect storm of adverse drug reactions masquerading as mental illnesses.
I don’t even have words for the tragedies I have witnessed through the ignorance of prescribers (and I am not including conscious members of the medical profession here; it is not my intention to insult).
The test for CYP450 genes is a simple cheek swab, although you will be hard-pressed to find a doctor who can understand the results and the implications for drug therapy. I am hoping in the future that personalised medicine will become the norm, and doctors will test all people they want to give medication to, as this is the most precise way we currently have to tell in advance who is at risk of an adverse drug reaction.
Marguerite says
Hi
I just finished reading your reply to Dr Healys post. Where can I find more
Information regarding the gene and or inability to metabolize psych medications leading to build up and adverse side effects like the ones you addressed in your post. I believe I suffer from this and it’s impossible to actually find proof this condition actually exist. Thank you.
Marguerite
Beverley Bell says
After reading the posts here I have wonder about the medication I take. I have been on SSRI and antipsychotic meds for nearly eighteen years and had a stay in acute ward for mental illness for two months at the beginning of this that started all sorts of meds on me. Because I have been on meds for so long I feel I don’t know who I really am anymore. At times I feel I am an experiment in a experimentation. I go along to my appointments see many doctors and nurses. In between the appointments I can have days feeling like rubbish and just about existing. I have had to work my meds out to suit what is best ie the time to take them and when if it be one sort morning the other sort before bed. In the mornings I can feel like a zombie or a drunk and my day could be gone and totally wasted in having to lie down and sleep. I have to force myself to do things like put a load of washing on and be a wife and mother. The last years have pasted with my children and seem that I have lost parts of it when I have been in a pit of misery.
What I’m trying to say is are the meds that I’m on making me stay in this state.
I use to be a happy person and nothing really bothered me.
Married 25years now life had ups and downs. My nearest has ME my late mum had MS and then cancer. Even I of late had cancer and major operation and thankfully I’m cleared of cancer without any further treatment because of detection early on that spead it on to get it done.
The past years have been stressful dealing with lots of things but what really really puts me down is people’s judgment the latest that has been said to me is ‘ it is all your fault ‘ I feel left up there hanging and nobody cares now.
I feel that my son call depression is non existing to family and maybe friends. Years of it down the toilet now. I am very careful now who I talk to now because anything I say may get past around and make me feel even worst. I feel at times it’s a game to people and maybe the medical professionals I don’t know. This may look brazare and unbelievable but it has come to this in have I been used.
I feel on my own now and don’t trust anyone now. Is it the meds doing this to me or is it just me?
sophie says
Maggie, you may not see this reply as it is 5 years after your post. But I want to commend you for having the intuition to follow what you know was best for your son!! I commend you for not allowing that young man to take that FIRST dose of poison. You are a rock star mom! Psychotropic medications prescribed to children is criminal. I know first hand. I trusted my daughter’s therapist and psychiatrist – she was 13 at the time. Now six years later, no friends, no social connection, cognitive deficits, withdrawn from school, the drugs have been debilitating and cognitively disabling. We are in the process of tampering her off and it is pure hades! But we are going to stay the course because it has to be better for her on the other side – free from psych medication.
C. S. Herrman says
Apart from what most of us know — that the psychiatric profession has been unforthcoming as to necessary facts or accountability, that the pharmaceutical companies exert entirely too much influence, and that too many doctors are more or less incompetent — the issue remains that you, too, Dr. Healy, are in at least one regard just as incompetent as those you imply to be. To be specific:
The impression you leave, and doubtless intend to leave (presuming you have an IQ worth mentioning), is that your morals and competence veer between the Scylla of Peter Duesberg of HIV denialist fame, and Thomas Szasz of pharmocological denialism fame. I suspect the latter is but a bipolar humbug in no mood to allow an empirical rational for his moods and exaggerations and embellishments. Fortunately they are more irritating than harmful. The former, however, is easily a medium for hundreds if not thousands of HIV deaths. And the reason you are keeping their delightful company is this — you suppose that because we do not have the Mack-truck-in-your-face evidence, you can feel free to idiotically assert that mental illness is mainly iatrogenic in the way Duesberg claims HIV is owing to drugs, recreational and therapeutic.
Now allow me to set you aright, Sir. When anti-retrovirals came to be statistically (at p < .001) associated with lowered viral loads and the latter, by the same significance with decreased symptomatology, it doesn't require anyone but a full-blown bipolar with an agenda to pronounce the antithesis to what is rational to all normals. Dr. Healy, you are expected as a professional to know these things very well, and yet you deliberately exaggerate, embellish and employ hyperbole to light tinder rather than educate minds.
How else to account for so ribald a denial of scientific orthodoxy? While you allow drugs in acute cases, the vast majority of mental illness that causes unemployment, poverty, vagrancy, belligerency, family destruction, and etc., are the result of chronic, not acute symptomatology, which you would have the reader believe are collectively, and in all likelihood, not requiring of treatment. Reread the thoughtful comment of GS. That person know what they were talking about.
You can't have it both ways, doctor. Get a grip and rewrite that article before reposting elsewhere.
Iskander says
To CS Herrmann.
I would like to add to the list:
– All psychotropic drugs (including antidepressants) have a chemical structure and an influence on neurotransmitter pathways similar to illegal drugs. It’s a myth that they are different. Consequently, addiction and side effect reported on psychotropic drugs are similar to illicit drug users.
– Pharmaceutical clinical trials include only small population and usually ‘trouble’ cases are excluded by participant selection criteria. That’s why only post-marketing surveillance can reveal all adverse effects. However the post-marketing results are very rare reach doctors.
– It is only a THEORY that depression is the consequence of neurotransmitters imbalance. We only know that SSRIs block the reuptake of the neurotransmitter serotonin in the brain. The result is an increased availability of serotonin in the synaptic space, which cause the decrease of specific transporters . Is this imbalance helps to ‘balance’ the brain function? In another words we only hypothesize that it helps to control depression. In my opinion, it’s brain cells that ‘adapt’ to long prescription of SSRI s and rebalance itself to norm. Changing the balance of serotonin SEEMS TO help brain cells send and receive chemical messages ( no clear evidence provided by research).
– What is norm and what is not in brain biochemistry? We all react differently to drugs. It is a known fact, however, data produced by pharmacogenetics, for example, are openly denied by majority of medical practitioners. In opposite, facts based on ‘SEEMS TO’ theory is embraced.
Dr Gotzsche is not denying requirement to treatment , he is raising awareness of adverse drug reaction on SSRIs and drug overuse. Ignoring the fact that any drug (including SSRI) can cause side effect is also leads to life-threatening situations for thousands of patients (deterioration of HIV patients is just quicker). You are obviously moved by losses because of HIV denial and Dr Gotzsche is also concerned about the health and well-being of mental patients due to the denial of drug safety knowledge.
Thanks for this brave post!
Christy says
Thank you.
Deirdre Oliver says
ANDREA – You are an inspiration to us all. Your strength and wisdom belies your age. The world is a better place because of people like you. There is a development in the UK, via Dr Lucy Johnstone, a style of `therapy’ called `psychological formulation’. There is an interview with her on Facebook. An idea. Thank you. Deirdre.
C. S. Herrman says
I appreciate your points, Iskander. But I also represent the commonsense understanding that science and experience together create and support, namely, that psychotropic drugs WORK on the vast array of mental illness.
As I said in my post at the very top, I am aware of the deficiencies of medical and psychiatric practice. It goes without saying that mistakes are rife, dangerous and indeed culpable of misery, debility and death.
But two points remain relevant by way of perspective. First, practically nobody who has any experience with mental illness or the health professions is unaware of all the issues surrounding SSRIs. It’s old hat. Period. What is at risk is that constant harping on the obvious risks losing track of the relevant fact that the drugs WORK. Second, people being people, those with agendas take advantage of others’ desire to place trust in experts. This means that readers are necessarily in adverse reliance, and must hope, without recourse to knowledge, that the experts will not abuse their trust. The two folks responsible for this cavalcade of overblown hyperbole are playing on natural instincts to question all of authority when only parts of it are problematic. Overstressing these errors, while independently necessary (but already done sufficiently) serves only to cause normals and patients alike to question exactly what is most dangerous to question — the efficacy of these drugs to greatly reduce infirmity. I am thousands of others are the proof of that.
So, again, while we require to know the whole truth, we must understand that overplaying our hand can do its own kind of damage. Think how many are refusing treatment for serious mental illness because they have taken literally all of these warnings of the two who sponsor this column and others. Were it not for the constant barrage of fear-mongering parading as innocent warnings there would be far less reason to worry over the continuing specter of mass killings. See my article Alice in a Mass Killer’s Wonderland either at OpEdNews or on ResearchGATE.
David_Healy says
We disagree on this point. First the data show rating scale changes rather than real benefits. Second RCTs are necessarily focussed on a primary outcome – one effect – and close to hypnotize doctors from noticing the 99 other things a drug does. On a numerical basis there are more people being injured than harmed. The drugs are risky. The risks may be worth taking if the condition warrants it – but most people being given SSRIs do not warrant such risks and are ill-informed as to the risks. Most of the Antidepressants currently being consumed in Western settings are being administered chronically – close to 10% of the population – and this likely reflects dependence.
DH
Altostrata says
C.S. Hermann says: “First, practically nobody who has any experience with mental illness or the health professions is unaware of all the issues surrounding SSRIs.”
I challenge that assumption. I wonder what your evidence might be.
Here are more than 1,000 current case reports demonstrating clear patterns of clinician error in misdiagnosing common adverse reactions, overprescribing, not knowing the basics of tapering, and not recognizing withdrawal symptoms http://tinyurl.com/3o4k3j5
It’s very, very obvious that many doctors all over the world, including psychiatrists, are completely unaware of the risks of antidepressants.
C. S. Herrman says
Oh, I hear you loud and clear. But recall what I actually said, that which you excerpted. I referenced those outside of the profession, not within. And I also, I say now for the third time in these comments, that the professions has been horrifically bad in many regards, and you are mentioning one of them, to which i can hardly offer complaint for being in full agreement.
But now note the larger perspective here. Patients MUST learn to be their own advocates when they cannot find others. And nmy advocates I DO NOT mean those whose counsel implies a denial of the basics: 1) mental illness is a reaction to stress and is due to the organism’s over-reactions that become generic and hard-wired, whence requiring more than talk therapy; 2) the drugs work. Not universally, but nearly enough so as to be a well taken fact of existence that is only foolish and worse to deny or ignore.
Ergo, when it comes to anti-depressants and SSRI in particular, ptirnets have to question openly thier doctors’ choices and explanatipons. They need to bring in copies of scholarly articles increasingly available for free on the internet (Elsevier especially good) — and I do NOT include in that category the off-hand half-truths of the two authors of this post series.
Admittedly, this is hardly an ideal solution. But there are no other better ones until we manage to reform medical education, especially the residency programs in psychiatry. We should also seriously consider giving better training to clinical psychologists and have them enabled to work hand-in-hand with physicians. More can be done. But again, it is NOT good policy to spread so much venom through half-truths that people are led away from the essentials. That is my undying belief and I will never waver in it, for my own experience and that of everyone I have counseled supports it.
Altostrata says
I can assure you through personal experience as well as 1,000 case reports that it is very, very difficult for patients to educate doctors by offering them scholarly articles, no matter how well chosen.
Physicians are fairly impervious to information, no matter how well documented, coming from a patient. They would rather function on the basis of their own belief systems, something they learned from a drug company, or word-of-mouth from a friend at a conference.
You say: “1) mental illness is a reaction to stress and is due to the organism’s over-reactions that become generic and hard-wired, whence requiring more than talk therapy; 2) the drugs work. Not universally, but nearly enough so as to be a well taken fact of existence that is only foolish and worse to deny or ignore.”
Both of those assertions are debatable. The first, out of biological psychiatry, is strongly contested by the psychotherapy community as well as psychiatry reformers. The foundations for the second — that the drugs undeniably work — have been shown to be riddled with all kinds of error: jiggered clinical trial results, conflict of interest, observer bias, etc. You may recall the huge uproar over Irving Kirsch’s findings? Plus, you have the testimony of patients — but who wants to hear from them?
Given the huge 30% dropout rates from clinical trials, mostly due to intolerable side effects, clinical trials reveal that about a third find antidepressants intolerable, a third get no beneficial effect, and a third supposedly benefit. This is what you’d expect from drugs that are no more effective than placebo.
I agree patients need to be their own advocates. In fact, I call this defensive medicine — you defend yourself against your doctors. The facts about antidepressants have been so thoroughly distorted, the general public needs strong corrective messages for its own good.
With the excessive overprescription of antidepressants in the developed world (example: the US http://www.cdc.gov/nchs/data/databriefs/db76.htm), it’s hard to believe the truth should be suppressed lest potential customers get scared off: Given the risks, antidepressants should be used only as a last resort in extreme cases.
Clearly, overprescription to millions is a public health issue that needs to be addressed. Waving the bloody shirt of dire consequences such as suicide serves no one but the psychiatry industry. Obviously, 11% of the US population doesn’t need to be taking antidepressants to reduce the .01% suicide rate.
Miss Diagnosed says
Well said. The what I have come to learn is (both from experience and my own extensive research into patient testimonials) is the worsening of both mental and physical health issues, that go dismissed by Doctors for being adverse reactions/side effects because not listed by Pharma.
The symptoms and ADRs instead believed as other ailments and thus also drugged to treat, these range from physical problems (bowel/skin/headaches/eye strain etc) to that of believed more aggressive mental health issues (Bipolar/Unipolar/Manic Depression)
Take a look at the Effexor petition itself, there are no less than 30.000 signatures asking Wyeth to list the full list and extremities of the ADRs and symptomatic reactions.
Are 30.000 people really that wrong? Is it not actual scientific evidence that 30.000 people are suffering as opposed to benefittng?
I truly believe common sense speaks for itself – A business needs customers, repeat customers to ever be successful – Pharma is indeed a business (one of the most powerful and successful businesses on the planet.
A patient cured is a customer lost – Nuff said.
Furthermore – Only now, years on I have come to learn terminology needs inspecting on every scientific study – Please note even the leaflets accompanying the antidepressant states how the drug is `believed` to work. there is no definitive actuality of how it works.
My further research has led to other studies claiming drugs and methods as `suggested` , `assumed`, inclined to, `indicating`, Nothing is proven as solid fact.
The people advocating these drugs based on pharma` marketing is scary – I do not wish ill on the anyone but, in this case, experience outweighs text book knowledge and I invite any advocate to have a taste of their own medicine (pun intended)
B says
Sorry but I must say you’re wrong, wrong and wrong.
First of all many of these drugs do not work (I suggest looking in Pubmed for meta-analysis studies on the original clinical trials submitted to FDA). Most if not all of the apparent “my patient got better so the drug works” can be attributed to the placebo effect. And even when one claims that the drugs “work” one has to wonder what is exactly the definition of “working” in case of psych drugs. This seems to be very often different for patients and doctors especially in involuntary cases. Walking around feeling like a zombie is not exactly what most people desire. Plus there is clear evidence that antipsychotics make people worse in the long-term and likely prevent spontaneous recovery.
Secondly, I’ve seen and talked to many so-called “professionals” and I can’t recall a single one of them who had any idea about the drugs they were so eager to prescribe for anything, including off-label uses. I had more knowledge about them after reading the leaflet for 5 minutes but everything I said was dismissed as nonsense. I’ve seen “good professionals” denying that benzos can cause anterograde amnesia despite the fact that they are used exactly for that effect in other areas of medicine. So I don’t believe for a second that “practically nobody who has any experience with mental illness or the health professions is unaware of all the issues surrounding SSRIs”.
Thirdly, it is not the folks who are questioning authority who are the problem. The problem is that the authority has lost it’s credibility to the point that many people who lack necessary education to understand the complexities of various problems don’t know what to believe anymore so they stop believing anything at all. Putting on a smiley face and pretending that everything’s OK and don’t panic does not work anymore nor should it work. The only thing to do is to fix the problem and apologise.
Emiliaj Abeyta says
Here in the United States there is C SPAN They are saying that incarceration is not working, that addicts need treatmnt. They talk circles around each others heads. They are saying doctors need to be educated. They are protecting doctors, pharmacists, Judges who arr sending people to jail and prisons and giving thm More skittles and stopping the drugs abrruptly. Then y never mention the WORD TITRATION or withdrawal. So more money for a failing system. They did say people need treatment, but I it ts only apparent it will be drugs on drugs polypharmacy again. Big pharma has trillions
Pam says
Thank you so much, C.S. Herrman. I have been helped by meds, and more recently by ECT. They have saved my life. It is very sad that some people push this anti-med/ECT agenda. There are probably many depressed people who have listened to internet advice instead of their own providers; how many still suffer, how many have killed themselves because they were scared away from effective treatments by people like those who post here. I would certainly be dead by now if I hadn’t trusted my doctors. And for God’s sake, David Healy, stop calling them “happy pills.” That is a gross mischaracterization.
I have a dear friend who heeds the instructions of a therapist who will not work with any client who takes psychotropics. So my friend struggles with severe emotional pain and suicidal ideation every fucking day. While I take my meds and offer what support I can. And why does she suffer? Because of some fearmongers she found on the internet. You guys can go to hell, while I live a healthy, productive life.
David Healy says
I didn’t write this post. Peter Goetzsche did. I never use the term Happy Pills. I believe the medication and ECT has its place but we have lost our balance and there is less scaremongering – if you like to call it that – than there should be. Any treatment can be crippling and we should always bear that in mind before using it.
DH
Jj says
That interesting because I have had entirely the opposite experience. From the moment I took SSRIs I was infinitely worse, I now recognise I had serotonin syndrome on a regular basis and I am still plagued by the after effects of SSRI damage which are common enough now to be well represented in the literature and to have colloquial names. Tinnitus from day 2 of my withdrawal (6 years ago) headzaps (especially when I’ll), balance issues, fasciculations and intention tremors not to mention anger issues that led a professional mild mannered 45 year old to end up contemplating suicide after several brushes with the law, something I would never had imagined feasible prior to my withdrawal.
I was put on these drugs because of a minor relationship issue, if the doctor had identified the issue correctly some councilling time and esteem building would have been a far more appropriate and effective intervention. I now have compromised reading ability mood swings motivation issues and my life has been affected drastically.
Recent DNA tests show I’m mao-a ++ , the last thing I should have had as an intervention is an uptake inhibitor.
Treating something on symptoms alone without any insight into the inner workings whilst getting financial kickbacks off the producers of the medicine , isn’t that the very definition the likes of quackwatch use to degenerate similar alternative interventions as quackery ?
At a minimum genetic ( mao-a) testing should be a prerequisite to a doctor prescribing uptake inhibitors.
I have no doubt there are people who benefit from interventions but there needs to be more effort to gather insight into problems rather than such coarse treatments that cause more harm than good. If my case was a minority this discussion would be but a few posts long, sites like surviving antidepressants wouldn’t exist. There is a long and unprofessional historic trend that allows poorly qualified and poorly informed physicians with a god complex to treat patients without proper insight. Psychiatry had the same issues 80 years ago
AMurphy says
Iskander,
So True! I have been in 12 step recovery for years, and having read through all of the literature, the fact remains that even these programs say that one should abstain from Mind and/or Mood altering substances. Bill Wilson did a ton of research before his death on Niacin and Dopamine Uptake as a way of preventing alcoholic cravings, yeah, yeah, and LSD. The sad part about it is I would say at least half the people are on some sort of psychiatric drug. I can tell by their energy when I meet them. It numbs people, and in this sick way, brainwashes them. I can’t tell you how many times after meetings if you share anything remotely related to depression, how fast people swarm you to push Antidepressants and the name of their Psychiatrist on you. My reply is normally, “Well, have you ever tried to get off the meds? Don’t you go through some horrific withdrawal, kinda like alcohol?” That usually shuts them up. Ugh. So sad. It has gotten to the point where I have a hard time socializing w people who are on these drugs. It really alters their personality.
Johanna says
Thank you Dr. Gotzsche for this breath of fresh air! If I had a dollar for every time I’ve been handed the “insulin story”, I could retire rich. One of the story’s selling points (especially among those who know it’s not good science) is the promise that it will reduce stigma attached to mental illness. Yet there’s considerable evidence that people who see psych diagnoses as caused by a “broken brain” are actually less likely to accept those diagnosed as neighbors, and more likely to fear them.
There’s also real evidence that this narrative of a “lifelong brain illness” especially when given to young people experiencing a first mental or emotional crisis, produces demoralizing hopelessness and helplessness. And it’s often reinforced by mental health professionals who tell them to relinquish their goals and accept a future built around their meds and their chronic illness.
MindFreedom USA conducted a survey of “Hope in Mental Health” interviewing 390 people, most of whom rated themselves as either fully or substantially recovered. Yet almost two-thirds reported being told their illness was lifelong and that symptom management was the best they could expect. Three-fourths were told at some point that they would be on medication for the rest of their life, and 49% were urged to give up a cherished life goal such as a career, a family or a home of their own.
http://www.madinamerica.com/2012/12/messages-of-hopelessness/
The story archive itself is a real treat – and they’re still accepting new stories:
http://igotbetter.org/stories
Deirdre Oliver says
Try this one for `mis-information +++Re ECT:
“It is one of the most effective treatments in all of medicine—not just psychiatry.” and…If a patient’s depression is one that requires lifetime treatment with ECT, then ECT would be used for life.”
Edward Coffey, MD, professor of psychiatry and of neurology at the Henry Ford Health System in Detroit, Michigan, and a member of the American Psychiatric Association’s (APA) task force on ECT.
…“the least accepted among the psychiatric treatments.” The authors attributed that perception to “outdated myths about the procedures and side effects,” as well as its portrayal in the media as “an inhumane or even sadistic form of treatment.” A survey published in the April 15, 2005 journal Psychiatry Research.
The media gets its info from the users. Not “Myths”, just experience.
Sophie says
It so sad how these psychiatrists prescribe poison to young minds that are still developing! Then turn around and tell them to give up your dreams, hopes, desires, because you are now incapable of achieving anything! Resign yourself to a life of chronic illness, living in a group home. It just ridiculous! My child was so creative and full of life. That light and genius has been dimmed. THESE DRUGS ARE THE WORST EVER! That’s fact.
Ruth says
was given these ssri drugs for panic attacks.I was given all the drivel of chemical imbalance etc etc, I took them for 8 years after being told I would need to take them for life, because I need them like a diabetic needs insulin.I became emotionally numb , gained a lot of weight and my love life disappeared.
So I stopped taking them, tapering over 3 months as instructed by my Gp, the withdrawl was horrendous I had the most horrid depression, suicidal thoughts, head shocks, head pains, stomach & bowel problems, balance problems, tinnitus, head pressure, lost over 2 stone below my normal weight, had anxiety, akathesia, and much more, These symptoms lingered for years and after 8 years off some still remain. I started with Panic attacks and ended up with a cocktail of awful symptoms I never had prior to these drugs!
Klaas says
Great article, and I can shake hands with former poster Ruth.
I was prescribed Paxil/Seroxat in 2002 for anxiety relates issues. While it worked pretty well in suppressing my anxiety, I also did some strange and dangerous things while under the influence of the drug. I wanted to get off after 2 years but I was addicted already and got so sick from the withdrawals I saw no other choice than restarting to keep my job.
No single explanation from my GP who ony told me that “some people needed it for life” without giving any explanation about the difference between relapse and withdrawal.
I remained a prisoner of Seroxat for three more years with severeal horrific withdrawal attempts, cold turkey, cutting the dose in two or alternating the dose. All method only led to acute and unbearable disease.
I finally quit in 2007, still not knowing about tapering and hoping for the best. It has become the most hellish ride of my life and almost my death.
Now 6 years later, having lost my job due to WD a long time ago, having lost tens of thousands of bugs I am still recovering from the withdrawal of this so-called “non addictive wonder drug”.
I reported my horrific and slmost fatal experience with Paxil/Seroxat to all involved watchdog offices in the Netherlands, only to get a 10-line answer in which I was “thanked for reporting”.
Also I wrote a letter to manufacturer GlaxoSmithKline to confront them with my experience and with the fact that all this was already reported since 2002 and asked director Van Olden how GSK was going to conpensate me and the many other victims of this “wonder drug” and how it was possible that is was marketed as non addictive.
In the reaction of this “doctor” Van Olden, he only stated that my files were closed “because of my anger”… Without answering any of my questions!
These murderous malpractices really need to stop and this article is one step in the right direction. Also finally tapering strips for Paroxetine are availiable now here in the Netherlands, way too late for me but even some psychiatrists seem to slowly see the light.
But unfortunately, we have to accept that many years of our lives have been destroyed by criminal companies pushing crinimal drugs and we just have to live with that…
Dr. Healy thanks for your bravey and good work. Your work helps me to accept what has happend to me and many others and find the force to build a new life on the smoking ruins of my old life which was destroyed by Seroxat.
daisy swadesh says
Thank you for this article. It’s short and very to the point–good for passing on to others. And thank you for your courage in speaking up.
As a teenager I found I got so sleepy drinking at parties I stopped trying to drink. I was totally uninterested in street drugs. When I was given antipsychotics the adverse side-effects were immediate and severe (one affected my fine motor coordination to the point that I couldn’t dress myself). Of course I have chosen to go as drug-free as possible.
If more doctors listened to their patients they would have discovered these and many other things long ago.
JWU says
Great article. I wish you would mention the benefits of psychotherapy as a treatment modality for many mental disorders; it is safe, effective, and creates lasting change. As more and more people begin to see through the claims of the pharmaceutical industry, safe alternatives to drugs need to be promoted.
Lucky says
Dr Healey,
If you don’t believe that mental illness is not caused by a chemical imbalance ; do you have an explanation for the pathogenesis of melancholic depression and schizophrenia ?
Don’t you believe in mental illness?
How do you think that these illnesses should be treated if you don’t believe in psychotropic medications ?
Your post is very confusing;I would recommend you to talk about the ideal ways of treating rather than wasting time on myths.
I agree that many psychological conditions can be contained by psychotherapy rather than medications and in such conditions medications cause no good than harm but tell us how genuine psychiatric illness can be treated because it not only is beneficial to the patient but also beneficial to the society as risks are minimised .
David_Healy says
Lucky
The post was written by Peter Gotzsche. I believe mental illness is real and physical treatments can help. The chemical imbalance ideas is just marketing copy – inspired marketing copy that has led millions of people to give themselves some very real chemical imbalances that have been far worse than anything that might have been wrong in the first instance. DH
GS says
DH – you have never addressed my question of a month ago — how should a family deal with an overtly psychotic family member, if not with antipsychotics?
Our son’s third break occurred in August 2012. because his two prior hospitalizations were so dreadfully bad, we promised him that WE would not take him to the hospital. In April 2013 he was hospitalized for a month — taken there by police.
The antipsychotics brought him back to some measure or nomalcy, to the point where he could resume his university studies.
We, as parents, are completely dissatisfied with the provision of psychiatric care. But the column’s contentions, while many are true, are not fully supported in fact or practice.
David_Healy says
Greg
I can’t find an original email from you on my system or a note from you on the blog so I am slightly at a disadvantage here. I also don’t know if you’re referring to Peter G’s post or to something from me.
Re use of antipychotics – I have never advocated not using them. But they do need to be used with care in that they are generic tranquilizers rather than specifically helpful for psychosis, and they come with risks of suicide, aggravation of psychosis, sudden cardiac death, a range of metabolic problems and dependence.
Any one using them should try to ensure the person being given them is on the right drug for them – some antipsychotics may be more dysphoric for me than others – and in the right dose – the best doses are usually much lower than ordinarily given – and only continued for as long as needed.
Is there something in this last statement you disagree with?
David
GS says
DH – I was referring to Peter G’s post, in particular in the last paragraph: “Our citizens would be far better off if we removed all the psychotropic drugs from the market”. My original post was January 22 as “GS”.
I agree that all psychotropics are over used. I agree that they can be harmful and have all sorts of nasty side effects and result in premature death or suicide. They should be prescribed far less than they are, at lower doses and for shorter durations when possible.
Our experience is a son with schizoaffective disorder, 3 psychotic breaks and a total of 78 days in “metal health units”. We lived with our son in the house in varying degrees of psychosis from Summer 2012 until Spring 2013. In our experience psychosis is not self-limiting, even if a person is getting psychotherapy. The antipsychotics are what brought him back to to some measure of reality.
I agree that some drugs are “less bad” than others (all “bad” to some extent). He had terrible side effects from some including EPS, akasthesia and dystonia. Others simply didn’t do anything. Some give him a measure of normalcy.
In the US provision of psychiatric care is terrible — even if you can afford to self pay, there simply are not the providers with either the time or experience to provide adequate guidance — psychotherapy and thoughtful and thorough psychopharmacology.
Blanket statements like “Our citizens would be far better off if we removed all the psychotropic drugs from the market” are just as bad as forced treatment model advocated by E. Fuller Torrey.
Deirdre Oliver says
I worked with a group of about 30 young people, 16-24, in a `schizophrenic rehab’ unit in the 70s. (We cynically called it the institutionalisation unit). All had been diagnosed with at least 2 psychotic episodes. The charge nurse of the unit was a musician and felt it would be a good idea to devise some kind of musical production. He called me in as he knew I’d had a career in the theatre before I became a psych nurse. We rehearsed and performed/toured this production for 6 months. Nobody had any kind of psychotic break, nobody missed a single rehearsal or performance. As time went by the kids, many of whom were almost paralysed with drugs, sparked up. We had a kind of professional theatre attitude going even though chlorpromazine etc had them by the throat). We found several really talented kids who blossomed, some who were discharged came back to keep going with the show. Parents & friends got involved in lending vans, (to carry sets & equipment), making costumes, (we had almost no money), a doctor’s wife, an artist, helped with painting sets. It was a wonderful time, for me as much as for them. One young woman with a terrible history, paranoid father, childhood schizophrenia, who had passed her final law exam during an acute psychotic episode, who never spoke (drugs) asked to be in the show I almost cried. I think she, (R), was one of the most inspiring people I ever met in my life. It ended after 6 months partly because I was a student and had to be moved on. Within 3 months my 2 most talented kids killed themselves. The wisdom then was, `you will not get better, you can only control…blah, blah. It wasn’t enough. I went on to become a nurse clinician (psychotherapy) and never returned to that unit. R was lost to the system, but one of the outpatients, a brilliant artist who also got depressed at the future being laid out in front of him, DID get better. He stopped his meds, (I knew that and I think quite a few of the others did too, but said nothing) and later became president of a mental health organisation. He retired a few years ago. I’m telling this story because it was a clear path that could have been followed but never was. Purpose, involvement, expectatio