Friday, July 30, 2010

Robert Whitaker's book "anatomy of an epidemic" receives glowing review in Tucson Green Times


Robert Whitaker's book "anatomy of an epidemic" receives glowing review in Tucson Green Times


http://tucsongreentimes.com/2010/book-review-mental-health-drugs-july-2010/

Book Review: Mental Health & Drugs – July 2010

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

By Robert Whitaker

Hardcover: 416 pages

Publisher: Crown

Review by Mary Ackerley, MD, MDH

Tucson Green Times – July 2010

Robert Whitaker’s brilliant book Anatomy of an Epidemic asks a simple question: Why, if psychiatric drug treatments are so efficacious, has the number of people on disability for mental illness more than tripled in the last 25 years?

Most doctors and researchers answered this question by stating that the numbers have increased simply because we are diagnosing more people with mental illness. In response to this stereotyped dismissal of his data, Whitaker began to do more research on the efficacy of known psychiatric treatments. And then, while poring through the psychiatric scientific literature on treatment effectiveness for the last 50 years, he found an even darker question beginning to emerge. “Is it possible that psychiatric drugs are actually making people much worse?”

Could it be that – far from “fixing broken brains” – the drugs being offered actually are worsening, and even causing, the very illnesses they claim to heal?

The year 1987 can be considered ground zero for the new era of psychopharmacology. Prozac had just been introduced and was being widely advertised to the psychiatric profession, as well as to the general public, as a new and safer antidepressant.

As a young psychiatric resident, I was proudly confident that the treatment of psychiatric illness was being revolutionized and that we could all look forward to a world where severe depression, anxiety and mania no longer crippled and ruined human lives. Wrong.

It should be apparent to many that, despite the incredible profiteering of the pharmaceutical industry off of psychiatric illness, that depression and anxiety are still rampant in this country. At the start of the psychopharmacological “revolution” when it became popular to blame all illness on “imbalanced brain chemistry” the percentage of bipolar patients who could return to work was 85 percent. Today it is less than 30 percent.

Certainly the introduction of the SSRI’s (selective serotonin reuptake inhibitors) revolutionized the profitability of the pharmaceutical industry. In 1987 about half a billion dollars were spent on psychiatric medications. By 2010 the figure is closer to $40 billion!

Actually, in children the disability figures are far more frightening. In 1987 there were less than 20,000 severely mentally disabled children. Today there are almost 600,000. That is a 30-fold increase. Part of that is due to the diagnosis of autism, while more is due to the even newer diagnosis of bipolar disorder in children, which has increased 40-fold in the last 10 years!

Most frightening are the numbers of children under the age of six receiving SSRI, which have tripled over the last 10 years to more than 65,000. Under six? How can this possibly be? Were psychiatrists 20 years ago oblivious to the plight of these severely disabled children? I can assure you, from my experience that is not true.

Rather, it seems that drug companies have discovered another very profitable market in young children and are busy pushing their drugs, in particular the atypical antipsychotics, onto children with the newly diagnosed pediatric bipolar disorder. How can anyone possibly predict the long-term impact of a major tranquilizer, used to subdue agitated and psychotic adults, on a five-year-old brain? Those studies have not been done.

From these sobering statistics, the author then goes on to answer the following questions about long-term results with psychiatric medicines:

  • Does antidepressant usage make it more likely that you will become disabled?
  • Are bipolar patients better off than they were 40 years ago?
  • When the National Institute of Health studied the long-term outcome of children treated for ADHD did they find that stimulants provided any benefit?
  • And, most startlingly of all to anyone who has been indoctrinated in the current medical thinking that psychiatric patients are always better off on medications, he asks an unthinkable question – are recovery rates for schizophrenics better with or without medication?

In addition, Whitaker chronicles the stories of many of the people who have been diagnosed for depression and bipolar disorder and treated with many different types of psychiatric medication. In fact, in some parts of the book where he examines scientific evidence it may seem a bit heavy, he more than makes up for it by interweaving the stories of many psychiatric patients whom he has personally interviewed.

In one of the most interesting parts of the book for me, it seems that if you are schizophrenic and living in India or Nigeria, your chances of a good outcome are far higher than if you live in the U.S. where everyone is medicated. The fact seems astonishing, and the World Health Organization repeated the study, but found the same thing: Living in an undeveloped country where meds are scarce, but patients are cared for by the community, assures a much better prognosis for schizophrenia.

However, Whitaker also quotes several studies done in the U.S. from the late 70s that showed similar results: Young adults suffering a first episode of schizophrenia who were not medicated showed significantly better outcomes in terms of subsequent relapse. Later in the book he details the current treatment of schizophrenia in an experimental clinic where drugs are rarely prescribed. Again, the findings are similar – patients there have much better long term outcomes than other schizophrenics who are routinely medicated.

I admit to having been somewhat naïve as a young doctor. I thought the fact that drug companies paid psychiatric professors to do their research was not a big deal. Again, wrong!

The last chapters of Anatomy of an Epidemic tallies up the enormous profits the drug companies and certain psychiatrists have made off the reinvention of psychiatry as biological psychopharmacology. He details how the growth of the Diagnostic and Statistical Manual from DSM 2 to DSM 4 has fueled the growth of diagnosing more and more Americans as having a psychiatric illness which requires pharmacological treatment, and suggests this was a necessary preparation for “building the market” for the drug company’s wares.

Now, most scientists would absolutely bristle at the suggestion that their passion to finally make psychiatry a real science was actually a ploy to help the drug companies remarkably expand their profits. Yet there is no doubt the expansion of the definitions of psychiatric illness, which now has one in every eight Americans taking a psychotropic medication, has been exceedingly profitable.

Drug company sales of psychotropic medication went from about half a billion in 1987 to more than $40 billion in 2008. Atypical antipsychotics, once reserved for the most severely ill patients, are now the top revenue producer for drug companies, helped by the psychiatric professions’ willingness to prescribe these meds even to two-year-olds. Dr. Joseph Biederman, the psychiatrist most associated with leading the way to using antipsychotics for children by popularizing pediatric bipolar illness, personally received $1.6 million from 2000 to 2007, as well as procuring another $2 million for a pediatric pathology department at Massachusetts General Hospital. He is a designated KOL by the drug companies, which means a Key Opinion Leader. That means what he writes and says is usually followed by other psychiatrists.

In a recent deposition, he was asked his rank at Harvard Medical School. “Full professor,” he replied. “What’s above that?” asked the attorney. “God,” replied Dr. Biederman. Truly that is a response worthy of a KOL.

This is not the book of a disgruntled patient who is angry at the system. It is the carefully researched and documented expose of a multi-billion dollar industry that affects the lives of at least a quarter of the population. It is also an engrossing read, and an accurate depiction of the lives of people who are afflicted with these illnesses. I would recommend it to anyone who has ever used, or had a family member use, psychiatric services or been given psychiatric medication.

Author: Mary Ackerley MD, MDH, is a classically trained psychiatrist and homeopathic physician in private practice in Tucson.

No comments:

Blog Archive

FAIR USE NOTICE: This may contain copyrighted (C) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit.

Terms and conditions on the use of the contents of the “Is Something Not Quite Right with Stan - A Mental Health Blog” site are for informational and entertainment purposes only. Stan does not represent or guarantee the accuracy, completeness, timeliness or reliability of the information or content (collectively, the "Materials") contained on, distributed through, or linked, downloaded or accessed from this website.

Stan encourages you to make your own health care and legal decisions based upon your research and in partnership with a qualified health care and/ or legal professional. The information posted here should not be considered medical advice and is not intended to replace consultation with a qualified medical professional if they exist. I do not answer specific medical questions.

Third party information is gathered from sources that Stan believes to be reliable. However, in no event shall Stan, or any third parties mentioned on this site be liable for any damages resulting directly or indirectly from the use of the content whether or not Stan is advised of the possibility of such damages.

Stan reserves the right, in its sole discretion and without any obligation, to make improvements to, or correct any error or omissions in any portion of the displayed materials.

You hereby acknowledge that any reliance upon any Materials shall be at your sole risk.

Disclaimer of Liability

The user assumes all responsibility and risk for the use of this web site and the Internet generally. Under no circumstances, including negligence, shall anyone involved in creating or maintaining this web site, or shall the website writer or any commenter’s be liable for any direct, indirect, incidental, special or consequential damages, or lost profits that result from the use or inability to use the web site and/or any other web sites which are linked to this site.

Nor shall they be liable for any such damages including, but not limited to, reliance by a visitor on any information obtained via the web site; or that result from mistakes, omissions, interruptions, deletion of files, viruses, errors, defects, or any failure of performance, communications failure, theft, destruction or unauthorized access.

ALL CONTENT ON THIS WEB SITE IS PROVIDED TO YOU ON AN "AS IS," "AS AVAILABLE" BASIS WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT. Stan MAKES NO WARRANTY AS TO THE ACCURACY, COMPLETENESS, CURRENCY, OR RELIABILITY OF ANY CONTENT AVAILABLE THROUGH THIS WEB SITE.

In states which do not allow some or all of the above limitations of liability, liability shall be limited to the greatest extent allowed by law.

Disclaimer of Endorsement - Reference to any products, services, hypertext link to the third parties or other information by trade name, trademark, supplier or otherwise does not constitute or imply its endorsement, sponsorship or recommendation by me. Nor is an endorsement by me is implied by such links. They are for convenience only, as an index in a public library.

Information Subject to Change - Any information on this web site may be removed without notice. Information may include technical inaccuracies or typographical errors. Furthermore, the information may change from time to time without any notice.

GENERAL INFORMATION - The information contained in this online site is presented and intended to provide a broad understanding and knowledge critical to psychiatric practices and humorous social interaction. The information should not be considered complete and should not be used in place of communication and consultation.

NO WARRANTIES “Is Something Not Quite Right With Stan - A Mental Health Blog” MAKES NO REPRESENTATIONS OR WARRANTIES THAT USE OF THE WEB SITE WILL BE UNINTERRUPTED OR ERROR-FREE. YOU ARE RESPONSIBLE FOR TAKING ALL PRECAUTIONS NECESSARY TO ENSURE THAT ANY CONTENT YOU MAY OBTAIN FROM THE WEB SITE IS FREE OF VIRUSES.

This site is not a monologue of truth. It is a catalyst for public debate about medical conduct and for entertainment purposes. The reader is urged to confront officials to clarify issues mentioned herein. This site is designed strictly to provide information for critical, literary, academic, entertainment, and public usage. A qualified and trustworthy medical professional must be consulted regarding medical issues, treatments, diagnoses, etc.; if they exist in all actuality or truth.