Sunday, August 15, 2010

It's time to end this grand experiment with psychiatric drugs


Via mindfreedom published in The Register-Guard, the daily newspaper of
Eugene, Oregon, USA:

The Register-Guard - 12 August 2010 - page A9

GUEST VIEWPOINT: It's time to end this grand experiment with
psychiatric drugs

BY ROBERT WHITAKER

For more than 20 years, our country has been conducting an
extraordinary medical experiment. Ever since Prozac arrived on the
market in 1987, our societal use of psychiatric medications has gone
up and up, and while the drugs generally have been shown to curb a
target symptom better than placebo over the short term, their long-
term effects have not been regularly assessed. Thus, 23 years into
this psychopharmacology era, it might be wise for us to ask: How is
this medical experiment turning out?

As a society, we naturally would expect that the widespread use of
these medications would have lessened the societal burden of mental
illness. Unfortunately, that has not been the case. From 1987 to 2007,
the number of adults receiving government disability payments due to
mental illness more than tripled, rising from 1.25 million to 4 million.

The disability numbers for children are even more alarming. In 1987,
there were 16,200 children under 18 years of age who received a
government payment because they were disabled by a mental illness. By
2007, there were 561,569 such children on the disability rolls. In the
short span of 20 years, during which time the prescribing of
psychiatric medications to children became common, the number of
disabled mentally ill children rose 35-fold.

These numbers do not tell of a paradigm of care that is working well
for us as a society. But we also need to look at a second question:
How is this paradigm of care working for individuals? Does the
scientific literature tell of medications that alter the long-term
course of mental disorders for the better? Or for the worse?

This is a controversial topic, but suffice to say that the scientific
literature contains one surprise after another. For instance, we all
"know" that people diagnosed with schizophrenia need to be on
antipsychotic medications all their lives. Yet, the National Institute
of Mental Health have been funding a long-term study of schizophrenia
outcomes by University of Illinois researcher Martin Harrow, and in
2007 he reported that at the end of 15 years, 40 percent of
schizophrenia patients off medication were "recovered," versus 5
percent of those on medication. More than 50 percent of those off
medications were working, including several in "high-level"
professional jobs.

"Our data is overwhelming that not all schizophrenic patients need to
be on antipsychotics all their lives," Harrow told the audience at the
2008 annual meeting of the American Psychiatric Association.

His study -- and many others -- suggests that selective use of
antipsychotics, with some patients given medical support to go off the
medication, would produce much better outcomes than a paradigm of care
that emphasized continual anti-psychotic use for all. The outcomes
literature for the major mood disorders -- major depression and
bipolar illness -- also suggests that there is something amiss with
the "drugs for life" paradigm.

Forty years ago, major depression and bipolar illness were understood
to run an episodic course, with fairly good long-term outcomes. Today,
they run a chronic course, with the deterioration in modern bipolar
outcomes especially striking. Employment rates for adults so diagnosed
have dropped from around 85 percent to 33 percent, and over the long-
term, many bipolar patients today show signs of cognitive decline,
which didn't use to be the case.

As Harvard Medical School psychiatrist Ross Baldessarini confessed in
a 2007 paper, "Prognosis for bipolar disorder was once considered
relatively favorable, but contemporary findings suggest that
disability and poor outcomes are prevalent."

Our society's grand medical experiment with psychiatric medications is
now entering its third decade, and it is clear we need to have a
vigorous public discussion about its merits. If some patients with
schizophrenia can fare better off antipsychotics, we need to know
that, and if mood disorders have been transformed from episodic
illnesses into chronic ones, we need to know that too.

Fortunately, something of this sort is starting to happen in the
Eugene area.

LaneCare, a provider of mental health services, and MindFreedom, a
patients' rights organization, are focusing attention on this subject,
and so perhaps it is here, in this corner of the United States, that a
seed for change can be planted.

~~~~~~~~~~~~


Update: I just wanted to add this link to another interesting review and conversation related to Whitaker's book and the information it provides here, because it comes from outside the Mental Health realm . It's definitely worth a few minutes of your reading time.



4 comments:

Radagast said...

Well, it's a helluva challenge, but if one wants to reduce the use of drugs to treat mental illnes (for whatever reason), then it is likely that one will need to discover something that genuinely works, in order to present it as an alternative. While we're at it, one should find something that genuinely works, without side effects. If one does that, and the solution that one finds is intuitively correct (ie, anybody can see it works), then no amount of interested political (and Political), shenanigans will keep the psychopharmalogical boat afloat.

Matt

Mark Krusen said...

Stanley,

I see from your live traffic feed thingy on the bottom of your blog,that Washington DC had checked out your blog 5 hours or so ago. It must be that Comrade Nobama clicked on to check on you before going to bed.

Keep on stirring the pot. That was an interesting post on Scary Reid.

betasheep said...

Totally OT for this post, but since it was brought up in the comments, I'll bring it up. Do you read truthman30's blog? He's a Paxil survivor. He had a run-in with an outfit called radian6. I mentioned you and I tried to explain what I thought was going on. And then the perps chimed in!

Stan said...

Yes Betasheep, I have had about 3/4 of a dozen other data gathers/spies here besides the V-invaders. Some are just BOTS while others like the "V" actually have targeted missions with real humans writing reports, rating impact of information, and doing strategical analysis while developing response plans for their corporate clients.

Sooner or later a suspicious public will demand full disclosure related to this corporate monitoring of private citizens and get to peek inside this nasty little world of information/message control.

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