Saturday 30 November 2013

If you gave away antipsychotics/ mood stablizers, free of charge, to anybody who asked for them - almost-nobody would want them

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The current mass drugging with antipsychotic/ neuroleptic drugs (now often re-named as 'mood stabilizers') is a phenomenon unique in the history of psychoactive drug over-use.

http://charltonteaching.blogspot.co.uk/2013/11/today-single-most-profitable-drug-in.html


In the past, over-used psychiatric drugs were ones that made people feel obviously better in some obvious way - and they were drugs that therefore people wanted to take.

The over-prescription was mostly a matter of doctors giving-in to strong patient demand.

This would apply to nearly all of the blockbuster psychotropic drugs in the post 1945 period from 'minor tranquillizers' such as Miltown, Librium and Valium to psychostimulants such as Dexedrine, Ritalin and Provigil.

The minor tranquillizers reduce anxiety and make people feel relaxed and pleasant (much like alcohol) and improve sleep; psychostimulant increase energy, reduce fatigue, improve concentration, promote weight loss... People, understandably, want these effects, and therefore many people want to take these drugs.

But of course all these drugs also have undesirable and serious side effects, and most of these emerge only in the longer term; also they may also be addictive. And that is why a good doctor will advise caution with using these drugs - they are superficially and immediately appealing; but deep down and over time they may do more harm than the obvious benefit.

But basically these types of drugs make people feel better and in some ways function better - even though this may just be temporary.

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However, antipsychotics/ neuroleptics do the opposite (pretty much) - they reduce energy and motivation, and make people feel indifferent and dulled at best, and miserable and unable to experience pleasure at worst - as well as creating dependence and having serious and often permanent side effects, especially a form of induced Parkinson's disease called Tardive Dyskinesia.

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If you gave-away psychostimulants, or had them on sale at pharmacists without prescription and no advertizing, there would be vast demand - people want them...

But if you could give-away antipsychotics at the street corner to anybody who asked, and (after giving them a try) almost nobody would take them.

Who would anybody want to take a drug which made them feel like a zombie - dead inside?

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Therefore the current mass drugging with antipsychotics/ mood stabilizers happens because, in one way or another, antipsychotics are being forced-upon people.

Traditionally, it required legal coercive power (or the threat of using such power) to force many or most patients to take antipsychotics. Patients usually needed to be forcibly committed to hospital, or put onto a compulsory treatment order - and given long acting injections whether they liked it or not...

But nowadays it is doctors 'strongly recommending' patients to take these drugs 'or else' something terrible will happen; or parents forcing their children to take antipsychotics/ neuroleptics on medical advice.

Essentially, the current mass usage of antipsychotics is evidence of an extraordinary level and effectiveness of propaganda - to the level of near-universal brain-washing - especially the widespread usage of "take them or else" terror tactics based on faked and incompetent pseudo-science.

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Of course, once people have been bullied into taking antipsychotics for a few months, then they produce dependence, and it becomes difficult, sometimes impossible to stop taking them without very severe side effects such as a full-blown psychotic breakdown on withdrawal.

So people will continue taking the tablets, despite that they make you feel like a zombie.

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My point is that there really is no precedent for what is happening now with mass usage of antipsychotics.

This phenomenon of mass drugging with agents that make people feel and function worse is evidence of the immense power of the psychiatric/ Big Pharma complex.

Mass drugging with anti-psychotics not only has nothing to do with patient demand, it has emerged in the teeth of patient demand - widespread antipsychotic usage is the opposite of patient demand.

But once the patients have been hooked on these drugs that make them feel worse, then they have no choice but to continue to demand them.

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Therefore, in my opinion, the evil of the present situation is unique in the history of psychopharmacology - we are in new territory.

In the past profit was made from giving people what they wanted, but which would harm them in the long term; now profit is made from giving people what they do not want, and which will harm them in the long term. 

The situation is so bad that decent people cannot comprehend it, cannot believe it is really happening - has indeed already happened. 

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13 comments:

dearieme said...

Will this prove to be a larger or smaller scandal than mass medication with statins?

Bruce Charlton said...

@d - Who knows. We do not live in a rational world but one of the mass media accepted as reality, where the obvious is hidden in plain sight - so maybe there will be no scandal at all.

Indeed, if there was going to be a scandal, I expect it would have happened several years ago,

http://qjmed.oxfordjournals.org/content/99/6/417.abstract

[Neuroleptic is the original and correct term for Antipsychotics]

instead of the situation of mass antipsychotics medication just getting worse and worse.

Dennis Mangan said...

It has struck me in this case and with statins that a good part of the problem is so-called "standard of care". Once a drug or treatment becomes entrenched, it's difficult to dislodge, even by skeptical doctors. They open themselves to lawsuits by, e.g., not prescribing a statin.

Bruce Charlton said...

@M - Yes, yet these standards derive from the proceedings of 'nonsensus consensus' meetings which were exploded comprehensively more than 20 years ago.

Samson J. said...

Bruce, I have to say I don't see the massive, widespread abuse of anti-psychotics that you describe. I see two sorts of patients on them: schizophrenics (who surely *should* be on them), and elderly patients with e.g. dementia who occasionally receive them for agitation. That's it.

Bruce Charlton said...

@SJ - The growth has been in people called 'Bipolar' disorder - but the majority of people on neuroleptics with supposed schizophrenia should not be taking them. Schizophrenia has always been rare and has become rarer.

What you are seeing is almost all antipsychotic-dependence - a combination of side effects, supersensitivity phenomena, and withdrawal symptoms - an artifact of treatment.

If such patients had not been given antipsychotics, most would not be patients - for most, the treatment is the disease.

Research has been clear for some decades that long term outcomes are *much* better if antipsychotics are not used, or are used only for a few days as emergency control agents during an acute admission.

See Robert Whitaker's Anatomy of an Epidemic.

Anonymous said...

Samson J:
The sales numbers for Abilify beg to differ.

Samson J. said...

the majority of people on neuroleptics with supposed schizophrenia should not be taking them...

What you are seeing is almost all antipsychotic-dependence - a combination of side effects, supersensitivity phenomena, and withdrawal symptoms - an artifact of treatment.


Well, Bruce, I'm afraid that for me to accept this would require a lengthier discussion. You know as well as I do how destructive and awful schizophrenia is.

The sales numbers for Abilify beg to differ.

*shrug* It may be a regional thing. I don't think that I have ever seen more than one or two patients on Abilify. And anyway the question is still begged that these patients, whoever they are that are consuming all this Abilify, should not be on it.

Bruce Charlton said...

@SJ - I'm not saying anything which is not amply documented in the literature as well as conformed by experience. All I can say is that you need to inform yourself on this topic by reading David Healy or Robert Whitaker - or even me! It is simply a matter of joining the dots. The current over-prescription of antipsychotics is one of the worst medical abuses of all time.

Nate said...

To Sampson J:

I would highly recommend Robert Whitaker's "Anatomy of an Epidemic". It goes into the detail of what Bruce is saying here. It is quite readable. The pathophysiologic changes are well documented.

I, like you, was skeptical at first. The recovery rate for schizophrenia really is higher in unmedicated patients. It is also higher in depression and anxiety.

This is not to say that the medications are never helpful. But they have great potential for harm, and should be rarely used-and with great caution.

Nate

Anonymous said...

Samson J:
*shrug* It may be a regional thing.

Maybe. Abilify has the highest gross sales of any drug in the US. 2.5 million prescriptions are filled per quarter. The "nothing to see here, move along" attitude is ludicrous on its face, and is part of why the only things that kill more patients in the US than their doctors are heart disease and cancer.

Bruce Charlton said...

@Zippy. It is strange indeed. 'Frontal Lobotomy' (which deliberately damaged the brain, physically) is recognized as having been grossly overused and misapplied - but purposive chemical damage to the brain is regarded as acceptable - even when that damage is often permanent. Antipsychotics are in their essence brain-damaging chemicals - inducing the disease of Parkinsonism as a way of controlling behaviour. The best that could be said about them is that the damage is usually temporary, and that sometimes brain damage may be preferable to the extremely distressing symptoms in some patients (I am not being facetious - there are such people - fortunately very few). But I think we agree that when a purposively brain-damaging drug is the best seller in the world, this is an intolerable situation, and one of the worst ever medical abuses.

Nate said...

Oops, I forgot to include the link to the video interview with Peter Gotzsche. Here it is:

http://www.madinamerica.com/2013/11/peter-gotzsche-2/

Nate