This issue has been troubling me for a number of years as I supported those who reached out to me through #PTSDChat or my art page I became more and more concerned that the psychiatric drugs those struggling with mental health challenges were put on were more harmful than helpful, and in some instances, the cause of suicides. To poke the bear I recently posted on my FaceBook an aggressive, biased and extreme video produced by a group that is focused on annihilating what they see as the evil of Psychiatry. It worked a treat and I am grateful to all those who joined in on the debate; interestingly all those who commented were adamantly opposed to the concept that psychotropic drugs were anything other than helpful and important.
I have the following diagnosed issues:
- Hemiplegic migraines which appear to be a stroke with paralysis of my right side
- Aural disturbances: progressing from small distortions in vision to full blown blindness
- Traumatic Brain Injuries from early childhood and blast injuries
- Blood clotting which has been diagnosed as Antiphospholipid Syndrome with Lupus markers
Undiagnosed but present:
- immune related issue that causes blood clots, fainting, dizziness, weakness in limbs and unconsciousness.
The root cause of all these issues was of course my brutal first fifteen years on planet earth. It wasn’t until I found myself in the care of a Neurologist in Singapore that life started to change for me for the better. He was the first doctor to give me answers, the others had simply treated symptoms. I have found a combination of Neurologist, Psychologist, Family Doctor, knowledgeable and competent Pharmacist and a rheumatologist when blood clots are bad is my best team. I have had appalling experiences with Psychiatrists who I have consistently found to be uncaring, uninformed, disinterested and about as useful as a chocolate teapot. So I have a bias straight out of the gate, which is why I sought out alternative views outside of my echo chamber of friends who share my experiences with psychiatry.
Brian’s comment: this bias might be shared by a lot of first responders and veterans because psychiatry is cheaper than psychology it’s where you are mandated to go first rather than what should be first: psychology.
To keep all of the above under control I take Pristiq which is a serotonin-norepinephrine repute inhibitor (SNRIs) made by Wyeth which is worth $516 million in revenues annually. One of the issues it controls remarkably well is my insane stress reactions, not visible but internal. My body and brain have no ability to control the amount of adrenalin, cortisol or noradrenalin released under stress or after it, I go from zero to nuclear doses produced quickly. After decades of this my body is worn thin, and can no longer handle these levels of stress hormones but interestingly it isn’t until the noradrenalin, a neurotransmitter, hits that I’m in trouble. Elavel (Amitriptyline) is the other psychiatric drug I take and have done since Singapore, without it my visual disturbances and auras are out of control, in addition to controlling the neuropathic pain I suffer from. The doses I need to take of Elavel to contain the pain and the auras is a long way below that needed to use it as an antidepressant.
I believe I am alive today and living pain free because of those two drugs. However, they do not come without side effects and I am cognizant of the issues they bring with them. It’s a life decision I have made, I would prefer to be me and functioning than curled in a ball of pain unable to function 2 days out of 3.
As a retired banker my first question is always: where is the money? Lyrica generated $4.4billion for Pfizer in 2016, it is the best selling psychiatric drug in the US (anti-convulsant used mostly for neuropathic pain). The other top sellers are as follows: Vyvanse $3.1billion; Invega Sustenna $1.304billion; Latuda $1.286billion; Cymbalta $930.5million; Abilify $878million; Namenda $682million; Seroquel XR $633 million. The story of Prozac is important to mention at this juncture: in 1987 it received its FDA approval and quickly made a fortune for Eli Lilly until generic drugs started to chip away at its success and then Pfizer’s Zoloft hit. Loren Mosher M.D. has written a number of illuminating papers on the money trail going to psychiatry from big pharma; it makes sordid reading to be honest with big pharma paying psychiatrists vast sums to run drug trials with less than satisfactory protocols; sponsored symposia with big pharma paying the speakers to push their products, etc. Clearly there is a lot of money at stake here.
So why has big pharma stopped researching new psychiatric drugs? Check out Gary Greenberg’s story in The New Yorker (2013) following Richard Friedman’s admission that psychiatry is in crisis (he contributes to the New York Times and is a Cornell psychiatrist) as all the big pharma names have shuttered their neuroscience labs, no more drugs are coming down the line and they are moving away from psychiatric drugs. I strongly recommend you read the entirety of that article but it boils down to a lack of science. They don’t know how or why or if psychiatric drugs work. Yup. I wasn’t expecting that either. The article details the many missteps and misconceptions in the serendipitous discovery of psychotropic drugs with most psychiatrists holding onto the chemical soup theory which has been proved to be incorrect. What I suspect is that there is significant liability to class action suits scaring these companies off given the less than stellar trials carried out to get FDA approval for many of their drugs. Only time will tell on that one, but as a banker I can tell you I wouldn’t invest in any big pharma who had a significant psychiatric drug representing a chunk of its revenue since 1989.
Insurance companies play a significant role in the psychiatry over psychology choice. Psychiatric drugs are a lot cheaper than weekly or bi-weekly psychologist visits.
Allen Frances is an American Psychiatric insider who writes regularly in the Psychiatric Times. I read all he had on this and other psychiatric topics and his views on how damaging those who campaign against the validity of psychiatry are. He claims all manner of successes comparing them to the same rates of recovery as the medical world (physical) without actually citing any specifics. There was one thing he said that struck me about psychotherapy:
There are 3 consistent research findings that should make a world of difference to therapists and to the people they treat.
1. Psychotherapy works at least as well as drugs for most mild to moderate problems and, all things being equal, should be used first
2. A good relationship is much more important in promoting good outcome than the specific psychotherapy techniques that are used
3. There is a very high placebo response rate for all sorts of milder psychiatric and medical problems
This is partly a “time effect”—people come for help at particularly bad times in their lives and are likely to improve with time even if nothing is done. But placebo response also reflects the magical power of hope and expectation. And the effect is not just psychological—the body often actually responds to placebo just as it would respond to active medication.These 3 findings add up to one crucial conclusion—the major focus of effective therapy should be to establish a powerfully healing relationship and to inspire hope. Specific techniques help when they enhance the primary focus on the relationship; they hurt when they distract from it.The paradox is that therapists are increasingly schooled in specific techniques to the detriment of learning how to heal. The reason is clear—it is easy to manualize technique, hard to teach great healing.
Over the years I have spoken with, discussed and listened to thousands of people tell me their mental health story, their journey and of them I can count two who had this relationship with their psychiatrist, specifically: the major focus of effective therapy should be to establish a powerfully healing relationship and to inspire hope. If this is the standard of care expected from a psychologist why not from a psychiatrist?
This led me to my next area of enquiry given how fast big pharma is moving away from psychiatric drugs because of a lack of science (unable to prove how their drugs work and a general acceptance that the brain remains a black box), what else is out there? Obviously machines. There are all manner of machines out there utilized by psychiatry. Which is how I found this: http://www.fedpractice.com/2017/09/26/1865/
It makes appalling reading. Psychiatrists we know have long used our veterans as lab rats, the stories are out there for anybody to read and you can ask doctors who have simply walked out on VA hospitals (not least of who is no less than the author of the best book on PTSD Bessel van der Kolk “The Body Keeps the Score”, his recounting of his experiences in the VA system is awful). Clearly the shutting down of big pharma money is forcing the psychiatric community to seek out other revenue. Please read that post.
90% of school shootings and mass murders have one common denominator: psychotropic drugs. Clearly correlation does not mean cause and prior to my research into this issue I had assumed we could simply DEMAND an independent review of those specific cases and find out the truth of the matter. However, if those manufacturers of these drugs are shutting down their psychiatric drug pipelines and are admitting that they don’t know how these drugs work, how on earth are we to answer that question?
The drugging of our children is a very worrying modern phenomena. The best place to find information on the over drugging of children is in the foster community. There are any number of alarming reports out there starting from 2008 when it was brought to the attention of various medical boards, this is a blog post that gathered much of the information out there and is easily digestible https://thetruthaboutantidepressants.wordpress.com/2014/11/30/foster-kids-get-more-psychiatric-drugs/ Check it out for yourself and judge for yourself: if we don’t know how these drugs work on an adult brain what on earth are we doing giving them to a child?
In the end, I am left no wiser. There is a lot of anecdotal evidence that speaks to the significant dangers of psychiatric drugs especially those of the benzodiazepines: https://www.drugs.com/drug-class/benzodiazepines.html
Authors abound on the subject and all are medical doctors or disenchanted psychiatrists or psychologists. Authors I’ve read include Peter Gotzche, J. Monerief, Robert Whitaker and for some balance Allen Frances but he never gives actual meat to any of his views or options which I found frustrating. Of the posts out there on school shootings and psychotropic drugs this is a good one as it encompasses most of the points being made:
One of those responding to my face book post was a Canadian Armed Forces member who felt I was being irresponsible as the risk to those going off their medications cold turkey (as in with no withdrawal period) is extremely high. It is one of the leading causes of suicide. Psychotropic drugs are addictive and you can’t just stop taking them or you will die. To my mind that says all we need to know about them. They are clearly dangerous and unless you have no option (like me) don’t touch them, try everything else first and if you have to go that route try to avoid the super nasty benzodiazepines.
Brian comments: much of the time the drug being prescribed is not being given for its primary effect or the effect it was licensed but a secondary one. For example, seroquel is an anti-psychotic but is given to thousands of veterans as a sleep aid. Kate has found hundreds of posts on prescriptions of psychiatric drugs to treat disorders not covered by their FDA licensing. What happens to a non-psychotic brain given a drug that alters your brain that nobody fully understands?
We have no answers. There is no science that we can turn to. Correlations and anecdotal evidence is all we have. Judge for yourself but I believe the risk of these drugs is so great we should have a far more robust system of prescription and care. At the very least anybody on these should be carefully monitored and be in, as Allen Frances said, a powerfully healing relationship with their psychiatrist or psychologist that inspires hope.
Note on the painting featured: I did this a few years ago for CanPraxis to illustrate what it is like to go cold turkey on your psychiatric drugs, that’s one veteran’s experience. It was difficult to paint and is even harder to look at.