Myth of the antipsychotic

Adam James
London Guardian
Tuesday, March 4, 2008

Antipsychotic drugs don't work, are causing a brain damage epidemic and almost triple the risk of dying early, a new book claims. Yet the mental health establishment, as it did with Prozac, is failing to take the evidence seriously.

Christian was slouched in a chair in Bradford psychiatric unit. He was, seemingly, only half-conscious, half alive. He could hardly speak, let alone raise his head. Christian had been diagnosed with schizophrenia. Two days before, in a haze of paranoia, he had punched a colleague of mine at a day centre. So Christian was sectioned and medicated, heavily, with neuroleptic drugs.

Most people, on seeing Christian, would have described him as being so whacked out he was a dribbling wreck. The drug-advisory body, the National Institute of Health and Clinical Excellence (Nice) would say the neuroleptic treatment had successfully "calmed" Christian, in preparation for treating the "underlying psychiatric condition".

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Neuroleptics - such as Clozapine, Olanzapine, Risperidone and Seroquel - are the "primary treatment" for psychosis, particularly schizophrenia. Indeed, 98%-100% of people diagnosed with schizophrenia inside our psychiatric units - and 90% living in the community - are on neuroleptics, also called antipsychotics. Nice's guidelines for the treatment of schizophrenia say: "There is well established evidence for the efficacy of antipsychotic drugs."

A similar efficacy used to be claimed for Prozac and other SSRIs in the treatment of depression. But a study published last Tuesday could well have pulled the plug on Prozac.

And now a London NHS psychiatrist, Joanna Moncrieff, has similarly endeavoured to expose the "myth" of antipsychotics. Whereas Moncrieff has already highlighted antidepressant non-effectiveness, it is her research on antipsychotics that is more shocking. The evidence shows, she says, that antipsychotics not only do not work long-term they also cause brain damage - a fact which is being "fatally" overlooked. Plus, because of a cocktail of vicious side-effects, antipsychotics almost triple a person's risk of dying prematurely.

Moncrieff particularly strikes out at her own profession, psychiatry, claiming it is ignoring the negative evidence for antipsychotics. In her book, The Myth of The Chemical Cure, Moncrieff argues, effectively, that psychiatry is guilty of gross scientific misconduct.

Having examined decades of clinical trials, Moncrieff's first point is that once variables such as placebo and drug withdrawal effects are accounted for, there is no concrete evidence for antipsychotic long-term effectiveness. This is a radically different interpretation of the meta-analyses and trials Nice used to arrive at its opposite conclusion. But Moncrieff is confident her scrutiny of the evidence is valid.

At the heart of years of dissent against psychiatry through the ages has been its use of drugs, particularly antipsychotics, to treat distress. Do such drugs actually target any "psychiatric condition"? Or are they chemical control - a socially-useful reduction of the paranoid, deluded, distressed, bizarre and odd into semi-vegetative zombies?

Historically, whatever dissenters thought has been ignored. So, it appears, have new studies which indicate that antipsychotics do not work long-term. For example, a US study last year in the Journal of Nervous and Mental Disease reported that people diagnosed with schizophrenia and not taking antipsychotics are more likely to recover than those on the drugs. The study was on 145 patients, and researchers reported that, after 15 years, 65% of patients on antipsychotics were psychotic, whereas only 28% of those not on medication were psychotic. A staggering finding, surely? So where were the mainstream media yelps of "breakthrough in schizophrenia treatment". Not a squeak.

Moncrieff's second point is that the psychiatric establishment, underpinned by the pharmaceutical industry, has glossed over studies showing that antipsychotics cause extensive damage - the most startling being permanent brain atrophy (brain damage) or tardive dyskinesia. As in Parkinson's Disease, patients suffer involuntary, repetitive movements, memory loss and behaviour changes. Antipsychotics cause atrophy within a year, Moncrieff says. She accuses her colleagues of risking creating an "epidemic of iatrogenic brain damage".

Full article here.

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