Psychotropic Drugs and the Mental Illness Epidemic

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Sat, 10 Sep 2005 22:14:14 -0500

Psychotropic Drugs and the Mental Illness Epidemic

 

 

 

 

 

 

Psychotropic Drugs and the Mental Illness Epidemic

 

Tue, 6 Sep 2005 18:19:48 -0500

 

 

 

 

Preventive Psychiatry E-Newsletter # 224

 

Excerpts from Robert Whitaker's Anatomy of an Epidemic:

 

 

 

Psychiatric Drugs and the Astonishing Rise of Mental Illness in America

 

Ethical Human Psychology and Psychiatry, Vol. 7, Number 1, Spring 2005

 

Full article, with extensive documentation, accessible at:

 

http://psychrights.org/index.htm

Excerpted, with minimal editing, by Gary G. Kohls, MD, Duluth, MN

 

 

 

 

 

The percentage of Americans disabled by mental illness has increased

fivefold

since 1955, when Thorazine ? remembered today as psychiatry's first

" wonder "

drug ? was introduced into the market.

 

There are now nearly 6 million Americans disabled by mental illness,

and this

number increased by more than 400 people each day. A review of the

scientific

literature reveals that it is our drug-based paradigm of care that is

fueling

this epidemic. The drugs increase the likelihood that a person will become

chronically ill, and induce new and more severe psychiatric symptoms in a

significant percentage of patients.

 

E. Fuller Torrey, in his 2001 book The Invisible Plague, concluded

that insanity

had risen to the level of an epidemic. This epidemic has unfolded in

lockstep

with the ever-increasing use of psychiatric drugs.

 

The number of disabled mentally ill has increased nearly six-fold since

Thorazine was introduced.

 

The number of disabled mentally ill has increased dramatically since

1987, the

year Prozac was introduced.

 

Anti-psychotics, antidepressants, and ant-anxiety drugs create

perturbations in

neurotransmitter functions. In response, the brain goes through a

series of

compensatory adaptations. Neurons both release less serotonin and

down-regulate

(or decrease) their number of serotonin receptors. The density of

serotonin

receptors in the brain may decrease by 50% or more. After a few weeks, the

patient's brain is functioning in a manner that is qualitatively as

well as

quantitatively different from the normal state.

 

Conditions that disrupt brain chemistry may cause delusions,

hallucinations,

disordered thinking, and mood swings ? the symptoms of insanity.

Infections

agents, tumors, metabolic and toxic disorders and various diseases

could all

affect the brain in this manner. Psychiatric medications also disrupt

brain

chemistry. Their (psychotropic drugs) increases the likelihood that a

person

will become chronically ill, and they cause a significant percentage

of patients

to become ill in new and more severe ways.

 

TURNING PATIENTS CHRONICALLY ILL

 

Neuroleptics (Anti-psychotics)

 

In an NIMH (National Institute of Mental Health) study, short-term (6

weeks)

anti-psychotic drug-treated patients were much improved compared to

placebo (75%

vs. 23%). However patients who received placebo treatment were less

likely to be

re-hospitalized over the next 3 years than were those who received any

of the

three active phenothiazines.

 

Relapse was found to be significantly related to the dose of the

tranquilizing

medication the patient was receiving before he was put on placebo ?

the higher

the dose, the greater the probability of relapse.

 

Neuroleptics increased the patients' biological vulnerability to

psychosis. A

retrospective study by Bockoven also indicated that the drugs were making

patients chronically ill.

 

There were three NIMH-funded studies conducted during the 1970s that

examined

this possibility (whether first-episode psychotic episodes could be

treated

without medications), and in each instance, the newly admitted

patients treated

without drugs did better than those treated in a conventional manner

(i.e. with

psychotic drugs).

 

Patients who were treated without neuroleptics in an experimental home

staffed

by nonprofessionals had lower relapse rates over a 2-year period than

a control

group treated with drugs in a hospital. Patients treated without drugs

were the

better functioning group as well.

 

The brain responds to neuroleptics ? which block 70% to 90% of all D2

dopamine

receptors in the brain ? as though they are a pathological insult. To

compensate, dopaminergic brain cells increase the density of their D2

receptors

by 30% or more. The brain is now supersensitive to dopamine and

becomes more

biologically vulnerable to psychosis and is at particularly high risk

of severe

relapse should he or she abruptly quit taking the drugs.

 

Neuroleptics can produce a dopamine supersensitivity that leads to both

dyskinetic and psychotic symptoms. Am implication is that the tendency

toward

psychotic relapse in a patient who had developed such a

supersensitivity is

determined by more that just the normal course of the illness.

 

With minimal or no exposure to neuroleptics, at least 40% of people

who suffered

a psychotic beak and were diagnosed with schizophrenia would not

relapse after

leaving the hospital, and perhaps as many as 65% would function fairly

well over

the long term. However, once first-episode patients were treated with

neuroleptics, a different fate awaited them. Their brains would undergo

drug-induced changes that would increase their biological vulnerability to

psychosis, and this would increase the likelihood that they would become

chronically ill (and thus permanently disabled).

 

In the mid 1990s, several research teams reported that the drugs cause

atrophy

of the cerebral cortex and an enlargement of the basal ganglia. The

drugs were

causing structural changes in the brain. The drug-induced enlargement

of the

basal ganglia was associated with greater severity of both negative

and positive

symptoms. Over the long term the drugs cause changes in the brain

associated

with a worsening of the very symptoms the drugs are supposed to alleviate.

 

Antidepressants

 

The story of antidepressants is a bit subtler, and et it leads to the same

conclusion that these drugs increase chronic illness over time.

Well-designed

studies, the differences between the effectiveness of antidepressant

drugs and

placebo are not impressive. About 61% of the drug-treated patients

improved,

versus 46% of the placebo patients, producing a net drug benefit of

only 15%.

 

At the end of 16 weeks (in a study comparing cognitive behavior therapy,

interpersonal therapy, the tricyclic imipramine and placebo) there were no

significant differences among treatments, including placebo plus clinical

management, for the less severely depressed and functionally impaired

patients.

Only the severely depressed patients fared better on a tricyclic than on

placebo. However, at the end of 18 months, even this minimal benefit

disappeared. Stay-well rates were best for the cognitive behavior

group (30%)

and poorest for the imipramine group (19%).

 

Antidepressants were making people chronically ill, just like the

anti-psychotics were. In 1985, a U.K. group reported that in a 2-year

study

comparing drug therapy to cognitive therapy, relapse was significantly

higher in

the pharmacotherapy group. Long-term use of antidepressants may

increase the

patient's biochemical vulnerability to depression and thus worsen the

course of

affective disorders. An analysis of 27 studies showed that whether one

treats a

depressed patient for 3 months of 3 years, it does not matter when one

stops the

drugs. The longer the drug treatment, the higher the likelihood of

relapse.

 

Benzodiazepines

 

..Xanax patients got better during the first four weeks of treatment;

they did

not improve any more in weeks 4 to 8, and their symptoms began to

worsen after

that. A high percentage relapsed and by the end of 23 weeks, they were

worse off

than patients treated without drugs on five different outcomes measures.

Patients tapered off Xanax suffered nearly 4 times as many panic

attacks as the

non-drug patients and 25% of the Xanax patients suffered from rebound

anxiety

more severe than when they began the study.

 

Then and Now

 

Today's drug-treated patients spend much more time in hospital beds

and are far

more likely to die from their mental illness than they were in 1896.

Modern

treatments have set up a revolving door and appear to be a leading

cause of

injury and death.

 

MANUFACTURING MENTAL ILLNESS

 

It is well-known that all of the major classes of psychiatric drugs ?

anti-psychotics, anti-depressants, benzodiazepines, and stimulants for

ADHD ?

can trigger new and more severe psychiatric symptoms in a significant

percentage

of patients. It is easy to see this epidemic-creating factor at work

with Prozac

and the other SSRIs.

 

Prozac quickly took up the top position as America's most complained

about drug.

By 1997, 39,000 adverse-event reports about it had been sent to

Medwatch. These

reports are thought to represent only 1% of the actual number of such

events,

suggesting that nearly 4 million people in the US had suffered such

problems,

which included mania, psychotic depression, nervousness, anxiety,

agitation,

hostility, hallucinations, memory loss, tremors, impotence, convulsions,

insomnia and nausea.

 

The propensity of Prozac and other SSRIs to trigger mania or psychosis is

undoubtedly the biggest problem with these drugs. The American Psychiatric

Association warns that manic or hypomanic episodes are estimated to

occur in %

to 20 % of patients treated with anti-depressants.

 

Anti-depressant-induced mania is not simply a temporary and reversible

phenomenon, but a complex biochemical mechanism of illness

deterioration. Yale

researchers reported that 8.1% of all admissions to a psychiatric

hospital they

studied were due to SSRI-induced mania or psychosis.

 

Thus the SSRI path to a disabling mental illness can be easily seen. A

depressed

patient treated with a n anti-depressant suffers a manic or psychotic

episode,

at which time his or her diagnosis is changed to bipolar disorder. At that

point, the person is prescribed an anti-psychotic to go along with the

Anti-depressant, and once on a drug cocktail, the person is well along

on the

road to permanent disability.

 

CONCLUSION

 

There is an outside agent fueling this epidemic of mental illness,

only it is to

be found in the medicine cabinet. Psychiatric drugs perturb normal

neurotransmitter function, and while that perturbation may curb

symptoms over a

short term, over the long run it increases the likelihood that a

person will

become chronically ill, or ill with a new and more severe symptom. A

review of

the scientific literature shows quite clearly that it is our

drug-based paradigm

of care that is fueling this modern-day plague.