The fall-out from Dr. Nancy C. Andreasen’s bombshell

From an interview with well-known neuroscientist and psychiatrist Dr. Nancy Andreasen which appeared in Sept. 2008 in the New York Times:

Q. AND WHAT HAVE YOU FOUND?

A. I haven’t published this yet. But I have spoken about it in public lectures. The big finding is that people with schizophrenia are losing brain tissue at a more rapid rate than healthy people of comparable age. Some are losing as much as 1 percent per year. That’s an awful lot over an 18-year period. And then we’re trying to figure out why. Another thing we’ve discovered is that the more drugs you’ve been given, the more brain tissue you lose.

Q. WHAT EACTLY DO THESE DRUGS DO?

A. They block basal ganglia activity. The prefrontal cortex doesn’t get the input it needs and is being shut down by drugs. That reduces the psychotic symptoms. It also causes the prefrontal cortex to slowly atrophy.

Q. WHAT ARE THE POLICY IMPLICATIONS OF THIS FINDING?

A. Implication 1: that these drugs have to be used at the lowest possible dose, which often doesn’t happen now. There’s huge economic pressure to medicate patients very rapidly and to get them out of the hospital right away. Implication 2: we need to find other drugs that work on other systems and parts of the brain. Implication 3: whatever medications we use need to be combined with more nonmedication-oriented treatments, like cognitive or social therapies.

Where do we go from here? Dr. Andreasen, by her own admission, sat on her findings for two years. Findings, might I add, the substance of which consumers have been complaining about for years. Our opinion, of course, is considered “anecdote” by people smarter than we are, such as Dr. Andreasen. I can quibble about her findings, because there is also something called the “plastic brain” which is a concept that wasn’t in much vogue a decade ago. The plastic brain, unlike the brain set in concrete, is adaptive and will find solutions and neuronal pathways around problems.

If Dr. Andreasen’s research will stick for the next decade or so until it is overthrown by yet another biochemical explanation for mental illness, then the service she has provided is that she has armed you with “scientific information” from a well-know U.S. researcher that you can take to your doctor and demand either no drugs and better alternative treatments to help you through this, or else medications only for the period of crisis and in low doses.

The Bonkers Institute for Nearly Genuine Resarch provides a look at the drug-addled schizophrenic brain. Before you feel like ending it all when you see this image, keep in mind that the brain is plastic and that science is unreliable.