Taken as prescribed, medications kill 100,000 people per year

What use do you make of your physician?” said the king to Molière one day. “We chat together, sire; he gives me his prescriptions; I never follow them, and so I get well.”

The 100,000 per year body count  is for the United States only. Medications, properly prescribed and properly taken, kill twice the number of people per day than car accidents do. The unsettling death statistics from prescribed meds is not something we hear much about. Yet many, if not most of us, simply take the medications we are given and probably take more than we need. It’s one thing if a person has a life threatening illness or condition and needs the medication in order to survive. But many people are taking prescription medications that they could shed if they changed their habits and did a bit of research into alternatives.

I got to thinking about this today when I visited a friend of mine in the hospital. She’ll be 90 years of age this month. She loves to tell me what her mother told her — to always buy the best food, because otherwise, instead of paying the grocer, you’ll be paying the doctor. She eats butter, not margarine. Up until a few weeks ago, my friend was on no prescription meds. None. She has a heart condition that gave her occasional problems in the past, but she always refused meds for the problem.  Today, the doctor informed her in my presence that she will need to take the meds he had prescribed her the rest of her life. After he left, she complained bitterly to me that she hated being on “these things.” I congratulated her for managing to dodge these bullets up until now, that she probably was healthier for having done so, and suggested that taking the meds now for the rest of her life was a small price to pay for avoiding landing back in the hospital. By all indications, she should be able to resume her normal activities within a month. But, she will be hounding her doctor to keep the medications to a minimum, I can guarantee it.

My favorite doctor, the one I prefer to go to avoid health problems in the first place, is Andrew Saul, Ph.D. When people protest that vitamins, not just meds, kill people, thereby implying that vitamins are inherently dangerous, Saul always asks the question, “where are the bodies?” He has done extensive data gathered from 61 U.S. poison control centers, which reported a mere 10 deaths linked to vitamins over the past 25 years.

Saul also recounts that “More than 1.5 million Americans are injured every year by drug errors in hospitals, nursing homes and doctor’s offices, a count that doesn’t even estimate patients’ own medication mix-ups. . . (O)n average, a hospitalized patient is subject to at least one medication error per day.” 

Just as I was about to push the publish button for this post, I was delighted to see that there is a new website about prescription medication side effects that contains a database for logging adverse effects. RxISK.org  The medical and research team behind this venture includes Dr. David Healy and author Robert Whitaker, and many other prominent names in pharmacology and other disciplines.

ALGERNON MONCRIEFF: The doctors found out that Bunbury could not live…so Bunbury died.

LADY BRACKNELL: He seems to have great confidence in the opinion of his physicians. I am glad, however, that he made up his mind at the last to some definite course of action, and acted under proper medical advice. (From Act III of The Importance of Being Earnest by Oscar Wilde)

The humorous quotes on this page were directly cribbed from Andrew Saul’s website: www.doctoryourself.com

Astonishing rise of mental illness – is it a global phenomenon?

Has anyone noticed that Robert Whitaker’s latest book has undergone a name change?

Old title: Anatomy of an Epidemic: Psychiatric Drugs, Magic Bullets, and the Astonishing Rise of Mental Illness in America
 

 
New title: Anatomy of an Epidemic: Psychiatric Drugs, Magic Bullets and the Astonishing Rise of 
Mental Illness

 

Does the name change reflect the observation that there is an astonishing rise of mental illness in other countries, as Robert Whitaker perhaps has learned over the course of his international speaking engagements?

David Healy and Robert Whitaker address suicide rate in New Zealand

I’m passing on this e-mail from Vince Boehm and video link that I received in my maibox today via ISEPP.

“Risk of suicide” was one of the many reasons given by my son’s psychiatrists for wanting to keep him on medications, not that he was suicidal, but because “statistics show that people with a diagnosis of schizophrenia have an increased risk for suicide during the first five years after diagnosis.”  I always felt that the specter of suicide was invoked often for the wrong reasons — not because patients were suicidal, but in order to keep them meds compliant. I was being made to feel irresponsible by continuing to inisist that my son was unlikely to commit suicide and I would prefer to work with him in non-drug interventions. The problem is, how do one ever really know that someone else is or is not suicidal?  That’s where I feel drug companies have gained the advantage. You don’t know, and nobody wants to assume the risk, so medications are prescribed as some sort of “insurance policy.”

People can and do commit suicide while on meds and when off meds, so it’s kind of murky to now whether the meds would have prevented it or caused it. On the other hand, there is valid scientific concern about the effect of antidepressants on suicide ideation in children and teenagers because antidepressants are being used off-label and little to no research had been done for this age group before this practice became widespread.

Here’s the e-mail from Vince Boehm about the video link:

CASPER (Community Action on Suicide Prevention Education & Research), the New Zealand organization organized by two mothers who lost children to suicide, invited two of our prominent list members to present at their conference this past month.   New Zealand has the highest rate of youth suicide in the OECD, twice the rate of the US and Australia and five times the rate of the UK. More young people in New Zealand die of suicide than all medical causes combined, with 10% of the deaths of New Zealand’s 10-14 year-olds being suicides.

David Healy is an Irish psychiatrist who is a professor in Psychological Medicine at Cardiff University School of Medicine, Wales.  He became the center of controversy concerning the influence of the pharmaceutical industry on medicine and academia. For most of his career Healy has held the view that Prozac and SSRIs (selective serotonin re-uptake inhibitors) can lead to suicide and has been critical of the amount of ghost writing in the current scientific literature.

In his segment of this compelling video, Healy delivers a powerful indictment of suicide and violence caused by psychiatric meds. Robert Whitaker is a friend and a former medical writer at the Albany Times Union newspaper.  In 1992, he was a Knight Science Journalism fellow at MIT.  Following that he became director of publications at Harvard Medical School. In 1994 he co-founded a publishing company, CenterWatch, that covered the pharmaceutical clinical trials industry. CenterWatch was acquired by Medical Economics, a division of The Thomson Corporation, in 1998. His articles on psychiatry and the pharmaceutical industry have won a George Polk Award for Medical Writing. and a National Association of Science Writers’ Award for best magazine article. In 1998, he co-wrote a series on abuses in psychiatric research that was a finalist for the Pulitzer Prize in Public Service. He is the author of four books. His most recent book is Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. His Mad in America has become a classic and belongs in your library.

These two books are destined to be mental health’s Silent Spring, the book that launched the environmental movement.

The definition of short

So, if we still don’t know what is meant by “short term” use of antipsychotics, is there a doctor in the house or out in cyberspace who can shed some light on this? If I don’t get an answer, shall I assume that nobody is looking seriously at this issue?

The question is quite deliberate on my part. Since most of us don’t get a dress rehearsal for a schizophrenia diagnosis (60% of new “cases” apparently do not have family history), we will find ourselves on medications because we haven’t got a clue that there are other ways of dealing with trauma.

I have heard that the most recent research says (patients have been saying this for years) that medications, if used at all, should be short term. If this is so, then people ought to know what short term is so they, and their doctors, can agree on an end date while bolstering their recovery with alternative therapies. Many doctors will claim that the patient has to be “stable” in order to go off them, while many patients claim that they shouldn’t be on meds in the first place and don’t function well on them. Doctors (pharma) have been getting a free pass up until now because the specifics, if there are any, are cloaked in mystery. I am not referring to how to go about withdrawal (there’s lots of information here), I mean how short is short?

Thanks to Robert Whitaker’s book, Anatomy of an Epidemic, we now know that the “medication is to schizophrenia just like insulin is to diabetes” argument was an falsehood (or misconception, depending on how you look at it) that was not clarified by the pharmaceutical companies until the author put the question directly to a pharmaceutical company executive.

If we are starting to hear that drugs, if used at all, should be short term, what is meant by short term?

Would you prefer “small brain volume?”

Robert Whitaker has a blog post today on a research finding* published in the American Journal of Psychiatry.

In this NIMH-funded study, researchers reported that male neonates born to mothers diagnosed and treated for schizophrenia were found to have “several larger than normal brain volumes.” The researchers concluded that this was evidence that “prenatal and early neonatal brain development is abnormal in males at genetic risk for schizophrenia.“

In other words, researchers saw this abnormality as evidence of a “schizophrenic” process already underway in the male neonates. But the mothers diagnosed with schizophrenia in this study were taking antipsychotics, which are known to cause changes in brain volumes. Thus, it may be that the abnormalities seen in the brains of the male neonates were due to the drugs, rather than to any underlying genetic risk for schizophrenia.

The female neonates born to mothers diagnosed with schizophrenia did not have “larger than normal brain volumes,” which of course leads to further doubt about any conclusions that can be drawn from this study.

I am in full agreement with Whitaker’s conclusions questioning whether the drugs are responsible for the observed results and why this affects only males and I will go further. It’s not a good idea for the results of these kinds of studies to fall into the hands of someone like me. First of all, I’m a parent who has never gone to medical school, and why am I subjected to stupid words like “male neonate” when I guess what we are really talking about here are male babies, not male monkeys. Bullshit factor number 1. It sounds impressive and potentially scares the hell out of your non-medical school graduate. Your psychiatrist will trot this kind of medical vocabulary to keep you in line.

Bullshit factor number 2 to the medically uneducated is the “larger than normal brain volumes.” Well, that sounds scary in this context because the research is signaling alarm, but come on, shouldn’t larger than normal brain volume be preferable to “smaller than normal brain volume?” Where is the actual problem here? Bigger volume, more room to think and make connections? Right? Who says it’s wrong? Bullshit factor number 3 is that the NIMH funded this study. The NIMH is strenuously looking into the magic bullet solution for schizophrenia and other serious mental health problems. It pays lip service to complementary and alternative mental health solutions. Bullshit factor number 4 is that so far, there is no identified gene for schizophrenia, so to my medically uneducated brain, there is no established genetic risk for schizophrenia. If my mother suffered from a mental health problem, no doubt I would have psychological problems myself from interacting with her (see my blog portrait) but don’t try to pin genetics on this. Try blaming the environment instead.

Unfortunately, these kind of research findings find their way into the public consciousness and are of no help to anyone actually wanting to recover from their diagnosis.

______________________
J. Gilmore. “Prenatal and neonatal brain structure and white matter maturation in children at high risk for schizophrenia.” American Journal of Psychiatry, published in advance online, June 1,2010.

Ramped up

In his latest book, Anatomy of an Epidemic, Robert Whitaker looks at the Open Dialogue program in Western Lapland (Finland) and can’t quite put his finger on why these group meetings generally in the person’s home are so effective. (The number of new cases annually in this region show an astonishing 90% drop from the 1980s.)

Without knowing this program either, but having spent two years in another program in Europe which thought it was cutting edge, I will offer some thoughts. First of all, the initial Open Dialogue meeting takes place usually in the person’s home within twenty-four hours of reported psychotic behavior. If the psychotic person jumps up and leaves the room, he is encouraged to listen in to the conversation even if not physically present in the room. (The open door policy.) Medication is not usually discussed in the first few meetings and often is not recommended at all.

Whitaker claims that the Open Dialogue concept of psychosis doesn’t fit into either the biological or psychological category. It is familiar to me because it is very much like the Family Constellation Therapy that Bert Hellinger and others espouse. “Psychosis does not live in the head. It lives in the in-between of family members, and the in-between of people,” Salo explained. “It is in the relationship and the one who is psychotic makes the bad situation visible. He or she ‘wears the symptoms’ and has the burden to carry them.”

As a parent, would this concept of the origin of psychosis make me feel better or worse about the situation compared to the group meetings that I went to with the family in the psychiatrist’s offices? There, psychosis was considered something foreign to everybody, family and patient included. It was something that just “happened,” like becoming diabetic or discovering that your house was burgled. Medications were part of the deal, and were insisted on. I’ll put my money on better outcomes in Lapland.

The program we were involved with made me feel anxious. I am sure that the families are anxious in Lapland, too, but it seems like the situation is diffused rather quickly within the privacy of the home. We suffered through the horror of thinking that my son’s brain was inexplicably damaged, we were led to believe that the doctors held the key and that there was nothing that we could have done to prevent this or to get over this. (There’s no cure, right?) We were also encouraged to attend meetings with other parents who, naturally, were worried about their children – and it showed. It was a climate of fear. Then the side effects of the drugs quickly became apparent – leading to more fear and a sense of doom.

The “problem” had been escalated by dragging it under a bigger spotlight instead of containing it and working through it where it arose – in the home. A massive case of over-reaction to a problem of living.

Big NIMH

One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It is simply too painful to acknowledge — even to ourselves — that we’ve been so credulous. – Carl Sagan

I swiped this quote from Beyond Meds because Robert Whitaker’s new book Anatomy of an Epidemic*, currently on my reading table, points to the “Big Bamboozle” in the pharmaceutical industry when it comes to the treatment of the mentally ill. As it was with Ida Tarbell and Standard Oil, Upton Sinclair and the meat packing industry, let’s hope that the Whitaker book will put an end to the encroachment of the big pharma/academia/American Medical Association alliance on your brain.

The meticulously documented book explains that it was the Medicare and Medicaid legislation enacted in 1965 that allowed the discharge of chronic schizophrenia patients from unsubsidized state mental hospitals into subsidized nursing homes, not the invention of Thorazine in 1955, as it is so often attributed. Patients treated with neuropleptics in a 1956 studied cited had a lower discharge rate for first psychotic episodes than those who had been treated with a neuroleptic. The general opinion of researchers back then was that patients treated with neuroleptics had lower discharge rates than patients for whom no neuroleptics were administered.

Unfortunately our societal belief that it was this medication that emptied the asylums, which is so central to the “psychopharmacology revolution” narrative, is belied by the hospital census data.

Numerous studies in the 1980s cited in the Whitaker book came to the conclusion that there was no evidence that the dopamine function of the brain is disturbed in schizophrenia. Still the public continued to be told that people diagnosed with schizophrenia had overactive dopamine systems, with the drugs likened to “insulin for diabetes,” and thus former NIMH director Steve Hyman, in his 2002 book, Molecular Neuropharmacology, was moved to once again remind readers of the truth. “There is no compelling evidence that a lesion in the dopamine system is a primary cause of schizophrenia,” he wrote.

The pharma bamboozle is particularly poignant because of the millions of lives wasted and lost. Parents have been told, by a medical profession that they trust, that their child has a brain disease, just like diabetes, and that in order to “protect the brain,” they must continue to take these medications, just like a diabetic must do with insulin. That guilt is overwhelming because it is personal and had we been less credulous, the outcome may have been different.

Having heard Dr. Thomas Insel, Director of the National Institute for Mental Health (NIMH), I have no great confidence that that organization, despite it being a supposed watchdog of public mental health, will suddenly “see the light”. He stated very clearly in that seminar that research has demonstrated again and again that current and past drugs are ineffective in treating mental disorders, but they were shining their flashlights looking for the key in the wrong areas! They just haven’t found the right drug targeted to the particular problem! There’s a term for that in business that eludes me. . . when you trash the old product in order to stimulate sales of the new one. Don’t worry, in the NIMH’s world, there are always exciting new drug possibilities. So, the Big Bamboozle will continue as long as the public is gullible. It will take a different pharmaceutical tactic, that’s all. The insulin for diabetics idea has been exposed, so we’re not buying that one, but what will it be? It’ll be clever, that’s for sure.

Here is where Dr. Insel’s flashlight is looking:
We must address mental illnesses, from autism to schizophrenia, as developmental brain disorders with genetic and environmental factors leading to altered circuits and altered behavior. Today’s state-of-the-art biology, neuroscience, imaging, and genomics are yielding new approaches to understanding mental illnesses, supplementing our psychological explanations. Understanding the causes and nature of malfunctioning brain circuits in mental disorders may make earlier diagnosis possible. Interventions could then be tailored to address the underlying causes directly and quickly, changing the trajectory of these illnesses, as we have done in ischemic heart disease and some forms of cancer. For serious mental illness, this is a new vision for prevention, based on understanding individual risk and developing innovative treatments to preempt disability.
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Anatomy of an Epidemic: Magic Bullets, Psychatric Drugs, and the Atonishing Rise of Mental Illness in America, author Robert Whitaker

“Shudder” Island

Saturday evening Ian and I saw Shutter Island, the new Martin Scorsese film starring Leonardo DiCaprio. It is a film noir, set in a fictitious asylum for the criminally insane in Boston Harbor, 1954. People may dismiss the film as giving psychiatry and the insane the “Hollywood” treatment, and there is always some truth to that when it comes to Hollywood, but I feel the film goes deeper and makes some interesting observations. The film is about trauma and doesn’t shy away from linking trauma to a later diagnosis of insanity.

So, Hollywood is there, but mainstream psychiatry continues to avoid linking trauma to insanity. It is nobody’s “fault” they say except your faulty brain chemisty. Pushing the diseased brain model of psychiatry for decades has prevented people en masse from regaining their health and well-being by confronting their deepest pain. If you believe that movies are the vanguard of social change, then be prepared for a sea change in treatments for mental health. It’s already evident in the number of books and articles taking the pharmaceutical industry and the medical profession to task for mental illness disease-mongering and drug treatments that are not only ineffective, but also ensure life long patients.

I am looking forward to reading Robert Whitaker’s latest book, due to be released in April, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. Whitaker is the author of the highly acclaimed Mad in America.

A review of this book by Daniel Dorman, UCLA School of Medicine, posted on Amazon, exposes the growing link between recovery outcomes and long term use of drugs.

Why are so many more people disabled by mental illness than ever before? Why are those so diagnosed dying 10-25 years earlier than others? In Anatomy of an Epidemic investigative reporter Robert Whitaker cuts through flawed science, greed and outright lies to reveal that the drugs hailed as the cure for mental disorders instead worsen them over the long term. But Whitaker’s investigation also offers hope for the future: solid science backs nature’s way of healing our mental ills through time and human relationships.