The hidden damage of psychiatric drugs! (awful for ALL Psychiatric patients)

"Anatomy of an Epidemic": The hidden damage of psychiatric drugs
An award-winning science reporter looks at the history of mental illness in America -- with disturbing results

In the past few months, the perennial controversy over psychiatric drug use has been growing considerably more heated. A January study showed a negligible difference between antidepressants and placebos in treating all but the severest cases of depression. The study became the subject of a Newsweek cover story, and the value of psychiatric drugs has recently been debated in the pages of the New Yorker, the New York Times and Salon. Many doctors and patients fiercely defend psychiatric drugs and their ability to improve lives. But others claim their popularity is a warning sign of a dangerously over-medicated culture.

The timing of Robert Whitaker’s "Anatomy of an Epidemic," a comprehensive and highly readable history of psychiatry in the United States, couldn’t be better. An acclaimed mental health journalist and winner of a George Polk Award for his reporting on the psychiatric field, Whitaker draws on 50 years of literature and in-person interviews with patients to answer a simple question: If "wonder drugs" like Prozac are really helping people, why has the number of Americans on government disability due to mental illness skyrocketed from 1.25 million in 1987 to over 4 million today?

"Anatomy of an Epidemic" is the first book to investigate the long-term outcomes of patients treated with psychiatric drugs, and Whitaker finds that, overall, the drugs may be doing more harm than good. Adhering to studies published in prominent medical journals, he argues that, over time, patients with schizophrenia do better off medication than on it. Children who take stimulants for ADHD, he writes, are more likely to suffer from mania and bipolar disorder than those who go unmedicated. Intended to challenge the conventional wisdom about psychiatric drugs, "Anatomy" is sure to provoke a hot-tempered response, especially from those inside the psychiatric community.

Salon spoke with Robert Whitaker over the phone about the reasons behind the pharmaceutical revolution, how "anxiety" became rebranded as "depression," and what he thinks psychiatrists are hiding from the American public.

Psychiatric drug use is a notoriously tough subject for writers, because of all the contradictory research. Why wade into it?

In 1998, I was writing a series for the Boston Globe on abuse of psychiatric patients in research settings. I came across the World Health Organization’s outcomes study for schizophrenia patients, and found that outcomes were better for poor countries of the world -- like India, Colombia, Nigeria -- than for the rich countries. And I was startled to find that only a small percentage of patients in those countries were medicated. I also discovered that the number of people on disability for mental illness in this country has tripled over the last 20 years.

If our psychiatric drugs are effective at preventing mental illness, I thought, why are we getting so many people unable to work? I felt we needed to look at long-term outcomes and ask: What does the evidence show? Are we improving long-term outcomes or not?

But you claim in the book that psychiatrists have long known that these drugs can cause harm.

In the late 1970s, Jonathan Cole -- the father of American psychopharmacology -- wrote a paper called "Is the Cure Worse Than the Disease?" that signaled that antipsychotics weren't the lifesaving drugs that people had hoped. In it, he reviewed all of the long-term harm the drugs could cause and observed that studies had shown that at least 50 percent of all schizophrenia patients could fare well without the drugs. He wrote, "Every schizophrenic outpatient maintained on antipsychotic medication should have the benefit of an adequate trial without drugs." This would save many from the dangers of tardive dyskinesia -- involuntary body movements -- as well as the financial and social burdens of prolonged drug therapy. The title of the paper poignantly sums up the awful long-term paradox.

Why didn't this change people's minds about psychiatric drugs?

Psychiatry essentially shut off any further public discussion of this sort. And there’s a reason for this. In the 1970s, psychiatry felt that it was in a fight for its survival. Its two prominent classes of drugs -- antipsychotics, and benzodiazepines like Valium -- were coming to be seen as problematic and even harmful, and sales of these drugs declined. At the same time, there’d been an explosion in the number of counselors and psychologists offering other forms of non-drug therapy.

Psychiatry saw itself in competition for patients with these other therapists, and in the late 1970s, the field realized that its advantage in the marketplace was its prescribing powers. Thus the field consciously sought to tell a public story that would support the use of its medications, and embraced the "medical model" of psychiatric disorders. This took off with the publication of the Diagnostic and Statistical Manual of Mental Disorders III in 1980, which introduced many new classes of “treatable” disorders.

In a recent New Yorker article, Louis Menand suggested that anxiety drugs were rebranded as antidepressants in the '80s, because anxiety drugs had acquired a bad name. Is that really true?

Depression and anxiety are pretty closely linked. Before benzodiapenes came out, the discomfort that younger people and working people felt was seen as anxiety, by and large. Depression was seen as less common, a disease among the middle-aged and older. It was this deep thing, where people are putting their heads in their hands and can’t move. But when the benzodiazepines were proven to be addictive and harmful, the pharmaceutical companies said, in essence, "We have this market of people who feel discomfort in their lives, which we used to call anxiety. If we can rebrand it as depression, then we can bring a new antidepressant to market." It was a reconceptualization of discomfort, and it opened up the giant market for antidepressants as we see today.

Read the rest of this article: http://www.salon.com/books/feature/2010/04/27/interview_whitaker_anatomy_of_an_e...