Psychoactive Medication

“The ethical use of Psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” ~ Dr Phil Thomas

I watched the movie All that Heaven Allows (1955). There is a line in it where Jane Wyman goes to the doctor after the break up of a relationship and he says “Do you expect me to give you a prescription to cure life?”. While there are some tranquilizers that can help people short term, there is no prescription that will cure life’s emotional problems, some of which may have stemmed from trauma in a person’s past that was not properly dealt with at the time. Or more recent distress.

There has to be a better way than drugging people into oblivion or disabling a person’s cognitive abilities as part of “treatment”. There are many parts of the world that do not rely on these drugs. According to research by medical journalist Robert Whitaker some of these countries have better overall outcomes [1].

Medication can actually intensify or magnify mental health problems for some of us. I personally found that some tranquilizers can help short term, but long term these drugs held me back. While a person may need some tranquilizers if in acute distress or ‘psychosis’ (a loss of touch with ‘reality’), what they really need is someone to listen with empathy non-judgmentally, to try to understand what’s happening and set them on the right path.

Adverse effects of Prescribed Psychotropic substances

Prescribed psychotropic substances can have very damaging effects, especially when used long term. In 2005, a study funded by Eli Lilly, the maker of Zyprexa / Olanzapine, found that long term exposure to this major tranquilizer causes shrinkage of the brain, “significant reduction in brain volume that affects both gray and white matter”[2]. I first learned this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. After I had an adverse reaction to the drug Citalopram, I was put on Zyprexa at what I now consider too high a dosage (10mg) long term in 2008. I did not have informed consent about this powerful but potentially damaging drug! There are no words to describe my shock and feeling of being let down by the medical profession. The damage is there and can be felt in subtle ways. I have to remind myself to be patient and hope that neuroplasticity will help, which is the brains ability to repair some of the damage and injury.

Over a 3 year period I was given Olanzapine, Seroquel/Quetiapine, Lamictal, Lithium, Rivotril and a number of other drugs. 9 foolscap pages in total. When it came to the large cocktail of drugs I was put on, no doctor seemed to care about the weight gain or damage the drugs they prescribed caused. There are law suits in the US relating to the drug Zyprexa / Olanzapine [3]. According to Robert Whitaker in his book Anatomy of an Epidemic twenty people died in the trial for Zyprexa, a scandal in itself.

Withdrawal from prescribed psychoactive substances

It is necessary to to be cautious with Psychiatric medication. It’s easier to get on them than to get off and easier to prescribe than deprescribe.

While some people may want to stay on these drugs for life, those who would like to come off prescribed drugs should be supported and given alternatives. Stopping psychoactive drugs needs to be carefully and safely managed. Some prescribers need more up to date information on correct withdrawal methods. Supporters and family need truthful information and advice about the withdrawal process. It is important to prepare well for withdrawal with nutrition, exercise, getting enough sleep (if possible), talking therapy and holistic work on health.

Relapse on discontinuation of psychoactive drugs can be a form of drug withdrawal state [4]. In the current biomedical system, any relapse will usually be seen as a sign of “illness” as opposed to the process of withdrawal.

In 2011, when I was trying to come off the drugs I was told by a doctor in a disapproving tone “These drugs are not made for a’la carte people like you!”. That particular day was a major turning point and I can thank him now for his sarcastic but valuable one liner. That was the day I knew I wanted to get off these drugs for sure. I was going to show him that I can do this. At the same time, without support from doctors or others, it was a bumpy ride.

When I was coming off the drugs I got no support or correct advice. In the first 2 years I was prone to relapse, as my brain/body readjusted. I did keep some Olanzapine 5 mg on standby during that time. I am now drug free and ‘Psychosis free’ since December 2012. Sleep is an important part of the healing journey and something I struggle with since the overuse of these mind altering drugs. I never get a full nights sleep and continue to work on that. My circadian clock is also out of sync.

It is very difficult to have a proper recovery in a system that revolves around the biomedical model. Some people are told they will be on drugs for life and are called “non-compliant” if they try to go down an alternative route. Coming off these drugs will usually be severely frowned upon. You are basically left to your own devices in what can be a very difficult process.

Sometimes people are taken off the drugs too fast, leading to failure, but this can also take away Hope of ever becoming drug free. Withdrawal and drug reduction has to be done very slowly, under the supervision of an expert who has the most up to date honest psychopharmacological information on the withdrawal process. I’ve added a section at the very end of this blog entitled Resources to help withdraw from prescribed Psychoactive drugs.

Yearly explosion in prescribing of anti-depressants

An article in the Sunday Business Post (SBP) by Susan Mitchell in February 2018 investigated our growing dependence on prescribed painkillers and psychoactive substances. “From anti-depressants to sedatives, from painkillers to sleeping pills, the use of prescription medication is spiraling” [5]. Some of the headlines in this edition of the SBP include “We are definitely overprescribing. We’ve all seen what has happened in America, so we can’t be complacent. The figures are fairly stark”.

“In 2016, €25 million was spent on the drug (Lyrica / Pregabalin which is a neuropathic pain drug) for medical card holders – up from €5 million in 2006” (1086% increase). “The number of prescriptions for the SSRI (antidepressant) Lexapro soared from 190,109 to 631,000 – a 232 % increase” (2006 to 2016). Sertraline prescriptions are up 252%. And Venlafaxine (Effexor) prescriptions up 107%. These are shocking increases in drug use.

The money used on the over prescription of painkillers and Psychotropic drugs could be redirected to a more humane system. But that would require a major shift in thinking from the current biomedical based model to a system that is based more on a Psycho-social and holistic approach to healing.

For example, the Power Threat Meaning Framework describes an “alternative to Psychiatric classification in relation to emotional distress and troubled or troubling behaviour” [6]. One of the lead authors, clinical Psychologist Dr Lucy Johnstone, came to Dublin in May 2018 to talk about this approach, thanks to the Youth mental health charity Jigsaw. While I have been disillusioned with the approach to mental health in Ireland for the last decade, I see some glimmers of hope that we might be moving out of the dark ages when it comes to helping distressed human beings.


Do doctors give out antidepressants too easily?

In April 2013 The Right Hook (George Hook’s show on Newstalk) discussed an article in the Irish Examiner which saw journalism student Niamh Drohan approach seven GPs telling them she was suffering from stress and anxiety problems from her final year in college [7]. All of the GPs diagnosed her with a mild form of depression. All doctors prescribed her with anti depressants! She said some of the doctors failed to inform her about appropriate dosage of tablets to take.

As someone who has been damaged by these drugs I was in shock at what I heard on The Right Hook. A doctor went on the show and claimed that these drugs are not addictive and far more seriously she claimed during the interview that anti-depressants are safe at overdose levels. Her exact words were “Not even dangerous at high levels at overdose”. Nothing could be further from the truth. A number of years ago, in a documentary on suicide, I heard a doctor say that if someone takes an overdose of certain prescription drugs they can end up alive and brain damaged.

In Ireland in 2009 there was the very tragic Shane Clancy case, which involved an overdose of the SSRI anti-depressant drug Citalopram. SSRI = Selective Serotonin Re-uptake Inhibitor. The tragedy happened 17 days after starting this mind altering drug. Thankfully Shane Clancy’s mother Leonie Fennell and Psychiatrist and Psychopharmacologist Prof David Healy got to speak on the George Hook show shortly after that. I had complained to the programme and made Leonie aware of it.

Evidence Based Medicine (EBM)

I’ve included a presentation by Prof David Healy [8]. 6 minutes into the presentation you will see that the negative trials on SSRIs anti-depressants have been hidden. Not forgetting ghost written articles.

Evidence Based Medicine is broken is an article from the British Medical Journal (2014) written by Scottish GP Des Spence [9] ~

“Now doctors can prescribe a pill for every ill. The billion prescriptions a year in England in 2012, up 66% in one decade, do not reflect a true increased burden of illness nor an ageing population, just polypharmacy supposedly based on evidence… How many people care that the research pond is polluted with fraud, sham diagnosis, short term data, poor regulation, surrogate ends, questionnaires that can’t be validated, and statistically significant but clinically irrelevant outcomes? Medical experts who should be providing oversight are on the take…the current incarnation of EBM (Evidence Based Medicine) is corrupted, let down by academics and regulators alike. What do we do? We must first recognise that we have a problem.”

The following is a quote from Psychiatrist Dr Allen Frances (chair of the taskforce that wrote the DSM-IV) “It’s been many years since I have trusted anything I read in a medical or psychiatric journal. There is an enterprise-wide positive bias; findings never seem to replicate; benefits are hyped; harms are hidden… In 1962, it took a year or two from the time of a drug’s launch to recognize its major hazards. It now takes decades” [10].

Placebo

This is from an article by Charlotte Blease [11]. Irving Kirsch is a Harvard Professor.

“The placebo effect is a genuine therapeutic mind-body effect. It can be triggered by a range of different phenomena in medicine and healthcare. The branding, the expensiveness, the colouration of pills, the number of times you have to take them per day, even experiencing side effects to medication can increase the placebo effect …

Kirsch and his colleagues discovered that antidepressants are not more effective than placebos for mild to moderate depression. They did find some research that antidepressants outperformed placebos for individuals with severe depression (in these cases, there is a small but clinically significant difference)”.

DSM (Diagnostic and Statistics Manual)

Mental health is an area where there are powerful vested interests. The pharmaceutical industry is a multi billion dollar industry. This has a major impact on the approach taken in treating people & the fact that the biomedical model is still dominant.

DSM stands for Diagnostic and Statistics manual and is now at revision 5. When you have 69 % of the DSM-5 taskforce with financial links to the pharmaceutical industry this leads to vast amounts of over diagnosis and over prescribing of drugs. These drugs can delay recovery and cause disability leading to a huge burden on the social welfare system. This burden could be reduced with more ethical prescribing and more honesty about the drugs.

The biomedical model may be the dominate approach used but it is the one that costs the individual and society a lot more in the long run. It is possible to get people through recovery and back to being a productive member of their community faster. This is not always possible if the person is on high doses of strong tranquilizers which can affect their ability to function e.g. in a work environment.

Conflicts of Interest

In academic research its important to know who funded the research and if there was any pharmaceutical company linked to it.

“Doctors, consultants and other medical practitioners will be obliged to declare gifts or donations from pharmaceutical and healthcare companies under new legislation introduced in the Dáil” [12].

“THE PHARMACEUTICAL INDUSTRY made payments worth €6.8 million to Irish doctors and €10.7 million to Irish healthcare institutions in 2015” [13].

“The HSE wants pharmaceutical companies to name those in receipt of payments for travel, sponsorship, medical education, grants and other activities” [14].

It’s frustrating to attend a public lecture in 2013 in a top medical college in Ireland and listen to a mainstream Psychiatrist speak without declaring his conflicts of interest at the start. It can potentially result in the public been misinformed about the serious risks that go with certain drugs. That’s also relevant when doctors / Psychiatrists go to the High Court with their “expert” advice which influences the judge.


GP training in mental health

“Medical knowledge should be open to public scrutiny” Dr Terry Lynch

Most GPs in Ireland do not have specific training in mental health. In the sample of GPs questioned in the SWAHB survey, 68% indicated they had no specific training in mental health; the remaining 32% had training consisting of between three and nine months clinical placement and/or during their hospital rotation” ‘Vision for Change’ policy document, pg 67 [15].

That is a staggering statistic. Hopefully it has improved since this document was written, but I personally feel that GPs should have more training in mental health. That is where a lot of emotional issues are dealt with. In my experience a prescription for pills rarely solves anything long term and can sometimes cause more harm than good. While doctors can be supportive, they work under time pressure in busy surgeries. Inadequate training can lead to damage to the patient and long term trauma.

The Power of the Sub-conscious mind

I have learned a lot about the power of the sub-conscious mind from a book by Dr Joseph Murphy [16]. “You should carefully watch all ideas and thoughts entertained in your conscious mind”…”You can interfere with the normal rhythm of your heart, lungs, and other organs by worry, anxiety and fear. Feed your sub-conscious with thoughts of harmony, health and peace and all the functions of your body will become normal again”.

Bernheim “was one of the first to explain how a physician’s suggestion to the patient took effect because of the force of the subconscious mind”. I was initially told by a doctor that I would need to be on the anti-depressant Citalopram for the rest of my life due to anxiety and panic attacks. When this drug triggered off mania/psychosis I was then taken off this drug ‘cold turkey’ by someone in the mental health system and saddled with the label Manic Depression / Bipolar (at a time when I was having an adverse reaction to the drug!). I was told I was ill and had a disorder. Bipolar Affective Disorder. BPAD for short in doctors notes.

Luckily, through some miraculous intervention and through the help of people like Ivor Browne I eventually started to realise that it was the drugs that were fueling the extreme lows and lethargy and also the highs, as well as the psychosis. Becoming aware of this was a major turning point in my healing journey. Due to the conditioning of society and the lack of support, breaking free from the indoctrination of the flawed biomedical approach, so I could try to heal, was no easy task.

I could still be living the “illness” and “disorder” model of mental health but decided that believing in this on a conscious and sub-conscious level was unhelpful, harmful and kept me stuck. Even though I have self-sabotaged throughout the years and tried to numb out some of the feelings, I persevered, while dealing with a lot of emotional distress and turmoil created by the whole ordeal.

“It is foolish to believe in sickness or in anything that will hurt or harm you. Believe in perfect health, prosperity, peace, wealth and divine guidance” Dr Joseph Murphy (PhD). I am a work in progress but a lot further along the road that I would be if I kept feeding my sub-conscious the biomedical view of emotional distress.

In my experience it was really a belief system. One that is very lucrative for the pharm industry. But not very helpful long term for the person in distress, who wants to heal and live a good quality, productive life. Natural balance, harmony, meaning, purpose and Peace of Mind are important to me. I still have days that I struggle and those are the days I need to stay self-aware and to mind myself. And to get enough rest. There is no pill that cures life. It requires daily work on physical and emotional health. And the ability to deal with any setbacks. I now feel Hope of healing, whereas before while sedated with drugs I felt no real hope at all.

References

[1] Anatomy of an Epidemic by Robert Whitaker, 2010 ~
https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/1491513217

[2] “The Influence of Chronic Exposure to Antipsychotic Medications”, 2005 ~ http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

[3] Lilly Settles With 18,000 Over Zyprexa / Olanzapine ~

www.nytimes.com/2007/01/05/business/05drug.html

[4] Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas, 2015 ~

https://www.amazon.com/Psychiatry-Context-Experience-Meaning-Communities/dp/1906254729

[5] Hooked: Ireland’s hidden addiction to prescription drugs, Sunday Business Post, Susan Mitchell, Feb 2018 ~
https://www.businesspost.ie/health-social/hooked-irelands-hidden-addiction-prescription-drugs-408128

[6] The Power Threat Meaning Framework overview ~ Lead authors Dr Lucy Johnstone (clinical Psychologist) and Prof Mary Boyle, 2018 ~

https://www1.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/INF299%20PTM%20overview%20web.pdf

Also video presentation on PTM Framework ~
https://vimeo.com/267401691

[7] “Depressing truth about treating depression in the young” Niamh Drohan ~

www.irishexaminer.com/ireland/depressing-truth-about-anxiety-and-doctors-227126.html

[8] A talk by Prof David Healy “Time to abandon evidence based medicine?”, (2012) ~ http://www.youtube.com/watch?v=A3YB59EKMKw

[9] Evidence based medicine is broken, GP Des Spence, 2014 ~
http://www.bmj.com/content/348/bmj.g22?ijkey=nedZMe934zzz5bC&keytype=ref

[10] The Crisis of Confidence in Medical Research, Dr Allen Frances, 2015 ~
https://www.huffingtonpost.com/allen-frances/the-crisis-of-confidence-_b_6432236.html


[11] “Research on the placebo effect is a bitter pill for pharmaceutical firms to swallow” Dr Charlotte Blease, 2015
www.herald.ie/lifestyle/research-on-the-placebo-effect-is-a-bitter-pill-for-pharmaceutical-firms-to-swallow-31219408.html

[12] Bill will require doctors to declare gifts from pharma firms. Healthcare companies gave €30 million to hospitals, medical staff in 2016, says Minister ~
https://www.irishtimes.com/news/politics/oireachtas/bill-will-require-doctors-to-declare-gifts-from-pharma-firms-1.3263608

[13] Pharmaceutical industry paid Irish doctors €3.7 million for “undisclosed” reasons in 2015

http://www.thejournal.ie/big-pharma-ireland-3068146-Nov2016/

[14] “The HSE wants pharmaceutical companies to name those in receipt of payments for travel, sponsorship, medical education, grants and other activities”
https://www.businesspost.ie/health-social/hse-warns-pharma-firms-payments-doctors-392431

[15] Vision for Change (Report of the expert group on Mental Health Policy), 2006 ~
www.hse.ie/eng/services/publications/Mentalhealth/Mental_Health_-_A_Vision_for_Change.pdf

[16] The Power of Your Subconscious Mind, Dr Joseph Murphy, 2011 (Originally published 1963).

https://www.amazon.com/Power-Your-Subconscious-Mind/dp/1614270198

Other Relevant Resources

* Study 329 – where the hell is the outrage? by Dr Malcolm Kendrick ~

www.drmalcolmkendrick.org/2015/10/01/study-329-where-the-hell-is-the-outrage/

* ‘I was unaware of potential adverse effects to my prescribed antidepressants’ ~

www.independent.ie/life/health-wellbeing/mental-health/aines-story-i-was-unaware-of-potential-adverse-effects-to-my-prescribed-antidepressants-31218347.html

* John Rengen Virapen ~ Pharma whistleblower ~ www.youtube.com/watch?v=pmnOni0xlM4

* Dr. Allen Frances on the Risks of DSM-5 (Diagnostic and Statistics Manual) – The Lens Report ~

www.youtube.com/watch?v=-AMvrcBvYWk

* Danish doctor Peter Gøtzsche is co-founder of the respected Cochrane Collaboration.

Interview ~ www.youtube.com/watch?v=VIIQVll7DYY

* Does long term use of psychiatric drugs cause more harm than good? ~

www.bmj.com/content/350/bmj.h2435

* AstraZeneca Settles Most Seroquel Suits ~
https://prescriptions.blogs.nytimes.com/2011/07/28/astrazeneca-settles-most-seroquel-suits/

* SPECIAL REPORT: The anti-depressant generation ~
www.irishexaminer.com/ireland/special-report-the-anti-depressant-generation-319128.html

* Our €40m drug problem ~

www.irishexaminer.com/viewpoints/analysis/special-report-our-euro40m-drug-problem-319134.html

* Recording from The International Society for Ethical Psychology & Psychiatry (ISEPP) Conference. A mother (nurse) speaks of how difficult it was for her son to come off Paxil (Seroxat).

www.youtube.com/watch?v=R8ReARNiAHI


* Yolande Lucire ~ Adverse reactions to Psychiatric drugs:

www.youtube.com/watch?v=IEoSs6Yo0DA&feature=youtu.be


* New study concludes psychiatric drug treatments haven’t resulted in an improvement

in the long-term outcome of patients with “mood disorders”:

www.ncbi.nlm.nih.gov/m/pubmed/24285565/

* Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare by

Peter Gøtzsche, 2013 ~

www.radcliffehealth.com/shop/deadly-medicines-and-organised-crime-how-big-pharma-has-corrupted-healthcare

* Deadly Psychiatry and Organised Denial by Peter Gøtzsche, 2015 ~
https://www.amazon.com/Deadly-Psychiatry-Organised-Denial-Gotzsche-ebook/dp/B014SO7GHS

* DEPRESSION DELUSION: The Myth of the Brain Chemical Imbalance, 2015 ~

www.amazon.com/DEPRESSION-DELUSION-Volume-One-Imbalance/dp/1908561017

* The Emperor’s New Drugs: Exploding the Antidepressant Myth, Irving Kirsch, 2009 ~

www.amazon.com/The-Emperors-New-Drugs-Antidepressant/dp/0465022006

* Deaths in the UK potentially of people on antidepressants ~ www.antidepaware.co.uk

* Psychiatrist / Psychopharmacologist Prof David Healy ~ www.davidhealy.org

* Peter Lehmann “Recovery from Psychosis and Depression by Taking Psychiatric Drugs versus Recovery by Coming off Psychiatric Drugs”

www.peter-lehmann-publishing.com/articles/lehmann/pdf/recovery-from.pdf

* Will Self ~ Psychiatrists: the drug pushers ~

www.theguardian.com/society/2013/aug/03/will-self-psychiatrist-drug-medication

* My review of Psychiatry in Context ~ www.goodreads.com/user/show/46943899-anne

This review was published in the Journal of Critical Psychology, Counselling and Psychotherapy (Volume 16, Number 1, March 2016)

* Youth mental health charity Jigsaw ~
https://www.jigsaw.ie/

Resources to help withdraw from prescribed Psychoactive drugs

* Psychiatric Drug Withdrawal A Guide for Prescribers, Therapists, Patients and their Families ~

www.breggin.com/index.php?option=com_content&task=view&id=296

* How to stop anti-depressants ~ https://rxisk.org/guide-stopping-antidepressants/

* Council for Evidence-Based Psychiatry Support Page ~ http://cepuk.org/support/

* Recovery stories ~ http://cepuk.org/recovery-stories/

* Withdrawal Advisers ~ http://cepuk.org/withdrawal-advisers/

* Drug safety website ~ www.rxisk.org

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