Neuroleptics

Here’s an interesting story from Australia, recently back in the spotlight. From 1962 to 1979, psychiatrist Harry Bailey, MD, serving as chief psychiatrist at Chelmsford Private Hospital in New South Wales, practiced “deep sleep therapy”, which involved keeping people in barbiturate-induced comas for days or even weeks. Twenty-four of the individuals who received this “treatment” died while still in the hospital. Many more died or showed permanent brain damage after discharge. ...

On March 4, 2020, the very eminent Allen Frances, MD, published an article in Aeon, which according to its About page is “a digital magazine, publishing some of the most profound and provocative thinking on the web. We ask the big questions and find the freshest, most original answers, provided by leading thinkers on science, philosophy, society and the arts.” The article is called The lure of ‘cool’ brain research is stifling psychotherapy. The central theme is that prior to 1990, the National Institute of Mental Health (NIMH) “appreciated the need for a well-rounded approach [to mental health] and maintained a balanced research budget that covered an extraordinarily wide range of topics and techniques.” However, since 1990, the opening year of the Decade of the Brain, the NIMH has “increasingly narrowed its focus almost exclusively to brain biology – leaving out everything else that makes us human, both in sickness and in health.” ...

INTRODUCTION On May 5, 2017, Donald Goff, MD and seven other psychiatrists, including the very eminent Jeffrey Lieberman, MD, published an article in the American Journal of Psychiatry. The title is: The Long-Term Effects of Antipsychotic Medication on Clinical Course in Schizophrenia. Here’s the abstract: "Concerns have been raised that treatment with antipsychotic medication might adversely affect long-term outcomes for people with schizophrenia. The evidence cited for these concerns includes the association of antipsychotic treatment with brain volume reduction and with dopamine receptor sensitization, which might make patients vulnerable to relapse and illness progression. An international group of experts was convened to examine findings from clinical and basic research relevant to these concerns. Little evidence was found to support a negative long-term effect of initial or maintenance antipsychotic treatment on outcomes, compared with withholding treatment. Randomized controlled trials strongly support the efficacy of antipsychotics for the acute treatment of psychosis and prevention of relapse; correlational evidence suggests that early intervention and reduced duration of untreated psychosis might improve longer-term outcomes. Strategies for treatment discontinuation or alternative nonpharmacologic treatment approaches may benefit a subgroup of patients but may be associated with incremental risk of relapse and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment." ...

Thirty-three years ago, in August 1983, an article titled Suicide Associated with Akathisia and Depot Fluphenazine Treatment appeared in the Journal of Clinical Psychopharmacology. The authors were Katherine Shear, MD, Allen Frances, MD, and Peter Weiden, MD. Here are some quotes, interspersed with my comments/observations: "Akathisia is a common and distressing side effect of neuroleptic medication that can be difficult to recognize and treat. Several previous reports mention maladaptive behavioral consequences, such as poor compliance with prescribed medication and aggressive or self-destructive outbursts. We are reporting suicides in two young Hispanic men who had developed severe akathisia after treatment with depot fluphenazine. Depression with suicidal behavior has been observed following fluphenazine injection, but suicide associated with akathisia has not been previously noted." ...

On February 1, Allen Frances, MD, published an interesting article on the Huffington Post blog. The article is called Do Antipsychotics Help or Harm Psychotic Symptoms?, and is a response to Robert Whitaker’s post of January 27: “Me, Allen Frances, and Climbing Out of a Pigeonhole. This post, in turn, was a response to Dr. Frances’s Psychiatric Medicines Are Not All Good or All Bad, which was published in the Huffington Post on January 15. Readers may remember that I published a critique of this latter article on February 9. ...

BACKGROUND On June 19, 2015, I published a post titled Allen Frances’ Ties to Johnson & Johnson. In that post, I set out some very serious allegations against Dr. Frances. I drew these allegations from a document titled Special Witness Report dated October 15, 2010. The report was written by David Rothman, PhD, Professor of Social Medicine at Columbia College of Physicians and Surgeons. Dr. Rothman’s report was produced in the context of a lawsuit filed by the State of Texas against Janssen Pharmaceutica, a subsidiary of Johnson & Johnson. ...

INTRODUCTION I recently came across an article titled Diagnosisgate: Conflict of Interest at the Top of the Psychiatric Apparatus, by Paula Caplan, PhD. The article was published in Aporia, the University of Ottawa nursing journal, in January 2015. Aporia is “a peer-reviewed, bilingual, and open access journal dedicated to scholarly debates in nursing and the health sciences.” Dr, Caplan is a clinical and research psychologist, and an Associate at Harvard’s DuBois Institute. She worked as a consultant to the DSM-IV task force in the 1980’s, but resigned from this position after two years. Here’s a quote from her February 2014 post on Mad in America The Great “Crazy” Cover-up: Harm Results from Rewriting the History of DSM: ...

In November of last year, the Schizophrenia Bulletin published online a research study: Antipsychotic Treatment and Mortality in Schizophrenia, by Minna Torniainen et al. The research was conducted in Sweden. The authors offer the following background for the study: "It is generally believed that long-term use of antipsychotics increases mortality and, especially, the risk of cardiovascular death. However, there are no solid data to substantiate this view." and the following conclusions: "Among patients with schizophrenia, the cumulative antipsychotic exposure displays a U-shaped curve for overall mortality, revealing the highest risk of death among those patients with no antipsychotic use. These results indicate that both excess overall and cardiovascular mortality in schizophrenia is attributable to other factors than antipsychotic treatment when used in adequate dosages." ...

It's no secret that here in America, foster children are being prescribed psychiatric drugs, especially neuroleptics, as a means of controlling their behavior. A great deal has been said and written on the matter. Politicians have declared the practice deplorable. Children's advocacy groups have expressed concern, and, of course, those of us in the antipsychiatry movement have screamed till we're hoarse. But the problem persists. For the past six months or so, the San Jose Mercury News, a California newspaper, has been running frequent articles on this topic, calling for oversight and corrective action. ...

Thomas Insel, MD, is the Director of the National Institute of Mental Health. In June of last year, he published, on the Director’s Blog, an article titled Are Children Overmedicated? The gist of the article is that children are not being overmedicated, but rather that there is an increase in “severe psychiatric problems” in this population. Here are some quotes, interspersed with my comments. "The latest estimate from the National Center for Health Statistics reports that 7.5 percent of U.S. children between ages 6 and 17 were taking medication for 'emotional or behavioral difficulties' in 2011-2012. The CDC reports a five-fold increase in the number of children under 18 on psychostimulants from 1988-1994 to 2007–2010, with the most recent rate of 4.2 percent. The same report estimates that 1.3 percent of children are on antidepressants. The rate of antipsychotic prescriptions for children has increased six-fold over this same period, according to a study of office visits within the National Ambulatory Medical Care Survey. In children under age 5, psychotropic prescription rates peaked at 1.45 percent in 2002-2005 and declined to 1.00 percent from 2006-2009." ...