Benzodiazepines: Dangerous Drugs

On February 25, Kristina Fiore published an article on MedPage today. It’s titled Killing Pain: Xanax Tops Charts. The article is based on a study conducted by Jann M et al, and published in the February 2014 issue of the Journal of Pharmacy Practice. The study is titled Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics. Here’s a quote: "During 2003 to 2009, the 2 prescriptions drugs with the highest increase in death rates were oxycodone 264.6% and alprazolam 233.8%. Therefore, benzodiazepines have a significant impact on prescription drug unintentional overdoses second only to the opioid analgesics. The combination prescribing of benzodiazepines and opioid analgesics commonly takes place. The pharmacokinetic drug interactions between benzodiazepines and opioid analgesics are complex. The pharmacodynamic actions of these agents differ as their combined effects produce significant respiratory depression." ...

March 12, 2014 · PhilHickeyPhD

Is Psychology Going the Way of Psychiatry?

On January 7, Maria Bradshaw, co-founder of CASPER, published an interesting article on Mad in America. It’s called Prescribing Rights for Psychologists, and it suggests that psychology as a profession may be falling into some of the same errors that enmire psychiatry. Maria makes some very compelling points, and focuses particularly on the fact that psychologists have won prescribing rights in a number of jurisdictions, and are engaged in an ongoing effort to expand this aspect of their work. ...

January 14, 2014 · PhilHickeyPhD

Understanding Human Behavior

A couple of months ago I wrote an article concerning ECT which generated some controversy. One of the issues that came up was the relationship between biological explanations of human activity and more global explanations, which, for want of a better term, I’ll call person-centered explanations. Any human activity can be viewed from different levels of abstraction. Suppose, for instance, that I am sitting in my living room reading a book. Then I put the book down, stand up, and go outside. If the question were to be asked: why did he put the book down and go outside? A wide range of perspectives and answers are possible. One could, for instance, focus on the fact that I am a biological organism, and one could develop a detailed and comprehensive flow sheet of every muscle movement, every heartbeat, every sensory input, neural impulse etc., that had occurred from the moment that I put the book down until I was standing outside. Such an account might be more or less detailed. There would, of course, be physical limitations on the amount of information of this sort that is attainable, but from a theoretical point of view, one could compile a detailed, complete, and accurate biological account of the actions in question. And such an account would be a valid response to the question: why did he put the book down and go outside. ...

January 13, 2014 · PhilHickeyPhD

The Sandcastle Continues to Crumble: ADHD Does Not Exist

BOOK PREVIEW Richard C. Saul, MD ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder Publication date: February 18, 2014 ************************ Those of us on this side of the psychiatry debate have been saying for decades that the condition known as ADHD is not an illness, but is rather an arbitrarily delineated cluster of vaguely defined problems that children have acquired in various ways. We have also pointed out that psychiatry's labeling of this condition as an illness is simply another instance of their inexorable turf expansion, and that their widespread drugging of the individuals so labeled is destructive and disempowering. And, also for decades, psychiatry has been marginalizing us as unscientific mental illness deniers, who seek to put the clock back and deprive people suffering from this “illness” of the vital “treatment” that they so desperately need. ...

January 7, 2014 · PhilHickeyPhD

Training the Psychiatrists of the Future (According to Dr. Lieberman): More Cheerleading

Jeffrey Lieberman, MD, President of the APA and Chair of Psychiatry at Columbia University, published a post on November 26 on Psychiatric News. The article is called Training the Psychiatrists of the Future, and is co-authored by Richard Summers, MD. Dr. Summers is a Professor of Psychiatry at the University of Pennsylvania. Drs. Lieberman and Summers open by telling us that psychiatrists’ roles “…are changing and will continue to change.” That sounds great, but don’t expect too much. There will still, they tell us, be a need for: ...

December 11, 2013 · PhilHickeyPhD

Neuroleptics for Children: Harvard's Shame

In December 2012, Mark Olfson, MD, et al, published an article in the Archives of General Psychiatry. The title is National Trends in the Office-Based Treatment of Children, Adolescents, and Adults with Antipsychotics. The authors collected data from the National Ambulatory Medical Care Surveys for the period 1993-2009, and looked for trends in antipsychotic prescribing for children, adolescents, and adults in outpatient visits. Here are the results: Age Increase in no. of antipsychotic prescriptions per 100 population (1993-2009) 0-13 0.24-1.83 (almost 8-fold) 14-20 0.78-3.76 (almost 5-fold) 21+ 3.25-6.18 (almost 2-fold)   The authors provide a breakdown of the diagnoses assigned to the children and adolescents during the antipsychotic visits. ...

December 4, 2013 · PhilHickeyPhD

Causes of High Mortality in People Labeled 'Mentally Ill'

ANOTHER VIDEO FROM DR. LIEBERMAN On October 28, Jeffrey Lieberman, MD, President of the APA, made another video. This one is titled An Important Look at Mortality in Mental Illness: A Decade of Data on Psychotropic Drugs, and was made for Medscape. You can see the transcript at the same site. Medscape is a web resource for medical practitioners. The video is Dr. Lieberman’s commentary on an article that appeared in JAMA Psychiatry online on August 28: Comparative Mortality Risk in Adult Patients With Schizophrenia, Depression, Bipolar Disorder, Anxiety Disorders, and Attention-Deficit/Hyperactivity Disorder Participating in Psychopharmacology Clinical Trials, by Arif Khan, MD, et al. ...

November 12, 2013 · PhilHickeyPhD

Care For Your Mind (CFYM): A New Advocacy Group

On September 27, Psychiatric Services, a journal of the APA, published an article called Blog Brings Doctors, Patients Together to Address MH Issues. It was written by Vabren Watts, a Psychiatric News Journalist. The article is a booster piece for the recently-formed CFYM (Care For Your Mind): "…an online forum for people with mood disorders—along with their families and psychiatrists—to discuss the mental health care system and changes that may affect them under health care reform." ...

November 9, 2013 · PhilHickeyPhD

The Allen Frances – Lucy Johnstone Debate

On October 28, Allen Frances, MD, Chairperson of the DSM-IV task force, published an article on Psychology Today. It is titled Does It Make Sense To Scrap Psychiatric Diagnosis? and is essentially a response to the British Psychological Society’s Division of Clinical Psychology’s (DCP) call to abandon the medical model in situations where it is not appropriate, and to embrace a psychosocial approach. You can see a copy of the DCP’s May 13, 2013, statement here. ...

November 1, 2013 · PhilHickeyPhD

A Psychiatric Case Study. A Sad Story

One of the criticisms that I routinely make of psychiatry is that its primary agenda during initial evaluations is the assignment of a “diagnosis,” and that ongoing “treatment” consists of 15-minute “med checks,” during which drug regimens are changed and adjusted. The essence of my criticism is that this kind of approach inevitably oversimplifies human problems, and in practice does more harm than good. My contentions in this regard have from time to time been challenged. It has been said that my portrayal of psychiatry is a kind of misleading caricature, and that in reality, psychiatrists do, in fact, concern themselves with human issues over and above “diagnosis” and drugs. This debate will, of course, continue, but I recently read an article on Psychiatric Times that has some bearing on the matter. [Thanks to Nick Stuart for the link.] The title is Conduct Disorder, ADHD – or Something Else Altogether? The author is Steven Dilsaver, MD, and the piece is dated October 11, 2013. The article is a case study of the psychiatric “treatment” of an eight-year-old boy (John). ...

October 24, 2013 · PhilHickeyPhD