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Damaged
Brains
A Warning
for Mental Health Professionals
Peter Wilberg
HEALTH
WARNING: your clients’ symptoms may be effects of the legally
prescribed drugs that are or have been used to ‘treat’ them.
Recent decades have seen an enormous rise in the number of people
treated with psychopharmaceutical medications - all of which have a
direct effect on brain functioning. Such medications include:
Antidepressants
Anxiolytics (for treating anxiety, sleep problems and panic attacks)
Neuroleptics (for treating so-called psychotic symptoms)
Stimulants (used on an increasing scale to treat children and
adults with so-called behaviour disorders such as Attention Deficit
Disorder)
What is not so well known is that many of the psychological and somatic
symptoms treated by counsellors and psychotherapists, physicians and
psychiatrists are a direct result of taking or having taken medications
of these sorts. Symptoms such as depression, anxiety, sleep disturbances
panic attacks, phobias, compulsions, mania, poor concentration, loss of
affect, suicidal thoughts and psychotic episodes are all recognised by
pharmaceutical themselves companies themselves as potential effects of
the very medications designed to treat them.
According the psychiatrist Peter Breggin, health practitioners now
confront a hidden epidemic of iatrogenic (medically caused)
psychical and somatic illness resulting from short or long-term chemical
disruption of brain functioning. The adverse effects of
psychopharmaceutical medications, both acute and chronic, include:
·
intended
effects (for example the mind-numbing depression of brain functioning
and the dulling of thought and emotion induced by neuroleptics).
· paradoxical effects (the accentuation of the very symptoms which the
drugs were prescribed to treat, such as panic attacks induced by
anxiolytics).
·
physiological side effects (ranging from respiratory, cardiac,
gastrointestinal problems to long-term brain and liver damage,
peripheral nerve damage, sexual dysfunction, weight gain, chronic
fatigue or dyskinesia (uncontrolled Parkinsonian-type movements).
· psychological side effects (symptoms of mania, depression, panic
attacks, psychotic episodes, suicidal ideation etc. of a sort not
previously experienced by the individual at any time before taking the
medications).
· withdrawal
effects (acute or chronic psychological and physiological effects
experienced when coming off prescribed medications).
·
tolerance
effects (needing ever-increasing dosages of the same drug to simply to
avoid acute and frightening withdrawal effects).
· short and
long-term dependency (addiction as a result of tolerance and withdrawal
effects).
There is a
tendency to interpret even the most dangerous physiological side-effects
- if reported - merely as symptoms of a patient’s psychological
disorder. Cardiac symptoms, for example, may be interpreted as ‘anxiety’
symptoms, rather than the other way round. As a result, patients with
genuine cardiac problems may remain medically untested and untreated
until they suffer a serious heart attack.
Many social workers, nurses, counsellors, psychotherapists and
alternative health practitioners however, still believe that the use and
efficacy of psychopharmaceutical drugs is scientifically proven.
The medical myth has it that mental disorders such as ‘depression’ are
caused by biochemical imbalances in the brain.. Not only has there never
been any scientific evidence of this whatsoever, it is actually not
technically possible to measure the levels of neurotransmitters in the
synapses between brain cells. The hypothesis of an original ‘chemical
imbalance’ was arrived at by arguing backwards from the supposedly
therapeutic effects of drugs designed to chemically influence the
release or reuptake of particular neurotransmitters - thereby altering
their respective levels in the brain, even though the latter cannot be
directly measured. Thus whilst there is no evidence that such drugs
correct imbalances in the brain, they can be chemically guaranteed to
cause them - artificially elevating or depressing neurotransmitter
levels in a way that may affect not only mood, but all body’s most basic
regulatory systems.
The principal ‘evidence’ for the therapeutic efficacy of
psychopharmaceutical medications comes from short-term clinically
controlled studies comparing the effects of an active drug with that of
an inactive or ‘inert’ placebo. In most cases, the difference between
the drug and placebo thought necessary to scientifically ‘prove’ the
efficacy of the former is minimal. But comparing the effects of any
active drug with an inert placebo is, as Breggin points out, misleading
in itself. This is because the active drug may have its own type of
placebo effect – giving the patient a felt sense of a drug’s power by
virtue of its felt effects, however subtle.
As Grohol points out “the double-blind placebo controlled study is not
blind. Side effects are so obvious that more than 80% of the patients
know whether they are on active medication or placebo, patients are
equally accurate about other patients on the ward, and nurses and other
personnel are privy as well. In some studies the only people who claim
to
be blind
are the prescribing physicians, and in other studies the prescribing
physicians admit being as aware of the patients' condition as everyone
else.” Even with active placebos “the empirical data show that
medication effect sizes are hard to distinguish from the placebo. Also
not mentioned is that most antidepressant medications habituate, and the
patients' symptoms return. Most patients believe they would feel even
worse if they were not taking their medication.”
Grohol goes on to question the use of clinician-rated rather than
patient-rated measures of ‘improvement’ in such trials, noting that “If
patients cannot tell that they are better off in a controlled study, one
must question the conventional wisdom about the efficacy of
antidepressant drugs.”
One of the main arguments in favour of the use of anti-depressants is
suicide and violence prevention. How is it then, that several studies
have shown an actual increase in suicide rates in those taking
anti-depressants? How is that otherwise sober and responsible
individuals with no history of violence or severe personality disorder
can, within a few day or weeks fall victim to violent or suicidal
impulses, even to the point of committing murder or suicide? One reason
is the stimulant effect of the new Prozac-type antidepressants or
Selective Serotonin Reuptake Inhibitors (SSRIs). The artificially
elevated serotonin levels they are designed to induce can result not
only in mild euphoria but manic states or psychotic syndromes similar to
those produced by illegal amphetamines. Alternatively, they may, in the
first few days of usage result in an unnatural depression of serotonin
levels as the brain tries to compensate for an artificially induced
chemical imbalance. In both cases the drug has brought about a form of
organic brain dysfunction of the very sort assumed, without evidence, to
be responsible for the patient’s symptoms. Another argument for the use
of anti-depressants is their ‘efficacy’ for many people. No thought is
given however, as to the reasons why such drugs are felt or deemed to be
‘effective’. Breggin points out that “A patient typically is rendered
unable to stay depressed during an episode of organic brain dysfunction,
because depression requires a relatively intact brain and mind. Rendered
either apathetic or artificially euphoric by brain dysfunction, the
patient is evaluated as ‘improved’.”
“What psychiatrists call ‘depression’ – lethargy, apathy, nervousness,
hopelessness, helplessness and unhappiness – is a serious problem often
unrecognised as drug-related. Because of their depressant and
debilitating effect, psychiatric drugs can make people feel so bad they
want to kill themselves.” Caligari
SSRI’s such as paroxetine (Seroxat/Paxil) and Prozac may be
authorised for use by patients over many years on the basis of clinical
trials lasting from only 6 to 10 weeks. GlaxoSmithKline, whose sales of
Seroxat/Paxil were valued at over one and a half billion pounds in 2000,
continue aggressive marketing of the drug to doctors, with 100 millions
prescriptions given annually. This despite the fact that their own staff
reported trial patients showing significant withdrawal symptoms of
agitation and insomnia after only a short period on the drug – which now
leads the list the World Health Organisation list of pharmaceuticals
reported by doctors cause acute withdrawal problems. GSK leaflet
accompanying prescriptions still tell the patient that “you cannot
become addicted to Seroxat.” No distinction is made between dependency
of the sort comparable to an addicts cravings for tobacco or heroine,
and addiction based purely on the need avoid acute physical or
psychological withdrawal symptoms. The information leaflet for Seroxat
also includes the following words:
“Occasionally, the symptoms of depression may include thoughts of
harming yourself or committing suicide. Until the full antidepressant
effect of your medication becomes apparent it is possible that these
symptoms may increase in the first few weeks of treatment.”
The tone is soothing. But in June 2001, GSK were forced to pay out
$6.4 million in damages to the family of a man who killed his wife,
daughter, granddaughter and then himself after only two days on Seroxat.
In contrast to the SSRIs, most neuroleptic drugs or
‘anti-psychotics’, together with the minor and major tranquillizers,
work by dulling and depressing brain activity through a wide range of
different neurotransmitters including dopamine and GABA. The
artificially-induced elevation or depression of mood brought on by the
elevation or depression of different neurotransmitters in the brain, may
have dramatic effects when the drug is withdrawn – either
producing a dramatic ‘rebound’ elevation of neurotransmitter levels or
leaving the brain incapable of generating normal neurotransmitter levels
by itself. Breggin cites a typical example of withdrawal syndrome:
“Recently one of my patients, a young man in his twenties, was trying
to taper off small doses of Elavil prescribed by another
physician…within a day or two of complete withdrawal he began to feel
ill. It seemed exactly like the flu. He felt lethargic and his muscles
ached, He lacked appetite, felt sick to his stomach, and vomited in the
morning. Despite his tiredness he had trouble falling asleep and staying
asleep. He felt increasing anxiety as well. A complete physical
examination by an internist revealed no evidence of an infection, and I
was forced to conclude that he had a typical flu-like withdrawal
syndrome. He gradually recovered over a few weeks, vomiting for the last
time about a month after ending the medication.”
Not all are so ‘lucky’ as this patient. Countless harrowing stories by
those who became unknowingly dependent on highly-addictive
benzodiazepine tranquillizers and sleeping pills, or so-called
‘non-addictive’ anti-depressants, bear testament to the years or even
decades of hell suffered in the attempt to withdraw from these drugs,
and/or of the permanent post-withdrawal symptoms they still suffer.
With one out of four people in the UK thought to be suffering from a
diagnosable mental disorder, the number of prescription of
anti-depressants and anxiolytics is vast. As long ago as 1984, it was
reported by Professor Malcom Lader that 11.2 percent of all adults took
a benzodiazepine for anxiety or sleeping problems in any one
year. “Even at a conservative estimate, 20% of these will develop
symptoms when they attempt to withdraw. That means a quarter of a
million people in the UK. It is now estimated that one and a half
million people in the UK alone are chronically addicted to
benzodiazepine anxiolytics such as diazepam (Valium) and lorazepam
(Ativan). All the drugs in this class can induce dependency in a matter
of days through suppressing the brain’s natural production of anxiety-
and stress-reducing neurotransmitters. Yet they account for 50% of
global sales of psychopharmaceutical medications.
"The biggest drug-addiction problem in the world doesn't involve
heroin, cocaine or marijuana. In fact, it doesn't involve an illegal
drug at all. The world's biggest drug-addiction problem is posed by a
group of drugs, the benzodiazepines, which are widely prescribed
by doctors and taken by countless millions of perfectly ordinary people
around the world... Drug-addiction experts claim that getting people off
the benzodiazepines is more difficult than getting addicts off heroin...
For several years now pressure-groups have been fighting to help
addicted individuals break free from their pharmacological chains. But
the fight has been a forlorn one. As fast as one individual breaks free
from one of the benzodiazepines another patient somewhere else becomes
addicted. I believe that the main reason for this is that doctors are
addicted to prescribing benzodiazepines just as much as patients are
hooked on taking them.” Vernon Coleman, Life Without Tranquillizers
The sheer scale of the problem with psychopharmaceutical medications
becomes clear if we consider that probably 75% or more of so-called
‘adverse reactions’, including withdrawal symptoms and withdrawal
syndromes, may be unreported. Worse still, they may be unrecognised as
such by patients themselves, interpreted as signs of endogenous
psychological disorders by physicians or psychotherapists, and/or
treated by prescriptions of further psychiatric drugs. In an attempt to
deal with recognised side-effects of these drugs, many psychiatrists and
psychiatric health clinics around the world now regularly prescribe
whole ‘cocktails’ of anti-depressant, neuroleptic and anxiolytic
medications in the hope that they will chemically counter-balance each
other’s inherently toxic and unbalancing effects on brain functioning.
At the same time pharmaceutical companies such as GSK are inventing ever
new ‘disorders’ which can be ‘treated’ by drugs such as paroxetine. As
well as ‘panic disorder’, ‘obsessive compulsive disorder’ the list now
includes ‘post-traumatic stress disorder’ and ‘social anxiety disorder’
and ‘attention deficit disorder’. But like standard DSM psychiatric
designations such as ‘bipolar disorder’, ‘personality disorder’, these
new ‘disorders’ terms seem to possess the authority of medical diagnoses
– implying the existence of specific disease entities with an organic
basis. In fact they are merely convenient labels for clusters of
troublesome symptoms or behaviours that society has a problem
understanding and responding to.
Biological psychiatry is founded on a flat denial that there is any
meaning in ‘mental illness’ – that in a sick society there may be good
reasons why a person feels anxious, depressed, disturbed, divided or
driven to compulsive behaviours. Health is defined only as the ability
to ‘function’ normally as an employee – to cheerfully play one’s part in
sustaining a market economy in which all human relations are geared
solely to commodity production and profit making. As a result, medicine
and psychiatry have both become tools of the ‘therapeutic state’ - their
sole aim being to control all bodily behavioural symptoms of the
distress and dis-ease engendered by a sick society, reducing them
instead to some manageable disease or psychiatric disorder that can be
‘managed’ with the help of drugs - thereby turning them into a lucrative
source of corporate profit.
Authoritarian psychiatry is now being legitimised by governments all
over the world through legislation, which denies mental patients the
right to refuse medication and permits their enforced detention and drug
‘treatment’. Given the enormous attention given by politicians and the
media to the problems caused by illegal drugs and drug addiction, the
failure by governments and health services to recognise the scale of
addiction to legally prescribed drugs and the dangers of their adverse
effects is hypocritical to say the least – amounting to a form of wilful
ignorance. It is all the more important then, that social workers,
mental health nurses, counsellors, psychotherapists and alternative
health practitioners do not fall into the trap that so many orthodox
physicians and psychiatrists have fallen into – that of accepting the
medical and marketing myths perpetuated by pharmaceutical companies
regarding the ‘benefits’ of psychiatric medications. Above all it is
important that they:
·
obtain
precise details of any client’s present or past use, not only of illegal
drugs but of legally prescribed medications, including the names of
these medications and the length of time over which they were or have
been taken.
·
educate
themselves in the adverse effects, addictive potentials and withdrawal
symptoms of specific anxiolytic, anti-depressant and neuroleptic
medications.
Thankfully, use of the internet now allows any patient or professional
to quickly obtain information regarding specific drugs and drug types,
as well as being host to many websites set up to support patients
suffering from adverse reactions or dependency on such drugs, to inform
health professionals of their dangers, to advise both patients and
practitioners on safe methods of withdrawal, or simply to provide a
forum in which users can share with each other the often horrifying
experiences they have had of particular medications and their
debilitating or life-destroying effects.
Recommended sites
www.benzo.org.uk info. on benzodiazepines
www.antidepressantfacts.com
www.Breggin.com excellent articles by Peter Breggin
www.pssg.org for Prozac survivors
www.antipsychiatry.org the case against biopsychiatry
www.april.org.uk on adverse drug reactions)
www.mindfreedom.org supporting patients
Recommended Reading
·
Peter R.
Breggin Toxic Psychiatry
·
Breggin /
Cohen Your Drug May be Your Problem
·
Joan
E.Gadsby Addiction by Prescription
·
Heather
Jones Prisoner on Prescription
·
David
Smail The Nature of Unhappiness
·
Dr Ann
Tracy Prozac - Panacea or Pandora
References
Fisher,
S., & Greenberg, R.P. (1993). How sounds is the double-blind design
for evaluating psychotropic drugs? The Journal of Nervous and Mental
Disease, 181, 345-350.
Greenberg, R.P., Bornstein, R.F., Greenberg, M.D., & Fisher, S. (1992).
A meta-analysis of antidepressant outcome under "blinder" conditions.
Journal of Consulting and Clinical Psychology, 60, 664-669. |