Psychiatric Drugs: The Modern Lobotomy
While it pains me to agree with someone who fears the galactic overlord Xenu, Tom Cruise was right when he said that there is no such thing as a chemical imbalance. These days critical views of psychiatry come across as hysterical and anti-science. Conventional wisdom is that the dark days of psychiatry’s past (drowning, electroshock, chemically-induced seizures, sterilization, and frontal lobotomy) are long behind us. With the advent of “anti-psychotic” drugs, modern psychiatry has found the cure to diseases of the fractured mind.
In fact, I don’t believe it would be a hyperbole to state the psychiatry in the United States today, in terms of both scale and methodology, is an abomination of science and personal liberty. And I say this as a scientist, as someone who believes the scientific method is the best way to improve human knowledge and quality of life.
It is a telling fact, in terms of psychiatry’s ability to abuse the mentally ill even in “enlightened” times, that the last lobotomy performed in the U.S. was in 1967. The discontinuation of this psychosurgery had less to do with society’s revulsion at the drilling of ice picks through an unconsenting patient’s eye sockets and more to do with the invention of a so-called “chemical lobotomy”, chlorpromazine (Thorazine) and its chemical cousins.
The advent of neuroleptic drugs (often called by the inaccurate name antipsychotic, despite the fact they “cure” psychosis in the same way a coma cures a headache) changed the face of psychiatry in a sweeping fashion. But has it been for the better? In fact, patient outcomes in the U.S. have actually declined since the advent of these drugs, and a person diagnosed today fares as poorly as someone diagnosed in 1900. A particularly damning piece of evidence comes from the WHO’s 1992 International Pilot Study of Schizophrenia. This study found that, surprisingly, patients in poor countries had far better outcomes than patients from rich countries. A follow-up study confirmed this: 64% of patients from developing countries were doing fairly well at the end of two years, compared with 37% from developed countries. This is telling because most patients in developed countries are treated with neuroleptic drugs, while most patients in developing countries are not.
This alone does not prove that the drugs are the cause of worse outcomes for the most “scientifically advanced” countries. But it is damning evidence when combined with other studies which reveal 1) neuroleptic drugs leave the patient more prone to future relapse, 2) these drugs have a host of common, irreversible side effects, and 3) these drugs are known to cause permanent brain damage.
Standard neuroleptic drugs target the brain’s dopamine system, while the newer atypicals arrest the serotonin pathway as well. This is not light stuff. Dopamine is instrumental in movement, motivation, and pleasure. When dopamine systems are damaged, the effects can be acute and irreversible. Some side effects of neuroleptics mimic Parkinson’s disease. In fact, it is estimated that two-thirds of patients treated eventually develop “persistent Parkinson’s”. Tardive dyskinesia is also extremely common, and it can affect 5-8% of medicated patients per year. A few decades of “treatment” nearly assures that a patient will develop permanent symptoms, which include repetitive, involuntary movements of the face, arms, and legs. And that’s just the side effects.
Patients today are being treated with drugs that, while they may temporarily relieve psychotic symptoms, are more likely to leave them chronically ill and vulnerable to future psychotic breaks. And they are told that these drugs cure a chemical imbalance in their brains. This is a claim that is provably false. Pre-medication, schizophrenics do not have a dopamine deficiency. MRI images of “schizophrenic brains” are presented as evidence that schizophrenia causes brain damage. It’s true that these images show a progressive deterioration during the course of the disease, but this is deterioration caused by massive amounts of psychotropic drugs, as it is not seen in the mentally ill who are not so drugged!
But aren’t there studies which show the efficacy of these drugs? Short-term: somewhat; long-term: no. A few facts first: This is big business. These drugs are top sellers. The FDA does not test drugs the drug companies do (or rather, a for-profit industry serving the drug companies tests the drugs). When the patents on the first generation of antipsychotic medications ran out, drug companies rushed to market new “atypical” drugs to maintain their profit margins. And the pseudo-science here is astounding. Optimal doses of the new drug were tested against excessive (even harmful) doses of competing drugs. The placebo groups were routinely abruptly withdrawn (“washed out”) from their old medications (this is extremely dangerous and some patients committed suicide as a result; these deaths were omitted from the published studies). Thus placebo groups were contaminated with withdrawal symptoms. In hubris typical of the field, patient outcomes were judged by psychiatrists, and patient voices remain entirely absent from the literature. (Even lobotomy was considered to have successful outcomes at the time speechless, incontinent patients were no longer psychotic.) Schizophrenics are said to lack insight, which seems to be a clinical way of saying that they cannot judge a drug’s effectiveness themselves.
The abuses of psychiatry are many. Here is a final story that I hope will move you: the Soviets also used many of psychiatry’s inventions to torture their dissidents. These included wet packs, insulin coma, and seizures induced with metrazol. But the torture most feared was the use of neuroleptic drugs. Vassily Chernishov wrote that a person so treated “loses his individuality, his mind is dulled, his emotions destroyed, his memory lost… as a result of the treatment, all the subtle distinctiveness of a person is wiped away… Although I am afraid of death, let them shoot me rather than this."
Fuckers.
The sources for this well-researched book are available here.
2 comments:
This is shocking.
Do you know how they treat the disease in the mentioned developing countries?
Do you know of other theories for the cause of the disease besides dopamine problems?
Are there developed nations that use other treatments?
Thank you!
Sean:
There really aren't any other treatments besides talk therapy or group care. Sedatives have been suggested as an alternative, but there haven't been studies to compare their efficacy with neuroleptic drugs.
There are studies which show that "moral treatment", which is simply group care that takes care of the person without drugging until they recover or learn to manage their symptoms, does quite well. In the US there was Soteria House, which showed dramatic results until it lost funding (big pharma strikes again). Some other developing countries have tried moral treatment with good results.
There are large differences in the typical dosage among developed countries as well, and patients in countries that typically use smaller doses fare better. (The third of patients in the US who have good outcomes also corresponds to the third that have successfully weaned themselves from neuroleptics.)
As far as other theories of mental illness go, there are many bad ones (with schizophrenia other theories include labeling, double bind, childhood trauma, the schizophrenic mother, and fetal brain damage). Really, we have no idea. Twin studies show both genetic and environmental components, as with most anything.
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