The Sedated Society pp 23-49 | Cite as
Psychopharmacology Is Not Evidence-Based Medicine
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Abstract
This chapter argues two evidence-based conclusions: not only are psychiatric drugs dramatically overprescribed and overvalued but the harms they unleash completely overwhelm any benefits accrued. While accepting numerous reasons for our current prescribing epidemic, this chapter focuses on the manipulation of most placebo controlled trials, the systematic underreporting of drug harms, the industry-led misrepresentation of drug safety and efficacy and the medical denial of the substantial role withdrawal and abstinence symptoms play in convincing patients to stay on drugs. This chapter concludes that a thorough and independent review of the evidence base reveals that psychiatric drugs, apart from calming some people down when taken short term, “have failed to deliver what patients want, which is to work specifically for specific mental or emotional problems.” Since mental illness is rarely chronic and lifelong, it argues there is no scientific justification for the widespread lifelong use of psychiatric drugs. If we are to restore balance, and reverse these harms, a total reappraisal of what the evidence teaches must be translated into reformed prescribing guidelines.
Keywords
Evidence-based medicine Clinical trials Drug benefits and harms Pharmaceutical sponsorshipReferences
- Adams, C., Awad, G., Rathbone, J., Thornley, B., & Soares-Weiser, K. (2014). Chlorpromazine versus placebo for schizophrenia. The Cochrane Database of Systematic Reviews, 1, CD000284. doi: 10.1002/14651858.CD000284.pub3.Google Scholar
- Baldessarini, R., & Viguera, A. (1995). Neuroleptic withdrawal in schizophrenic patients. Archives of General Psychiatry, 52(3), 189–192.CrossRefPubMedGoogle Scholar
- Bockting, C., ten Doesschate, M., Spijker, J., Spinhoven, P., Koeter, M., & Schene, A. (2008). Continuation and maintenance use of antidepressants in recurrent depression. Psychotherapy and Psychosomatics, 77(1), 17–26. doi: 10.1159/000110056.CrossRefPubMedGoogle Scholar
- Bola, J., Kao, D., & Soydan, H. (2011). Antipsychotic medication for early episode schizophrenia. The Cochrane Database of Systematic Reviews, 6, CD006374. doi: 10.1002/14651858.CD006374.pub2.Google Scholar
- Breggin, P. (1994). Talking back to Prozac. New York: E-reads.Google Scholar
- Breggin, P. (2008). Medication madness. New York: St. Martin’s Griffin.Google Scholar
- Breggin, P. (2013). Psychiatric drug withdrawal: A guide for prescribers, therapists, patients, and their families. New York: Springer Publishing Company.Google Scholar
- Breggin, P. (2014). The rights of children and parents in regard to children receiving psychiatric diagnoses and drugs. Children and Society, 28, 231–241. doi: 10.1111/chso.12049.CrossRefGoogle Scholar
- Cipriani, A., Hawton, K., Stockton, S., & Geddes, J. (2013). Lithium in the prevention of suicide in mood disorders: Updated systematic review and meta-analysis. BMJ (Clinical Research Ed.), 346, f3646.Google Scholar
- Cole, J. (1964). Phenothiazine treatment in acute schizophrenia; effectiveness: The National Institute of Mental Health Psychopharmacology Service Center Collaborative Study Group. Archives of General Psychiatry, 10(3), 246–261. doi: 10.1001/archpsyc.1964.01720210028005.
- Council for Evidence-based Psychiatry. (2014). Unrecognised facts about modern psychiatric practice.Google Scholar
- Coupland, C., Dhiman, P., Morriss, R., Arthur, A., Barton, G., & Hippisley-Cox, J. (2011). Antidepressant use and risk of adverse outcomes in older people: Population based cohort study. BMJ (Clinical Research Ed.), 343, d4551.CrossRefGoogle Scholar
- Dickersin, K. (2008). Reporting and other biases in studies of Neurontin for migraine, psychiatric/bipolar disorders, nociceptive pain, and neuropathic pain. Retrieved from www.pharmalot.com/wp-content/uploads/2008/10/neurontin-dickersin-2.pdf
- Dold, M., Li, C., Tardy, M., Khorsand, V., Gillies, D., & Leucht, S. (2012). Benzodiazepines for schizophrenia. Cochrane Database of Systematic Reviews. John Wiley & Sons Ltd. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006391.pub2/abstract
- Fava, G. (2003). Can long-term treatment with antidepressant drugs worsen the course of depression? The Journal of Clinical Psychiatry, 64(2), 123–133.CrossRefPubMedGoogle Scholar
- Felholt, L. (2016, February 16). [More and More Adults Get an ADHD Diagnosis]. BT.Google Scholar
- Fournier, J., DeRubeis, R., Hollon, S., Dimidjian, S., Amsterdam, J., Shelton, R., & et al. (2010). Antidepressant drug effects and depression severity: A patient-level meta-analysis. JAMA, 303(1), 47–53.doi: 10.1001/jama.2009.1943
- Goldacre, B. (2012). Bad Pharma. London: Fourth Estate.Google Scholar
- Gøtzsche, P. (2013). Deadly medicines and organised crime: How big pharma has corrupted health care. London: Radcliffe Publishing.Google Scholar
- Gøtzsche, P. (2014). Why I think antidepressants cause more harm than good. The Lancet Psychiatry, 1(2), 104–106. doi: 10.1016/S2215-0366(14)70280-9.CrossRefPubMedGoogle Scholar
- Gøtzsche, P. (2015). Deadly Psychiatry and Organized Denial. Copenhagen: People’s Press.Google Scholar
- Gøtzsche, P. (2016a). Author’s reply to Dubicka and colleagues and Stone. BMJ (Clinical Research Ed.), 352, i915.Google Scholar
- Gøtzsche, P. (2016b, March 8). Forced admission and forced treatment in psychiatry causes more harm than good. Retrieved from www.deadlymedicines.dk
- Gøtzsche, P., Young, A., & Crace, J. (2015). Does long term use of psychiatric drugs cause more harm than good? BMJ (Clinical Research Ed.), 350, h2435.Google Scholar
- Healy, D. (2004). Let Them Eat Prozac. New York: New York Univerisity Press.Google Scholar
- Healy, D. (2006). Did regulators fail over selective serotonin reuptake inhibitors? BMJ (Clinical Research Ed.), 333(7558), 92–95. doi: 10.1136/bmj.333.7558.92.CrossRefGoogle Scholar
- Hjorthøj, C., Madsen, T., Agerbo, E., & Nordentoft, M. (2014). Risk of suicide according to level of psychiatric treatment: A nationwide nested case-control study. Social Psychiatry and Psychiatric Epidemiology, 49(9), 1357–1365. doi: 10.1007/s00127-014-0860-x.CrossRefPubMedGoogle Scholar
- Ho, B., Andreasen, N. C., Ziebell, S., Pierson, R., & Magnotta, V. (2011). Long-term antipsychotic treatment and brain volumes: A longitudinal study of first-episode schizophrenia. Archives of General Psychiatry, 68(2), 128–137. doi: 10.1001/archgenpsychiatry.2010.199.CrossRefPubMedPubMedCentralGoogle Scholar
- Hogan, C., Le Noury, J., Healy, D., & Mangin, D. (2014). One hundred and twenty cases of enduring sexual dysfunction following treatment. The International Journal of Risk & Safety in Medicine, 26(2), 109–116. doi: 10.3233/JRS-140617.Google Scholar
- Hughes, S., Cohen, D., & Jaggi, R. (2014). Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: A cross-sectional study. BMJ Open, 4(7), e005535. doi: 10.1136/bmjopen-2014-005535.CrossRefPubMedPubMedCentralGoogle Scholar
- Jackson, G. (2003, March 3). An analysis of the olanzapine clinical trials—dangerous drug, dubious efficacy. Retrieved from http://psychrights.org/states/Alaska/CaseOne/30-Day/ExhibitD-Olanzapine.htm
- Jorm, A., Korten, A., Jacomb, P., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. The Medical Journal of Australia, 166(4), 182–186.PubMedGoogle Scholar
- Khin, N., Chen, Y., Yang, Y., Yang, P., & Laughren, T. P. (2012). Exploratory analyses of efficacy data from schizophrenia trials in support of new drug applications submitted to the US Food and Drug Administration. The Journal of Clinical Psychiatry, 73(6), 856–864. doi: 10.4088/JCP.11r07539.CrossRefPubMedGoogle Scholar
- Kirsch, I. (2009). The emperor’s new drugs: Exploding the antidepressant myth. London: The Bodley Head.Google Scholar
- Large, M., & Ryan, C. (2014). Disturbing findings about the risk of suicide and psychiatric hospitals. Social Psychiatry and Psychiatric Epidemiology, 49(9), 1353–1355. doi: 10.1007/s00127-014-0912-2.CrossRefPubMedGoogle Scholar
- Leucht, S., Kane, J., Etschel, E., Kissling, W., Hamann, J., & Engel, R. (2006). Linking the PANSS, BPRS, and CGI: Clinical implications. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 31(10), 2318–2325. doi: 10.1038/sj.npp.1301147.Google Scholar
- Medawar, C., & Hardon, A. (2004). Medicines out of control? Antidepressants and the conspiracy of goodwill. Netherlands: Aksant Academic Publishers.Google Scholar
- Medikamentfri behandling for psykisk syke i alle helseregioner. (no date). Retrieved from Regjeringen.noGoogle Scholar
- Molina, B., Flory, K., Hinshaw, S., Greiner, A., Arnold, L., Swanson, J., et al. (2007). Delinquent behavior and emerging substance use in the MTA at 36 months: Prevalence, course, and treatment effects. Journal of the American Academy of Child and Adolescent Psychiatry, 46(8), 1028–1040. doi: 10.1097/chi.0b013e3180686d96.CrossRefPubMedGoogle Scholar
- Moncrieff, J. (2013). The Bitterest Pills. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
- Moncrieff, J., Wessely, S., & Hardy, R. (2004). Active placebos versus antidepressants for depression. The Cochrane Database of Systematic Reviews, 1, CD003012. doi: 10.1002/14651858.CD003012.pub2.Google Scholar
- Montejo, A., Llorca, G., Izquierdo, J., & Rico-Villademoros, F. (2001). Incidence of sexual dysfunction associated with antidepressant agents: A prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The Journal of Clinical Psychiatry, 62(Suppl 3), 10–21.PubMedGoogle Scholar
- Neurontin prescribing information. (no date). Retrieved January 9, 2015, from http://labeling.pfizer.com/ShowLabeling.aspx?id=630
- Nielsen, M., Hansen, E., & Gøtzsche, P. (2012). What is the difference between dependence and withdrawal reactions? A comparison of benzodiazepines and selective serotonin re-uptake inhibitors. Addiction (Abingdon, England), 107(5), 900–908. doi: 10.1111/j.1360-0443.2011.03686.x.CrossRefGoogle Scholar
- Radua, J., Borgwardt, S., Crescini, A., Mataix-Cols, D., Meyer-Lindenberg, A., McGuire, P., et al. (2012). Multimodal meta-analysis of structural and functional brain changes in first episode psychosis and the effects of antipsychotic medication. Neuroscience and Biobehavioral Reviews, 36(10), 2325–2333. doi: 10.1016/j.neubiorev.2012.07.012.CrossRefPubMedGoogle Scholar
- Rosenbaum, J., Fava, M., Hoog, S., Ascroft, R., & Krebs, W. (1998). Selective serotonin reuptake inhibitor discontinuation syndrome: A randomized clinical trial. Biological Psychiatry, 44(2), 77–87.CrossRefPubMedGoogle Scholar
- Schneider, L., Dagerman, K., & Insel, P. (2005). Risk of death with atypical antipsychotic drug treatment for dementia: Meta-analysis of randomized placebo-controlled trials. JAMA, 294(15), 1934–1943. doi: 10.1001/jama.294.15.1934.CrossRefPubMedGoogle Scholar
- Sharma, T., Guski, L., Freund, N., & Gøtzsche, P. (2016). Suicidality and aggression during antidepressant treatment: Systematic review and meta-analyses based on clinical study reports. BMJ (Clinical Research Ed.), 352, i65.Google Scholar
- Simonsen, A., Danborg, P., & Gøtzsche, P. (2016). Persistent sexual dysfunction after early exposure to SSRIs: Systematic review of animal studies. International Journal of Risk & Safety in Medicine, 28, 1–12.Google Scholar
- Søndergård, L., Kvist, K., Andersen, P., & Kessing, L. (2006). Do antidepressants precipitate youth suicide?: A nationwide pharmacoepidemiological study. European Child & Adolescent Psychiatry, 15(4), 232–240. doi: 10.1007/s00787-006-0527-6.CrossRefGoogle Scholar
- Stone, M., Laughren, T., Jones, M., Levenson, M., Holland, P., Hughes, A., et al. (2009). Risk of suicidality in clinical trials of antidepressants in adults: Analysis of proprietary data submitted to US Food and Drug Administration. BMJ (Clinical Research Ed.), 339, b2880.CrossRefPubMedCentralGoogle Scholar
- Storebø, O., Skoog, M., Damm, D., Thomsen, P., Simonsen, E., & Gluud, C. (2011). Social skills training for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years. The Cochrane Database of Systematic Reviews, 12, CD009885. doi: 10.1002/14651858.CD008223.pub2.
- United Nations Convention on the Rights of Persons with Disabilities. (2014, May 19). General comment No. 1. Retrieved from http://daccess-dds.ny.un.org/doc/UNDOC/GEN/G14/031/20/PDF/G1403120.pdf?OpenElement
- Vedula, S., Bero, L., Scherer, R., & Dickersin, K. (2009). Outcome reporting in industry-sponsored trials of gabapentin for off-label use. The New England Journal of Medicine, 361(20), 1963–1971. doi: 10.1056/NEJMsa0906126.CrossRefPubMedGoogle Scholar
- Whitaker, R. (2002). Mad in America. Cambridge: Perseus Books Group.Google Scholar
- Whitaker, R. (2010). Anatomy of an epidemic. New York: Broadway Paperbacks.Google Scholar
- Wunderink, L., Nieboer, R., Wiersma, D., Sytema, S., & Nienhuis, F. (2013). Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: Long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry, 70(9), 913–920. doi: 10.1001/jamapsychiatry.2013.19.CrossRefPubMedGoogle Scholar
- Zipursky, R.B., Reilly, T.J., & Murray, R.M. (2013). The myth of schizophrenia as a progressive brain disease. Schizophrenia Bulletin, 39(6), 1363–1372. doi: 10.1093/schbul/sbs135.