Skip to main content
SpringerLink
Log in

Psychopharmacology Is Not Evidence-Based Medicine

  • Chapter
  • First Online:
The Sedated Society

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  Google 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.

    Article  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  PubMed Central  Google 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.

    Article  PubMed  PubMed Central  Google 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.

    PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.no

    Google 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.

    Article  PubMed  Google Scholar 

  • Moncrieff, J. (2013). The Bitterest Pills. Basingstoke: Palgrave Macmillan.

    Book  Google 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.

    PubMed  Google 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.

    Article  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  Google 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.

    Article  PubMed Central  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Peter C. Gøtzsche

Authors
  1. Peter C. Gøtzsche
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Life Sciences, University of Roehampton, London, United Kingdom

    James Davies

Rights and permissions

Reprints and permissions

Copyright information

© 2017 The Author(s)

About this chapter

Cite this chapter

Gøtzsche, P.C. (2017). Psychopharmacology Is Not Evidence-Based Medicine. In: Davies, J. (eds) The Sedated Society. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-44911-1_2

Download citation

Publish with us

Policies and ethics

Search

Navigation