Are Antipsychotics Beneficial?
by Jeffrey Rubin, PhD
Recently I provided a post titled, “Are Mental Illnesses Really Illnesses? And Why do People Care?” There are a lot of people out there who were very supportive of the post, but at the same time, some were angry that I would even raise the question. One of the most angry person mentioned that the proof that mental illnesses are real illnesses was that the antipsychotic drugs are enormously helpful to people classified by psychiatrists as having schizophrenia.
It just so happens that one of the leading authors challenging that position, Robert Whitaker, has provided for the public a free PDF titled, “The Case Against Antipsychotics: A Review of Their Long-term Effects.” By clicking on the blue title, you can read all of his arguments.
Who Is Robert Whitaker?
According to Wikipedia:
Whitaker was a medical writer at the Albany Times Union newspaper in Albany, New York from 1989 to 1994. In 1992, he was a Knight Science Journalism fellow at MIT.[2] Following that, he became director of publications at Harvard Medical School.[3] In 1994, he co-founded a publishing company, CenterWatch, that covered the pharmaceutical clinical trials industry. CenterWatch was acquired by Medical Economics, a division of The Thomson Corporation, in 1998.[4]
In 2002, USA Today published an article of Whitaker, Mind drugs may hinder recovery in its Editorial/Opinion section.[5] In 2004, Whitaker published a paper in the non-peer-reviewed journal Medical Hypotheses, titled, The case against antipsychotic drugs: a 50-year record of doing more harm than good.[6] In 2005, he published his paper Anatomy of an Epidemic: Psychiatric Drugs and the Astonishing Rise of Mental Illness in America in Ethical Human Psychology and Psychiatry.[7] In his book Anatomy of an Epidemic, published in 2010, Whitaker continued his work.[8][9][10]
He has written on and off for the Boston Globe and in 2001, he wrote his first book Mad in America about psychiatric research and medications, the domains of some of his earlier journalism.[11][12] He appeared in the film Take These Broken Wings: Recovery from Schizophrenia Without Medication released in 2008, a film detailing the pitfalls of administering medication for the illness. [1]
Articles that Whitaker co-wrote won the 1998 George Polk Award for Medical Writing[13] and the 1998 National Association of Science Writers’ Science in Society Journalism Award for best magazine article.[14]
A 1998 Boston Globe article series he co-wrote on psychiatric research was a finalist for the 1999 Pulitzer Prize for Public Service.[15]
In April 2011, IRE announced that Anatomy of an Epidemic had won its award as the best investigative journalism book of 2010 stating, “this book provides an in-depth exploration of medical studies and science and intersperses compelling anecdotal examples. In the end, Whitaker punches holes in the conventional wisdom of treatment of mental illness with drugs.”[16]
Judgement word cloud concept
What I particularly like about Whitaker’s PDF article is that he defends his position first with the best science-based research articles. Then he acknowledges that other authorities have disagreed with his position. He summarizes their position, and then, point by point, explains why he disagrees with them.
For those who are particularly interested in this topic, I highly recommend that you take some time to study what he has to say.
The PDF is a little long for most of my readers, over 40 pages, so below, I’ll conclude for today with Whitaker’s summary statement.
Summary of the case against antipsychotics
As Stip noted in his 2002 paper, there is no compelling evidence in the literature that antipsychotics improve long-term outcomes. The relapse studies do not provide such evidence, and there is no other body of research that does. However, as can be seen in this paper, there is a history of science, stretching across six decades, that consistently tells of a medical treatment that, in the aggregate, does more harm than good.
Here is a chronological presentation of that history of science:
The first long-term study reveals a higher rehospitalization rate for patients treated initially with antipsychotics.
- Psychiatrists and other hospital staff describe a new “revolving door syndrome” seen in drug-treated patients.
- Bockoven’s retrospective study finds a decline in functional outcomes in the antipsychotic era.
- Three experimental studies funded by the NIMH in the 1970s tell of better outcomes with treatment that minimizes antipsychotic use.
- One of the lead investigators in those studies, William Carpenter, raises the possibility that antipsychotics induce a change that makes patients more biologically vulnerable to psychosis.
Guy Chouinard and Barry Jones, drawing on an emerging understanding of how antipsychotics change the brain, provide a biological explanation of why that would be so. They then test their hypothesis and find that a significant percentage of medicated patients suffer from drug-induced tardive psychosis.
- In cross-cultural studies conducted by the World Health Organization, schizophrenia outcomes are found to be much better in developing countries where only a small percentage of patients are regularly maintained on antipsychotics.
MRI studies reveal that antipsychotics induce changes in brain volumes that are associated with a worsening of positive and negative symptoms, and adverse cognitive effects.
- Animal-model studies lead Philip Seeman to conclude that drug- induced dopamine supersensitivity explains why antipsychotics “fail over time.”
- Longitudinal studies in the United States, the Netherlands, and Australia all find that less use of antipsychotics, or no use of the drugs, is associated with better outcomes.That is a robust body of evidence.
In order to argue that antipsychotics do not worsen long-term outcomes in the aggregate, all of this evidence would have to be explained away. This entire history of science would need to be discounted. In addition, this review has focused on the benefit side of the risk-benefit equation for antipsychotics. The drugs are supposed to provide the benefit of reducing psychotic symptoms.
But the research reveals that, over the long term, this benefit turns into a negative, and so, over the long-term, there are only negatives to be chalked up: the increased chronicity of psychotic symptoms, the impaired functional outcomes, the worse cognitive functioning, and, of course, a broad range of “side effects,” such as tardive dyskinesia, metabolic problems, sexual dysfunction, and so forth. Such is the bottom-line arithmetic that makes the case against antipsychotics.
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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.
“Antipsychotic” drugs are used more for social control and repression by authoritarian institutions. They don’t help people. They only zombify them. What the psychs classify as “improvement” is only people becoming so zombified that they sit around and don’t do or even think anything. What is called “mental illness” is often pathologization of dissent by psychiatrists and the various fascist controllers who put people under their “care”.
“’Antipsychotic’ drugs are used more for social control and repression by authoritarian institutions. They don’t help people. They only zombify them. What the psychs classify as “improvement” is only people becoming so zombified that they sit around and don’t do or even think anything.”
Absolutely spot on, especially those that specifically diminish Dopamine levels and activity, moreover long term ‘treatment’ with such like drugs leaves patients with Anhedonia and cognitive difficulties that were not apparent before ‘treatment’.
Long term treatment with these types of drugs is barbaric as patients become so depleted that attempts to raise their levels of ‘well-being’ with the introduction of an SSRI can be quite dangerous as many reports have suggested.
“Antipsychotic” drugs are used more for social control and repression by authoritarian institutions. They don’t help people. They only zombify them. What the psychs classify as “improvement” is only people becoming so zombified that they sit around and don’t do or even think anything. What is called “mental illness” is often pathologization of dissent by psychiatrists and the various fascist controllers who put people under their “care”. Psychiatry is more a force for authoritarian control than healing.
Thanks for that great article- well written- balanced and considerate. I just wish they’d bring in a Law- that allowed all first time psychosed patients the right to withdraw – from any psychotropics – especially those forcefully administered–within the first 72hrs- if we had a law like that- who’d care- who’d worry- no one- except the dealers and their doctors.
I do not consider “psychosis” a valid concept. “Loss of contact with reality” cannot be defined per se but rather as a divergence from the materialistic / psychiatric interpretation of human experience and the mainstream way of expressing this experience.
For exemple mystic considerations are not “loss of contact with reality”, because most of mankind untertain unreasonable beliefs, too.
Psychosis is not defined clearly, has no pathologic characterization, therefore antipsychotic is an invalid term.
Instead of using pseudo-pathology labelling, we should evaluate precisely what the client’s demand is, especially the demands to be exempted from personal responsibility.
I think the term antipsychotic is marketing: Validation of the phoney concept of intrinsequely “psychotic” people as “schizophrenics”, and also to forget the negative literature about neuroleptics. We should not grovel to the drug industry propaganda enterprise.
Neuroleptics act as mind dampeners. The products dull the emotions and the interpretative mechanisms of the mind. However some of these products may induce hallucinations and their effects may be interpreted as derealization or catatonia or anhedonia or social withdrawal.
I think any condition occuring under medication should be considered iatrogenic unless otherwise proven.
Also any condition occuring in the month following the lowering of a dosage and corrected by the return to the previous dosage is a withdrawal syndrome and not anything else.
These simple precautions would clear an awful lot of our “psychotic” labelling.