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Big Drugs and Psychiatry

September 28, 2011

There ought to be a searching review of how big pharmacology is manipulating psychiatry, I told the book launch gathering last night. I urged Tanveer Ahmed, as a psychiatrist and journalist, to devote his next book to exposing how psychiatry is being overtaken by pharmacology.

If you’re interested look at the articles in The New York Review of Books by Marcia Angell, an American physician and Senior Lecturer in Social Medicine at Harvard Medical School. The articles appeared January 15 2009 and June 23 2011. New York Review of Books

Youngsters as young as two are now being diagnosed with bipolar disorder and treated with cocktails of powerful drugs. Drug companies like GlaxoSmithKlein are pouring money into psychiatric research, which leads to:

• definition of new psychiatric diseases at a dizzying rate
• development of drugs to treat them

One of the books reviewed by Marcia Angell is called Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial. It tells the story of how the British drug giant GlaxoSmithKlein buried evidence that its top-selling antidepressant, Paxil, was ineffective and possibly harmful to children and adolescents. These drugs which generate huge profits for big pharmacology – Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor are very dubious. On average placebos were 80 percent as effective as the drugs. Yet psychiatrists began to refer to themselves in the 1980’s as psychopharmacologists and were less and less interested in exploring the stories of their patients. Their main function became eliminating or reducing symptoms by treating sufferers with drugs that would alter brain functions.

As a result psychiatry became the darling of the pharmaceutical industry which “soon made its gratitude tangible” by pouring money into the profession. With each subsequent new edition of the basic text book used by psychiatrists (the DSM or Diagnostic and Statistical Manual of Mental Disorders) writes Daniel Carlat in his book “the number of diagnostic categories multiplied, and the books became larger and more expensive. Each became a best seller for the APA, and DSM is now one of the major sources of income for the organisation.” The DSM-IV sold over a million copies. It is bursting with newly-defined psychiatric conditions. Shyness has become one, for example.

One patient quoted in Carlat’s material ended up with seven separate diagnoses, drug piled on drug. “A typical patient,” he writes, “might be taking Celexa for depression, Antivan for anxiety, Ambien for insomnia, Provigil for fatigue (a side effect of Celexa), and Viagra for impotence (another side effect of Celexa).”

Daniel Carlat's book Unhinged: The Trouble with Psychiatry - A Doctor's Revelation About a Profession in Crisis

Writes Angell in her July 14 review:

      There seem to be fashions in childhood psychiatric diagnoses, with one disorder giving way to the next. At first, ADHD, manifested by hyperactivity, inattentiveness, and impulsivity usually in school-age children, was the fastest-growing diagnosis. But in the mid-1990s, two highly influential psychiatrists at the Massachusetts General Hospital proposed that many children with ADHD really had bipolar disorder that could sometimes be diagnosed as early as infancy. They proposed that the manic episodes characteristic of bipolar disorder in adults might be manifested in children as irritability. That gave rise to a flood of diagnoses of juvenile bipolar disorder. Eventually this created something of a backlash, and the DMS-V now proposes partly to replace the diagnosis with abrand-new one, called “temper dysregulation disorder with dysphoria,” or TDD, which Allen Frances calls “a new monster.”

    Angell concludes “One would be hard pressed to find a two-year-old who is not sometimes irritable, a boy in fifth grade who is not sometimes inattentive, or a girl in middle school who is not anxious.” But now more and more frequently such youngsters are being diagnosed with psychiatric illnesses and pumped with drugs.

    That’s why I said this deserves the attention of a psychiatrist and writer like Tanveer.

  1. September 28, 2011 2:33 pm

    Bob, As a physician,and being well versed in pharmacology, i am appalled by the excessive and inappropriate use of drugs.
    There is much to gain by understanding genomics, pharmacogenomics and nutrigenomics

  2. Dr Rachel Heath permalink
    September 28, 2011 9:56 pm

    I care for a loved one who has been misdiagnosed for over 30 years. Over that period I have discovered that the only way we could get improvement in her condition is to force the psychiatrist to remove a drug. At present, she is in a locked ward under the Mental health Act at the whim of collusion between a lawyer and an ill-informed psychiatrist. The nurses have caught on …. by removing two more of these drugs she has started to show improvement. If the Drs find out all hell may break loose but then the Drs only attend the ward once or twice a week. One of the problems faced by the psychiatrists is that I am a retired Professor of Psychology (a real science) and they need all their wits to keep up with me 🙂

  3. September 29, 2011 7:21 am

    The Jan-Feb 2011 issue of Quadrant has a piece by Dale Atrens (Reader Emeritus in Psychobiology at the University of Sydney) saying much the same as you do in this post.

  4. Patrick permalink
    September 29, 2011 3:50 pm

    CBT is a more effective treatment for almost all conditions. To get it most people need to make large out of pocket payments.

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