Experts say psychiatric drugs do more harm than good
Do psychiatric drugs cause madness. Peter Gotsche argues that most recipes can be stopped without causing harm, but other experts strongly disagree
An expert on clinical trials in a leading medical journal says psychiatric drugs do more harm than good. And most antidepressants and dementia drugs can be stopped virtually without causing harm. Because of their lack of benefit, I estimate that we can stop almost all psychotropic drugs without causing harm, Peter Götche
The views expressed by Peter Gotsche, Professor and Director of the Nordic Cochrane Center in Denmark in a discussion in the British Medical Journal. It is strongly opposed by many mental health experts. However, others say the controversy over the use of psychiatric drugs is important and acknowledge that there is an overuse of antipsychotics to calm aggressive patients with dementia.
Gotcha says that more than half a million people over the age of 65 die from the use of psychiatric drugs each year in the Western world. He writes: “Their benefits must be enormous to justify this, but they are minimal.”
He claims that drug company-funded trials on the efficacy of psychiatric drugs have been nearly all biased, because the patients involved usually took other drugs first. They stop their medication and often go through a withdrawal phase before starting the experimental drug, which then appears to have a significant benefit. He also claims that deaths from suicide in clinical trials are not reported.
Do psychiatric drugs cause madness?
In trials of the newer antidepressants fluoxetine and venlafaxine, Götsche says, it only takes a few extra days for depression in the placebo group — which is given dummy pills — to raise the same amount in the group given the drugs. He argues that there is spontaneous remission of the disease over time.
He also argues that the results of trials of schizophrenia drugs are disappointing. And those for ADHD (attention deficit hyperactivity disorder) are uncertain. Short-term relief appears to have been replaced by long-term damage. Animal studies strongly suggest that these drugs can cause brain damage, which is probably the case for all psychotropic drugs.
“Because of their low usefulness, I estimate that we can stop almost all psychotropic drugs without causing harm. By dropping all the antidepressants, the ADHD medication, the dementia medications…and using only a fraction of the antipsychotics and benzodiazepines we currently use.
This would lead to a healthier and longer life span. Because psychotropic drugs are so harmful when used long-term, they should be used almost exclusively in acute situations and always with a consistent plan to slim down, which can be difficult for many patients.
In the BMJ discussion, which is the curtain-raiser for the Maudsley debate at Kings College in London on Wednesday, Gøtzsche’s views were reported by Alan Young, a professor of mood disorders at King’s College London, and John Krasey, a psychiatrist and Guardian writer.
They argue that research evidence shows that the drugs work and are as beneficial and effective as drugs for other complex conditions. In fact, it is badly needed, they say, because psychiatric conditions are the fifth leading cause of disability worldwide. They add that many psychiatric patients suffer from other physical conditions, which are a greater cause of premature death than suicide.
Do psychiatric drugs cause madness?
They note that the drugs’ effects and safety are monitored and studied in the general population after the research trials are over. They wrote: “Nevertheless, many concerns have been expressed about psychiatric medications. For some critics, it appears that the onus is often the drug that needs to be proven innocent of causing harm rather than a balanced approach to evaluating the available evidence.”
“It is not clear whether the concerns are genuine or an expression of prejudice. But over time, many of the concerns turned out to be exaggerated.”
They cite the example of lithium, whose side effects are now believed to be less severe than previously feared. And clozapine, an atypical antipsychotic. It was thought that clozapine increased patients’ risk of death, but recent data have been reassuring, they say.
Dementia experts said the use of antipsychotics for hard-to-manage elderly patients has been a problem. Dr Simon Ridley said, “The risks of long-term use of antipsychotic medication for symptoms of aggressiveness and agitation in dementia have been highlighted. In a study funded by Alzheimer’s Research in the UK in 2009, steps have since been taken to reduce its use. Alzheimer’s Research UK.
But he and Dr. Doug Brown, director of research and development at the Alzheimer’s Association, said. Medicines such as Aricept. Developed specifically for people with dementia, they have some effect and were needed.
Dr Michael Bloomfield, Academic Fellow in Psychiatry at the Medical Research Council and University College London, said: Gotcha’s view that most psychotropic drugs can be stopped without harm is not supported by evidence.
Long-term use of schizophrenia drugs appears to reduce early mortality. But he added: “In practice, regular reviews of treatment are needed among the patient. and his psychiatrist in order to constantly weigh the pros and cons of any treatment.”