Skepticism about science and medicine

In search of disinterested science

Anti-psychotic drugs: initial benefit, long-term harm

Posted by Henry Bauer on 2016/08/03

Recently (Trust medical science at your peril (2): What is the evidence, especially in psychiatry? ) I recommended the newsletter of Mad in America  for disseminating reliable information about psychiatric matters. A recent issue of the Newsletter has links to a very thorough examination of the evidence that anti-psychotic drugs make things worse if used long-term: “The case against antipsychotics — A review of their long-term effects”, by Robert Whitaker (July 2016).

There is considerable support for the hypothesis that psychotic episodes are associated with heightened sensitivity to dopamine. Anti-psychotics ameliorate such episodes by blocking dopamine receptors. These drugs appear to be beneficial immediately, and for perhaps as long as a couple of years. However, once exposed to the drugs, withdrawal almost always has severe bad effects.

It appears that the brain tries to overcome the blocking of the dopamine receptors by increasing the number of these receptors. That takes appreciably long time, apparently many months if not years, so the consequences become significantly important only eventually. That explains why withdrawal brings even worse symptoms than the original ones were, and why long-term treatment is more harmful than beneficial. The drugs must be used forever, and their cumulating “side” effects are very debilitating.

Non-drug treatment of schizophrenia and other psychoses, sometimes teamed with short-term drug use, has much better long-term outcomes than does continual medication; better outcomes in terms of better all-around functioning and fewer relapses.

 

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4 Responses to “Anti-psychotic drugs: initial benefit, long-term harm”

  1. AlzScience said

    Thanks for posting! Antipsychotics are also often prescribed inappropriately to dementia patients, which can increase the rate of cognitive decline and death.

  2. Carol S said

    Is there any course of action that might reduce the harm caused by these drugs?

    Sent from my iPhone

    >

    • Henry Bauer said

      Carol S:

      It’s in the hands of and up to the medical profession; or perhaps Congress. Neither is likely to do anything, I fear

  3. Vortex said

    Recently, Robert Whitaker and other critics of psychiatry were again under fire – “The Case again Antipsychotics”, quite expectedly, are not welcome in the psychiatric establishment circles! Here are the reaction of two high-level psychiatrists, Ronald Pies and Joseph Pierre…

    http://www.psychiatrictimes.com/schizophrenia/quality-life-and-case-antipsychotics/page/0/1

    …which, expectedly, contain standard appeal to (exclusive) authority and insistence that non-psychiatrists have to rights to analyse and criticise psychiatric research. Whitaker responded to this piece in detail and defended his positions:

    http://www.madinamerica.com/2016/09/confessions-of-a-trespasser/

    What were especially hilarious in this exchange is psychiatrists’ comments to Pies and Pierre, which were filled with praise and (implicit) self-promotion as true helpers, who are justified to enforce their treatments for everyone’s benefit. And what is scary, they are probably indeed percieve themselves as true healers, and sincerely so.

    Here I will quote myself – to precise, I will reinterate my post from the forum discussion of the interview which you gave Alex Tsakiris on Skeptiko podcast:

    ______________________________________

    During 18th, 19th and early 20th century, the overwhelming majority of Western scientists and medical doctors believed that masturbation was a devastatingly dangerous practice, which caused a terrible number of severe physical and mental problems . Now we know that their belief in catastrophic perils of masturbation was totally baseless – in fact, just plain wrong.

    Does it mean that nearly all scientists and doctors of the West were participants of a global conspiracy that lasted for two centuries? Certainly not. It just mean that the scientific and medical consensus of the time was wrong – and that the vast majority of doctors and scientists were sincerely believing what they were taught, and have no tendency to rebel against the established academic positions.

    The situatuion today is still the same – most academicians and practitioners accept the dominant dogma without much questioning. Why? Because they believe in it, and assume that this is a reasonable choice. They are not some kind of malicious conspirators; they are honest believers in this dogma, whose choise may be misguided – but still sincere.

    Of course, rebels do exist – but their fate, as fate of all heretics, is quite unpleasant. They suffer a whole range of harsh consequences of their dissidence, from personal vilification in media to refusal of funding and promotion to outright banishment from profession. And – and this is the most terrible fact of all – ones who attack these contrarians, ones who mercilessly destroy their careers and damage their lives, are thinking that they are doing the right thing. They are thinking that they are protecting the profession – and the gullible public – from the sinful influence of deceptive or delusional individuals and groups. For these attackers, their victims are either mad or bad, and have nobody but themselves to blame for the misery which fall on them.

    Most of attackers will not even try to familiaraze themselves with the heretical experiments and theories. The reason is simple – they are certain that there are nothing to understand at all, or at least nothing worth understanding. For them, everyting that contradict the current consensus is by definition faulty or fradulent, and anyone who disagree is a madman or a liar.

    These are the common processes of human psyche and society – processes to which academicians are not immune; to the contrary, they are easy victims of them. They do not require organized conspiring; they require only uncritical acceptance of authority – probably the most common, and the most dangerous, psychosocial weakness of human species.

    ______________________________________

    And fighting against child masturbation was sometimes quite atrocious – it included, as far as I know, burning children’s genitalia by hot iron. Yet people who performed it were believing that they were doing it for children’s own good…

    And similar situation repeat again and again in history – since most people who are doing terrible things are not intentionally malevolent. To the contrary, they want to help – and simply refuse to look at evidence that their helping attempts causes more damage than benefit, or just entirely misguided.

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