Dr. Peter Breggin2013-05-25T05:36:37-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/author/index.php?author=dr-peter-bregginCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Dr. Peter BregginGood old fashioned elbow grease.A National Day of Male Atonementtag:www.huffingtonpost.com,2013:/theblog//3.32344222013-05-08T16:08:28-04:002013-05-08T16:08:35-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/sexual enslavement in Cleveland, I found myself becoming increasingly uneasy. I knew I would be talking about it to millions of Americans on a nationwide radio talk show that night, but didn't know what I wanted to say.
On TV there were the usual discussions about how long the captivity had been endured, about why the girls growing into women could not or did not escape earlier, references to the Stockholm syndrome, and questions about how psychologically scarred they would remain and whether therapy would help. But one thing was not being discussed: the male abuse of women that is endemic in societies and cultures throughout the world.
Has any woman in America escaped some amount of sexual or physical abuse at the hands of men? Are men comfortable or even remotely willing to face this? More than two decades ago, when I created and taught a graduate course, "The Male Abuse of Women," too many male colleagues made dismissive and even off-color jokes about it. Few male students attended.
The known rates of male abuse were staggering then, as they are now. According to a 2000 CDC report, nearly 52 percent of all women surveyed had been physically assaulted as a child or adult. More than 17 percent had been raped, most of them before the age of 18. Approximately 1 million women are stalked each year, according to the same report. The U.S. Pentagon is preparing to release new statistics about sexual assault in the military. Early information suggests sexual assaults have increased by one-third in two years.
In my clinical experience as a psychiatrist and in my personal life as well, nearly every woman who has spoken openly with me has told me about experiences of sexual molestation and physical abuse or threats at the hands of males. Many of them grew up in families or lived for years in relationships and marriages where they felt emotionally, sexually, and physically threatened and controlled by men.
Almost any woman experiences fear at night when walking down a street or crossing a parking lot alone. Even being home alone at night can make a woman understandably uneasy.
Many women watching the coverage of Cleveland will painfully be reminded of events in their own lives, or the lives of other women close to them. Who is paying attention to them? Not the media. There is no recognition whatsoever of the emotional trauma that these current events will be stirring in women throughout America.
Then there is the worldwide trafficking in children -- and the widespread raping in the chaos of war.
Without diminishing the heinous atrocities committed against the women in Cleveland, millions of women living with their boyfriends or husbands feel oppressed and controlled on a daily basis, while the men in their lives feel entitled to have sex with them and to dominate them.
Maybe we should spend less time being curious about the female victims and more time asking ourselves as men, "What can we do to resist this age-old male drive to dominate and have power over women?"
Perhaps it's time to declare a "National Day of Male Atonement." It would be a good start to finally saying "no!" to the male abuse of women.]]>Be Skeptical of Pharmaceutical Company Claimstag:www.huffingtonpost.com,2013:/theblog//3.30208412013-04-07T11:19:56-04:002013-04-07T14:20:00-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/Click here to read an original op-ed from the TED speaker who inspired this post and watch the TEDTalk below.
Ben Goldacre's TEDTalk describes the selective bias in research and publishing which strongly favors articles with positive outcomes. In my field of psychiatry, this bias is only the tip of the iceberg. In many cases, the articles are not even written by the scientists whose names appear on them. They are "ghostwritten" by drug company minions.
In my role as a medical expert in product liability lawsuits against drug companies, judges have empowered me to dig into the otherwise secret interiors of drug company data vaults. The following observations have been generated during my forensic investigations and have been documented in my books and scientific articles.
Published articles about psychiatric drugs frequently fail to reflect the actual results of the study. After the FDA rejected an antidepressant clinical trial for failing to demonstrate effectiveness, the pharmaceutical company authored a paper based on the same study that was manipulated to show a positive outcome. In another example, a major journal editor was complicit with a drug company in publishing an article about a benzodiazepine tranquilizer that emphasized its supposed effectiveness at six weeks. But the study had lasted an additional two weeks, at which time many of the patients had become addicted to the drug and were suffering from greater than before starting the medication.
In the 1980s, a drug company conducted an in-house review showing that its soon-to-be approved antidepressant increased the suicide attempt rate in adults 6-12 times compared to placebo. The report remained secret until I unearthed it several years later in a legal case. When I informed the FDA, the agency showed no interest in it.
When pharmaceutical corporations have received reports of suicide related to their drugs, more than one has changed the identifying description of the report from "suicide" to "no drug effect," "depression," or "emotional liability." This sleight of hand made the reports invisible to the drug company and the FDA when looking for cases of suicide. In one drug company file, I found an internal memorandum from an employee to his bosses expressing shame about this self-serving misreporting. The employee asked rhetorically how he could explain these actions to "a judge, to a reporter or even to my family... " Nothing changed.
Akathisia (agitation accompanied by a compulsion to move) is a drug effect that can lead to violence, suicide, and psychosis. Some drug companies have successfully avoided receiving reports of akathisia when testing their drugs. They simply remove akathisia from the list of possible adverse effects that are given to their clinical investigators. The researchers end up reporting akathisia as something much less ominous such as "hyperactivity" or "jitteriness."
There is no simple remedy for drug-company falsification of data and scientific reports. We can exert political pressure to strengthen the FDA; but to strengthen the FDA we must go up against... the FDA itself. -- Peter Breggin, M.D.
Too many patients were dropping out of the clinical trials for an antidepressant due to insomnia and agitation. So a top executive sent out a secret memo illegally allowing patients in the study to be given tranquilizers. When the FDA found out, it nonetheless allowed the company to use the fraudulent studies to gain approval for the drug. Doctors and patients had no idea that the drug was so over-stimulating it could only be approved in combination with dangerous addictive tranquilizers.
There is no simple remedy for drug-company falsification of data and scientific reports. We can exert political pressure to strengthen the FDA; but to strengthen the FDA we must go up against... the FDA itself. Unlike medical experts in product liability suits, the FDA does not examine the company's data-gathering and culling process. More like a lapdog than a watchdog, it rarely challenges the validity of drug company data. To strengthen the FDA, we must also go up against NIMH, the AMA, the American Psychiatric Association and multiple other interests groups closely tied to the drug companies.
Product liability suits have helped to control and publicize drug company malfeasance, but too often cases are settled and incriminating facts are sealed. In recent years the U.S. Department of Justice has forced drug companies to accept billion-dollar settlements in criminal and civil cases, often based on the false marketing of psychiatric drugs. But drug companies are able to sacrifice a few billions of dollars as a part of conducting "business as usual."
At present, most drug company records are treated as proprietary secrets. As a public health measure, drug companies should be required to make public all of their internal documentation concerning any drugs that begin the FDA approval process.
In the meanwhile, as individuals we need to be skeptical about pharmaceutical claims for the safety and efficacy of their products. Be aware and be wary, especially in the arena of psychiatric medications, and seek non-drug approaches to healthcare whenever possible.
Warning: Do not abruptly stop psychiatric drugs. Especially after months of treatment, withdrawal can be dangerous, and should be done cautiously with experienced clinical supervision and family or peer support.
Ideas are not set in stone. When exposed to thoughtful people, they morph and adapt into their most potent form. TEDWeekends will highlight some of today's most intriguing ideas and allow them to develop in real time through your voice! Tweet #TEDWeekends to share your perspective or email tedweekends@huffingtonpost.com to learn about future weekend's ideas to contribute as a writer.
]]>What Lance Armstrong and Bernie Madoff Have in Commontag:www.huffingtonpost.com,2013:/theblog//3.24897652013-01-17T12:17:26-05:002013-01-17T12:21:35-05:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/
It starts out with feeling entitled to get what you want no matter what. You want to look good and be great, without the work it takes.
It's like being the "Great Impostor." Lance and Bernie alike are great impostors. The goal is power and glory -- without the work, but even more so without the risk of failure and humiliation.
A subsidiary goal involves looking benevolent and being adored. You're on the board of charities, you give away some of your money, without letting out what a paltry amount it really is compared to what you're stealing.
If you are lucky enough to succeed through your lies like sports dopers who break all the records, like dishonest politicians who rise to the top, or like fraudulent investors who become wealthy -- then you are stuck living the fiction forever. Your lies become the very fabric of your life and there's no turning back. It's not that you believe your lies; you're not stupid. You cannot live without your lies. If the truth comes out, then it's all over for you.
Lance Armstrong is among the most successful dopers of all time, but there are lots of lesser dopers as well, right down to the lawyer who takes cocaine up his nose to keep up his courage and energy in the face of his upcoming trial.
Some dopers and financial frauds need a group in order to succeed. They need co-conspirators. Lance had his team, Bernie his family. They may even feel some loyalty. The pressure of lying and the fear of getting caught sets the little group apart, a kind of mini-cult that breeds an "us against the world" mentality. It keeps up their spirits while they lie and cheat. But these attachments are likely to fall apart when the truth comes out, and when the scandals and the prosecutions begin.
A comparison to drug abuse and lying in childhood can be enlightening. Working with families as a therapist, I see children begin to lie when they feel alienated from their parents or fearful that they cannot meet their expectations. The lying becomes a habit, so easy to use, and so automatic, the child seemingly cannot let go of it.
The answer for children is not punishment but a rebuilding of trust. I tell these children -- and they get it -- that lying is like drug addiction. It seems easy and even indispensable, but it will make them feel more alone and even less able to succeed or gain approval in the normal ways. Then I work with the parents to help them to guide their children toward more fulfilling lives.
If and when children start using drugs or alcohol, the gulf between themselves and their parents grows. Lying becomes yet more embedded in their lives. The chemical "high" that they get replaces their shattered dreams of being successful, respected and loved in the real world. It's similar to doping, but in doping the individual is actually working at something, and the high comes from reaching superhuman greatness, power and glory, regardless of the cost.
With the child, setting limits and trust building can help to change the youngster's life. Any child with the right help can outgrow the shortcuts and detours of lying and drug abuse or addiction.
What about remorse when adults like Lance Armstrong or Bernie Madoff see the light and fess up in public?
Lance Armstrong is now playing the "mea culpa" card. Don't believe it. The odds are overwhelming that he's too embedded in a life of lies to work his way out of it. Besides, he's still under assault from a teammate-turned-whistleblower, and the U.S. Department of Justice may be going after him. He wants to hang on to the shreds of his life and to protect his embattled fortune. He'll do what he does best, without or with drugs. He'll lie.
Remorse?
He left that behind decades ago.
Peter R. Breggin, M.D., is a psychiatrist in private practice in Ithaca, New York, and the author of more than twenty books and dozens of scientific articles. His most relevant book to this blog isThe Heart of Being Helpful. His most recent book is Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. His professional website is www.breggin.com. Dr. Breggin's national nonprofit organization, The Center for the Study of Empathic Therapy, is holding its annual conference in Syracuse New in April of this year. Learn about the organization and conference at www.empathictherapy.org.
For more healthy living health news, click here.]]>How Forgiveness Can Change Your Lifetag:www.huffingtonpost.com,2013:/theblog//3.23935242013-01-02T14:35:48-05:002013-01-02T14:38:56-05:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/implored the people of America:
With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation's wounds, to care for him who shall have borne the battle and for his widow and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.
Forgiveness is not an occasional act, it is a constant attitude.
Mandela, like Lincoln, tried to bring forgiveness to a whole nation. About himself, he said:
As I walked out the door toward the gate that would lead to my freedom, I knew if I didn't leave my bitterness and hatred behind, I'd still be in prison.
Mandela's life is emblematic. After spending decades imprisoned by his political enemies, he never became embittered and went on to devote the rest of his life to helping the people of South Africa forgive each other and to bind together as one. In 1994, he explained to a reporter, "Men of peace must not think about retribution or recriminations. Courageous people do not fear forgiving, for the sake of peace."
In our personal lives, our attitudes are much more guaranteed to have an impact than in the more distant chaos of the political world. Forgiveness in regard to those around us is guaranteed to improve how we feel about ourselves, and it may have a good impact on others as well.
Let's begin with what forgiveness is not, because the greatest barriers toward forgiveness involve falsely entangling it with things it is not.
Forgiveness is not about giving up fighting for our ideals. Although I'm sure they may have flinched at times, at least in the privacy of their own hearts, Mother Teresa, Gandhi, King, and Mandela never gave up their determination to make the world a better place, regardless of opposition. Their capacity for forgiveness did not weaken their resolve to fight for what they knew to be right.
Forgiveness is not about ignoring the harm done to us by others, and in particular it is not about allowing the harm to persist.
Forgiveness is not about letting go our capacity for moral judgment. It is instead a moral judgment of the highest spiritual quality.
Forgiveness is not about making believe that people are better than they are or that human nature is more benign than it is.
Now for the hardest part: What is forgiveness?
Forgiveness, as I understand it after all these decades on Earth, is about an attitude toward both ourselves and others. Forgiveness is an attitude of letting go of enmity and resentment and encouraging ourselves to feel genuine love and empathy. It begins with kindness and understanding toward ourselves.
Forgiving ourselves allows us to recognize our own faults and then to correct them as much as we can without languishing in unforgiving guilt and shame. Guilt and shame actually make us less able to examine ourselves. We try to relieve these self-punishing attitudes by denying responsibility for any wrong actions. In a state of denial that protects us from guilt and shame, we cannot identify what we need change about ourselves.
Further in regard to ourselves, to forgive others is to make peace within ourselves. We give up anger and resentment and thereby become freer of spiritually-corrupting malice. We no longer give those who have hurt us the power to continue to do so by preoccupying us with their deeds.
In regard to others, forgiveness relieves us of the motivation to gratuitously harm others. We may still feel the necessity of taking self-protective actions that end up harming them, for example, by excluding them from our lives, but we have not done so out of malice. We have acted to protect ourselves or our families and not for the purpose of inflicting harm.
Similarly, people may be harmed in our political lives if we fight against their interests, but we are better off if we are motivated by the pursuit of ideals and principles rather than resentment. If we are trying to improve the world in some way, this difference in attitude enables us to behave more rationally and often results in our having a better impact.
Forgiveness also leaves room to welcome back friends or family when they have changed and are no longer a danger to us or our loved ones. The same is true in our political lives where, whenever possible, we try to let go of old resentments in order to accomplish a greater good.
Forgiveness ultimately empowers us by clarifying our minds. Unclouded by resentment, jealousy, or hate, it is far easier to make rational decisions about who can be trusted and who cannot be trusted, and about how to best improve our lives and the lives of others.
Forgiveness goes hand in hand with empathy. Empathy involves a caring and even loving response to another's viewpoint and experience. It does not, however, mean that we approve or reward another person's viewpoint and behavior. In my experience, when we approach other people in an open and receptive manner, if these people have bad intentions, it becomes much more readily apparent to us than when we approach them with suspicion and callousness.
People who are forgiving do not become vulnerable to individuals who have harmed them or have the intent to harm them. Forgiveness involves seeing people for who they are, both the good and the bad, while letting go of spiritually-corrupting negative emotions that make us anxious and keep us up at night, wasting our energy, which can be turned to better uses.
As a psychiatrist and psychotherapist, it's apparent to me that the most forgiving people are the happiest and most effective, and that the least forgiving people are the most miserable and ineffective. A great deal of personal suffering, including what gets called mental illness, is rooted in an angry, unforgiving attitude toward oneself, other people, and the world.
Yes, harboring a grudge and feeling hateful can temporarily energize us, but in the long run it wears us out. Burnout is often the product of resentment. Driven by an unforgiving attitude, we are also likely to sacrifice and to exhaust ourselves in the name of getting even or not letting someone "get away with it."
When we let go of hard feelings and stop expressing resentment, it enables positive change in those who may have hurt us. With less reason to focus on our enmity, they are given the maximum opportunity to retake responsibility for their own actions.
Forgiveness has no downside. A renewal of our capacity to forgive can only improve our inner life and empower us in every activity we undertake. Think about Mother Teresa, Gandhi, Mandela, and Martin Luther King Jr. It is no coincidence that each of these spiritual and political leaders advocated forgiveness. Each found in forgiveness an empowering attitude toward their personal lives as well as toward their political work in the world.
Peter R. Breggin, M.D., is a psychiatrist in private practice in Ithaca, New York, and the author of more than twenty books and dozens of scientific articles. His most relevant book to this blog isThe Heart of Being Helpful. His most recent book is Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. His professional website is www.breggin.com
For more on emotional wellness, click here.]]>The Newtown Shootings: Mourning the Loss of Children Taken So Suddenly Awaytag:www.huffingtonpost.com,2012:/theblog//3.23081572012-12-16T14:40:17-05:002012-12-16T14:48:44-05:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/
We look at the mistakes our own parents made and vow to do better and to provide our children the best possible family life. We look at the suffering we endured as children, perhaps from poverty, from family conflict, from bullying, from failing to accomplish, and then we do everything we can to make their way easier.
We look at the opportunities we had, or didn't have, growing up and work hard to make sure that our children's lives will offer them even better and more-varied choices. When times are difficult for us, we try not to let our own frustrations spill over onto our children. We try to be the best parents we can so that our children will have the best of us upon which to build their own lives.
There are conflicts and difficulties, of course, as we bring up our children, but there are also moments that seemed bathed in grace when our children shine like angels in our lives, and other moments after seeing them work so hard to achieve, that we bask in their success, knowing we helped to make it possible. And then there is the quiet, ever-present sense of satisfaction we achieve from day to day from simply knowing that they exist.
Sometimes our children seem so much a part of us, and our hopes, that it can be difficult to know when and where they begin as individuals and when and where our hope for ourselves becomes more purely hope for them, for their lives, and their future families.
So what, then, are we to do when our children, one or more, are taken from us in one horrible instant that dashes all of our hopes? And what about the slower, sometimes more torturous tragedies we endure as parents? The unexpected traumatic loss of a child at the hands of a murderer or a drunk driver is among the most unendurable losses, but it is not the only kind.
There is the loss of watching our children become estranged from us through marital conflict and divorce that has spun out of control. There is the loss in witnessing our children sink into drug abuse and addiction, or profound emotional distress, dragging them beyond our reach.
There is chronic illness that afflicts our child and breaks our heart. There is seemingly-inexplicable conflict that creates rifts between us and our children, conflicts that we cannot seem to heal no matter how we try.
The loss of a child is the loss of a part of ourselves, and especially that part of us from which hope springs eternal. It faces us with the knowledge that hope may not spring eternally -- at least not in our lives and lifetimes.
I don't have any answers. But I do have a direction: to revive hope, to love again, and to reconnect with the eternal in ourselves, our children, and our loved ones.
We don't necessarily "recover." We may never "get over it." Instead, we may wrap ourselves in the wisdom gained from loss. We may learn that life means even more to us than we realized before our loved one was taken away.
We may learn to treasure life in a deeper way, bathed in the knowledge that loved ones can never be taken for granted. We may be sustained by accepting that we never do stop loving, even when our loved ones are removed from sight, because love persists beyond loss.
In this knowledge that love transcends loss, we can find continued strength to love. It is because of love that hope can spring eternal. It's at all times a fragile effort, but it's what we're supposed to do.
Peter R. Breggin, M.D., is a psychiatrist in private practice in Ithaca, New York, and the author of more than 20 books, most recently, Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. With his wife Ginger, he is the co-founder of The Center for the Study of Empathic Therapy, Education and Living (a nonprofit 501c3). His website is www.breggin.com.
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Suicide malpractice suits are notoriously difficult to win. Juries, like most people, want to hold individuals responsible for their self-destructive behavior. They are reluctant to blame a suicide on a drug or on a doctor's negligent behavior.
Many years ago, I used to believe that people must be held responsible for their own behavior under all conditions, but my philosophical beliefs were eventually eroded by the mountain of scientific evidence that I developed through my research and clinical experience indicating that psychiatric drugs can indeed drive people to suicide. This scientific reality is now enshrined in black-box warnings in the FDA-approved labels for many drugs, including allantidepressants, all anticonvulsants, and individual medications like the ADHD drug Strattera (atomoxetine) and the smoking aid Chantix (varenicline).
Because of difficulties in evaluating and in winning suicide malpractice suits, I looked very carefully at the case of Joseph Mazella when it was sent to me for my expert opinion by attorney DelDuchetto. Mr. Mazella was a 51-year-old revered high school basketball coach, teacher and assistant principal; and his self-inflicted death was unexpected and shocking to those who knew him and to the Syracuse community.
In addition to the potential hazards of the antidepressants themselves, including Paxil (paroxetine) and then Effexor (venlafaxine), I found that a glaring negligence had been committed in the case. Family physician William Beals, M.D., who had a reputation for treating psychiatric and addiction patients, had prescribed Paxil for Mr. Mazella for 10 years without seeing him. When Mr. Mazella began to feel anxious and depressed again, on Aug. 9, 2009 he and his wife telephoned the doctor, who was reportedly on vacation on Cape Cod. Despite having no contact with the patient for a decade, by telephone Dr. Beals doubled his Paxil from 20 mg to 40 mg and added the antipsychotic drug, Zyprexa (olanzapine). This began an escalating decline in his mental condition that ended a little more than one month later with his suicide.
After reviewing extensive records and interviewing Mr. Mazella's wife Janice, I concluded that Dr. Beals was negligent in reportedly prescribing Paxil for 10 years without seeing the patient, in failing to warn the patient and his wife about the serious risks associated with Paxil, in his doubling the Paxil dose and adding Zyprexa by telephone, and then in abandoning the patient during his decline. I also concluded that a hospital psychiatrist was negligent in not recognizing that Mr. Mazella was suffering from adverse drug effects and in discharging him without proper followup two weeks before his death.
I later learned that I was not the only one critical of Dr. Beals. The NYS Board for Professional Medical Conduct has placed him on probation for prescribing for patients without seeing them, and has also disciplined him for personally abusing alcohol and drugs.
In trial I testified for a day and a half concerning how antidepressant drugs including Paxil and Effexor can increase suicide risk in adults, and also my opinion of how the behavior of the two doctors contributed to or caused the tragic outcome.
On Nov. 21, 2012 the jury found both doctors negligent, but concluded that only Dr. Beals' acts had contributed to or caused Mr. Mazella's suicide. The jury awarded his wife and three children $1.5 million.
This courtroom victory is consistent with a change that I have been witnessing in my media and public appearances, and in my communications with professionals and laypersons around the world. People are becoming increasingly aware that psychiatric drugs are capable of doing more harm than good, including potentially increasing the risk of violence and suicide. Unfortunately, the medical profession, and especially psychiatry, has been slow to catch on. Hopefully this malpractice verdict will encourage my colleagues to take a closer look at their too often cavalier attitudes toward prescribing psychiatric drugs.
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10 October 2012 -- Terming depression, which afflicts 350 million people worldwide, an "under-appreciated global health crisis," Secretary-General Ban Ki-moon today called for an international effort to increase access to a wide variety of effective and affordable treatments and remove the social stigma attached to the illness.
This current barrage of "educational" propaganda on behalf of pharmaceutic interests is even supported by the State Department, which heavily endorses the industry's astroturf lobbying group, called the National Alliance on Mental Illness:
In the United States, the National Alliance on Mental Illness (NAMI) observes a week of awareness in the first full week of October by the direction of a congressional order passed in 1990. NAMI reports that one in four U.S. adults experiences a mental health problem in any given year. One in 17 lives with serious, chronic illness.
A key player is the World Federation for Mental Health, whose multi-color brochure declares Oct. 10, 2012 as "World Mental Health Day," again targeting depression in its booklet title: "Depression: A Global Crisis." Perhaps because markets for psychiatric medications in the industrialized world are getting saturated and because drug companies and their products have been coming under heavy criticism, the "World Mental Health Day" is mostly aimed at poorer nations. The World Federation for Mental Health booklet advocates the use of antidepressant drugs. This colorful document was "made possible" by... guess whom? The only three sponsors are companies that make psychiatric drugs: Eli Lilly, Otsuka and Lundbeck.
Is this what we really need? More diagnoses, more patients, more psychiatric drugs spreading like a chemical plague throughout the world? We are now learning that the longer-term use of some of these psychiatric drugs can cause chronic mental disability. Several of my books (for example and for example), recently bolstered by Robert Whitaker's, leave no doubt that the evidence for longer-term efficacy (months or years) is insufficient, while the evidence for longer-term harm is escalating. Studies are showing that this chronicity actually reflects physical damage to the brain. Studies -- included in my books and revealing changes to the brain from antidepressants, from the so-called antipsychotic drugs (the neuroleptics), from stimulants and from benzodiazepines and prescription sleep medications -- are piling up, documenting patient risks. In my professional experience, psychiatric drug-induced chronic brain impairment is now a much greater threat to society than the emotional problems that the drugs are supposed to treat.
With so much objective misery oppressing people in poor countries, everything from war to famine, it is bizarre and misleading to talk about 350 million worldwide with depression. Most of all, the poor countries need increased liberty, opportunity, and economic growth. As Ethan Watters documents in his bookCrazy Like Us: The Globalization of the American Psyche, the last thing these countries need is to import our biological psychiatric diagnoses and drugs into their societies.
When people are not overwhelmed by oppressive life circumstances, which must be rectified, in my opinion the best forms of help for depressed people are supportive and encouraging human relationships. When professional help is needed or desired, depression is best approached through psychotherapy, counseling and other human services. Studies have documented that this works and doesn't have the adverse effects of drugs. We agree with Dr. Norman B. Anderson, the CEO of the American Psychological Association, who has called for therapy to be made the first choice of treatment for depression.
Tragically, despite the harm being done by psychiatric drugs, trying to withdraw from these chemicals can be very distressing and even life-threatening. Psychiatric drug withdrawal needs to be done responsibly and thoughtfully. But the alternative of continuing to take psychiatric drugs indefinitely increases the risk of damage, and even shortened lifespan in some patient populations. Instead of persisting in pushing psychiatric drugs, health professionals and organizations around the world would do far more good by developing and supporting programs for psychiatric drug withdrawal. My new book Psychiatric Drug Withdrawal provides the guidelines for withdrawing from psychiatric drugs as safely as possible.
But who's going to sponsor these reform efforts? Not the UN. Not the State Department. Not the drug companies. Not organized medicine and psychiatry. It will take a grassroots demand led by professionals with conscience, concerned patients, and responsible citizens.
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You will never guess what the fifth and sixth best-selling prescription drugs are in the United States, so I'll just tell you: Abilify and Seroquel, two powerful antipsychotics. In 2011 alone, they and other antipsychotic drugs were prescribed to 3.1 million Americans at a cost of $18.2 billion, a 13 percent increase over the previous year, according to the market research firm IMS Health.
Others drugs in this group of so-called atypical or second-generation antipsychotic drugs include Risperdal, Zyprexa, Geodon, Invega, and now Latuda.
Friedman goes on to observe:
It was also soon discovered that the second-generation antipsychotic drugs had serious side effects of their own, namely a risk of increased blood sugar, elevated lipids and cholesterol, and weight gain. They can also cause a potentially irreversible movement disorder called tardive dyskinesia, though the risk is thought to be significantly lower than with the older antipsychotic drugs.
Notice he says that the risk of tardive dyskinesia is "thought" to be significantly lower. In reality, the very study that he cites in his column, the National Institute of Mental Health (NIMH) sponsored CATIE study, did not find that the newer antipsychotics were safer in this regard.
Friedman correctly laments that these dangerous drugs, proven no more effective and no safer than the older ones, are being given off-label to individuals with much less severe psychiatric problems than psychosis: "But now, unbelievably, these powerful medications are prescribed for conditions as varied as very mild mood disorders, everyday anxiety, insomnia and even mild emotional discomfort."
How can an establishment psychiatrist dare to make such devastating criticisms? He covers himself at the end with this obligatory tag line: "Let's be clear: The new atypical antipsychotic drugs are effective and safe." Then he calls them lifesaving.
The reality is that all of these drugs are nonspecific lobotomizing agents that disrupt biochemical neurotransmission to the frontal lobes. I examine these effects in my book:Brain Disabling Treatments in Psychiatry, Second Edition. They achieve their effect by making people indifferent and apathetic toward their own suffering and toward life itself, in the extreme creating a grossly apparent zombie effect. A number of studies, summarized in my new book, Psychiatric Drug Withdrawal, also indicate that they may shorten the lifespan by many years in some patient populations.
Friedman is right that by any standards these drugs are overprescribed. But he leaves out two groups that are especially vulnerable to abuse by these chemical agents: the elderly and children.
In nursing homes throughout North America, antipsychotic drugs are given wholesale to patients in order to lower the costs of confining them, in particular by reducing the need for staff to meet the needs of these chemically-lobotomized individuals. Elders are placed at risk of many adverse effects and an early, hastened death due to the off-label prescription of antipsychotic drugs.
Children throughout America are being given these drugs for everything from insomnia to ADHD. Some of these children are developing horrific side adverse effects, including gynecomastia in preadolescent boys and girls who develop breasts indistinguishable from those of adult women. Sometimes these breasts grow back after surgical removal, despite stopping the medications. Steve Sheller, an attorney in Philadelphia, is pursuing numerous cases of gynecomastia and has described many cases to me. In addition, boys are developing premature puberty, like one of my patients is, at age 7.
The FDA has approved the use of some of these newer antipsychotics for a variety of purposes in children, including irritability associated with autism and bipolar disorder. It is time to stop this epidemic of pharmacological child abuse.
Attorney Sheller is circulating a petition that we endorse, asking the FDA to revoke approval of the prescribing of antipsychotic drugs to children. Mr. Sheller states in the petition:
We hereby petition the Food and Drug Administration (hereinafter "FDA"), pursuant to the Federal Food, Drug and Cosmetic Act ... to immediately revoke the pediatric indication for Risperdal®, all generic version of risperidone, and Invega (an extended release and injectable medication which includes the same primary active metabolite as Risperdal) unless and until the long-term safety of the drug can be demonstrated, or in the alternative to immediately require that labeling for Risperdal® and all generic versions of risperidone include a black box warning on the lack of sufficient safety data.
We urge concerned professionals and laypersons to sign the petition to the FDA. Each of us, as alarmed physicians, psychiatrists, therapists, counselors, educators, attorneys and citizens, needs to add our voice to this formal appeal to stop the wholesale over-drugging of one of the most vulnerable populations of our society -- our children. By supporting this petition and encouraging the FDA to take action, we also protect children every place in the world because as America goes with psychiatric drugs, so goes the world. You can go right now to the official government website to add your voice to protect children against the chemical assault of these powerful and dangerous chemical agents.
For more healthy living health news, click here.]]>Soaring Numbers of Children on Powerful Adult Psychiatric Drugstag:www.huffingtonpost.com,2012:/theblog//3.17711522012-08-14T16:54:46-04:002012-08-14T16:56:09-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/recent blog of mine described how unethical and illegal drug company activities have driven the prescription of toxic antipsychotic drugs to children. Now the "success" of this campaign has been documented in the Archives of General Psychiatry. In a comparison between the years 1993-1998 and 2005-2009, prescriptions of antipsychotic drugs for per 100 children (0-13 years old) rose from 0.24 to 1.83. That's more than a sevenfold increase. Given that most of prescriptions are for the older children in this age range, the rate would be substantially higher among preteens and 13-year-olds. For adolescents (14-20 years old) the increase was nearly fivefold.
This report comes out at a poignant time for me. Right now one of my patients, a 7-year-old boy I will called "Joey," has just returned from being psychiatrically hospitalized because he could not be withdrawn from the antipsychotic drug Risperdal as an outpatient. The family came to me for help in getting this child off the psychiatric drugs he'd been prescribed by another psychiatrist. A basically sweet and lovable boy, the withdrawal was such an agony for him that he became uncontrollably violent. Meanwhile, he already suffers from tardive dyskinesia, a persistent and commonly permanent movement disorder from antipsychotic drug exposure that causes abnormal movements, including deforming facial grimaces and disabling involuntary movements of the torso and limbs.
Joey is also a victim of precocious puberty, almost certainly caused by the Risperdal. Although largely ignored in the scientific literature, according to Philadelphia attorney Steve Sheller, many cases of Risperdal-induced premature puberty in boys are showing up as legal cases.
My patient Joey became dangerously violent for the first time after exposure to antipsychotic medication and then became even more violent during withdrawal. You can witness similar reactions in stunning footage from an ABC News documentary about U.S. foster children prescribed large quantities of psychiatric drugs, including Brooke, also age 7, who had been exposed to the drugs since the age of 4. When she was finally taken to a psychiatrist who recognized what was happening to her, the doctor observed, "The first thing we've got to think about: Is the medicine causing this? ... There always has to be a high index of suspicion when we're using these agents."
Unlike the escalation in stimulant drugs prescribed to children for attention deficit hyperactivity disorder (ADHD), which is led by pediatricians and family doctors, psychiatrists are doing most of the prescribing of antipsychotic drugs to children. As reported earlier, the drugging of children with antipsychotic drugs is a direct result of off-label (unapproved) uses promoted by the drug companies in cooperation with unscrupulous psychiatrists and researchers in leadership roles in the profession. The new Archives of General Psychiatry study confirms that most of the prescriptions of antipsychotic drugs to children have indeed been off-label for disruptive behavioral disorders. Instead of helping parents and teachers to improve their methods of disciplining children, psychiatrists are suppressing the overall mental life and behavior of these youngsters with antipsychotic drugs.
A courageous psychologist, Jerome Kagan, was recently interviewed by Spiegel about the epidemic of "mental illness" in children:
SPIEGEL: Experts speak of 5.4 million American children who display the symptoms typical of ADHD. Are you saying that this mental disorder is just an invention?
Kagan: That's correct; it is an invention. Every child who's not doing well in school is sent to see a pediatrician, and the pediatrician says: "It's ADHD; here's Ritalin." ... The problem is, if a drug is available to doctors, they'll make the corresponding diagnosis.
SPIEGEL: So the alleged health crisis among children is actually nothing but a bugaboo?
Kagan: We could get philosophical and ask ourselves: "What does mental illness mean?" If you do interviews with children and adolescents aged 12 to 19, then 40 percent can be categorized as anxious or depressed. But if you take a closer look and ask how many of them are seriously impaired by this, the number shrinks to 8 percent. Describing every child who is depressed or anxious as being mentally ill is ridiculous. Adolescents are anxious, that's normal. They don't know what college to go to. Their boyfriend or girlfriend just stood them up. Being sad or anxious is just as much a part of life as anger or sexual frustration.
SPIEGEL: What does it mean if millions of American children are wrongly being declared mentally ill?
Kagan: Well, most of all, it means more money for the pharmaceutical industry and more money for psychiatrists and people doing research.
SPIEGEL: And what does it mean for the children concerned?
Kagan: For them, it is a sign that something is wrong with them -- and that can be debilitating. I'm not the only psychologist to say this. But we're up against an enormously powerful alliance: pharmaceutical companies that are making billions, and a profession that is self-interested.
As Dr. Kagan confirms, children suffer psychologically and developmentally from being wrongly diagnosed "mentally ill." There are also extraordinary medical risks from exposure to antipsychotics. The Archives of General Psychiatry report mentions that these drugs may cause increased blood sugar, diabetes, increased lipids (cholesterol), and obesity. It does not mention that these adverse reactions greatly elevate the risk of later heart disease, especially since these drugs also compromise cardiac function.
The study also neglects to mention tardive dyskinesia, neuroleptic malignant syndrome (a potential fatal disease that mimics a viral brain disease), and a variety of other hazards caused by these drugs in children as well as adults. It does not mention that studies done on schizophrenic patients being treated with these drugs -- here, here and here, for example -- continue to indicate that antipsychotic drugs are toxic to brain cells, and that they are associated with shrinkage of the brain.
Documenting the rising trend of antipsychotic prescriptions for children and youth is vital, but why do the authors of the new study call for more clinical trials to test the safety and efficacy of these drugs in children? Why don't they call for a moratorium on the off-label psychiatric drugging of children and youth with antipsychotic drugs? The answer may lie in the authors' many financial ties to multiple international drug companies.
In the financial disclosures section at the end of this report, a rogues gallery of pharmaceutical companies are listed including Eli Lilly, Bristol-Myers Squibb, AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Novartis, Janssen/Johnson & Johnson, Pfizer, Schering-Plough, and more.
As I describe in my new book, Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families, health professionals must stop the psychiatric drugging of children and focus on developing facilities and approaches for helping children as well as adults to withdraw from these drugs as safely as possible. An epidemic of brain damage and other bodily harms could be stopped by curtailing the drugging of children and by encouraging their safe withdrawal from these hazardous chemical intrusions into their brains, minds, and lives.
Meanwhile, there is no mystery about what children need from us. They need more of us. Whether the child is having difficulty focusing in school or behaving at home, whether the child is having difficulty socializing or communicating, and whether the child is given no psychiatric diagnosis or a serious diagnosis -- all children need caring, informed, disciplined and dedicated attention from the adults in their lives. As adults, we need to retake responsibility for raising and educating our children.
Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York, and the author of dozens of scientific articles and more than twenty books. His most recent book is Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. The first half of the book describes a broad array of adverse effects that should lead to drug reduction or withdrawal, and the second half describes a person-centered team approach to accomplishing drug withdrawal. Dr. Breggin's website is www.breggin.com.
For more healthy living health news, click here.]]>Psychiatry: Start Listening to Your Patients and Their Familiestag:www.huffingtonpost.com,2012:/theblog//3.17421192012-08-10T13:18:50-04:002012-08-10T13:19:17-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/are asked to be involved to make sure patients comply with taking their medications as instructed.
On the face of it, medication compliance makes sense. Patients should take their medications as instructed and families should ensure that they do. But is it that simple? I am not alone in concluding that especially in psychiatry, getting patients to comply with medication runs counter to central principles of therapy. According to a paper printed in the journal Psychiatric Services:
Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine ... Shared decision making diverges radically from compliance because it assumes that two experts -- the client and the practitioner -- must share their respective information and determine collaboratively the optimal treatment. ... Choice, self-determination, and empowerment are foundational values for people with disabilities, including people with psychiatric disabilities.
This month the British Journal of Psychiatry carries an editorial asking "Antipsychotics: Is it time to introduce patient choice?" The abstract states:
Evidence regarding overestimation of the efficacy of antipsychotics and underestimation of their toxicity, as well as emerging data regarding alternative treatment options, suggests it may be time to introduce patient choice and reconsider whether everyone who meets the criteria for a schizophrenia spectrum diagnosis requires antipsychotics in order to recover.
Despite the enlightened sentiments expressed in these articles, medication compliance remains a buzzword with enormous power to control psychiatric patients, their families, and even their non-medical health care providers, such as therapists. Students in psychology, social work, counseling, nursing and other health professions are taught that their job is to make sure that patients take their medications. Medication compliance becomes a tool for coercion.
When I teach or address students who are being trained as therapists, some usually express fear that they will "get in trouble" if they do not blindly encourage and even compel their patients to take the psychiatric drugs prescribed to them. Whether the drugs are being prescribed by a psychiatrist, pediatrician, ob-gyn or family doctor, most therapists feel obliged to avoid questioning the medication regiments of their patients, even if the patients appear grossly over-medicated. They are afraid that they will be accused of practicing medicine without a license. However, I'm in agreement with the Mental Health Desk Reference, which finds this to be an unrealistic fear, and sides with those who believe that therapists should learn about drugs and share information with their clients.
Family members tend to respond in a similar way as many therapists by blindly encouraging patients to take their medications, even when the drugs seem to be doing more harm than good. At the most, family members are likely to encourage the patient to "talk to your doctor" about the drugs. There are exceptions, and some more confident family members are sometimes more able to evaluate drug effects without their ideas being as clouded by the drug company propaganda that bombards prescribers.
In addition to the basic undermining of the patient's personal freedom, autonomy, hope and confidence, there are a number of practical reasons why medication compliance is a particularly hazardous approach to psychiatric treatment:
When clinicians become overly focused on getting their patients to take psychiatric drugs, they can discourage patients from "complaining" about adverse effects. As a result, these clinicians may never get vital and even potentially lifesaving information from their patients and their families about harmful drug effects.
Psychiatrists, pediatricians, internists, family doctors and other prescribers tend to see patients for 10- to 15-minute "med checks," during which time they can do little more than a superficial check based on the patient's abbreviated remarks about how he or she is doing. To actually evaluate medication effects, the prescriber needs lengthier sessions, more focus on what the patient is feeling and saying, and greater feedback from the patient's therapist and family. This collaborative team approach, which I describe in Psychiatric Drug Withdrawal, can be lifesaving.
Prescribers must keep track of the adverse effects of dozens of medications. In this information age with multiple Internet information sites, the patient, therapist, or family member, by contrast, can focus on the few medications involved in their specific case and spend time learning much more about a few drugs than the prescriber can possibly remember or integrate into the treatment. Even in regards to medications where I am very informed, patients sometimes tell me about new and important drug information that has thus far escaped my attention.
Because of medication spellbinding, patients often fail to perceive adverse drug effects. As I document in Medication Madness, when the patient declares "I'm doing better than ever," it may potentially be a danger signal for impending mania that doctors can overlook. Therefore, family input is really needed to monitor patients during drug treatment, and especially during dose changes and drug withdrawal.
Since long-term exposure to psychiatric drugs can cause chronic brain impairment (CBI), patients exposed for months or years to psychiatric drugs may lack the cognitive ability to grasp increasing mental dysfunction.
Unfortunately, there is another yet larger problem. Drug company influence over prescription practices has made commonplace what previously was considered bad medical practice. These include:
Rushing patients onto brand new drugs before they have been field tested in the larger market over months or years
Giving patients multiple drugs at once even though they have never been tested in combination
Prescribing patients the maximum doses of several drugs when maximum doses are determined on the basis of a patient taking only one psychiatric drug at a time
Prescribing drugs off-label without any scientific basis
Telling patients to take drugs for the rest of their lives.
Trying to Impose Evidence
Ironically, the emphasis on pushing evidence-based medicine as the standard for prescribing has led to the abusive prescription of more expensive and more toxic medications, including the newer antipsychotic drugs, because doctors aligned with the drug companies lead the attempts to determine what particular practices are "evidence-based." One of the largest attempts to standardize treatment in this manner, the Texas Medication Algorithm Project, was underwritten by 11 drug companies: Abbott, AstraZeneca, Bristol-Myers Squibb, Eli Lilly , Forest Laboratories, GlaxoSmithKline, Janssen, Novartis, Organon, Pfizer, and WyethAyerst.
Attempts to standardize prescription practices also have a potentially disastrous unforeseen outcome. There is such huge biological and psychological variation from human being to human being that many patients will respond in ways that do not fit the cookie cutter, including experiencing serious adverse reactions to relatively low doses. Rote prescription practices will tend to ignore or deny these untoward occurrences.
Psychiatric medications are being so over-prescribed for such excessive periods of time that in my professional opinion, it is no exaggeration to say that curtailing the use of these drugs would greatly alleviate a worldwide epidemic of adverse drug effects, including chronic disability and injury to the brain, which I have written about here and here and here. Furthermore, the health professions would do far more good if they put less emphasis on kneejerk prescribing and much more on learning how to help patients withdraw from psychiatric drugs. If prescribers spent more time undoing the widespread harm that's already been done by helping patients reduce or stop the medications, these same patients and many new ones would feel empowered to seek out more effective psychotherapeutic and educational approaches. They would feel encouraged to explore the great variety of currently available psychotherapeutic approaches from which they could more readily benefit with unmedicated minds.
Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York, and the author of dozens of scientific articles and more than twenty books. His most recent book is Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. The first half of the book describes a broad array of adverse effects that should lead to drug reduction or withdrawal, and the second half describes a person-centered team approach to accomplishing drug withdrawal. Dr. Breggin's website is www.breggin.com.
References:
[1] Mental Health Desk Reference. Elizabeth Reynolds Welfel and R. Elliott Ingersoll, eds. New York: Wiley, 2004. pp. 90-91
For more on mental health, click here.]]>Drug Companies Drive the Psychiatric Drugging of Childrentag:www.huffingtonpost.com,2012:/theblog//3.16936492012-07-24T11:24:58-04:002012-07-24T16:44:22-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/With Ginger Breggin
Johnson & Johnson, the company that makes the antipsychotic drug Risperdal, has tentatively agreed to a settlement of $2.2 billion to resolve a federal investigation into the company's marketing practices. Although details are not fully finalized, this includes "a roughly $400 million criminal fine for the illegal promotion of the antipsychotic Risperdal," according to the Wall Street Journal. It's been well documented that Johnson & Johnson confidentially paid psychiatrists such as Harvard's Joseph Biederman to promote adult drugs such as the powerful antipsychotic drug Risperdal for children. The company has even ghost-written at least one of the Harvard professor's "scientific" articles.
Another recent DOJ settlement with drug company GlaxoSmithKline resulted in Glaxo's agreement to pay $3 billion in criminal and civil fines. As I wrote in an earlier Huffington Post blog:
In one of the most egregious examples of fraudulent marketing, "In the case of Paxil, prosecutors claim GlaxoSmithKline employed several tactics aimed at promoting the use of the drug in children, including helping to publish a medical journal article that misreported data from a clinical trial," [according to the New York Times].
Glaxo manipulated and rewrote this study, which was rejected by the FDA for failing to show efficacy. The Glaxo rewrite made it appear as though the drug was useful for adolescent depression even though the FDA had not approved Paxil for adolescents. The company then got almost two dozen well-known researchers and "experts" to put their names on the article as if they had written it.
GlaxoSmithKline also secretly paid about $500,000 to psychiatrist Charles Nemeroff, while he was a professor at Emory University, to promote Paxil. Glaxo even ghostwrote a psychopharmacology textbook for family doctors, who write many prescriptions for children, which was "coauthored" by Nemeroff and psychiatrist Alan Schatzberg. Nemeroff was sanctioned for failing to report the Glaxo payments he received while at Emory. But he's landed on his feet running, now chairing the psychiatry department at the Miller School of Medicine at the University of Miami.
None of these drug-company-bought psychiatrists has suffered serious consequences. Biederman remains a star at Harvard and Nemeroff recently received a new $2 million federal grant from the National Institute of Mental Health. These influential psychiatrists are just two out of many doctors who have been investigated for extensive financial relationships with drug companies.
Meanwhile, the DOJ has now enforced a total of $8.9 billion in criminal and civil fines against GlaxoSmithKline, Pfizer, Eli Lilly, and Johnson & Johnson.
Drug-company marketing has bought rich rewards, as reflected in the increasing numbers of children and youth diagnosed with attention deficit hyperactivity disorder and other psychiatric problems. According to the Centers for Disease Control (CDC), 12.3 percent of boys and 5.5 percent of girls age 5-17 were diagnosed with the disorder in 2009. With the rates growing especially rapidly in the older children, considerably more than 12.3 percent of older boys are given this diagnosis, which almost inevitably leads to treatment with stimulant drugs such as Ritalin, Concerta, Focalin, Dexedrine and Adderall. Given estimates of 2.8 million children taking stimulants for ADHD in 2008, the number is now well over three million and rising.
Last year, the American Academy of Pediatrics overrode FDA drug guidelines and advised that children as young as 4 could be diagnosed with ADHD and treated with stimulants. This will surely increase the numbers of younger children psychiatrically diagnosed and medicated with other drugs as well. In our professional experience, children given stimulants may become the targets of additional drugs as their conditions worsen due to the stimulants. Stimulants have been the entering wedge into the widespread psychiatric drugging of America's children. Once the door was opened, nearly all the other psychiatric drugs came rushing in.
Keep in mind that the more than three million children on psychiatric drugs are for only one class of medication -- stimulants for ADHD. Large numbers of other children are being put on highly dangerous adult antipsychotic drugs, antidepressants, and mood stabilizers, often to treat so-called "childhood bipolar disorder." Psychiatrist Biederman's work "helped to fuel a controversial 40-fold increase from 1994 to 2003 in the diagnosis of pediatric bipolar disorder ... and a rapid rise in the use of antipsychotic medicines in children," according to the New York Times. Bipolar disorder, like most other psychiatric diagnoses for children, is linked to the greater use of various psychiatric drugs. No surprise that this is so, since as in the case of Joseph Biederman, the "top" researchers in child psychiatry are heavily funded by pharmaceutical companies.
It is our personal and professional opinion that most childhood psychiatric diagnoses have no scientific validity. ADHD, for example, is described and diagnosed by a collection of behaviors -- inattention, impulsivity, and hyperactivity -- that can be caused by innumerable factors including too high expectations for a child, confused parenting, family disintegration, racism and poverty, inadequate teaching, poor nutrition, bullying, and head injury. The diagnosis literally shuts down the search for the real causes, undermines effective parenting and teaching approaches, and guarantees that the child will be medicated.
As another example, oppositional defiant disorder (ODD) merely describes a child who displays anger. In the words of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, ODD involves "A pattern of negativistic, hostile, and defiant behavior lasting at least six months." The top three "symptoms" are "(1) often loses temper, (2) often argues with adults, and (3) often actively defies or refuses to comply with adults' requests or rules." That's not a disease in a child, it's a sign that something has gone haywire in the child's life and is not being remedied.
My most recent review of the scientific literature in Psychiatric Drug Withdrawal concludes that stimulants, antidepressants and antipsychotic drugs are very harmful to the brain. With increasing millions of children being placed on drugs that can harm normal development of the child's brain and mind, and substitute for proper teaching and parenting, it's time to change emphasis. As a society, we need to resist the quick fix that does more harm than good, and to stand up against the massive drugging of children.
The health professions would do far more good stopping the drugging of children than continuing or increasing it. Ethical professionals need to work toward removing children from psychiatric drugs.
The health professions would make a major contribution to the wide-scale health of children not only by curtailing psychiatric drugging, but also by offering the opportunity for parents to withdraw their children from these psychoactive substances.
Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York, and the cofounder with his wife Ginger Breggin of the Center for the Study of Empathic Therapy. He is the author of dozens of scientific articles and more than twenty books. His latest book isPsychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families.It is based on a Person-Centered Collaborative Approach to psychiatric treatment with the focus on psychiatric drug withdrawal. It also describes many of the most severe adverse effects of psychiatric drugs that require drug withdrawal.
Ginger Breggin, in addition to cofounding and managing the Center for the Study of Empathic Therapy, has coauthored books with her husband, contributes to their mutual research projects, and blogs independently onThe Huffington Post.
Disclosure: Peter Breggin, M.D. has been a plaintiffs' medical expert in product liability suits against the mentioned drug companies including Eli Lilly, Pfizer, GlaxoSmithKline, and Johnson & Johnson.
For more healthy living health news, click here.]]>Drug Company GlaxoSmithKline Puts American Values to Shametag:www.huffingtonpost.com,2012:/theblog//3.16563972012-07-09T14:06:44-04:002012-07-09T14:07:25-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/With Ginger Breggin
Implemented a marketing effort of unprecedented scale ... with 2,300 sales representatives scheduled to visit some 70,000 US doctors, responsible for writing 80% of asthma prescriptions, in the first week ... This push will be accompanied by a direct-to-consumer advertising campaign on television, aimed at raising the profile of the new drug with patients and maximizing sales of the drug within two to three years.
It worked! The asthma drug Advair became a never-ending blockbuster with sales of $7.8 billion in 2010 and predictions that the COPD drug market, which Advair leads, will reach $13.4 billion worldwide in 2020.
The success is especially remarkable in regard to the limitations of Advair as an asthma treatment. It has a huge array of adverse effects, including adrenal insufficiency, worsening of asthma, and death. It is not helpful in episodes of acute asthma and can even make them worse. It is a combination drug, which can be bought more cheaply and better tailored to the patient's needs when prescribed as two separate drugs.
As described in my previous blog, during this same period of time the U.S. Department of Justice (DOJ) began a lengthy investigation of Glaxo, resulting in recent civil and criminal fines of $3 billion for improper off-label marketing of the antidepressants Paxil and Wellbutrin, and Advair. (Although recording-breaking, the penalty was paltry in comparison to sales for the three drugs, with Advair by itself pulling in considerably more than twice that much per year for several years.)
The Wall Street Journal notes that Advair was singled out for allegedly "promoting the drug for the treatment of mild asthma and other uses [the government] said weren't licensed by the Food and Drug Administration, an illegal practice known as off-label marketing."
Reading the DOJ documents is mind-numbing enough in the documents' disclosures of corporate malfeasance, including Glaxo marketing Paxil off-label to children while withholding or manipulating data that demonstrated the drug's lack of efficacy when used for pediatric patients. But there's something especially impactful about seeing the corporate executives on film "doing their thing."
My wife Ginger found the video excerpts exhibit from Department of Justice website that was used as one piece of evidence in their case against GlaxoSmithKline. The film documents a rollicking in-house sales launch for their asthma drug, Advair, with company executives whipping up fervor among what looks like an audience of thousands of salespersons.
With age and hopefully with growing wisdom, my values have become more traditionally American. I have faith in God as a source of love; I believe my country is unique and special in its principles of liberty and democracy; and I've concluded that the free enterprise system, with all its flaws, remains the best engine of progress. When I watch feature films that ridicule these values, I'm often caught between laughing at the comedy and resenting Hollywood for making such caricatures of what I believe in.
A couple of years ago, for example, there was a hilarious movie about a pharmaceutical sales representative's efforts to woo doctors into prescribing Viagra. Called Love and Other Drugs, it showed a seemingly bizarre in-house launch of the drug with executives regaling the sales teams. Terribly overdone, too exaggerated in its lambasting of corporate America, I thought, but nonetheless funny.
The DOJ's real-life film recording of Glaxo corporate execs exhorting their sales teams to shove Advair down the trachea of doctors and their patients was more bizarrely exaggerated than Love and Other Drugs, or most other Hollywood films that mock traditional American values. The DOJ film clips of the launch of Advair begin with a music and lightshow that rivals a rock band with the executives leaping onto stage with face-splitting grins, theatrical gestures, Blues Brothers sunglasses and sports team-like camaraderie. The giant screen flashes with pyrotechnics. The mood is euphoric. The crowd is urged into waves of applause with predictions of how rich they will all become from selling Advair off-label to "every patient" with asthma in America.
As if scripted by Michael Moore, at 5.5 minutes into the DOJ video, one of the executives brays, "There are people in this room who are going to make ungodly sums of money selling Advair." People squirm in their seats with delight and loudly applaud. "The more you sell, the more you make," he nearly shrieks while using his handheld remote to display a giant simulated slot machine on the huge screen. "God bless America. Free enterprise is a wonderful concept," he crows.
Watching this video, I felt appalled by this misuse and abuse of my values. I felt outraged, as a physician, at the utter contempt with which GlaxoSmithKline holds the medical profession. I felt frightened for all of us who consume the products of these corporations.
It's not that I am naive about corporate evil. I have been a plaintiffs' medical expert in a series of cases against that same company, GlaxoSmithKline. I experienced firsthand how far the company and its lawyers would go to defend the drug against allegations that it could be a cause of violence and suicide. My analysis of Glaxo's internal documents showed how the company hid data about possible links to violence and suicide. My original report was made into a sworn affidavit for the court on July 21, 2001, and hopefully helped inspire the DOJ's later attempts to hold the company responsible.
But I'd never before seen anything like these DOJ video clips showing the executives themselves exhorting their sales teams to make themselves millionaires by pushing these drugs without regard for their alleged adverse effects or therapeutic limits.
Ultimately, it may come down to this, that corporations are no better nor worse than human beings in general, and that capitalism can bring out the worst in some human beings, even while overall providing the best if imperfect environment for individuality, freedom, and productivity to flourish.
But those of us who believe in the free market must never overlook or minimize the dreadful reality of how this system can and will be abused. In particular, some who seem worshipful of corporations call for tort "reform" to make companies less vulnerable to lawsuits. Yet if I had never been a medical expert in product liability cases against a number of drug companies, I would never have discovered, evaluated and published so much information on the potentially harmful effects of psychiatric drugs. And without the Department of Justice suing GlaxoSmithKline, these startling video clips and the treasure trove of other documents would never have seen the light of day.
The capacity of government and its citizens to sue these companies for fraudulent practices is a necessary part of the checks and balances needed to restrain personal and corporate greed.
This is the second in my series of Huffington Post blogs based on the Department of Justice documents about GlaxoSmithKline. More to come.
Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York, and the co-founder with his wife Ginger Breggin of the Center for the Study of Empathic Therapy. He is the author of dozens of scientific articles and more than twenty books. His latest book is Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. It is based on a Person-Centered Collaborative Approach to psychiatric treatment with the focus on psychiatric drug withdrawal. It also describes many of the most severe adverse effects of psychiatric drugs that require drug withdrawal. His website is www.breggin.com.
Ginger Breggin, in addition to co-founding and managing the Center for the Study of Empathic Therapy, has coauthored books with her husband, contributes to their mutual research projects, and blogs independently on The Huffington Post.
Disclosure: Peter Breggin, M.D. was a plaintiffs' medical expert in several product liability suits against GlaxoSmithKline.
For more healthy living health news, click here.]]>$3 Billion in Fines for Illegal Marketing of Paxil, Wellbutrin and Other Drugstag:www.huffingtonpost.com,2012:/theblog//3.16469342012-07-04T13:42:32-04:002012-07-08T14:59:49-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/
In January 2009, the Department of Justice announced:
American pharmaceutical giant Eli Lilly and Company today agreed to plead guilty and pay $1.415 billion for promoting its drug Zyprexa for uses not approved by the Food and Drug Administration (FDA), the Department of Justice announced today. This resolution includes a criminal fine of $515 million, the largest ever in a health care case, and the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind. Eli Lilly will also pay up to $800 million in a civil settlement with the federal government and the states.
In recent months, Abbott Laboratories settled for $1.6 billion in regard to false marketing of the antiepileptic and mood-stabilizing drug Depakote and an agreement with Johnson & Johnson that "could result in a fine of as much as $2 billion is said to be imminent over its off-label promotion of another antipsychotic drug, Risperdal," according to the New York Times.
The states have also been suing drug manufacturers, often in regard to psychiatric drugs, and winning huge verdicts. In April, an Arkansas judge ordered Johnson & Johnson and a subsidiary to pay more than $1.2 billion in fines after a jury found that the companies had minimized or concealed the dangers associated with the antipsychotic drug Risperdal.
Now the federal government has announced the largest settlement of all involving civil and criminal fines of $3 billion against GlaxoSmithKline (GSK). Criminal fines of $1 billion were levied in regard to the marketing of the antidepressants Paxil and Wellbutrin, and withholding negative information about the diabetes drug Avandia. Another $2 billion in fines involved sales and marketing practices surrounding the asthma drug Advair and several other drugs.
"GSK's sales force bribed physicians to prescribe GSK products using every imaginable form of high priced entertainment, from Hawaiian vacations to paying doctors millions of dollars to go on speaking tours to a European pheasant hunt to tickets to Madonna concerts, and this is just to name a few," according to Carmin M. Ortiz, the U.S. attorney in Massachusetts.
GSK admitted wrongdoing in the criminal action but not in the civil settlement.
Despite the large amount, $3 billion represents only a portion of what Glaxo made on the drugs. Avandia, for example, racked up $10.4 billion in sales, Paxil brought in $11.6 billion, and Wellbutrin sales were $5.9 billion during the years covered by the settlement, according to IMS Health, a data group that consults for drugmakers.
In one of the most egregious examples of fraudulent marketing, "In the case of Paxil, prosecutors claim GlaxoSmithKline employed several tactics aimed at promoting the use of the drug in children, including helping to publish a medical journal article that misreported data from a clinical trial."
Extreme tactics have also been used by other drug companies in regard to marketing psychiatric drugs for children. Drug companies allegedly paid seven figures to three Harvard professors of psychiatry -- Joseph Biederman, Thomas Spencer, and Timothy Wilens -- who then went on to encourage diagnosing children with bipolar disorder and medicating them with antipsychotic drugs.
I have been involved as a medical expert in a number of product liability suits against drug companies. In a case against GSK regarding Paxil as an alleged cause of violence and suicide, a judge made public my report, leading to my publication of three articles, here, here, and here, concerning the drug company's practices in the development and marketing of Paxil, and in particular its alleged withholding or manipulation of information about the drug's dangerousness. (The case had been resolved without the drug company admitting any wrongdoing.) My observations are also published in Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime.
Although it is encouraging to see the legal system to some degree catching up with drug company malfeasance, there are a number of problems with the criminal and civil cases brought by the Department of Justice against drug companies.
As in the case of the recent settlements with GSK, the company makes so much money from the drugs that they are little affected by paying out even $3 billion. Its stock rose significantly after the announcement.
Individuals within the companies, including the CEOs, rarely have to face individual charges or fines.
None of the money goes to the victims of the civil and criminal offenses, including the many children injured by the fraudulent off-label marketing of drugs like Risperdal and Paxil.
There is little or no public examination and reform of many of the promotional and marketing practices that have contributed to such egregious behavior on the part of drug companies. Reforms might include requiring public, internet-accessible reporting of any payments from drug companies to doctors, researchers and institutions such as universities.
There is no requirement for drug companies to disclose all research programs and their results, for example, making available the data from failed and negative research studies, as well as all adverse drug reaction data before it is combed and manicured.
Genuine reform will begin when these problems are addressed by making the fines so large that the companies cannot do business as usual, by holding corporate executives personally responsible, by compensating the victims and their families and by fully disclosing manipulative sales and marketing techniques and underlying "spun science" that invalidates many claims for safety and efficacy.
Above all else, the health professions and the public need to view medications of all kinds with much more skepticism in regard to drug-company claims for their safety and efficacy. In my field of psychiatry, nothing would contribute more to public health than cutting back on psychiatric drug prescriptions and encouraging patients, whenever possible, to carefully withdraw from psychiatric medications with professional supervision, while turning to non-drug, psychosocial support and counseling.
Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York, and the co-founder with Ginger Breggin of the Center for the Study of Empathic Therapy. He is the author of dozens of scientific articles and more than twenty books. His latest book is Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. It is based on a Person-Centered Collaborative Approach to psychiatric treatment with the focus on psychiatric drug withdrawal. It also describes many of the most severe adverse effects of psychiatric drugs that require drug withdrawal.
Disclosure: Peter Breggin, M.D. was the plaintiff's medical expert in the Paxil/GSK suit referenced above.
For more healthy living health news, click here.]]>Military to Hold Conference on Escalating Suicides; Drugs Not Allowedtag:www.huffingtonpost.com,2012:/theblog//3.16029272012-06-21T17:36:09-04:002012-06-21T17:36:28-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/first began warning about these problems and their relationship to the simultaneously escalating prescription of psychiatric drugs to active duty soldiers. The Associated Press has reported:
Suicides are surging among America's troops, averaging nearly one a day this year -- the fastest pace in the nation's decade of war.
The 154 suicides for active-duty troops in the first 155 days of the year far outdistance the U.S. forces killed in action in Afghanistan -- about 50 percent more -- according to Pentagon statistics obtained by The Associated Press ... The military also is struggling with increased sexual assaults, alcohol abuse, domestic violence and other misbehavior.
Now the Department of Defense has announced it will be holding a suicide prevention conference in Washington, D.C. on June 20-23. But nowhere in the media coverage nor the description of the conference is there any mention of examining the obvious role of psychiatric drugs, including antidepressants and polydrug treatment.
None of those involved in publicizing the relationships between increasing military suicides and violence and increasing psychiatric drug usage has been invited to present information at the upcoming conference. This seems inexcusable in light of Congressman Bob Filner's (D-CA) hearings on antidepressants and suicide in the military held in D.C. on Feb. 24, 2010. Filner is chair of the House Committee on Veterans' Affairs. He decided to hold the hearings after being made aware of my book, Medication Madness: The Role of Psychiatric Drugs in Cases of Suicide, Violence, and Crime. A video of my testimony is available on my website, and retired military psychologist Bart P. Billings' written testimony is available on the hearing's website. In preparation for my testimony I also wrote a paper on "Antidepressant-Induced Suicide, Mania and Violence: Risks for Military Personnel," which was subsequently published.
Estimates vary widely on the numbers of active duty soldiers taking these drugs. In May of this year I made a presentation on psychiatric drugs, suicide and violence at the 20th Annual International Military and Civilian Stress Conference in L.A., organized by Dr. Billings. According to journalist Bob Brewin:
A June 2010 internal report from the Defense Department's Pharmacoeconomic Center at Fort Sam Houston in San Antonio showed that 213,972, or 20 percent of the 1.1 million active-duty troops surveyed, were taking some form of psychotropic drug: antidepressants, antipsychotics, sedative hypnotics, or other controlled substances.
Every knowledgeable person I spoke with at this year's military conference believed that the numbers were increasing and now considerably beyond 20 percent for psychiatric medicatons prescribed to active-duty soldiers.
All antidepressants now have a black box warning in their FDA-approved label (package insert) that states that children, youth, and young adults up to age 24 have an increased rate of suicidality when taking these drugs in short-term controlled clinical trials. Of course, young adults up to age 24 includes many soldiers. In addition, the rates will be considerably higher in the army population where the drugs are given for much longer than the six weeks common in clinical trials, where polydrug therapy is routine, where there is often no supervision at all, and even the soldiers' mental health records cannot be tracked. Army regulations permit soldiers to be sent into combat with 180-day supplies of psychiatric medication with no medical supervision. Furthermore, a large body of research confirms an increased risk of suicidality among adults taking antidepressants.
Anyone out there listening? Urge the Department of Defense to give serious consideration to the role of psychiatric drugs in the escalating rates of suicide and personal violence in the military. Our men and women in the armed services, and their families, deserve nothing less.
For more healthy living health news, click here.]]>New Study Confirms Electroshock (ECT) Causes Brain Damagetag:www.huffingtonpost.com,2012:/theblog//3.13736192012-04-09T13:47:00-04:002012-04-09T13:47:36-04:00Dr. Peter Bregginhttp://www.huffingtonpost.com/dr-peter-breggin/Bloomberg News headline crowed: "Shock Therapy's Effect on Depression Discovered, Researchers Say." The Huffington Postnews headline, posted March 20, 2012 declared "Shock Therapy's Effect On Depressed Brain Explained by New Electroconvulsive Therapy Study." Time Healthland's article was titled "How Electroconvulsive Therapy Works for Depression." Fox News' headline for the Reuters news story they carried said: "Study shows how electrotherapy may treat depression."
The media coverage was unquestioning and wholly positive. ECT is touted as the best treatment for depression and we are told that science has finally, after more than 70 years, found out how it works. The method used was bilateral ECT -- the most grossly damaging and most commonly used form of the treatment. Both electrodes are placed over the temples, overlapping the frontal lobes of the brain. The most intensive surge of electricity hits the memory centers in the tip of the temporal lobes and affects the highest human functions in the frontal lobes.
The title of the research paper actually tells the story: "Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder." The specific area is the "dorsolateral prefrontal cortical region." This is the same area assaulted by surgical lobotomy. It contains nerve trunks connecting the rest of the brain with the frontal lobes -- the seat of our capacity to be thoughtful, insightful, loving, and creative. Think of what it takes to be a person; all of that requires the unimpaired functioning and connectivity of the frontal lobes of your brain.
Using a functional MRI in nine patients, the authors of the study conclude, "Our results show that ECT has lasting effects on the functional architecture of the brain." The result of these lasting effects is "decrease in functional connectivity" with other parts of the brain. In other words, the frontal lobes are cut off from the rest of the brain. The authors call this "disconnectivity." Does this sound familiar? It is a "lasting" frontal lobotomy.
This new study contradicts claims by shock advocates such as psychiatrist David Healy that ECT does not cause brain damage.
The report argues that this ECT effect supports the idea that depressive patients have too much activity in their frontal lobes and are returned to normal bv damaging the offending area of the brain. Psychiatry frequently takes this position. For example, antipsychotic drugs (which four of the nine patients were taking) also reduce the function of the frontal lobes, in this case by suppressing the main trunk nerves from deeper in the brain to the frontal lobes (dopamine neurotransmission). Proponents of the drugs then claim that the patients have an excess of activity in these nerve trunks, so that the patient is helped by damaging the region.
The word "damage" is never used in this study. But what else are these "lasting effects on the functional architecture of the brain," other than a manifestation of ECT-induced brain damage in the before and after shock treatment MRIs that were done? The study is so poorly reported that we only know that the MRIs were conducted sometime "after," presumably very soon after the ECT. We can only hope that these victims of ECT will recover with time, but the most extensive long-term follow-up study indicates that most ECT patients will never recover from the damage in the form of persistent severe mental deficits.
Since the patients had all been heavily medicated in the past, and were continued on medications and given anesthesia during the ECT -- a combination of traumatic effects probably complicate and add to the brain damage to the frontal lobes.
For a long time now, I have been scientifically demonstrating that ECT is a closed-head injury in the form of an electrical lobotomy. Now we find that the ECT damage is sufficiently gross to show up on an MRI -- but we are told it's good for the patients. This is what I call "the brain-disabling principle of psychiatric treatment." Lobotomy, ECT and psychiatric drugs all share the common factor that they "work" by damaging the brain and suppressing brain function.
The authors of the study note that antidepressants probably work by doing the same thing -- producing "disconnectivity" between emotion-regulating centers in the brain.
From its inception, psychiatry has promoted brain damage as treatment. Nothing has changed in this regard except the arguments are more subtle and lobotomy is now being called "disconnectivity."
The authors argue that the patients are helped because they do better on a checklist of depressive symptoms. In this study, the checklist was administered after the last ECT, the period of time when the patient's brain is most acutely disturbed and the individual is frequently disoriented and even delirious. It would be similar to giving a psychological test to someone right after a very severe series of concussions.
After brain injury -- especially to the highest centers which express emotional awareness, self-insight, and judgment -- individuals stop reporting their upset or distressing feelings. They have either lost awareness or they are too apathetic to care anymore. That, again, is the lobotomy effect. Apathy and indifference is the final result of all of the most potent psychiatric treatments.
Peter R. Breggin, MD, is a psychiatrist in private practice in Ithaca, New York, and the author of more than 20 books, including The Heart of Being Helpful, Toxic Psychiatry, and Medication Madness. On April 13-15, 2012, Dr. Breggin and Mrs. Breggin welcome professionals and the public to their second Empathic Therapy Conference in Syracuse, New York. Meet the Breggins and listen to dozens of other incredible presenters talk about the hazards of modern psychiatry and the benefits of caring therapeutic approaches to emotional suffering. You can learn about and sign up for this inspiring and confidence-building conference at www.EmpathicTherapy.org.