Quote of the day that lends itself to some modeling:
A century ago, fewer than two people per 1,000 were considered to be “disabled” by mental illness and in need of hospitalisation . By 1955, that number had jumped to 3.38 people per 1,000, and during the past 50 years, a period when psychiatric drugs have been the cornerstone of care, the disability rate has climbed steadily, and has now reached around 20 people per 1,000. As with any epidemic, one would suspect that an outside agent of some type-a virus, a bacterial infection, or an environmental toxin was causing this rise in illness. That is indeed the case here. There is an outside agent fueling this epidemic of mental illness, only it is to be found in the medicine cabinet. Psychiatric drugs perturb normal neurotransmitter function, and while that perturbation may curb symptoms over a short term, over the long run it increases the likelihood that a person will become chronically ill, or ill with new and more severe symptoms . A review of the scientific literature shows quite clearly that it is our drug-based paradigm of care that is fueling this modem-day plague.
from Robert Whitaker’s article “Anatomy of an Epidemic: The Astonishing Rise of Mental Illness in America” recently expanded into a full length book. [Excellent Salon review here]
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When one starts wading into the literature surrounding psychiatric drug use, it is astonishing how many of the studies focus on short-term efficacy, not long-term effects. Part of this is the nature of the double-blind placebo-controlled FDA efficacy studies, which often demand evidence for a short-term effect, but rarely look at long-term usage effects. [Possibly for good reason, far fewer drugs would ever be brought to market if effects had to be looked at over a period of years or decades]. Even more astonishing is the disconnect between the popular conception and “party line” of drug reps that psychiatric drugs are short-term solutions to manage crises, whereas in reality most psychiatric patients are kept on polydrug cocktails for years – often gradually increasing doses and adding drugs over time, rather than the reverse.
Short-term solutions that actually make problems worse in the long run are so common as to be canonical in system dynamics modeling. What then, are we to make of long term behavior patterns like the ones below. [All quotes are taken from the original version of Robert Whitaker's paper, linked above].
The study that is still cited today as proving the efficacy of neuroleptics for curbing acute episodes of schizophrenia was a nine-hospital trial of 344 patients conducted by the National Institute of Mental Health in the early 1960s. At the end of six weeks, 75% of the drug-treated patients were “much improved” or “very much improved” compared to 23% of the placebo patients. (Cole, Klermn et al., 1964).
However, three years later, the NIMH reported on one-year outcomes for the patients. Much to their surprise, they found that “patients who received placebo treatment were less likely to be rehospitalized than those who received any of the three active phenothiazines” (Schooler, Goldberg et al., 1967, pp. 991).
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In 1988, researchers who led the large Cross-National Collaborative Panic Study, which involved 1,700 patients in 14 countries, reported that at the end of four weeks, 82% of the patients treated with Xanax (alprazolam) were “moderately improved” or “better,” versus 42% of the placebo patients. However, by the end of eight weeks, there was no difference between the groups, at least among those who remained in the study (Balanger, 1988). Any benefit with Xanax seemed to last for only a short period. As a followup to that study, researchers in Canada and the U.K. studied benzodiazepine-treated patients over a period of six months. They reported that the Xanax patients got better during the first four weeks of treatment, that they did not improve any more in weeks four to eight, and that their symptoms began to worsen after that. As patients were weaned from the drugs, a high percentage relapsed, and by the end of 23 weeks, they were worse off than patients treated without drugs on five different outcomes measures (Marks, 1993).
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Lastly, multiple studies looking at the long-term wellness of people diagnosed with schizophrenia based on anti-psychotic use that suggest that longterm anti-psychotic use is inversely correlated with wellbeing.
