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Rethinking Psychiatric Drugs

A Guide for Informed Consent

by
Grace E. Jackson, MD
2005

reviewed by Mira de Vries

Some medical professionals take care to make their writing accessible to the lay reader. In the Netherlands, for instance, Ivan Wolffers has been doing this for decades. Recently Deyo & Patrick published another fine example of such writing in the US.

Jackson does the opposite. She takes information that has been known to psychiatric victims and the lay people who care about them for half a century, and recasts it in pharmacochemical jargon that should appeal to the professional reader, particularly physicians. For instance, instead of pointing out that different things can have a bad effect on the chemical balance in our bodies, she states “...derangements of glucose and lipid metabolism are multifactorially determined.” Not that physicians on the whole are better equipped to understand this type of lingo than lay people, but it will hopefully make them take Jackson’s message seriously. As precisely physicians should be reading this, I highly applaud Jackson's work, though I'm not quite sure it was her intention to address her peers.

Between the fancy words Jackson points out that physicians, and particularly psychiatrists, are trained to ignore the testimony of their own eyes and ears in favor of (mis)information from published drug trials. “Evidence biased medicine” she calls them. The design of these trials has been manipulated to obscure the drugs' inefficacy and the harm they do. “The pharmaceutical industry pays the piper, and the pharmaceutical industry calls the tune. In the field of psychiatry, the tune has one lyric: drug therapies are effective, safe, and well tolerated.” In reality, the data reveal that the drug with the highest efficacy and safety rates is consistently the placebo. Comparison of data pertaining to psychiatric patients in Northwest Wales in 1896 and 1996 show that mortality was higher in the second group. In other words, one hundred years later, outcomes are worse than before psychopharmacology was invented. In a longitudinal study in Vermont, all of the patients with full recoveries were among the 50% who had stopped taking medications.

She further says that:
Depression is an episodic phenomenon that has been turned into a lifelong disease by pharmacotherapy. Antidepressant-withdrawal symptoms have been used by the industry to construct a mythology of chronic disease. The FDA backed down on demands to put a warning about increased risk for suicidality on the label of antidepressants because of pressure from the American Psychiatric Association.

The dopamine theory of schizophrenia has been challenged and revised even by some of its original proponents. Fifty years of research have failed to confirm the existence of any pre-medication dopamine imbalance in the blood, urine, or spinal fluid of people experiencing psychosis. There aren’t even any tests for measuring dopamine levels in the human brain. Suppositions about the reliability of information from brain scans are wrong. Such instruments are seldom employed by clinicians outside of research settings anyway.

On the other hand, there are dopamine receptors throughout the brain and body, all of which are affected by psycho-drugs. In the discussion of medication effects in the chronically neuroleptized (her term), large networks of neurophysiology are consistently neglected.
What tantalizes me is the subtitle of the book and that she sandwiches her excellent exposures between a prologue and an epilogue about informed consent. Whose consent does she mean? Her writing will certainly be an eye-opener for physicians who have kept their eyes firmly shut until now. But informed consent is supposed to come from the patient, not the physician. She writes: “Informed consent has been jeopardized by the subjugation of medicine to the motives and methods of industry.” What has been subjugated by the motives and methods of industry is physicians’ protocol. Informed consent from the patient never existed. When is the last time your doctor asked your consent, informed or not? Even in somatic medicine, which is supposedly voluntary, you’re given a prescription and told to take it. Informed consent is a legal fiction justifying physicians’ authority over their patients.

When it comes to recommendations for improvement, Jackson displays praiseworthy restraint. She lists just three, on the last page of the book:
  • researchers and regulators should acknowledge and correct the methodological deficiencies of research on psychiatric drugs;
  • clinicians should recognize the philosophical limitations of Evidence Based (as opposed to Reality Based) Medicine;
  • physicians should be allowed and unafraid to reject the conflict-ridden, profit driven guidelines, consensus statements, and review processes which are now imposed on them.
Of course none of that is going to happen, anymore than physicians are going to read this book. Jackson lets them off lightly, as though they are innocent victims of pharmaceutical and political corruption. But physicians, and especially psychiatrists, do not ignore the testimony of their eyes and ears for no reason. They too benefit from the “simulacrum of medicine … based upon illusion” as she calls it.

In the Netherlands, psychiatrists earn between €100,000 and €200,000 (US$120,000 - US$240,000) per year, not counting kickbacks, honoraria, fake research fees, free vacations, and other pharma-bribes. In the United States and Canada their incomes are no more modest. In what other profession can one achieve such high status and earnings without ever accomplishing anything? How would psychiatrists make that kind of money without their "simulacrum" and the poison pills they push down the throats of powerless patients to maintain the illusion of healing? Their profession consists precisely of turning healthy people with social problems which they (the psychiatrists) cannot solve into lifelong neurological cripples whose iatrogenic disability appears to justify their treatment by psychiatrists.

This is Jackson's unambiguous message. Hurray to Jackson for joining the whistle blowers.

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