Frontlines – The human cost of antipsychotic drugs

Western affluence has driven a drug-dependency culture in mental health circles, says Nigel Leaney

Psychiatric treatment has an ignoble history. Over the years those deemed mad have been bled, whipped, made to vomit, dunked in water, shot with insulin, stunned with shock therapies and had their frontal lobes severed. All such treatments were supposed to have worked at the time.

The past 50 years have seen the hegemony of a multi-billion pound pharmaceuticals industry. Drugs that are now also said to work. As a mental health worker I wonder whether future generations will look back at this era with similar disbelief.

Suffer a psychotic breakdown in a third world country and your chances of recovery are more favourable than in the West where you are more likely to become chronically ill. How can this be?

One of the main differences is that our affluence gives us greater access to expensive pharmaceuticals.

Antipsychotic medication creates its own need to “keep taking the tablets”. They act by blocking dopamine receptors – and, in the case of the newer “atypicals”, serotonin as well – which are said to be responsible for some of the more overt characteristics of psychosis. The brain responds combatively, producing more receptors. Consequently, any withdrawal of the drug results in an overwhelming of the dopamine/serotonin system – a much more serious situation than before treatment started.

Research is funded by the drug companies. It is no secret that the results have often been skewed in favour of the drug being tested. The “atypicals” were the bright new shining light, boosting
corporate profit margins. Yet one of the newer drugs, Clozapine, was tested 30 years ago then abandoned because of the serious side-effects, one of which was a 2 per cent risk of a potentially fatal blood disorder.

The biochemical theory for the cause of schizophrenia is founded on the actions of antipsychotics. It is logic as absurd as suggesting that because Aspirin may ease the pain of headaches then headaches must be caused by a deficit in Aspirin.

Although the new antipsychotics are marketed as having less distressing side-effects than the older variety there is still a long list of possible side-effects, including sexual dysfunction, weight gain and risk of heart disease and diabetes – to name a few.

This is the real cost of our modern madness.

Nigel Leaney manages a mental health residential service