Mental Illness: the Real “Epidemic” is the Drugs

Every once in a while, good journalism can expose a great lie that has gone mostly undetected – and unpublished – for decades. Case in point: Anatomy of an Epidemic, a new book by Robert Whitaker.

First, consider a few facts:

  • Between 1996 and 2005, the number of Americans taking antidepressants doubled.Anatomy of an Epidemic
  • Mental illness disability rates have doubled since 1987, and increased six-fold since 1955.
  • According to the Centers for Disease Control, antidepressants are now the most commonly prescribed class of drugs in the U.S. — ahead of drugs for cholesterol, blood pressure and asthma.
  • Of the 2.4 billion drugs prescribed in 2005, 118 million were for depression.
  • Antidepressant and antipsychotic drugs gross more than $25 billion each year in the U.S.

Now, people who have followed me for any length of time know that I’m an advocate for drug-free health care. You know my bias. But this is not another one of Terry Rondberg’s tirades against the pharmaceutical companies.

This book, Anatomy of an Epidemic, is written by a former reporter for the Boston Globe. He won a George Polk Award for medical writing, a National Association of Science Writers Award for best magazine article, and was a finalist for a Pulitzer Prize. In other words, Whitaker is an investigative journalist, not some nut with an ax to grind.

In preparation for writing the book, Whitaker pored over 50 years of psychiatric literature and conducted dozens of in-depth interviews with patients.

The book’s conclusion: overall, antidepressants and antipsychotic drugs may be doing more harm than good. Here are some examples:

  • Based on studies published in leading medical journals, patients with schizophrenia do better off medication than on it.
  • Children who take drugs for ADHD are more likely to wind up suffering from mania and bipolar disorder than kids who go unmedicated.
  • In the pre-antidepressant era, most severely depressed, hospitalized patients could expect to get well over time. Today, however, there’s a high incidence of patients on long-term drug therapy who become chronically ill.

The sad fact is, the industry has known about this for years. In the 1970s, Jonathan Cole – often called the father of American psychopharmacology – wrote a paper called “Is the Cure Worse Than the Disease?” stipulating that antipsychotics weren’t the lifesaving drugs that people had hoped.

In his book, Whitaker discusses another study in 2007 regarding outcomes for schizophrenia patients, which found that the recovery rate was 40 percent for patients without medication, and just 5 percent for those using medication. Says Whitaker: “I checked all the [National Institutes for Mental Health] press releases for 2007, and found no release on this study. I found no announcement of it in any American Psychiatric Association publication or textbook. Not a single newspaper published an account of the study… even the National Alliance on Mental Illness, an advocacy organization — did not put out any press release about it or try to alert the media in any way.”

Again, I have been saying things like this for decades. And complaining that studies discussing negative aspects of drug therapy go under-reported. So it’s nice to have some third-party endorsement. I just hope that Whitaker’s book will get more attention than those that have gone before, if not from the medical establishment, then from consumers and policymakers.

Is FDA “Waking Up” to Off-Label Use?

The U.S. Food & Drug Administration (FDA) recently denied Cephalon’s bid to use its alertness drug, Nuvigil, to treat jet lag. Nuvigil is a longer-lasting form of the drugmaker Cephalon’s top seller, Provigil, which raked in $1 billion in sales last year.

FDA denies off-label use of drugAccording to the New York Times, Provigil is expected to face generic competition in 2012, so Cephalon is “trying to shift as many patients as possible to the newer drug.” Both drugs are approved to treat the excessive sleepiness associated with narcolepsy, sleep apnea and shift work.

Note that Nuvigil is not designed to actually treat jet lag, in which the body’s internal clock is out of sync with the time in one’s location. It simply helps people stay awake. Of course, that’s not going to help half of the jet lag sufferers out there, who (due to traveling the “wrong” direction) are feeling alert when they should be sleeping. You can bet other pharmaceutical companies that make insomnia medications are working on an off-label jet lag application for their drugs.

On second thought, maybe not. You see, the most frequently used drugs for treating chronic insomnia have never been approved for that purpose by the FDA, according to a sleep expert from Wake Forest University Baptist Medical Center.

Vaughn McCall, MD, MS, professor and chairman of the Department of Psychiatry and Behavioral Medicine, told a special panel at the National Institutes of Health (NIH) that he could find no evidence that randomized controlled clinical trials had ever been conducted for five of the 10 pharmaceuticals prescribed most often for chronic insomnia.

None of the 10 is currently approved for insomnia, though all are FDA-approved as antidepressants, antipsychotics or sedatives, he said.

The NIH State-of-the-Science Conference on Manifestations and Management of Chronic Insomnia in Adults, sponsored by the National Institute of Mental Health and Office of Medical Applications Research was held in an effort to build consensus on a series of questions regarding chronic insomnia.

“There is widespread use of off-label prescribed medications for insomnia,” said McCall, who directs the sleep laboratory at Wake Forest Baptist. Further, he stated that evidence to support their effectiveness is poor.

McCall said that between 1987 and 1996 the use of FDA-approved sleep medications called “hypnotics” declined by 54 percent. Yet, during the same period, “the use of trazodone (Desyrel) and other sedating antidepressants rose by 146 percent. “This trend continued through 2002,” he pointed out, “such that trazodone became the most frequently used medication for the treatment of insomnia.”

According to McCall, 78 percent of psychiatrists now make trazodone their first choice.

“In addition to trazodone, a wide variety of antidepressants, antipsychotics and sedatives gained favor for the treatment of insomnia despite the fact that none of these medications are approved for the treatment of insomnia,” McCall said.

McCall said he believes the widespread use of these drugs “suggests that there must be substantial evidence supporting this practice.” He searched the medical literature for all 10 drugs, looking for randomized controlled trials, particularly those in which the drug being tested was compared to an inert placebo.

McCall said he found one study that showed that trazodone was superior to placebo in the first week of treatment for insomnia, but no better than placebo in the second week. Meanwhile, McCall uncovered two small short-term trials that showed use of trazodone was better than placebo for patients already on antidepressants, but he found only a limited number of small studies to support use of four other drugs.

“Why are they used so often?” he asked.

Possibly many of the approved hypnotic drugs, which are controlled substances, have firm limits on duration of use, forcing psychiatrists to find something else. Or, McCall offered, it may be due to “Erroneous beliefs on the part of providers that off-label medications have demonstrated sustained efficacy and are safer.”

He told the panel, “Full scale, placebo-controlled clinical trials of some off-label medications are warranted in the treatment of insomnia.”

SOURCE: Wake Forest University.

Medical and drug industry motivated to push vaccines

By Terry A. Rondberg, DC

The medical and pharmaceutical industries are highly motivated to push for vaccine usage to gain more power and earn more money. But they are equally motivated to pressure the chiropractic profession, by dictating to doctors of chiropractic how they can and cannot practice, and making it difficult (if not impossible) for patients to choose chiropractic care.

Dangers of VaccinesWe’ve been in denial too long, convinced that this cannot happen, but we must face reality NOW. It is happening and the situation is deteriorating. Unless the trend reverses, chiropractors can face criminal charges and jail time for providing subluxation correction, caring for asymptomatic patients, and adjusting anyone under age 18.

Let’s be honest! I am unsure if we can act at this point because it may be too late. But I certainly will continue trying to stop this train until I take my last breath.

The first item on our agenda is to dig deep inside ourselves and find the courage to take a stand and act. This isn’t easy or without risk. The World Chiropractic Alliance has discovered this during its two decades of taking bold stands. But we’re not here to win popularity contests with the medical industry or acceptance by the pharmaceutical companies. We’re here to fight for our right to practice chiropractic. We can accomplish this by conducting the following:

  • Educate the public. Tell the chiropractic story loudly and often. Write letters to your newspaper editors explaining why people should protest forced vaccines. Get the facts from the World Chiropractic Alliance (www.worldchiropracticalliance.org) or NVIC (www.nvic.org) websites and widely distribute the information. Include vaccine facts in your office newsletters.
  • Fund the NVIC. Provide a generous donation to the National Vaccine Information Center (www.nvic.org). They are the most valuable resource we have for educating the public and fighting mandatory vaccines.
  • Support chiropractic research. The lack of scientific evidence is the top criticism against chiropractic. Support research journals like the Journal of Vertebral Subluxation Research (www.jvsr.com) or research and clinical science projects. If we can prove that chiropractic helps strengthen the immune system, we can offer it as a scientifically proven natural alternative to vaccines.
  • Donate to the Chiropractic Anti Defamation Fund. Help pay for efforts to raise awareness about chiropractic and fight attacks directed towards the profession. Visit the CADF online donation page.
  • Join the WCA. If you’re a member of another chiropractic organization, ask if it’s doing enough to fight for you and your patients’ rights. If you are not a member of any group then it’s time to take a stand on the issues and become a chiropractic “freedom fighter.”

Take action NOW. You will not be able to do so once you are behind bars.