Drug Control

The neuroleptics (nerve-seizing drugs), also known as antipsychotics, prescribed for so-called “schizophrenia” were first developed by the French to numb the nervous system during surgery. Psychiatrists learned very early on that neuroleptics cause Parkinsonism and symptoms of encephalitis lethargica, the very problem Kraepelin had misiden- tified and called dementia praecox.

The drugs damage the extrapyramidal system (EPS)—the extensive complex network of nerve fibers that moderates motor control—resulting in muscle rigidity, spasms and various involuntary movements.

The drug-induced side effect tardive dyskinesia (tardive, meaning “late” and dyskinesia meaning, “abnormal movement of muscles”), is a permanent impairment of the power of voluntary movement of the lips, tongue, jaw, fingers, toes and other body parts and has appeared in 5% of patients within one year of neuroleptic treatment.

Researchers and psychiatrists also knew the risk of “neuroleptic malignant syndrome,” a potentially fatal toxic reaction where patients break into fevers and become confused, agitated and extremely rigid. An estimated 100,000 Americans have died from it.

To counter negative publicity, articles placed in medical journals regularly exaggerated the benefits of the new drugs and obscured their risks. Whitaker says that in the 1950s, what physicians and the general public learned about new drugs was tailored: “This molding of opinion, of course, played a critical
role in the recasting of neuroleptics as safe, antischiz- ophrenic drugs for the mentally ill.”

However, independent research outcomes were worrisome. In a study over eight years, the World Health Organization found that patients in three economically disadvantaged countries—India, Nigeria and Colombia—“were doing dramatically better than patients in the United States and four other developed countries.” Indeed, after five years, “64% of the patients in the poor countries were asymptomatic and functioning well.” In contrast, only 18% of the patients in the prosperous countries were doing well.

Western psychiatrists responded by arguing that people in poorer countries simply didn’t have schizophrenia at all. However, a second follow-up study using the same diagnostic criteria reached the same conclusion.

Whereas only 16% of the patients were maintained on neuroleptics in the poor countries, in prosperous countries, the figure was 61%. Neuroleptics were clearly implicated in the significantly inferior Western result. Western experience also showed that relapse rates were lower for non-drugged patients than drugged patients.

Not until 1985 did the American Psychiatric Association issue a warning letter to its members, and then only after several highly publicized lawsuits that “found psychiatrists and their institutions negligent for failing to warn patients of the drug- related risk, with damages in one case topping $3 million.” The reason for this silence had nothing to do with the practice of medicine. The initial investment in chlorpromazine (a neuroleptic) in 1954 was $350,000. By 1970 it was generating revenues of $116 million ( 95.6 million) a year.

Increasing public awareness that neuroleptics “frequently caused irreversible brain damage threatened to derail this whole gravy train,” Whitaker says. In response, new “atypical” (not usual; having less effect on the EPS system) drugs for schizophrenia were introduced in the 1990s, promising fewer side effects.

However, the atypicals actually have even more severe effects: blindness, fatal blood clots, heart arrhythmia (irregularity), heat stroke, swollen and leaking breasts, impotence and sexual dysfunction, blood disorders, painful skin rashes, seizures, birth defects and extreme inneranxiety and restlessness.

One of the atypicals had been tested in the 1960s and found to cause seizures, dense sedation, marked drooling, constipation, urinary incontinence, weight gain, respiratory arrest, heart attack and rare sudden death. When introduced into Europe in the 1970s, the drug was withdrawn because it caused agranulocytosis (a potentially fatal depletion of white blood cells) in up to 2% of patients.

On May 20, 2003, The New York Times reported that the atypicals may cause diabetes, “in some cases leading to death.” Dr. Joseph Deveaugh-Geiss, a con- sulting professor of psychiatry at Duke University, said that the diabetes link “is looking a lot like what we saw 25 years ago with [tardive dyskinesia].”

In May 2003, a study of atypical use in 17 Veteran Affairs hospitals found that one antipsychotic drug cost $3,000 to $9,000 more than the earlier drugs per patient, with no benefit to symptoms, easing of Parkinson’s-like side effects or improvement in overall quality of life.

In 2000, the total annual U.S. sales of antipsychotic drugs was $4 billion . By 2003, sales had reached $8.1 billion. Internationally, the sales were over $12 billion.

Today, psychiatry clings tenaciously to antipsychotics as the treatment for “schizophrenia,” despite their proven risks and studies which show that when patients stop taking the atypicals, they improve.

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