The following information is vital for anyone thinking of taking or already using psychiatric drugs including antidepressants, anti-psychotics or anti-anxiety medications. Many of you may not have been able to make truly informed decisions about your medications because of widespread half truths about these drugs. I will discuss the effects of chronic brain impairment caused by psychiatric drugs, what the telltale signs are, and what you can do about it.
Why are prevailing opinions misguided? The prevailing view about these drugs is that they work by helping to re-balance abnormal brain chemistry responsible for depression, schizophrenia, panic attacks, bipolar disorder and the like. Anti-depressants specifically are marketed as ‘mood normalizers’. However, there is little proof demonstrating that depressed people have low serotonin levels or that schizophrenics have abnormal dopamine regulation.(1) An alternate compelling opinion is that they work because they alter brain chemistry so that it is no longer in a normal state. The underlying cause(s) of depression specifically are likely varied, complex and often reflect normal responses to extreme life circumstances, compounded by nutritional imbalances, inflammation and poor life skills.
Are we better off since antidepressants arrived? It is more than curious that mental illness grew five fold since the introduction of the first antidepressant Thorazine in 1955 and doubled since 1987 when Prozac came about.(2) Studies have shown repeatable and disturbing long term effects of these and other psychiatric drugs which are thought to occur because rather than correct abnormal brain chemistry, they alter normal brain chemistry. This altered chemistry may explain some of the benefits experienced in the short run, but also explain the long term effects.
Based on studies from 1987 to 2004 the medical literature suggests that 94% of antidepressant trials have positive beneficial results. The actual number of positive studies is closer to 51%. Approximately 1/3 of the negative trials submitted to the FDA were never published. About half of antidepressant trials failed to show a benefit that exceeded that of a placebo.(3)
Despite minimal and questionable short term gains there is little focus on the long term effects of many of these drugs and the consequences of drug withdrawal or inability to withdraw for that matter. The pharmaceutical industry and prescribing doctors are quite hush hush about a phenomenon known as Psychiatric Drug-induced Chronic Brain Impairment (CBI). I have yet to meet a patient who was informed about this prior to initiating the use of psychiatric drugs.
Robert Whitaker, author of “Anatomy of an Epidemic” believes “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.”(4)
What are common signs of brain induced injury? Studies can be found including all classes of psychiatric drugs that demonstrate brain shrinkage and mental dysfunction.(5) Drug induced dysfunction may often be missed and instead attributed to a mental illness. Four common signs of CBI are as follows:
• Cognitive problems involving memory, learning, attention and focus
• Apathy, indifference and lack of any enjoyment for life activities
• Deterioration of emotional wellness such as moodiness, impatience, anger and/or stress
• Lack of self-awareness(6)
CBI may explain some of the more disturbing effects from frequently prescribed SSRI antidepressants such as “mania, psychotic depression, nervousness, anxiety, agitation, hostility and hallucinations”(7). Instead of considering the possibility that these are medication induced, people are put on increasing doses or multiple medications. The only way to really know if these are medication induced side effects is by experiencing improvements after weaning off. Most people with mild to moderate depression can improve and those that don’t may have other compounding or underlining unrelated diseases.
Are there other options? On a personal level I have seem too many of my patients put on psychiatric medications without being fully informed and/or presented with other viable and safer options. Some of them don’t even know they are on antidepressants or deny having ever been depressed! Many of their stories relay understandable depressive episodes brought on by harsh life experiences which may have been handled through reasonable non-drug supports. I believe most of these cases would have simply resolved as is part of the natural process of emotional cycles that we all must deal with, given good social and cognitive coaching and support. And in the process they would likely grow and learn important coping skills for future. I find in many cases these drugs limit rather than enhance quality of life.
Are the side effects reversible? The good news is partial or full recovery can be obtained by many with careful weaning off of medications combined with good emotional supports. This should be done with great care and close monitoring. Usually the weaning process length will reflect the time spent on medications. Natural supports can be carefully incorporated to deal with withdrawal symptoms such as insomnia, nervousness, poor concentration, nausea and the like. Sometimes switching to medications with a longer half life (meaning they hang around in the body longer) can minimize withdrawal symptoms. Not everyone can be weaned off medications as may be the case for those who have been on very high doses of multiple medications for many years and have suffered serious brain damage. This is the unfortunate reality for most schizophrenic patients I have seen. And some people may have residual effects of CBI but are still able to lead fulfilling drug free lives with a few coping mechanisms.
What is involved in weaning? First and foremost you never want to wean off psychiatric drugs without professional guidance. If your medical doctor is not supportive of your desire to reduce or stop medications seek a second opinion rather than self-weaning. Make sure you are able to participate by helping set the pace of weaning as to match your comfort level. Consistent, open and respectful dialogue between your prescribing physician and other healthcare workers on your team will be important.
Outside supports including Naturopathic Medicine, psychotherapy and other complimentary medicines can make a world of difference. I often use custom made herbal tinctures, acupuncture, meditation, dietary support and homeopathy to help balance the nervous system, support sleep, aid in recovery of brain damage and to address other side effects. The role of diet is often underestimated as food can dramatically affect our moods, brain functioning and body’s ability to repair. I often do a lot of lifestyle counseling since many depressed people have developed very poor eating, sleeping and social habits which are not conducive to mental health.
(1) Whitaker, Robert. “Anatomy of an Epidemic: Psychiatric Drugs and the Astonishing Rise of Mental Illness in America” , 2005, p. 25.
(2) Ibid, p. 23.
(3) Turner, et al. (2008). The New England Journal of Medicine, 358: 252-260
(4) Anatomy of an Epidemic: Psychiatric Drugs and the Astonishing Rise of Mental Illness in America by Robert Whitaker, 2005, p. 33.
(5) Breggin, Peter, Psychiatric drug-induced Chronic Brain Impairment (CBI): Implications for long-term treatment with psychiatric medication” International J of Risk & Safety Medicine, 23 (2011), p.194.
(6) Ibid, 195.
(7) Whitaker, p. 32.