I recently read “Anatomy of an Epidemic” by Investigative Journalist, Robert Whitaker, where he explores the merits of psychiatric medications. I was so impressed by the book and so disgusted by what I feel is one of the most outrageous offenses perpetrated by the Psychiatric Profession, that I tracked him down and asked him a few questions. Here is the interview.
Dr L: The market for Psychiatric Drugs has boomed in the last 30 years and generated a great deal of wealth for many. However this lucrative enterprise has depended on the telling of a false story to the American Public. Can you explain?
Robert Whitaker: After the APA published the third edition of its Diagnostic and Statistical Manual in 1980, the psychiatric profession began regularly telling of how great advances were being made in understanding the biological causes of mental disorders. Soon we began to hear that they were known to be due to chemical imbalances in the brain, and that psychiatric medications—like Prozac and other SSRIs—corrected those imbalances, and thus were like “insulin for diabetes.” But if you look into the research, you find that in fact the researchers failed to find that simple chemical imbalances were the cause of mental disorders. As Kenneth Kendler, co-editor in chief of the journal Psychological Medicine, confessed in 2005, researchers had hunted for such chemical imbalances and “not found them.” Thus, we as a society were told a false story, one that benefitted the selling of drugs, but led to a societal misconception about what these drugs do.
Dr L: The Pharmaceutical Industry and the Psychiatry Establishment have hidden the results of studies that reveal the poor long term outcomes with most of their commonly used drugs. Can you tell us about this?
Robert Whitaker: One of the things I did in Anatomy of an Epidemic was look for studies that assessed the long-term effects of psychiatric medications, and time and again, those studies told of better outcomes for the unmedicated patients. Yet, those results were never publicized. They have not been incorporated into psychiatric textbooks, or made part of the information that is provided by the NIMH and the American Psychiatric Association to the public.
For instance, Martin Harrow, a researcher at the University of Illinois, followed a large group of psychotic patients for 20 years, and those off meds had much higher recovery rates and better global outcomes. That study was funded by the National Institute of Mental Health (NIMH), and yet neither the American Psychiatric Association (APA) nor the NIMH ever publicized the results to the media. As a result, no newspaper or magazine reported on them when Harrow published his studies.
Dr L: These drugs which are not even particularly effective in the long term, are exacting a horrible toll on our society. Can you tell us more?
Robert Whitaker: When you look at what science has to say about the long-term effects of psychiatric medications, you find, unfortunately, that these drugs worsen long-term outcomes, at least in the aggregate. Over the long-term, they increase the likelihood that people will become chronically ill.
One way you see the toll they are exacting on our society is the dramatic increase in the number of adults on government disability due to mental illness: This number increased from 1.25 million adults in 1987 to around 4 million in 2007. In addition, we are seeing a dramatic increase in children receiving a disability payment due to mental illness. Thus, as we have embraced the widespread use of these drugs, the burden of mental illness in our society has increased dramatically, rather than been reduced, as you would hope if effective treatments had been developed.
Dr L: As a Society we put our trust in the medical profession to do what’s best for their patients. But after reading Anatomy of an Epidemic, its hard to trust the Psychiatry Profession to do what’s best for us. Tell us your thoughts
Robert Whitaker: This is the real problem. In the 1980s, the pharmaceutical industry began hiring academic psychiatrists to serve as consultants, speakers, and advisors. Once this happened, the very people we trust to tell us the truth about psychiatric medications now had a profound financial conflict of interest, and it is easy to see that this affected what they told to the public. They protected a belief in the psychiatric medications at every turn. In addition, psychiatry as a profession has had a guild interest in maintaining a societal belief in psychiatric medications as highly safe and effective, and those guild interests have clearly shaped its storytelling. Unfortunately, I don’t think we can trust academic psychiatry or the APA to provide us with unbiased information about psychiatric medications.
Dr L: How have the Scientific “Authorities” managed to hoodwink society as well as they have?
Robert Whitaker: This is very simple. As I said, our society looks to the experts—physicians at academic medical centers—to tell us about medical disorders and the efficacy of treatments for those disorders. If those experts don’t tell an honest story, but rather one corrupted by financial interests, then our society is going to be hoodwinked. And that is what has happened in this sphere of medicine.
Dr L: Can you give us an idea of some of the growth in sales of some of these drugs from the 1980’s when they started getting introduced?
Robert Whitaker: In 1987, which is the year that Prozac was approved for market, we spent around $800 million in the United States on psychiatric medications. Prozac was the first of the SSRI antidepressants to come to market, and then in the 1990s we got a new class of antipsychotics, known as atypical antipsychotics, which today are widely prescribed. Today, we spend more than $30 billion annually on psychiatric medications.
Dr L: Can you tell us about the marketing machinery that lured more and more Americans into the Psychiatric drugstore?
Robert Whitaker: The marketing machinery that lured Americans into the psychiatric drug store was quite simple. The APA and organized psychiatry told the public a story of drugs that fixed chemical imbalances in the brain, and thus were highly safe and effective. The pharmaceutical industry then advertised these products to the American public in this way, as “antidotes” to major mental disorders. You turned on your tv and you saw an ad showing that if you take an antidepressant, your chemical imbalance will be fixed and you will suddenly become happy and good-looking, walking on a beach with a beautiful partner. And so we bought this story, and today one in five Americans takes a psychiatric drug on a daily basis.
Dr L: Can you tell us how the Pharmaceutical Industry co-opted top Psychiatrists in the Academic world to give these drugs credibility?
Robert Whitaker: This goes back to 1980. That year, the American Psychiatric Association voted to allow pharmaceutical companies to start “sponsoring” scientific symposiums at its annual meeting. The drug companies began hiring academic psychiatrists to lead those symposiums, and this opened the door to the drug companies paying academic psychiatrists on a regular basis to serve as speakers, consultants and advisors. Academic psychiatry became co-opted by the pharmaceutical industry. However, the public would see these top doctors as the experts in the field, rather than as physicians who had a financial conflict of interest. And the pharmaceutical industry basically tried to co-op all of the academic psychiatrists in the U.S.In 1998, when the New England Journal of Medicine wanted to find an “expert” to write a review on antidepressants, it found it difficult to find an “expert” who didn’t have ties to the pharmaceutical industry.
Dr L: Can you give us some examples of how critics were silenced?
Robert Whitaker: In the 1970s, Loren Mosher, who was then head of the schizophrenia section at the NIMH, ran a study that involved treating schizophrenia patients with selective, limited use of antipsychotics. His experiment proved successful, which challenged the conventional wisdom that these drugs were essential for all patients so diagnosed, and needed to be taken indefinitely. His biologically oriented colleagues accused him of fraud and forced him from the NIMH. The fraud challenges were completely spurious. But his ouster from the NIMH served as an example to others of the possible cost of challenging the merits of psychiatric medications.
More recently, David Healy, an Irish psychiatrist, was hired to direct a mood disorders program at the University of Toronto. As he was preparing to move there, he gave a talk about the risk of SSRI-induced suicide, and he questioned the merits of psychiatric medications in general. The job offer was quickly rescinded. There are numerous examples like this, of critics of psychiatric medications who have paid a professional price for their findings or for their critical comments about psychiatric medications.
Dr L: It is what we are doing to our children that upsets me most. We are handing out these dangerous drugs to kids like candy (while at the same time telling them to say NO to drugs). Your thoughts?
Robert Whitaker: What we are doing to our children, plying so many with these medications, is scandalous, and a national tragedy. When we look at how these drugs affect the children over the long term, science tells us, again and again, that we are doing considerable harm, particularly when we prescribe SSRIs and antipsychotics to children. These drugs affect the developing brain in profound ways. I am quite sure that one day we as a society will look back at this and think, how did we possibly let this happen? It breaks my heart to think of this, of how we are taking away from so many children their right to grow up without being medicated, and to feel the world with all of their natural senses intact and not dulled by drugs.
Dr L: Even kids as young as 2 years old are starting to be put on these drugs. There obviously aren’t studies. How do they get away with this?
Robert Whitaker: The medicating of two-year-olds with powerful antipsychotics is nothing short of criminal. If you trace how this came about, you see the influence of money: Janssen, the manufacturer of Risperdal, paid a psychiatrist at Massachusetts General Hospital in Boston, Joseph Biederman, something like $1.3 million to help promote a story that very young children could be diagnosed with bipolar disorder, and that Risperdal was an effective treatment for these children. And the fact that other psychiatrists would begin to accept the notion that this was a good idea, and that more and more two-year-olds would be placed on antipsychotics, which are known to cause all sorts of horrible side effects, boggles my mind. We are ruining those two-year-olds with this practice. We should be ashamed of ourselves as a society for letting this go on.
Dr L: How do we get Physicians to prescribe meds in a much more limited cautious way?
Robert Whitaker: I don’t really know. But my hope is that if physicians can learn more about the long-term effects of these drugs, and of how science doesn’t tell of treatments that are improving long-term outcomes, but rather of treatments that are worsening long-term outcomes, then they will start to rethink their use of these drugs.