October 09, 2007

New Treatments Have Not Improved Outcomes For Schizophrenics

There was an upsetting study in this month's Archives of General Psychiatry stating that schizophrenics are two to three times more likely to die than is someone in the general population, based upon a review of dozens of studies from countries around the world. The mortality picture for people with schizophrenia has not improved in decades and has not been been helped by the adoption of the atypical antipsychotics.

It's not clear how much this mortality is driven by injuries caused by meds or by the way schizophrenics take care of themselves. Some of the mortality was related to suicide. But as the authors noted:

"In light of the potential for second-generation antipsychotic medications to further adversely influence mortality rates in the decades to come, optimizing the general health of people with schizophrenia warrants urgent attention."

I'm glad the authors said it so I have some cover for this: the atypical antipsychotics have been a multi-billion scam that has resulted in early deaths for schizophrenics and bipolars (and others), and much of the expense has been footed by American taxpayers (a third to one half of monies spent on atypicals in the US comes from Medicaid) and insurance companies, and of course by individual patients themselves. We have not improved outcomes from these patients despite dumping about $13 billion a year into these alleged silver bullets that have crept into every corner of America's mood management paradigm. I am no fan of the first-generation antipsychotics--they are very nasty and fit only for short term use--but given that they cost 10 percent or less the cost of the atypicals, one has to wonder exactly how this deal went down.

(Psych Central has written about the study here.)

This runs completely counter to the hype when the atypicals came out in the 1990s. From a NAMI press release of the time, NAMI's then-executive director noted:

"'The introduction of atypical antipsychotics as first-line medications represents an unrivaled turning point for the more than five million Americans suffering from the most debilitating brain disorders,' said NAMI Executive Director Laurie Flynn. 'The new drugs offer these individuals renewed hope and exciting new possibilities for full and productive lives. Unfortunately, however, far too many people with chronic mental illnesses are denied access to these life-changing remedies.'"

Life-changing? Oh my.

I feel especially hosed by this outcome since I did write articles touting the atypicals as kinder and gentler treatments for patients. I was relying on the judgment of my sources, who clearly did not know what they were talking about. I regret the error.

Clearly, the atypicals have huge problems in long-term use, so can someone please explain to me why we are using these drugs on children, pressing women to take them to settle their agitation, and forcing people with bipolar disorder and schizophrenia to take them for a lifetime when it is clear that these drugs are big expensive problems?

Thoughts?

Posted by Philip Dawdy at October 9, 2007 12:05 AM
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Comments

re"It's not clear how much this mortality is driven by injuries caused by meds or by the way schizophrenics take care of themselves"

Just have to point out that the "diagnosis" of schizophrenia can ruin a persons life. Once stigmatized by doctor,family and friends what is there to live for? So to say the (bad)way schizos take care of themselves has no reason/reference is somewhat shortsighted - not looking at the big picture.

Posted by: mark p.s. at October 8, 2007 10:40 PM

And remember that the atypicals are supposed to lower suicide rates, but if you look at clinical trial data -- guess what -- there is an increased risk of suicide in comparison to placebo. If suicide risk is increased in schizophrenia, then shouldn't we be providing treatments that DON'T increase the risk of suicide to an even greater extent?

Great NAMI quote, Philip!

Posted by: CL Psy at October 9, 2007 05:26 AM

You know, for all of the antipsychotics given to my daughter [at especially high doses inside psych wards] not one of those psychiatrists has ever given her the dx of schizophrenia.[not even today! after 8 years] I find that alarming in itself considering her first dx at age 11 was OCD in 1999.I would like to say I call bullshit. NAMI should be ashamed of themselves. This is why I don't go get "parental support" from them. Good luck to anyone who buys the new Abilify bunk. Have a nice life. For all of the people that read my words who these drugs have helped--great, glad to hear it. For those that these drugs [antipsychotics] did not help--I'd like to hear that too.

Posted by: Stephany at October 9, 2007 06:10 AM

Thanks Phillip...the really scary thing is that what NAMI, law enforcement and psychiatry like about these drugs is that they are so much more debilitating to the person taking them than earlier drgus that the person taking them is easier to deal with if significantly less functional which is why people taking them grow to hate them. They are not miracle drugs, just stronger drugs, stronger neurological tranquilizers.

Also, the dehumanization of people labeled mentally ill, as the judge in the zyprexa papers case implied somewhere, the fact that these people die early is early is really a blessing, being diabetic, and such not being nearly as bad as being an untreated mental defective (schizophrenic or bipolar).

As Mark pointed out, having the label of schizophrenic is what causes the harm. And it's hard to know what to do about it. Are we part of the beginning of a backlash against the biopsychiatric holocaust that has been going on? (sorry here's my obligatory I'm not a scientologist) It's terrible that with this information widely known at least in the "mental health professional community" people are still being legally forced to take these drugs and are being legally forced in more places and more numbers.

Posted by: Sally at October 9, 2007 09:57 AM

The day my mother found out not only was I bipolar, but I was also schizoaffective she cried, my father cried and my sister looked at me and said words to the effect she no longer had a sister. It was the second time I ever saw my father cry in my life.

Then my parents ripped their clothes and sat shiva.

Maybe this is why schizophrenics die in such high numbers. It isn't from their illness. It is from their families and friends shunning them and breaking their hearts. "T"o this day I do not tell anyone I know in real life I am schizoaffective and wouldn't even on my deathbed.


Posted by: anon at October 9, 2007 12:49 PM

Anon, your story is both absurd and heartbreaking. If you can "get by" without telling people you are "schizoaffective," then, for crying out loud, DON'T TELL THEM!!! Your parents "ripped their clothes"? What the hell does that mean?!? Sat shiva? Okee-dokee, is that helpful for schizos?

I only tell people that I'm "bipolar" when I've had too much to drink at parties and, even then, they're like "What?" And I say "Yeah, really. Really bipolar. Just got released from a mental institution." And they're like "What?"

If you're able to keep your "schizoaffective disorder" a secret, then in what language would you term it a "disorder"? Think of other disorders ... (can't think of any, right off the top of my head) ... are they hideable? Can they be kept secret? In what sense is it a disorder? (Gee, I secretly like that Gloria Whats-Her-Name's song, "I Will Survive." If I never tell anyone, is it really a "disorder"?)

Get a grip, people!!! The only thing a psych label is good for is a pension cheque.

Posted by: Francesca Allan at October 9, 2007 02:53 PM

I am unfortunately one of the guinea pigs in this experiment with the atypicals and antidepressants in women and teenagers. Though I am twenty now, I was given antidepressants at age fifteen I was on them for three months.I was prescribed the medication for the run-of-the-mill blues. I somehow thought needing to take medication for my sadness legitimized it as real, and romanticized the process of taking meds in the process (hooray advertising!). I do not feel I was made aware of any risks in any sense.


I had some kind of psychotic reaction. I wanted to kill myself, had really strong dissociation symptoms, and suffered delusions. I still get flashbacks. I have posttraumatic stress disorder from taking the medication. (Paxil)


Of course at the end of the time on this medication, I was put on an atypical antipsychotic (risperdal). I started lactating. Yes, as a sixteen year old (at that time), I was lactating. I had to wear breast pads for pregnant mothers. I have very few memories of that time because I wasn't quite sure if I existed. (Take that statement for what you will).


I spent about four years trying to find the right medication after that, and I am still wondering if it was the medication that caused the problem in the beginning. I am currently on lamictal and doing great, for the first time since fifteen. Not sure how I feel about the whole mess, while doctors refuse to admit it was the medication that sent me on such a precipitous decline. I never had any symptoms like that before the medication, and they set in very suddenly.

Posted by: NAP at October 9, 2007 04:59 PM

Francesca, tearing one's clothes and shiva is traditional Jewish mourning.

What I was trying to say- I run a support group, and I see people come in and say "I am so and so and I am bipolar and schizoaffective'.

I usually say when I give talks and go around to people I am just me. If the subject comes up for bipolar I talk about it and have written about it and am working on a book on it. But I never ever tell people I am schizoaffective.

I am truly sorry for any confusion I may have caused you.


Posted by: anon at October 9, 2007 07:35 PM

Very interesting. Flynn, formerly of NAMI is now the head honcho at TeenScreen!
She pushed the antipsychotics with NAMI and is now pushing suicide screening of kids that will benefit pharmaceuticals.

There is a psychiatric / pharmaceutical plan to "suicide screen" every
child in the United States before they graduate from high school.
Evidence exists that shows massive pharmaceutical backing that will
result in even more overdrugging of kids with psychiatric drugs .

Can you take a moment to view this very short video? Click here:
http://www.youtube.com/watch?v=RfU9puZQKBY

And then sign and forward this petition
http://www.petitiononline.com/TScreen/petition.html to your associates
and everyone you know? It already has over 23,000 signatures.

It's simply a race to inform enough parents so something can be done
about this.

Federal Bill to ban funding for screening here:
http://thomas.loc.gov/home/gpoxmlc110/h2387_ih.xml

Posted by: Amy Gemoules at October 10, 2007 01:43 PM

Exactly what would you prescribe for schizophrenics? The older drugs had a host of side effects and long term problems that were horrific. Are you suggesting that there are no treatment options that are acceptable for people with schizophrenia? You are at war with the entire class of atypicals but what is your answer? There are people who have been helped by these drugs. I have been.

Posted by: Martha at October 16, 2007 05:06 AM
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