Are Psychiatric drugs overused and doing more harm than good? That is the central question of a debate that is now reaching a crescendo in the world of mental health and psychiatry. Professor Peter Gøtzsche, director of Denmark’s Nordic Cochrane Centre in Denmark, recently expressed his view on this matter in a debate in a British Medical Journal. Professor Gøtzsche’s views are strongly opposed by many mental health professionals. However, others say the question is both important and timely and say that there has been overuse of antipsychotics on aggressive patients with dementia. Some experts even go so far as to say that the use of most antidepressants and dementia drugs could be virtually stopped with no consequence.
However, Gøtzsche’s arguments are fervently opposed by Allan Young, Professor of Mood Disorders, and John Crace, who argue that the drugs are useful. “For some critics, the onus often seems to be on the drug needing to prove innocence from causing harm rather than a balanced approach to evaluating the available evidence,” wrote Young and Crace. “Whether concerns are genuine or an expression of prejudice is not clear, but over time many concerns have been found to be overinflated.”
This week, the California State Senate approved a legislative package that would limit what many experts view as the excessive use of psychiatric drugs on foster children. This bill, the first of its kind in the US, is now being viewed as what might become a model for more sweeping federal legislation which would cover the entire nation. The California package includes four proposed laws — if approved by the state Assembly and signed by Governor Brown, — would become the United State’ most sweeping set of laws aimed at curtailing what many doctors believe to be over-reliance on psychotropic medications.
“I know that it will inspire other states. I have no doubt about it,” said U.S. Rep. Karen Bass, D-Los Angeles, of the landmark legislation. “We are going to continue to make sure that we can do the same on a federal level.”
“More than half a million people over the age of 65 die as a result of the use of psychiatric drugs every year in the western world.” says Professor Gøtzsche, “Their benefits would need to be colossal to justify this, but they are minimal.”
“In trials of the modern antidepressants fluoxetine and venlafaxine, says Gøtzsche, it takes only a few extra days for depression in the placebo group – given dummy pills – to lift as much as in the group given the drugs.”
“Given their lack of benefit, I estimate we could stop almost all psychotropic drugs without causing harm – by dropping all antidepressants, ADHD drugs and dementia drugs … and using only a fraction of the antipsychotics and benzodiazepines we currently use.” said Gøtzsche, “This would lead to healthier and more long-lived populations. Because psychotropic drugs are immensely harmful when used long-term, they should almost exclusively be used in acute situations and always with a firm plan for tapering off, which can be difficult for many patients.”
“The short-term relief seems to be replaced by long-term harms. Animal studies strongly suggest that these drugs can produce brain damage, which is probably the case for all psychotropic drugs,” Gøtzsche writes.
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