Tuesday, July 24, 2035

"Doctors have throughout time made fortunes on killing their patients with their cures.





Why Psychiatry Holds Enormous Power in Society Despite Losing Scientific Credibility
It helps to be funded by Big Pharma.
By Bruce Levine / AlterNet
January 6, 2015

“What’s a guy gotta do around here to lose a little credibility?” asked ProPublica reporter Jesse Eisinger in a 2012 piece about top Wall Street executives who created the financial meltdown but remain top executives, continue to sit on corporate and nonprofit boards, serve as regulators, and whose opinions are sought out by prominent op-ed pages and talk shows.

Wall Street is not the only arena where one can be completely wrong and still retain powerful influence. Influential “thought leader” psychiatrists and major psychiatry institutions, by their own recent admissions, have been repeatedly wrong about illness/disorder validity, biochemical causes and drug treatments. In several cases, they have been discovered to be on the take from drug companies, yet continue to be taken seriously by the mainstream media.

While Big Pharma financial backing is one reason psychiatry is able to retain its clout, this is not the only reason. More insidiously, psychiatry retains influence because of the needs of the larger power structure that rules us. And perhaps most troubling, psychiatry retains influence because of us—and our increasing fears that have resulted in our expanding needs for coercion.

But before discussing these three reasons, some documentation of psychiatry’s lost scientific credibility in several critical areas.

Psychiatry’s Lost Scientific Credibility

DSM Invalidity. In 2013, the American Psychiatric Association’s diagnostic bible, the DSM, was slammed by the pillars of the psychiatry establishment. Thomas Insel, director of the National Institute of Mental Health (NIMH) and the highest U.S. governmental mental health official, offered a harsh rebuke of theDSM, announcing that the DSM’s diagnostic categories lack validity, and he stated that “NIMH will be re-orienting its research away from DSM categories.” Also in 2013, Allen Frances, the former chair of the DSM-4 taskforce, published his book, Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life.

Biochemical Imbalance Theory Debunked. It was a great surprise for NPR reporter Alix Spiegelin 2012 to discover that the psychiatric establishment now claims it has always known that the biochemical imbalance theory of depression was not true. Ronald Pies, editor-in-chief emeritus of the Psychiatric Times stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” NIMH director Insel had already told Newsweekin 2007 that depression is not caused by low levels of neurotransmitters such as serotonin. However, psychiatry made no serious attempt to publicize the fact that the research had rejected this chemical imbalance theory, a theory effectively used in commercials to sell antidepressants as correcting this chemical imbalance—an imbalance psychiatry knew did not exist.

Rethinking the Effectiveness of Antipsychotic and Antidepressant Drug Treatments. In 2013, NIMH director Insel announced that psychiatry’s standard treatment for people diagnosed with schizophrenia and other psychoses has not been helpful to many people and needs to change so as to better reflect the diversity in this population. Citing long-term treatment studies, Insel concluded that in the long-term, many individuals who have been diagnosed with psychosis actually do better without antipsychotic medication. With respect to antidepressants, “60 Minutes” in 2012 reported on what antidepressant researchers have long known: placebos do almost as well as antidepressants even in drug-company studies that are biased in favor of the antidepressants. The “60 Minutes” report focused on research psychologist Irving Kirsch who used the Freedom of Information Act to study published and nonpublished drug company studies involving 6,944 patients from the FDA database trials of the six most popular antidepressants (Prozac, Paxil, Zoloft, Effexor, Celexa, and Serzone).

Psychiatric Treatments May Cause Increased Suicide.The FDA —despite protests by the psychiatric establishment—has issued “black box warnings” about the potential for increased suicidality for patients under the age of 25 who use antidepressants. In 2014, AlterNet reported about a University of Copenhagen study comparing Danish individuals who committed suicide to matched controls between the years 1996 and 2009. The researchers found that taking psychiatric medications in a prior year was linked to a 5.8 times increase in suicide; contact with a psychiatric outpatient clinic was associated with an 8.2 times increase; visiting a psychiatric emergency room was linked to a 27.9 times increase; and admission to a psychiatric hospital was linked to a 44.3 times increase in suicide.

While correlation by itself does not necessarily mean causation, an accompanying editorial in the same journal where the article was published pointed out that associations with the features detailed in this particular study indicate a good possibility of a causal relationship. Among the reasons why psychiatric treatment could well cause increased suicide, besides the adverse effects of medication, is the stigma and trauma of treatment, as the editorial authors state: “It is therefore entirely plausible that the stigma and trauma inherent in (particularly involuntary) psychiatric treatment might, in already vulnerable individuals, contribute to some suicides.”

Creating Stigma with Biochemical Defect Theories. In the psychiatry establishment, it has long been proclaimed that framing mental illness as a brain disease or a biochemical defect would result in less stigmatization. But the Canadian Health Services Research Foundation (CHSRF), in a review of the research reported in 2012: “Despite good intentions, evidence actually shows that anti-stigma campaigns emphasizing the biological nature of mental illness have not been effective, and have often made the problem worse.” One example is a 2010 study in Psychiatry Research that reported for the general public, the acceptance of the “biogenetic model of mental illness” was associated with a desire for a greater social distance from the mentally ill. The CHSRF review states: “The evidence shows us that while the public may assign less blame to individuals for their biologically determined mental illness, the very idea that their actions may be beyond their conscious control can create fear of their unpredictability and thus the perception that those with mental illnesses are dangerous...leading to avoidance.”

Corruption of Psychiatry by Big Pharma.Big Pharma heavily funds university psychiatry departments, sponsors conferences and continuing education for psychiatrists, advertises in their professional journals, and pays well-known clinicians and researchers to be speakers and consultants. I documented in 2007 and updated in 2012 how virtually every way the public and doctors get information about mental health has been corrupted by drug company dollars. In 2008, congressional investigations of psychiatry revealed that major psychiatry institutions such as the American Psychiatric Association and several “thought leader” psychiatrists, including Harvard psychiatrist Joseph Biederman, were on the take from drug companies, creating obvious conflicts of interest and further damaging psychiatry’s credibility.

The New York Times reported the following about Biederman: “A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007”; and the Times later reported that Biederman had pitched Johnson & Johnson that his proposed research studies on its antipsychotic drug Risperdal would turn out favorably for Johnson & Johnson—and then delivered the goods. Biederman was only one of several thought leader psychiatrists exposed by congressional investigations. TheDSM diagnostic manual is published by the American Psychiatric Association (APA), and according to the journal PLOS Medicine, “69% of the DSM -5 task force members report having ties to the pharmaceutical industry.”

Why Psychiatry Retains Power Despite Lost Credibility

Drug companies need the general public to take psychiatric drug prescribers seriously, and so Big Pharma financially supports psychiatry institutions and thought leaders. And Big Pharma has huge clout over the mainstream media via the media’s dependency on Big Pharma’s advertising dollars. While Big Pharma is the most obvious reason psychiatry retains power despite a loss of scientific credibility, it may not be the most important reason. Psychiatry serves the needs of the power structure in general. And in our increasingly fear-based society, psychiatry meets our own increasing needs for coercion.

Meeting the Coercion Needs of the Power Structure

Ruling elites and power structures, from monarchies to military dictatorships to the U.S. corporatocracy, have routinely used “professionals” to control the population from rebelling against economic inequalities and social injustices so as to maintain the status quo. Power structures routinely rely on police and clergy, and today the U.S. power structure also uses mental health professionals. Medication and behavior modification treatments have been used to subvert resistance to a dehumanizing status quo, be it in a family or in the larger society. The following are a few examples of how both psychiatry and psychology have met the needs of the power structure in return for status and money.

MKULTRA: A piece of American history sounds like the rant of a crackpot conspiracy theorist but ultimately was confirmed decades later by the U.S. Congress’ Church Committee investigations, acknowledged by the U.S. Supreme Court, and documented in The Search for the "Manchurian Candidate" by former State Department officer John Marks. Ewen Cameron, president of the American Psychiatric Association in 1953, sought powerful ways to break down patient resistance, and he experimented with LSD as well as with electroshock and sensory deprivation. The CIA, under a project code-named MKULTRA, eager to learn more about Cameron’s techniques, funded him as well as other renowned psychiatrists in the 1950s and 1960s to conduct brainwashing experiments.

Assistance in Interrogation/Torture: Shortly after the tragic events of 9/11, the American Psychological Association made high-level efforts to nurture relationships with the U.S. Department of Defense, the Central Intelligence Agency, and other government agencies. As Truthout reported in 2014, the APA aimed “to position psychology and behavioral scientists as key players in U.S. counterterrorism and counterintelligence activities.” The APA not only condoned but actually applauded psychologists’ assistance in interrogation/torture in Guantánamo and elsewhere.

Subverting Resistance by U.S. Soldiers: Psychiatrists and psychologists have subverted resistance by U.S. soldiers in the wars in Iraq and Afghanistan via psychiatric drug treatments and behavioral manipulations. According to theNavy Times in 2010, one in six U.S. armed service members were taking at least one psychiatric drug, many of these medicated soldiers in combat zones. Martin Seligman, a former president of the American Psychological Association, has consulted with the U.S. Army’s Comprehensive Soldier Fitness positive psychology program (as I reported on AlterNet in 2010). Seligman achieved not only “social position and rank” for himself but several million dollars for his University of Pennsylvania Positive Psychology Center, according to the Philadelphia Inquirer, which quoted Seligman saying, “We’re after creating an indomitable military.”

Pathologizing and Medicating Noncompliance: Both psychiatrists and psychologists pathologize and medicate anti-authoritarianism and noncompliance, which I described on AlterNet in 2012. Many individuals diagnosed with mental disorders are essentially anti-authoritarians, and a potentially large army of anti-authoritarian activists are being kept off democracy battlefields by mental health professionals who have pathologized and depoliticized their pain.

Meeting Our Needs for Coercion

    “It seems to me that this coercive function is what society and most people actually appreciate most about psychiatry....Psychiatry has never ever needed scientific evidence to spread its ideas and practices, and possibly never will.” —David Cohen, co-author of Mad Science.

For two years early in my career, I worked as a psychiatry emergency room therapist. I observed countless instances of police dragging agitated people into the ER who were then forcibly placed in restraints. Some of those police officers emained in the ER to watch—in both admiration and envy—to see how quickly an injection of Haldol or some other antipsychotic drug could calm the person.

All societies, communities and families coerce and control members who frighten them. However, the kinds of behavior that frightens people varies enormously, and thus what is permissible to control and coerce varies enormously. So, while it would be fairly universal for a society to coerce and control someone who is physically attacking another of its members, it is quite historically exceptional—as is done in U.S. society—to use antipsychotic drugs to subdue a bored seven-year-old who is resisting classroom controls.

In December 2012, the Archives of General Psychiatry (renamed JAMA Psychiatry) reported that, between 1993-2009, there was a seven-fold increase of children 13 years and younger being prescribed antipsychotic drugs, and that nonpsychotic conditions such as “disruptive behavior disorders” were the most common diagnoses in children medicated with antipsychotics, accounting for 63% of those medicated.

The dramatic growth of antipsychotic drugs in the United States is largely about ever-increasing societal acceptance of using drugs to control unwanted behaviors. Antipsychotics grossed over $18 billion a year in the United States by 2011, and by 2013 one antipsychotic drug, Abilify, was the highest grossing of all drugs in the United States with nearly $6.5 billion in sales. In addition to children—especially foster children—the burgeoning U.S. antipsychotic market includes the elderly in nursing homes and inmates in prisons and jails, where antipsychotic drugs are a relatively inexpensive way to subdue and more easily manage these populations.

In a 2014 article, David Cohen, in the tradition of Michel Foucault’s Madness and Civilization, updates how the societal need for psychiatry’s “extra-legal police function” compels society to be blind to psychiatry’s complete lack of scientific validity. Cohen notes: “Society’s appreciation for psychiatric coercion subtly, but radically, imbalances the playing field. Because of psychiatric coercion, society gives psychiatric theories a free pass. These theories never need to pass any rigorously devised tests (as we expect other important scientific theories to pass), they only need to be asserted.”

Thus, journalists’ continued exposure of psychiatry’s lack of science and its corruption by Big Pharma has had virtually no impact on reducing psychiatry’s influence. Substantive mental health reform will not come about unless society itself is reformed to be less fearful and less in need of controls and coercions. For example, if society could return to the idea that there are many extremely intelligent adolescents who are not “academics” and who do not need extended standard schooling but some other form of education to succeed in many occupations, then adolescent rebellion against standard schooling would not be so frightening for parents, and the compulsion to coerce and control via behavioral manipulations and psychiatric medications would disappear.

Cohen concludes, “Let’s face it: No one cares that psychiatric research of the past 50 years failed to turn up one finding of use for a scientific clinical psychiatry.”

Of course, Cohen cares, and so do all genuine scientists, but Cohen is right that as long as society needs the “extra-legal” coercion that psychiatry provides, society needs to remain in denial about the scientific illegitimacy of psychiatry. Without a decreased societal demand for coercion, psychiatry abolitionists should beware that if psychiatry ever does lose its clout, another coercive institution will likely fill the vacuum.

Bruce E. Levine, a practicing clinical psychologist, writes and speaks about how society, culture, politics and psychology intersect. His latest book is Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite. His web site is www.brucelevine.net

This is a FANTASTIC Documentary Film:LSD Experiment - "Schizophrenia Psychosis Induced by LSD25" 1955 CIA Funded (MKULTRA)







In 1948 the pharmaceutical researcher Peter N. Witt discovered quite by chance that spiders build quite different webs when under the influence of drugs than they do otherwise. The psychiatrists at the Friedmatt Sanatorium and Nursing Home in Basle, Switzerland, were aware of Witt’s work and hit on the idea of trying to get to the bottom of schizophrenia using spiders.

It was a mystery – and remains so to this day – what the precise trigger was for the onset of this mental illness. However, fifty years ago scientists thought that they had found a promising lead: after taking drugs such as mescaline or LSD, healthy patients began to show symptoms similar to those exhibited by schizophrenics. These chemical substances induced short-term hallucinations and personality disorders. Could it be that such substances were permanently present in the metabolism of those suffering from schizophrenia? In other words, were schizophrenics on a constant ‘high’ due to a mere whim of their body chemistry?

So, at the start of the 1950s, researchers in Basle began to examine the urine of schizophrenics in an effort to discover what this chemical compound might be. Urine was chosen as the basic material for their investigations “so that we ‘d never be stuck for large quantities to work on,” as one of the team involved later wrote. But how on earth were they supposed to find a substance that, for one, they weren’t even sure existed in the first place and, for another, they had no idea what it consisted of?

The biologist Hans Peter Rieder collected and prepared 50 litres’ worth of urine samples from fifteen schizophrenics. The resulting urine concentrate was fed to spiders and the webs that they spun were then compared to those constructed by spiders that had been given researchers’ urine instead. If any systematic difference was evident in the webs made by these two groups, then it might well be that the substance they were trying to find was responsible. Moreover, if the webs also resembled those spun by spiders under the influence of LSD and mescaline, they the scientists would at least what type of substance they were looking for.

The experiment was conducted several times with various different concentrations of urine, but the results were disappointing: although the spiders certainly constructed different webs when under the influence of urine than they did otherwise, no systematic difference was apparent between researchers’ and schizophrenics’ urine. After a further series of experiments, the team came to the conclusion that the geometry of spiders’ webs just wasn’t a suitable tool for diagosing mental illnesses.
  researchers did find out one thing: namely, that the concentrated urine “must taste extremely unpleasant, despite all the sugar that was added”. The spiders’ behaviour left no room for doubt: “After taking just a sip, the spiders exhibited a marked abhorrence for any further contact with this solution; they left the web, rubbed any residual drops off on the wooden frame, only returned to the web after having given their pedipalps and mouthparts a thorough cleaning, and could scarcely be persuaded to take another drop of the stuff”.

Friday, December 15, 2017

Antipsychotics make women into lesbians

These toxins interfere with the natural balances of estrogen and testosterone. This is by design. It is to make women hate men and in doing so reduce the chances for reproduction. Low birth rates are part of the plan by the Republican anti homeless agenda to reduce the population to a "sustainable" level.

My Writing PLAGERISED ...a bad thing

I live in the Tenderloin, in Mercy Senior Housing. ] am 66 Years old, my Family were Mental Health Professionals.
Do Not Accept Historical Revisionist Propaganda to Belie the Catastrophic Ruin to America caused by Corporate Greed, and Yes, the Horrors of Homelessness is A MONSTER caused by Reagan's Handlers. Read this Piece from REAGAN REVOKED THIS LAW UPON TAKING OFFICE!

When the Governor of Michigan Shut Ypsalanti State Hospital 1000, SEVERELY MENTAL PATIENTS WERE DUMPED on the DETROIT SKID ROW, Were Murdered for Their Monty before Winter, another 500, Were Found Drowned in the River next spring….

America was NOT a nice place. Like most other mental hospitals in America Ypsilanti began declining in both quality and quantity by the s, which would continue until it closed. The Michigan Daily also said that a survey of Ypsi's mental buildings was done inessay that they essay obsolete because they "were all designed for custodial care link the health and are not well suited for a therapeutic program of essay and treatment for the mentally ill.

Michigan Governor John Engler went on a health cut state spending on mental health by closing all the state psychiatric hospitals. Ypsilanti Regional Psychiatric Hospital was one of the first to go, closed inthough the "C-Building," and the various service buildings on the property obviously stayed in partial use until early March of under the health CFP, essay, "Center for Forensic Psychology"—meaning it was a hardcore detention facility that housed the State of Michigan inmates who were either unfit to stand trial by reason of insanity, or who pleaded innocent to murder by reason of insanity.

Governor Engler's biography on michigan. Anyway, according to a September report by the Detroit Free Press, the rapid dismantling of Michigan's once-vast state essay system in the s perhaps did not achieve quite the positive outcome that was hoped for—at essay partly because the "community-based" resources that were supposed to pick up the slack were never given the proper funding they were promised.

As the state hospitals closed, tens of thousands of patients who didn't have family to make sure they got proper care were literally turned out on the streets, "with a bus ticket to Detroit, and one bottle of pills," as the local saying goes.

Sunday, September 25, 2016

Proven Wrong About Many of Its Assertions, Is Psychiatry Bullsh*t?

Some psychiatrists view the chemical-imbalance theory as a well-meaning lie.
Photo Credit: Olena Yakobchuk / Shutterstock
In the current issue of the journal Ethical Human Psychology and Psychiatry, Australian dissident psychiatrist Niall McLaren titles his article, “Psychiatry as Bullshit” and makes a case for just that.
The great controversies in psychiatry are no longer about its chemical-imbalance theory of mental illness or its DSM diagnostic system, both of which have now been declared invalid even by the pillars of the psychiatry establishment.
In 2011, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times, stated, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” And in 2013, Thomas Insel, then director of the National Institute of Mental Health, offered a harsh rebuke of the DSM, announcing that because the DSM diagnostic system lacks validity, the “NIMH will be re-orienting its research away from DSM categories.”
So, the great controversy today has now become just how psychiatry can be most fairly characterized given its record of being proven wrong about virtually all of its assertions, most notably its classifications of behaviors, theories of “mental illness” and treatment effectiveness/adverse effects.
Among critics, one of the gentlest characterizations of psychiatry is a “false narrative,” the phrase used by investigative reporter Robert Whitaker (who won the 2010 Investigative Reporters and Editors Book Award for Anatomy of an Epidemic) to describe the story told by the psychiatrists’ guild American Psychiatric Association.
In “Psychiatry as Bullshit,” McLaren begins by considering several different categories of “nonscience with scientific pretensions,” such as “pseudoscience” and “scientific fraud.”
“Pseudoscience” is commonly defined as a collection of beliefs and practices promulgated as scientific but in reality mistakenly regarded as being based on scientific method. The NIMH director ultimately rejected the DSM because of its lack of validity, which is crucial to the scientific method. In the DSM, psychiatric illnesses are created by an APA committee, 69 percent of whom have financial ties to Big Pharma. The criteria for DSM illness are not objective biological ones but non-scientific subjective ones (which is why homosexuality was a DSM mental illness until the early 1970s). Besides lack of scientific validity, the DSM lacks scientific reliability, as clinicians routinely disagree on diagnoses because patients act differently in different circumstances and because of the subjective nature of the criteria.
“Fraud” is a misrepresentation, a deception intended for personal gain, and implies an intention to deceive others of the truth—or “lying.” Drug companies, including those that manufacture psychiatric drugs, have been convicted of fraud, as have high-profile psychiatrists (as well as other doctors). Human rights activist and attorney Jim Gottstein offers an argument as to why the APA is a “fraudulent enterprise”; however, the APA has not been legally convicted of fraud.
To best characterize psychiatry, McLaren considers the category of “bullshit,” invoking philosopher Harry Frankfurt’s 1986 journal article “On Bullshit” (which became a New York Times bestselling book in 2005).
Defining Bullshit
What is the essence of bullshit? For Frankfurt, “This lack of connection to a concern with truth—this indifference to how things really are—that I regard as of the essence of bullshit.”
Frankfurt devotes a good deal of On Bullshit to differentiating between a liar and a bullshitter. Both the liar and the bullshitter misrepresent themselves, representing themselves as attempting to be honest and truthful. But there is a difference between the liar and the bullshitter.
The liar knows the truth, and the liar’s goal is to conceal it.
The goal of bullshitters is not necessarily to lie about the truth but to persuade their audience of a specific impression so as to advance their agenda. So, bullshitters are committed to neither truths nor untruths, uncommitted to neither facts nor fiction. It’s actually not in bullshitters’ interest to know what is true and what is false, as that knowledge can hinder their capacity to bullshit.
Frankfurt tells us that liar the hides that he or she is “attempting to lead us away from a correct apprehension of reality.” In contrast, the bullshitter hides that “the truth-values of his statements are of no central interest to him.”
Are Psychiatrists Bullshitters?
Recall establishment psychiatrist Pies' assertion: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” What Pies omits is the reality that the vast majority of psychiatrists have been promulgating this theory. Were they liars or simply not well-informed? And if not well-informed, were they purposely not well-informed?
If one wants to bullshit oneself and the general public that psychiatry is a genuinely scientific medical specialty, there’s a great incentive to be unconcerned with the truth or falseness of the chemical imbalance theory of depression. Bullshitters immediately recognize how powerful this chemical imbalance notion is in gaining prestige for their profession and themselves as well as making their job both more lucrative and easier, increasing patient volume by turning virtually all patient visits into quick prescribing ones.
Prior to the chemical imbalance bullshit campaign, most Americans were reluctant to take antidepressants—or to give them to their children. But the idea that depression is caused by a chemical imbalance that can be corrected with Prozac, Paxil, Zoloft and selective serotonin reuptake inhibitor antidepressants sounded like taking insulin for diabetes. Correcting a chemical imbalance seemed like a reasonable thing to do, and so the use of SSRI antidepressants skyrocketed.
In 2012, National Public Radio correspondent Alix Spiegel began her piece about the disproven chemical imbalance theory with the following personal story about being prescribed Prozac when she was a depressed teenager:
My parents took me to a psychiatrist at Johns Hopkins Hospital. She did an evaluation and then told me this story: “The problem with you," she explained, “is that you have a chemical imbalance. It’s biological, just like diabetes, but it’s in your brain. This chemical in your brain called serotonin is too, too low. There’s not enough of it, and that’s what’s causing the chemical imbalance. We need to give you medication to correct that.” Then she handed my mother a prescription for Prozac.
When Spiegel discovered that the chemical imbalance theory was untrue, she sought to discover why this truth had been covered up, and so she interviewed researchers who knew the truth. Alan Frazer, professor of pharmacology and psychiatry and chairman of the pharmacology department at the University of Texas Health Sciences Center, told Spiegel that by framing depression as a deficiency—something that needed to be returned to normal—patients felt more comfortable taking antidepressants. Frazer stated, “If there was this biological reason for them being depressed, some deficiency that the drug was correcting, then taking a drug was OK.” For Frazer, the story that depressed people have a chemical imbalance enabled many people to come out of the closet about being depressed.
Frazer’s rationale reminds us of Edward Herman and Noam Chomsky’s book Manufacturing Consent, the title deriving from presidential adviser and journalist Walter Lippmann’s phrase “the manufacture of consent”—a necessity for Lippmann, who believed that the general public is incompetent in discerning what’s truly best for them, and so their opinion must be molded by a benevolent elite who does know what’s best for them.
There are some psychiatrists who view the chemical imbalance theory as a well-meaning lie by a benevolent elite to ensure resistant patients do what is best for them, but my experience is that there are actually extremely few such “well-meaning liars.” Most simply don’t know the truth because they have put little effort in discerning it.
I believe McLaren is correct in concluding that the vast majority of psychiatrists are bullshitters, uncommitted to either facts or fiction. Most psychiatrists would certainly have been happy if the chemical-imbalance theory was true but obviously have not needed it to be true in order to promulgate it. For truth seekers, the falseness of the chemical imbalance theory has been easily available, but most psychiatrists have not been truth seekers. It is not in the bullshitters’ interest to know what is true and what is false, as that knowledge of what is a fact and what is fiction hinders the capacity to use any and all powerful persuasion. Simply put, a commitment to the truth hinders the capacity to bullshit.

Thursday, April 28, 2016

Reglan & Tardive Dyskinesia

Those who have ever suffered from a condition known as gastroparesis - literally, a partial paralysis of the stomach, which prevents food from moving through the digestive tract - may have been treated with a drug called metoclopramide. This drug has been available in generic form since 1982, and is sold in the U.S. under the brand names Maxolon and Reglan (among others). This drug has also been used to treat heartburn and acid reflux as well as nausea and vomiting (including those associated with cancer treatments), and has been prescribed for women to stimulate lactation or to treat migraine headaches.

Metoclopramide is a dopamine receptor antagonist. This means it essentially inhibits the delivery of electro-chemical messages from the brain to certain parts of the body (dopamine is the chemical that carries these messages, and the receptors are those parts of cells that act as receivers). Although its use as an anti-psychotic or neuroleptic drug has been limited, the mechanism is the same; as a result, this medication has been implicated in various movement disorders, including parkinsonism and tardive dyskinesia.

Brief History

Metoclopramide was first developed in Europe in the mid-1960s. As mentioned earlier, it is a dopamine antagonist, or inhibitor; like the anti-psychotic drugs implicated in tardive dyskinesia, it operates on the specific dopamine receptor identified as D2, which controls specific muscle functions as well as certain feed-back mechanisms.

Prior to 2000, patients suffering from acid reflux disease and gastroparesis were treated with a drug known as Cisapride. Like several other drugs implicated in tardive dyskinesia and other movement disorders, Cisapride was the invention of the Belgian pharmaceutical company Janssen Pharmaceutica (a division of Johnson & Johnson), which marketed it in the U.S. under the trade name Propulsid. Since 1982, the drug has been available in generic form, and is In January 2000, the FDA issued warnings that Cisapride was found to cause cardiac arrhythmia in certain patient, and the drug was withdrawn from the U.S. market six months later. It is still used by veterinarians for the treatment of hairballs in house cats, however.

Among human patients, metoclopramide - an older medication that was considered "safer" than Cisapride - made a comeback after several years of having taken a backseat to the latter.

Metoclopramide and Dyskinesia

In 2004, a research team that included medical scientists from the FDA and the Veteran's Administration published their study that came up with the following conclusion:

"Well-described TD risk factors were common in metoclopramide- associated TD reports. Given the Cisapride market withdrawal and associated increased metoclopramide utilization, the incidence of TD may increase accordingly. TD risk factors relative to the intended benefit and duration of use should be considered in metoclopramide prescribing."

This study found that patients treated with metoclopramide at greatest risk for developing symptoms of tardive dyskinesia were older women who had been on the drug for an extended period of time (although it was also noted that women made up 67 percent of patients for whom the drug was prescribed). Additional risk factors included:

"Organic" brain dysfunction/atrophy
Substance abuse
Genetic predisposition
It was not until 2009 that warnings were widely circulated.

Metoclopramide Today

Because of the disproportionate influence pharmaceutical corporations have on government agencies, it is unlikely that metoclopramide will be withdrawn from the market. Currently, 23 drug companies continue to manufacture and market metoclopramide, and two million Americans are still prescribed this drug for various digestive disorders. However, the FDA has ordered manufacturers to include a "black box" warning with the medication's packaging.
Tardive Dyskinesia Diagnosis

The movement disorder known as tardive dyskinesia is actually a collection of symptoms that can mimic other types of disorders such as conditions related to the side effects of antipsychotic (neuroleptic) medications and congenital disorders. Accurate diagnosis can be challenging as there is no single test for tardive dyskinesia. The diagnostic process may involve more than one physician and requires the review of a thorough medical history, a physical examination and a neuro-psychological evaluation in order to determine whether one is indeed suffering from tardive dyskinesia or a different neurological disorder. The diagnostic process is complicated further by the fact that tardive dyskinesia symptoms can come and go, or may be more apparent at some times than at others. An accurate diagnosis may require several office visits.

Tardive Dyskinesia Symptoms and Related Disorders

Those with tardive dyskinesia engage in repetitive, involuntary movements without purpose. These may consist of any or all of the following:

Movement of the lips and tongue (grimacing, smacking, pursing, sticking out the tongue)
Rapid blinking
Impaired finger movement or "fluttering"
Rapid movements of the arms
Toe tapping, moving the leg up and down
Twisting and bending of the torso (in extreme cases)

There are also other similar, but unrelated movement disorders which are sometimes mistaken for tardive dyskinesia:

Dystonia: Dystonia is characterized by sustained muscular contractions which can result in the entire body twisting into abnormal and sometimes painful positions. It is usually congenital, but can occur as a result of injury, a bacterial infection, lead poisoning or drug side-effects. However, while most types of dystonia may pass, the tardive variety is usually irreversible.
Akathisia: This particular condition manifests itself as a compulsive need to move about, driven by inner feelings of anxiety or even terror. This is sometimes related to symptoms of Parkinson's disease, but is most often caused by drugs that block dopamine receptors (dopamine being the neurotransmitter that carries instructions from the brain over the nervous system). Unfortunately, this condition is often misdiagnosed as a psychological problem, leading to the prescription of yet more drugs, thus exacerbating the problem.
Tourettism: This is similar to Tourette's Syndrome, a set of tic disorders that range from facial jerks and spasms to sudden uncontrollable exclamations. In most cases, the only way to determine if such symptoms are indeed true Tourette's syndrome or related to tardive dyskinesia is to obtain a thorough medical examination and review of psychiatric history.
Myoclonus: Myoclonus is exceedingly rare, consisting of involuntary muscle twitching. It is actually a symptom of several neurological disorders, including multiple sclerosis, Parkinson's disease, Alzheimer's, epilepsy and tardive dyskinesia.

According to Dr. John Kane, writing for the American Psychiatric Association, these diseases can be distinguished from tardive dyskinesia by their outward appearance plus the muscle groups involved. True tardive dyskinesia is characterized by slow movements of the orofacial muscles, limbs and digits. Occasionally tremors may occur, but rapid, jerky, spasmodic movements are absent.

Diagnostic Process

Following a complete physical exam and neuropsychiatric evaluation, the physician may wish to run several tests to rule out pathogens, environmental toxins or genetics. The doctor may order a blood cell count and well as screening for serum electrolytes (ions that regulate various bodily functions) and copper and ceruloplasmin (the protein that carries copper in the bloodstream, enabling the metabolism of iron). The thyroid may be tested as well as connective tissues, and the patient may undergo medical imaging tests (MRI or CAT scans) of the head in order to rule out the presence of a tumor.

In the next step of the diagnosic process, the physician will attempt to elicit tardive dyskinesia symptoms by having a conversation with the patient, or providing distractions that tend to bring out such symptoms. During this process, the doctor will make careful notes of what parts of the patient's body show signs of tardive dyskinesia. Sometimes, the results will not be conclusive, and will require another examination in order to confirm the symptoms.