Tuesday, 22 July 2014

Powerful Embrace #Omphalos film, Dr Peter J Gordon

Powerful Embrace from omphalos 

"Anxious I consulted my doctor.

This was 1997.

I was started on Seroxat (Paroxetine). In America this is Paxil.

Today (2014) I am still on Seroxat/Paxil (Paroxetine) 

17 years: this has indeed been a "powerful embrace". 

After I made this film (in 2011) several of my consultant psychiatrist colleagues expressed concern.  I had apparently brokered acceptable boundaries; my thoughts were loose and I was misguided, perhaps even "disordered".  Label upon label was how it felt to me."

'The Rights of Children and Parents In Regard to Children Receiving Psychiatric Diagnoses and Drugs' Peter Breggin

'The Rights of Children and Parents In Regard to Children Receiving Psychiatric Diagnoses and Drugs

Peter R. Breggin, Center for the Study of Empathic Therapy, Private Practice of Psychiatry, Ithaca, New York, USA
Children & Society Volume 28, (2014) pp. 231-241 

"Based on the author's extensive clinical, forensic and research experience, this article addresses the scientific and moral question of whether it is ever in the best interests of a child to be given a psychiatric drug. The focus is on the diagnosis Attention Deficit Hyperactivity Disorder (ADHD) and stimulant drugs, and on the diagnosis Bipolar Disorder and antipsychotic (neuroleptic) drugs. 

The conclusion is that we should work towards a prohibition against giving psychiatric drugs to children, and instead focus on safe and effective alternative ways of meeting the needs of children within their families, schools and society."

c2014 John Wiley & Sons Ltd and National Children's Bureau.
Keywords: children, mental health, rights. 

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Monday, 21 July 2014

'Seeing the strings' Rebecca Coombes, BMJ - "Patients need full disclosure"

'Seeing the strings' by Rebecca Coombes, magazine editor, The BMJ:

"Patients need full disclosure to make up their own minds about whether treatment decisions might be affected by their doctors’ commercial interests. They need to see the “strings.”

"In The BMJ’s London office hangs a puppet on a string: a bespectacled doctor. It was used on a past journal cover to illustrate key opinion leaders (www.bmj.com/content/336/7658).  The inference is that doctors who are paid by drug companies to advise on marketing strategies, present at conferences, or write in medical journals are puppets, whose message is controlled by their commercial paymasters. 

Our cover story this week also deals with payments to doctors (BMJ 2014;349:g4601, doi:10.1136/bmj.g4601). As Clare Dyer explains, this is not remuneration for the day job but additional income. This extra cash can take many forms: sponsorship to attend or speak at meetings or membership of an advisory board.  Some doctors may own or have shares in a company that provides medical services. We already know that these benefits and financial interests, especially if undisclosed, can lead to bias in treatment decisions, and The BMJ has long campaigned that transparency is the best antidote.  

In recent years we have begun to get a sense of the scale of the problem, as legislation and reputational damage have forced drug companies to publish data on their payments to doctors (BMJ 2013;346:f615, doi:10.1136/bmj.f615; BMJ 2012;344:e515, doi:10.1136/bmj.e515). So now we know that the world’s top 12 drug manufacturers paid US doctors $1bn (£0.6bn; €0.7bn) in 2012. In the same year UK companies paid 21 000 unnamed clinicians around £40m ..."

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Thursday, 10 July 2014

on CEPuk: 'Peter Gøtzsche responds to criticism from Nutt et al in The Lancet'

'Peter Gøtzsche responds to criticism from Nutt et al in The Lancet' on Council for Evidence-Based Psychiatry website.

"Professor Peter Gøtzsche has today published an article in The Lancet entitled: ‘Why I think antidepressants cause more harm than good’. It was written in response to an earlier piece by Professor David Nutt, Professor Guy Goodwin and others under the heading: ‘Attacks on antidepressants: signs of deep-seated stigma?’

Gøtzsche’s article can be read here: 
(access is free though registration is required)

You can also download a PDF of the article from this link:

Wednesday, 9 July 2014

'The medicalisation of “ups and downs”: The marketing of the new bipolar disorder' by Joanna Moncrieff

Joanna Moncrieff
In Transcultural Psychiatry April 2014, 'The medicalisation of “ups and downs”: The marketing of the new bipolar disorder' by Joanna Moncrieff

The concept of bipolar disorder has undergone a transformation over the last two decades. Once considered a rare and serious mental disorder, bipolar disorder is being diagnosed with increasing frequency in Europe and North America, and is suggested to replace many other diagnoses. The current article shows how the modern concept of bipolar disorder has been created in the course of efforts to market new antipsychotics and other drugs for bipolar disorder, to enable these drugs to migrate out of the arena of serious mental disorder and into the more profitable realm of everyday emotional problems. A new and flexible notion of the condition has been created that bears little resemblance to the classical condition, and that can easily be applied to ordinary variations in temperament. 

The assertion that bipolar disorder is a brain disease arising from a biochemical imbalance helps justify this expansion by portraying drug treatment as targeted and specific, and by diverting attention from the adverse effects and mind-altering properties of the drugs themselves. Childhood behavioural problems have also been metamorphosed into “paediatric bipolar disorder” under the leadership of academic psychiatry, with the assistance of drug company financing. The expansion of bipolar disorder, like depression before it, medicalises personal and social difficulties, and profoundly affects the way people in Western nations conceive of what it means to be human."

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Monday, 7 July 2014

Prof Peter Kinderman blog post on his taking chlorpromazine "to experience the effects of antipsychotic medication"

Yesterday's blog post from Peter Kinderman (@peterkinderman), Professor of Clinical Psychology, University of Liverpool: "This is a very bad idea, Peter… seriously!"on his decision to take chlorpromazine as an experiment.

"Several things motivated me to experience the effects of antipsychotic medication. Clearly my professional life has introduced me to many people who take them regularly, and I have seen their effects in members of my close family. And, of course, I also write about mental health issues, and that means touching on the issue of medication. I don’t think anecdotes are valid alternatives to systematic data collection, but I do think personal experience can be helpful – at least for me - in balancing and contextualising the available literature.

There are two rather interesting videos available online (here and here) that show examples of so-called extrapyramidal side-effects of anti-psychotic drugs (dystonia, parkinsonism, akathisia and tardive dyskinesia). I have to confess that they slightly frightened me (especially the first video at 6 minutes in), but they brought home the unenviable choices some people have to make… and especially the idea that the adverse effects of the drugs can sometimes be as bad as the problems they are intended to treat.

Immediately after I posted my intention to take chlorpromazine on social media, there was a flurry of comments from friends and followers ..."

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Sunday, 6 July 2014

my response on BMJ website to 'Overprescribing antidepressants: where’s the evidence?' by Dr Margaret McCartney

'Re: Overprescribing antidepressants: A lived experience perspective and response' by Chrys E Muirhead Unpaid Carer. Writer, activist, campaigner in mental health on BMJ website  

"I want to make a response to Dr McCartney's mention of "Is this true?" in relation to antidepressants leading to falls and fractures and her last sentence with phrases "overshoot the evidence" and "cause harm through the under-recognition and undertreatment of mental illness". I am responding as a person who was prescribed venlafaxine in maximum doses in 2002/3 and who has made a complete recovery from a "severe and enduring mental illness" diagnosis, a label of schizoaffective disorder given in 2002.

I experienced a menopausal psychosis in 2002 aged 50 and the treatment in Fife was hospitalisation, detention and being made to swallow the antipsychotic risperidone which brought me out of the psychosis quickly and also depressed me. The psychiatrist then gave me venlafaxine which did not lift my mood, still flat I had suicidal impulse and took an overdose of the antidepressant, a bottle of pills, and ended up in Ninewells Hospital getting my stomach pumped. After this episode I was put on a maximum dose of venlafaxine. Still flatness of mood so I was prescribed lithium to "augment" the antidepressant. Still no change.

Therefore it was up to me to do something about it and so I did. I got involved in volunteering and got active. This gradually helped to lift my mood so I tapered each of the drugs in turn, latterly getting off the lithium completely in 2004. I went back to paid work, full-time in 2006 and gained another postgrad qualification in 2008. 

However in March 2005 I broke my fibula in 3 places when walking down a stair after a job interview in Cupar Library. I didn't trip or fall. It was a mystery as to how this happened. I got a 6 inch metal plate inserted, was in a wheelchair for 6 weeks then learnt to walk again, drive etc. Tests for osteoporosis came back negative. 

Then recently I came upon research articles that mentioned venlafaxine in maximum doses in older people can cause bone loss:
and finally it made sense to me why I broke my leg when only walking down a stair. I'm now 62 this year and fortunately am fit because, I think, of the swimming and weight training I did in my 40's. Exercises I did daily when working in the community (I'm a community development worker, latterly a lecturer in care subjects at an FE college). I believe that my workouts prior to taking venlafaxine have helped me counteract the effects of the venlafaxine on my system.

In addition I was told in 2003/4 that I had a lifelong mental illness and would require to be on lithium for life. I didn't believe it because I'd recovered from puerperal psychosis on two occasions previously, after breakdowns in 1978 and 1984. I knew I could do the same again despite the psychiatrist telling me of the DSM4 and its many diagnoses. And so I recovered. The schizoaffective disorder label still sits in my medical/psychiatric notes, "in perpetuity", whatever that means. I still have a 6 inch metal plate in my leg and get cramp, pain, arthritis like, but I don't let this keep me back from being physically active.

However if others believe the mental illness labels/diagnoses given to them and have swallowed the pills/antidepressants then theirs might be a different outcome. I see many women in psychiatric settings walking with sticks. The ones who have survived. There are others who are no longer with us. I can name a few. I know of quite a few women in their 40's walking with sticks, on clozapine, diagnoses of SEMI. This tells me that something isn't right with psychiatric drug prescribing. I count myself very fortunate to have avoided the disability of antidepressant and antipsychotic prescribing. My mother wasn't so fortunate, died at 68 after more than 25 years on a depot injection of depixol. Because of what she went through I was prepared not to accept the same outcome without putting up a fight, or resisting."

No competing interests