Psychiatric Drugs Overused?
Debate over medication vs.
talk therapy continues
WASHINGTON, March 24 — At 7,
Susan was diagnosed with major depression and given antidepressant
drugs. At 12, she was tagged with both depression and borderline
personality disorder, and more drugs were prescribed.
"At 12, I was on uppers and
downers," said Susan, who asked that her real name not be used.
At 18 Susan, now 27, took herself off all psychiatric drugs and has
been healthy and productive ever since. A miracle cure, thanks to
modern psychiatric wonder drugs? Not quite, she insists. "I
recovered not because of the mental health system but in spite of
it," Susan, a university administrator, writer and poet said in
a recent interview. With little fanfare but much passion, a movement
has arisen in recent years against what critics regard as a psycho-
pharmaceutical industry that has slowly undermined the therapeutic
foundations of psychiatry with a drug- and profit-driven model for
treatment of illnesses, real and — they say — imagined.
Psychiatrists say Susan
represents a small fraction of those treated with newer classes of
psychiatric drugs, many of which have proven highly effective with
fewer side effects than older drugs — which are potentially
addictive or cause drowsiness, disorientation and other serious side
Still, she is not alone in her
beliefs. The more radical of these activists say the system serves
to enrich psychiatrists, drug makers and insurers while doing little
to help those labeled with psychiatric diagnoses.
ANXIETY DISORDERS' DEBATED
Advocates for the mentally ill,
including groups like the Anxiety Disorders Association of America,
strongly disagree. On its Web site, the ADAA says some 19.1 million
Americans suffer from these disorders, which it says costs the
United States more than $42 billion a year.
The group claims some 4 million
Americans suffer from generalized anxiety disorder — a condition
which many anti-psychiatry activists say was invented to sell drugs.
Among the best-selling
psychiatric drugs are three that Susan took: Eli Lilly and Co.'s
anti-depressant Prozac; Pfizer Inc.'s Zoloft, used to combat
depression and anxiety and recently approved to treat social anxiety
disorder; and GlaxoSmithKline Plc's , Paxilused for depression and
"Both GAD and SAD (social
anxiety disorder) are acknowledged and recognized as serious ...
health conditions by the APA (AmericanPsychiatric
Association)," said Michael Fleming, a spokesman
survivors," as many call themselves, just disgruntled
individuals, isolated cases in a psychiatric system that has found
new pharmaceutical cures for illnesses once deemed untreatable?
But some in the medical
profession now also find fault with the rising tide of diagnoses for
behaviors once thought of simply as troublesome or odd, and
especially the rising number of children andyoung adults labeled
"sick" and medicated.
Dr. Lawrence Plumlee was one of
about 150 people crammed into a tiny classroom at American
University in Washington for a recent seminar called "Fighting
Corporate Psychiatry," part of a larger anti-corporate,
Plumlee, 66, a retired
toxicologist with the Environmental Protection Agency, was diagnosed
with schizophrenia as a troubled young solder in the Army in the
1960s. He believes his personal turmoil in turbulent times was
misinterpreted as mental illness because society wasn't prepared to
confront the difficult ethical and cultural issues he felt he had to
"The reasons we get visions
and some delusions when we're coming of age is because we're looking
for meaning in life," he told that forum. "When you're
having this kind of personal turmoil, you're labeled as
While some of these critics scorn
psychiatry as a pseudo-science of hucksters in an unholy alliance
with predatory drug companies, others simply see an overburdened
profession that relies too heavily on drugs. But the strand that
binds them is a belief that the psychiatric profession is being led
astray by an over dependence on drugs at the expense of
time-intensive "talk" therapy — and intangibles like
compassion, societal and family support, meaningful work and
creative outlets for troubling thoughts and emotions.
PRESSURE FROM INSURERS
That they find common ground with
the anti-globalization movement is little surprise in light of the
fact that more than half the new patients of corporate psychiatry
are children or young adults.
The drugging of millions of
children diagnosed with attention deficit hyperactivity disorder
(ADHD) is a rallying point for many who say such children need
patience, not drugs.
Susan is among the moderates in
this backlash against a system she believes stole more than a decade
of her young life. Psychiatric drugs are useful for some, she
conceded, "as long as it's with extremely informed
Dr. Paul Applebaum, president of
the American Psychiatric Association (APA) and chairman of the
psychiatry department at the University of Massachusetts Medical
School, said increased reliance on drugs over more expensive and
time-consuming therapies stems in part from "pressure"
Behavioral health insurers
"have made a great deal of money and come to dominate their
industries ... by in some cases denying extended care ... and in
some cases only agreeing to care if relatively brief and few
therapeutic sessions are used and medication is applied," he
"The profession as a whole
is extremely unhappy about that situation," Applebaum said in a
telephone interview. "There are new forms of therapy ...
cognitive behavioral approaches that have proven as effective with
many forms of anxiety disorders and depression, if not more so than
Still, Applebaum insists, the new
anti-depressant and anti- anxiety drugs are in many cases effective,
with fewer side effects and liabilities — like addiction — than
older classes of drugs including sedatives and tranquilizers. The
anti-drug activists say the focus on relatively new emotional and
psychiatric complaints like GAD and SAD are cynical attempts to
apply the disease model to — and sell drugs to correct —
perfectly normal behavior. Applebaum counters that for such
disorders to warrant diagnoses as a mental illness, "they must
cause significant objective distress and dysfunction in the
POST SEPT. 11 SURGE
The critics point to a
well-documented surge in advertising for anti-anxiety drugs in the
post-Sept. 11 world, saying drug companies are capitalizing on
widespread fear of further attacks to sell drugs to people who might
not need them.
While the APA doesn't have a
formal position on direct marketing of psychiatric drugs to
consumers, Applebaum said there is "a plus side and a minus
side" to the practice.
"The plus side is that
consumers are so much better informed as to their choices," he
said. "The down side is that people shouldunnecessarily request
medications of their physicians that they have a hard time
Jeff Trewhitt, a spokesman for
the Pharmaceutical Research and Manufacturers of America, said the
mass-marketing of psychiatric drugs "is not something that's on
the radar screen for us. "However, "direct consumer
advertising is closely monitored and regulated" by the Food and
Drug Administration, he said, "and the FDA is a rough
regulatory task master."
Invest in Your
Visit Our Book
Kathi's Mental Health Review
Copyright © Kathi
Stringer & Respective Authors.
|Site Powered By
Online web site design