Remember One Flew Over the Cuckoo’s Nest? You know the way Jack Nicholson was docile and apathetic at the end? That’s because he got a frontal lobotomy. Doctors don’t do surgical frontal lobotomies any more, but they did perform them on mental patients up until the 1950s.
In 1949, Henri-Marie Laborit, a French army surgeon, was using a certain kind of anesthetic during operations. He noticed that patients who were extremely anxious became relaxed and indifferent to the surroundings.
These patients were so subdued and cooperative it was as if they had gotten what he called a “pharmacological lobotomy.”1
In 1950, researchers added chlorine to its anesthetic called promethazine and invented chlorpromazine. This new drug seemed to slow the involuntary movements of mental patients and make them indifferent to their environment.
You might know chlorpromazine better as Thorazine, and it was the first anti-psychotic medication.
More than 50 years later, doctors aren’t doing surgical lobotomies any more. But they’re prescribing anti-psychotics more than any other drug.
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Let me explain…
Anti-psychotic drugs were originally created and sold only to treat schizophrenia and extreme manic depressive disorder.
But now they’re no longer just being prescribed for mental illnesses that incapacitate people. And that’s how the drug companies have managed to make this the number-one selling class of drugs.
In fact, if you’ve been diagnosed with chronic depression, dementia, autism, ADHD, post-traumatic stress disorder (PTSD), or even Tourette’s syndrome, you’re probably getting your own “pharmacological lobotomy.”
So just how did anti-psychotics become America’s biggest selling drug?
In 1990, the now-giant pharmaceutical companies reintroduced them as “atypical anti-psychotics.” At first, they were still seen as drugs used to treat serious mental illness. But that all changed when drugmakers began to use clever marketing tactics to promote broad, off-label uses of the drugs and downplay the dangers.
As of 1999, 70 percent of anti-psychotics have been used for off-label reasons.2 The most common are dementia, depression, obsessive-compulsive disorder, PTSD, personality disorders, Tourette’s syndrome and autism.3 But some are even used for eating disorders (Risperidone), cocaine dependence and restless leg syndrome (Aripiprazole), agitation and imsomnia (Quetiapine) and stuttering (Olazapine).4
What are some of the tactics Big Pharma used to make these drugs so popular? Gifts, meals, money, and vacations for doctors and researchers who promote the drugs. And that’s just scratching the surface.5
| Cracking Down on Off-label Uses of Anti-psychotics Recently, drugmakers such as Astra Zeneca, Johnson & Johnson, Bristol-Myers Squibb, Eli Lilly, and Pfizer have either settled health-care fraud lawsuits filed against them for the fraudulent marketing of anti-psychotics, or they’re currently under investigation for health-care fraud. There are still more than 1,000 of these suits, many focused on the deceitful promotion of anti-psychotics. |
In fact, many of the “scholarly” studies about the safety and effectiveness of anti-psychotics were really ghostwritten by pharmaceutical marketing execs. These studies then became the basis of even more research that reaffirmed the “safety” of anti-psychotics. And that’s because many of the researchers didn’t know the previous studies were erroneous to begin with.6
What’s more, drug makers found clever ways to get around regulations aimed at reigning in their marketing practices. For example, drug companies can’t promote off-label uses of drugs. But they can hire researchers, consultants and others to do it for them. And that’s just what Pharma giants like Astra Zeneca, Johnson & Johnson, Bristol-Myers Squibb, Eli Lilly, and Pfizer – have been doing for years.7
Case in point: Harvard professor, Joseph Bierderman. A 2008 Senate investigation revealed that he received more than $1.6 million from makers of anti-psychotics for children. According to the Archives of General Psychiatry, his studies on bipolar disorder led to a forty-fold increase in children being diagnosed with the condition. And some of his studies were published during the same time he was getting paid by Big Pharma.8
Drugmakers also took advantage of the loose definition of “psychiatric problems,”9 which can range from depressed mood to anxiety disorder to schizophrenia, and everything in between.
That’s because they know doctors can legally prescribe any approved drug to patients – even if it’s for a condition other than what the drug has been approved to treat.
But…
All too often these drugs cause more harm than good
Anti-psychotics are some of the most dangerous drugs on the market.
That’s because they’ve been linked to pneumonia, high-blood pressure, heart disease, weight gain, stroke and diabetes.
And they’re being prescribed to two of the most vulnerable groups: children and the elderly.
Did you know that 25 percent of all nursing home residents have taken these drugs?10 And according to a survey by the Alzheimer’s Society, 25 percent of nurses said they’d seen anti-psychotics used inappropriately on dementia patients.11
Meanwhile, anti-psychotics carry black-box warnings about the increased risk of death in elderly patients.12
A study published by Lancet Neurology examined 165 Alzheimer patients. One group took anti-psychotics, and the other took a placebo during this period. After three years, less than a third of those who took anti-psychotics were still alive compared to nearly two-thirds who took the placebo. And those who did survive experienced mental decline and an increase in Parkinson’s disease, sedation, edema, chest infections and stroke.13
But many elderly people in nursing homes – who don’t even have dementia – are also being given these drugs. Drugmaker Eli-Lilly even went as far as to promote what they called “5 at 5” treatments in nursing homes – 5mg of their anti-psychotic Zyprexa each day – to zonk out disruptive residents.
A recent University of Massachusetts Medical School study assessed the use of anti-psychotics among 16,586 residents newly admitted to 1,257 nursing homes in 2006. They found that about 30 percent (4,818) of new residents in the study received at least one antipsychotic medication in 2006. But 32 percent of those who received the meds didn’t even have dementia, psychosis or any other clinical reason to be using them.14
But the elderly aren’t the only group at risk. Children are, too. In fact, a new study published in Health Affairs reveals children ages 2-5 are being treated with anti-psychotics twice as much as they were 10 years ago. And they’re not being used to treat schizophrenia and bipolar disorder. They’re being prescribed for disruptive behavior, hyperactivity and developmental disabilities – as a first, not last, resort.15 Less than 50 percent of the children studied who were taking the anti-psychotics had ever received therapy, let alone an evaluation from a mental health professional.16
The effects of these drugs on the developing brains of children are unknown. In fact, there have NEVER been any long-term studies of anti-psychotic use in children.17
But in adults their effects are known all too well. A recent study that examined the effects of anti-psychotic drugs like aripiprazole, olanzapine, quetiapine, risperidone, or ziprasidone found that any adult who takes these drugs has a 225 percent risk of suffering a stroke.18 Anti-psychotics have also been linked to significant weight gain and diabetes.
If your doctor recommends anti-psychotic drugs for you
or someone you love, consider these alternatives.
1. Know the risks. Always read drug labels. You can find them online. The label clearly indicates the approved use of the drugs, side effects, and FDA warnings. If your doctor has prescribed a drug for anything other than its approved use, ask questions, seek a second, third or fourth medical opinion, and be sure to seek counsel from an alternative health doctor. Also, do your own homework. I’d recommend these two websites for information about side effects and reactions to drugs and treatments.
2. Make sure your doctor is looking for the underlying causes of your behavior and not just writing a prescription. Many times a condition can be resolved once the underlying cause is treated. The best doctors will prescribe a combination of therapy to treat your condition – such as natural foods and vitamin and herbal supplements – along with behavioral or developmental therapies. If any doctor prescribes an anti-psychotic to you as a first – and not last – resort, run in the other direction.
3. Eat foods that will lift your spirits. That means natural foods high in protein, vitamin B1, and vitamin C. Proteins contain amino acids which help to regulate emotions. Also, foods rich in vitamin B1 – such as asparagus, romaine lettuce, mushrooms, spinach, green peas, tomatoes, eggplant and brussels sprouts – help to metabolize carbs that give your body energy and improve your mood.
I also recommend a daily dose of vitamin C. A new double-blind study published in Nutrition shows that it‘s not just one of nature’s best immune boosters. It’s also an effective anti-depressant.19 The best way to get your dosage of vitamin C is to eat citrus fruits, green pepper, broccoli, kale, brussels sprouts, steak and oysters. Or you can supplement with 500 mg twice a day.
4. Get your omega-3s. Omega-3s fight chronic illnesses and ease symptoms of mental and developmental disabilities. That’s because they play a critical role in brain development and functioning. A deficiency in omega-3 can affect the levels and functioning of dopamine and serotonin – your body’s feel-good hormones, which play an important role in your mood and behavior.
A new study published in the Archives of General Psychiatry examined 81 people at high risk of psychosis. Half of the participants received fish oil supplements for 12 weeks, and the other half took a placebo. After 12 weeks, only two people in the fish-oil group developed a psychosis compared to only 11 in the placebo group.
The best omega-3 sources are wild-caught salmon, grass-fed beef, sacha inchi oil, nuts, leafy green veggies, eggs and avocados. Or you can supplement. I recommend 1.8-2.4 grams a day.
5. Consider this natural amino acid. Amino acids such as 5-HTP increase levels of chemicals in the brain connected to mood and concentration. These are natural and safe alternatives to anti-depressants, anti-psychotics and ADHD drugs I use in my medical practice. They aren’t harmful or addictive, and they actually work. They’re easy to find at health food stores. I recommend 50 to 100 mg of 5-HTP three times per day with meals.
6. Sleep. Inability to sleep is one of the most common symptoms of psychiatric problems, but not sleeping can throw your whole body out of whack. One of the most powerful sleep aids I recommend is melatonin. Look for drops, or a sublingual that melts under your tongue. It’s easier to absorb and works fast. Start with 0.5 mg and work your way up to 3 mg max. Take it 20 minutes before you want to fall asleep.
7. Avoid stress. This underlies many behaviors – from anxiety, agitation, frustration and outburst of anger – to difficulty sleeping, eating and getting through each day. You can get your life back in balance by identifying what’s stressing you and taking action to get rid of the stress in your life. Often this alone can “cure” many behavior problems and struggles with depression.
8. Limit sugars and grains. Eating starchy carbs can cause too much insulin to build up in the blood. When this happens, your body will release insulin to try to bring your blood sugar down But if your blood sugar gets too low, you become hypoglycemic. And hypoglycemia can spike glutamate to levels that can cause everything from agitation and depression to anger and panic attacks.
9. Exercise at least three or four days a week. It’ll boost your body’s feel-good chemicals. One of the most important is serotonin. Your brain needs balanced levels of this hormone to maintain a good mood. Short duration, high-intensity workouts, like my PACE program, are all you need to increase your serotonin levels. It only takes 12 minutes a day.
If you are making the decision to put your elder relative in a nursing home…
Make sure there’s plenty of staff around who can provide daily compassionate care and hands-on psychosocial therapy. Many nursing homes resort to using anti-psychotics because they lack the personnel to deal with aggression and outbursts from dementia patients. They’re also forbidden by law to use physical restraints on residents. So they use less visible “drug restraints.”
In addition to making sure there’s adequate staff trained to use intervention strategies – such as therapy – be sure the environment is stimulating for your loved one. Look for nursing homes that offer strategies to reduce boredom and agitation, such as exercise, music and intellectually stimulating games.
And finally, visit the nursing home as much as you can – without making an appointment – to see if your loved one and other residents seem doped up. If they do, don’t hesitate to get them out of there.
If your pediatrician has prescribed an anti-psychotic drug for your child…
Just say NO – point blank. There have been no studies to indicate the long-term consequences of anti-psychotics for children. But countless studies show their dangerous effects on adults. Seek the approaches above as alternatives.
1 Ramachandraiah, Chaitra T., Subramaniam, Narayana, Tancer, Manuel, “The story of antipsychotics: Past and present,” Indian J Psychiatry. Oct.-Dec. 2009; 51(4): 324–326
2 Glick, Ira D. “Treatment with atypical antipsychotics: new indications and new populations,” Journal of Psychiatric Research May-June 2001; Vol. 35, Issue 3, pgs. 187-191
3,4,5,6,18 Shekelle, Paul, et al, “Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics,” Comparative Effectiveness Reviews, No. Agency for Healthcare Research and Quality (US); January 2007
8,9 Archives of General Psychiatry, 2007
10 Douglas, I.J., Smeeth, L., “Exposure to antipsychotics and risk of stroke: self controlled case series study,” British Medical Journal Aug. 28, 2008
11 “77% of nurses say people with dementia in hospital given dangerous drugs,” Alzheimer Society, Oct. 2009
12 Yan, Jun, “FDA Extends Black-Box Warning to All Antipsychotics,” Psychiatric News July. 18, 2008; 43,14:1, American Psychiatric Association
13 Ballard, Clive, et al, “The dementia antipsychotic withdrawal trial (DART-AD),”The Lancet Neurology, Feb. 2009; 8,2: 151-157
14 Chen, Yong, Briesacher, Becky A., Field, Terry S., et al, “Unexplained Variation Across US Nursing Homes in Antipsychotic Prescribing Rates,” Arch Intern Med 2010; 170 (1): 89-95
15,16 Olfson, Mark, et al, “Trends in Antipsychotic Drug Use by Very Young, Privately Insured Children,” Jour. Am. Acad. Child & Adol. Psych. Jan. 2010; 49,1: 13-23
17 Wilson, Duff, “Side Effects May Include Lawsuits,” New York Times Oct. 2, 2010
19 Zhang, M., et al, “Vitamin C provision improves mood in acutely hospitalized patients,” Nutrition Aug. 4, 2010