Mad In America Weekly Newsletter, Wednesday, June 22nd, 2016
Dear Friend of Mad in America,
This week a number of our bloggers at Mad in America have taken on the issue of forced treatment in psychiatry. 

The conversation was initiated by Peter Gøtzsche, the co-founder of the widely respected Cochrane Collaboration, who writes in support of United Nations provisions calling for the abolishment of our laws about forced treatment. For Gøtzsche, it is important to point out, on scientific grounds, that removing a patient's right to informed consent cannot be defended as evidence-based medicine, as it "has never been shown that forced treatment does more good than harm." In fact, he writes, "it is highly likely that the opposite is true." 

Inspired by Gøtzsche's work, Peter Breggin, one of the most well-known critics and reformers of psychiatry, added a new section to his own website on "Psychiatric Coercion and Involuntary Treatment." In an accompanying blog for MIA, Breggin goes further, writing that forced 'treatment' is not just unscientific, unconstitutional, and an assault on human rights, it is also a form of torture. 

"In my decades of clinical experience, many if not most victims of involuntary treatment experience it as torture," Breggin writes. "They know it aims at breaking their will and they physically and mentally resist, resulting in even more dire consequences." 

The critical Australian psychiatrist Niall McLaren similarly compares forced treatment to torture in his latest blog. Specifically, he references the infamous treatment of Garth Daniels, who has been subjected to over one hundred consecutive forced episodes of ECT. McLaren takes on the "Kafkaesque" nature of many of the arguments used to justify this treatment. One problem, for instance, being that Daniels' doctors argued that he would not give informed consent for ECT because he had a memory defect that prevented him from recalling the benefits of the procedure. The memory defect, of course, was a result of the ECT treatment itself. 

As always, we welcome you to follow and join in on these critical conversations, and many others, through our news features and blogs.  
Until next week,

Justin Karter

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Peter Gøtzsche, MD
"Abolishing Forced Treatment in Psychiatry is an Ethical Imperative​"

by Peter Gøtzsche, MD

James Schroeder, PhD
"Pain’s Promise, and the Problem with Pills"

by James Schroeder, PhD

Cochrane Review Finds No Evidence for “PRN” Drugs in Mental Health Treatment

It is common for “as required” or PRN (Pro re nata) medications to be prescribed during inpatient mental health visits. The most likely drugs prescribed “as needed” include benzodiazepines, antipsychotics, and sleeping pills. A newly updated Cochrane review finds, however, that “there is no good evidence” for this practice.

New Study Finds Brain Changes in Newborns Exposed to Antidepressants

A first of its kind neuroscience study, published this month in Cerebral Cortex, found changes in the brain electrical activity of infants exposed to SSRI antidepressants during pregnancy. The changes are associated with less-organized communication between the brain’s hemispheres and are comparable to the effects found in previous animal studies. The researchers call for more critical evaluations of the prescription of antidepressants during pregnancy and suggest that non-pharmacologic and therapeutic alternatives should be the preferred treatment.

Many Foster Kids Are Still Being Prescribed Antipsychotic Drugs

Many experts expressed concern when the rate of antipsychotic prescriptions to children in foster care showed a rapid increase, peaking in 2008, and new recommendations and policies have tried to curb the use of these drugs. While the rate has plateaued, a new study points out that the “new normal” prescription levels are still dangerously high. The data reveals that almost one in ten children in foster care are currently being prescribed antipsychotic drugs with dangerous side-effects, many for diagnoses like ‘ADHD’ and disruptive behavior.

Pat Risser, Long-Time Leader in Psychiatric Survivor Movement, Dies

Pat Risser, who has been a leading voice in the psychiatric survivor movement for decades, died on Wednesday of  heart failure. Mr. Risser, who was once diagnosed with schizophrenia, wrote and spoke elegantly about trauma, including the horrible abuse he had suffered as a child, the fight for civil rights in the mental health system and in society, and of the many destructive elements of the psychiatric system. He published many papers on these topics and, as a mental health consultant, gave presentations and workshops to survivor groups and professional groups, his voice recognized for its power and authority. He spent his last years living in Ohio. He was 63.

JAMA Review Questions Use of Ritalin for ‘ADHD’

In December, MIA  reported on a systematic Cochrane review on the research for the safety and effectiveness of Ritalin (methylphenidate) that found substantial bias in previous studies and a lack of quality evidence. Major medical associations, however, recommend this drug as a treatment for children and teens diagnosed with ‘ADHD.’ In a major step,  the Journal of the American Medical Association (JAMA) has issued a “Clinical Evidence Synopsis” that reiterates the Cochrane findings and calls for guidelines to be reevaluated.

Air Pollution Linked to Mental Health Problems in Children

A new study, published in BMJ Open-Access this week, found a significant link between the level of air pollution in a community and the mental health of the children living there. After controlling for socio-economic status and other potential variables, researchers in Sweden discovered a strong association between the concentration of air pollution in a neighborhood and the amount of ‘antipsychotic’ and psychiatric drugs prescribed to children. The link remained strong even at pollution levels well below half of what is considered acceptable by the World Health Organization (WHO).
Pharmacists Join Physicians’ Rallying Cry for a Ban on Pharma’s DTC Advertising

This week a national pharmacist group, the American Society of Health-System Pharmacists, joined the physicians of the American Medical Association in a call to ban direct-to-consumer (DTC) drug ads.

“You Could Be Paying More for Less Effective Medicine”

A new study by Lisa Cosgrove, "Under the Influence: The Interplay among Industry, Publishing, and Drug Regulation," suggests that weak drug regulation can lead doctors to prescribe more expensive, riskier, and less beneficial drugs. In his review of the article, Dr. Nardo, on his 1boringoldman blog, writes, that the "article doesn’t stop with demonstrating some of the methodology of the misreporting illustrated in the articles, but goes on to make suggestions about problems in the system and pathways to change. While you might not completely agree with all of them, they’re all valuable food for thought. That’s what academic publication is supposed to be about."

This Ranking of the 10 Most Harmful Drugs May Surprise You

From Sarah Beller at the influence: “Two leading UK health organizations— the Royal Society for Public Health and the Faculty of Public Health–have just made an unprecedented call for decriminalization of all personal possession and use of drugs. In their report, “Taking a New Line on Drugs,” they list the top 10 most harmful drugs, and in what ways each specific drug is most harmful.”

“Held in a Hospital: Bellevue Hospital is Refusing to Acknowledge Derya Demirtas’s Diagnosis”

Derya Demitras, a young honors student from Amherst College, is being held in the Bellevue psychiatric hospital against her wishes and the wishes of her family despite the fact that she has been diagnosed with autoimmune encephalitis, a condition that affects the brain.  “The family repeatedly informed the hospital that Derya’s condition worsened under the use of psychotropic medications. When Derya’s psychiatric behaviors worsened, after receiving drugs to treat mental illness, she was involuntarily committed to the psychiatric ward of Bellevue Hospital where they continued to administer more psychotropic medicine.”

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