The BMJ today publishes an article by CEP member Professor Peter Gøtzsche, in which he claims that the long-term use of psychiatric medication is causing more harm than good. The article is timed to co-incide with a Maudsley Debate which will be held today on the same topic.
More than half a million people aged above 65 years die from the use of psychiatric drugs every year in the Western world and the benefits would need to be “colossal” to justify these “immensely harmful” treatments, argues Gøtzsche, who is director of the Nordic Cochrane Centre, Denmark.
But benefits are “minimal”, he explains, adding that these treatments should “almost exclusively be used in acute situations”. New guidelines should support this change as well as widespread withdrawal clinics to help many patients gradually come off these medications.
Benefits have been overemphasised and harms understated, he says, because randomised controlled trials have been biased, not blinded appropriately, have not fully evaluated the effects of these drugs and deaths have gone under reported.
For example, the majority of studies have included patients already using a psychiatric drug and such patients may undergo abstinence and suffer from withdrawal symptoms. As a result, this study design exaggerates benefits and increases harms, and has even driven some patients to suicide, he explains.
Industry funded trials have under reported deaths, he adds, estimating that there have probably been 15 times more suicides among people taking antidepressants than reported by the US Food and Drug Administration (FDA).
He calculates that deaths from three classes of drugs – antipsychotics, benzodiazepines and similar drugs, and antidepressants were responsible for 3693 deaths every year in Denmark. This number corresponds to 539,000 deaths in the United States and European Union combined.
The effects of psychiatric drugs are so small, he says, and that it would be possible to lower current use by 98%. He recommends stopping the use of all antidepressant, ADHD and dementia drugs, and prescribing only 6% of antipsychotics and benzodiazepines.