The third leading cause of death after heart disease and cancer? Experts debate the harmful effects of psychiatric medications

Following its launch last year and the subsequent criticism of its position by prominent psychiatrists in the The Times and The Lancet Psychiatry, the Council for Evidence-based Psychiatry (CEP) responded by issuing a challenge to its critics to engage in an open, public debate on psychiatric drug harm.

Taking up this challenge, the Institute of Psychiatry at Kings College London will be hosting the 52nd Maudsley Debate starting at 17.30 on 13 May 2015 entitled: ‘This house believes that the long-term use of psychiatric medications is causing more harm than good’.

Speaking for the motion will be Professor Sami Timimi (consultant child and adolescent psychiatrist, University of Lincoln) and Professor Peter Gøtzsche (director of The Nordic Cochrane Centre), both of whom are members of CEP.  Speaking against the motion will be Prof Allan Young (professor of mood disorders, King’s College London) and Mr John Crace (journalist at The Guardian).

Professor Gøtzsche will begin by highlighting the deadly impact of psychiatric drugs on the elderly: ‘I have estimated, based on randomised trials and cohort studies, that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the USA and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. The drugs furthermore cripple tens of millions. There are no benefits that can justify so much harm.’

Professor Timimi will then challenge the medical establishment to recognise and act upon these harms: ‘We are in danger of creating morbidity on a massive scale with our current non evidence-based mass use of long-term psychiatric medication… The evidence is clear and the big question is not whether long-term prescription of psychiatric drugs does more harm than good but what are we going to do about it. Bodies like the Royal College of Psychiatrists have a scientific and moral duty to do something. If they won’t they are in danger of becoming part of the problem rather than what they should be, which is a strong advocate for patients and those who serve them.’

Around 85 million prescriptions were issued for psychiatric medications last year in England, including over 57 million prescriptions for antidepressants – enough for every man, woman and child. Antidepressant prescribing has increased by 7.5% since 2013, and over 500% since 1992. This level of prescribing is particularly worrying given that the prevalence of severe depression has remained steady for decades.

Recent research indicates that prescriptions are rising because more people are taking antidepressants for longer; often they become dependent on them and cannot stop.  However there is no good research supporting the safe long-term use of these drugs, and withdrawal support charities report that over 50% of their enquiries now relate to the negative withdrawal effects, which can be debilitating and sometimes lasts for years.

To reduce harm Professor Gøtzsche believes that prescribing practices urgently need to change: ‘As psychotropic drugs are immensely harmful when used long term, they should almost exclusively be used in acute situations and always with a firm plan for tapering off which can be difficult for many patients. We need new guidelines to reflect this. We also need withdrawal clinics all over the country, as many patients have become dependent on psychiatric drugs, including antidepressants, and need help to get off them slowly and safely.’

8 Responses to The third leading cause of death after heart disease and cancer? Experts debate the harmful effects of psychiatric medications

  1. Ruth 13/05/2015 at 4:57 pm #

    I am so happy to see this being addressed.I was prescribed antidepressants for panic attacks, I was left on them for 8 years, I stopped taking them and was dreadfully ill for many years. It’s been 10 years since I stopped taking them I still have many problems including problem with my balance and a rocking sensation. no doctor can do anything to help me .It is a terrible situation to be in , I am far worse now than I was before I started taking the pills and all the symptoms were not present with my original problem.Many thanks to all concerned for raising this issue.

  2. Reni Landor 13/05/2015 at 8:37 pm #

    I am on my way home from the debate! Very interesting but some personalised comments and hecklers got in the way of the science and reasoned argument. Would value another listen on the podcast when available.

  3. Reni 13/05/2015 at 8:51 pm #

    Just on my way home from attending the debate. Very interesting but became rather heated due to personalised comments and some heckling! Look forward to another listen via the promised podcast in due course. The arguments against the motion did not change my mind!

  4. Alto Strata 13/05/2015 at 9:11 pm #

    No matter the outcome of the debate, we need withdrawal clinics for psychiatric drugs all over the world, or much better training for clinicians.

    Currently, patients have a great deal of difficulty finding clinicians who understand the basic principles of tapering, can recognize withdrawal symptoms, and who know what to do if withdrawal symptoms appear (stop tapering, possibly updose slightly and, after stabilization, taper at a much slower rate).

    For example, patients requesting the liquid form of the drug to taper are told by their doctors that such does not exist (when it does) or meet outright refusal. Or, they are told to simply quit, despite insert warnings about sudden discontinuation. Doctors will even refuse to provide stepped dosages of drugs for tapering.

    (I want to thank those doctors who do take withdrawal syndrome seriously and have learned to taper patients at individualized rates.)

    The task of counseling patients about tapering falls to peer support sites such as mine, http://SurvivingAntidepressants.org. I would close my site tomorrow if patients could find the advice they need from physicians.

    What’s emerged on patient-run Web sites is that some people require very, very gradual decrements in dosage, sometimes 5% or less per month, to minimize withdrawal symptoms. Some can tolerate decreases of only a fraction of a milligram at a time.

    We have found very gradual reductions in dosage can avoid neurological destabilization. You may read hundreds of case histories here http://survivingantidepressants.org/index.php?/forum/3-introductions-and-updates/

    We have also found that skipping doses, a discontinuation technique recommended by many doctors, is a very effective trigger for severe withdrawal syndromes in some people. Most of these drugs have short half-lives; clearly a skipped dose will cause undesirable blood level variations of the drug. It’s a tribute to the human nervous system that severe withdrawal syndrome does not occur more often.

    I am always looking for doctors anywhere in the world for local referrals for tapering. If you can offer this service, please click on the Web site link above, click on The Moderating Team at the bottom of the page, and send e-mail to me at the address provided.

    Thank you,

    Altostrata
    Administrator
    SurvivingAntidepressants.org

  5. Lauren 14/05/2015 at 1:38 pm #

    Excellent debate
    Can i clarify ? What is the 3rd leading cause of death – all psychiatric drugs ?
    What is the evidence

    Thanks

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  7. jane 10/04/2016 at 6:55 pm #

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