The People's Perspective on Medicine

Modern Mind Medicines Lose Luster

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Hundreds of years ago, people with mental illness might be burned at the stake or locked away in a dungeon. In the early 20th century, some patients with schizophrenia were lobotomized with an ice pick to blunt emotions and reduce agitation.

Other treatments included padded cells, straitjackets, cold wet sheets and electroshock therapy. Mental institutions in the first part of the 20th century were sometimes referred to as “snake pits.”

It was in this barbaric context that the first antipsychotic drugs were developed. In 1952, when Thorazine (chlorpromazine) was first introduced, it was hailed as a breakthrough.

Other drugs such as Stelazine (trifluoperazine), Mellaril (thioridazine) and Haldol (haloperidol) followed. Although these antipsychotic medications were popular with psychiatrists, patients often thought of them as chemical straitjackets.
Such drugs helped reduce hallucinations and agitation. But there was a high price to pay for the apparent benefits. The drugs made people feel sedated and slowed them down, resulting in a zombie-like shuffle.

Other side effects included dizziness, slurred speech, seizures, and a variety of movement disorders such as severe neck muscle spasms causing head twitches or uncontrollable rhythmic movements such as sticking out the tongue. Urinary retention, constipation and sexual difficulties also contributed to the drugs’ unpopularity with patients, who often discontinued their medicines as soon as they were discharged.

A newer generation of schizophrenia drugs was introduced in the early 1990s with great fanfare. Drugs like Clozaril (clozapine), Risperdal (risperidone), Zyprexa (olanzapine), Seroquel (quetiapine), Geodon (ziprasidone) and Abilify (aripiprazole) are known as atypical antipsychotics.

Psychiatrists hoped that these medications would be better tolerated and much more effective than older antipsychotics. Some even believed the new drugs would help schizophrenic patients return to normal.

Over $13 billion is spent on antipsychotic medications each year. They are prescribed for a range of conditions beyond schizophrenia, including Alzheimer’s and dementia, bipolar disorder, insomnia, autism, obsessive-compulsive disorder, ADHD and major depression.
Despite the initial enthusiasm, there is growing consternation about the safety and effectiveness of these powerful mind medicines. A few years ago a study found that the newer and far pricier drugs were no more effective or less likely to cause troublesome side effects than an older antipsychotic (New England Journal of Medicine, Sept. 22, 2005). A new study in the same journal (Jan. 15, 2009) reported an alarming rate of sudden cardiac death linked to the newer drugs.

It’s no wonder that patients and families are nervous about these medicines, especially when you consider that they can cause other complications such as dramatic weight gain, diabetes, strokes and irregular heart rhythms. Children and older people may be particularly vulnerable.

People with mental illness deserve much better treatment than they have received to date. Although lobotomies and straitjackets are no longer used, modern medications leave a lot to be desired.

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    About the Author
    Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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    Risperidone+Olanzapine seem to have ruined my life. I used a relatively small dose for 4 weeks. Since then I can’t access my brain other than in an autopilot fashion, and I can’t access my emotions. The effect is as if the drugs clogged up an entire series of synapses [before: I would think and the thought would spring to mind instantaneously, whereas now it is as if the blood flow into my mind is blocked/clogged with cement and it’s near completely blocking access into my mind, likewise my emotions don’t seem to reveal themselves, there is a clogging effect stopping them from rising up into my chest. Since stopping the meds 4 weeks ago, this clogging effect has only strengthened, it hasn’t worn off at all, I feel more and more clogged every day since stopping, with no sign of the homeostasis returning.

    We have a mentally challenged child-38yrs. old who has a rare chromosomal defect. 13 years ago she was diagnosed with Lyme Disease & after that time frame, behavior issues came to the forefront as well as having huge sleep issues. At the time of the chromosomal defect the Dr. tried her on other things to help the behavior which helped for a time & then we had to go to a psychiatrist. First she was on Depacote-but that cause her to loose half the hair on her head & all her body hair.
    Next. we have tried Abilify, but sleeplessness is a side affect, plus she had tremors. Now we have pulled her off the drug & have her on Serquel and she is sleeping-much better than this 2-3 hrs. a night & all the sleeping pills on the market did nothing more than wind her up-the opposite desired affect. Abilify is a good drug, I guess, but yah sure wonder. Thanks!

    I used Abilify as a complementary med to the Depakote and Lamictal I take for bipolar disorder. It was a god-send because I was completely depression-free for the first time. Unfortunately, a few months after I started taking it, I developed a severe tremor and it has not resolved in the more than 8 months since I stopped taking it. I now take Seroquel, which is pretty effective, but not to the degree Abilify was.

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