Book Review

Your Drug May Be Your Problem:
How and Why to Stop Taking Psychiatric Drugs

by
Peter R. Breggin, M.D. & David Cohen, Ph.D.
Perseus Books - Reading, Massachusetts - 1999

reviewed by Douglas A. Smith

      If you need specific advice about how to stop taking one or more psychiatric drugs, this is the book to read.  In this respect, this book fills in a gap left in other books by Dr. Peter Breggin I have read, including Psychiatric Drugs: Hazards to the Brain (1983), Toxic Psychiatry (1991), and Talking Back to Prozac (1998).  In this book Drs. Breggin & Cohen also make clear they think the concept of "mental illness" is erroneous.  For example, they repeatedly put the term mental illness in mocking quotation marks.  They state clearly that in their opinion you are better off without psychiatric drugs, whatever your "psychiatric problem" may be: depression, manic-depressive mood swings, anxiety attacks, "schizophrenia" or psychosis, or anything else.
      In this book Drs. Breggin & Cohen review the reasons you should not be taking any kind of psychiatric drug:

• "No psychiatric drug has ever been tailored to a known biochemical derangement. ... no biochemical imbalances have ever been documented with certainty in association with any psychiatric diagnosis.  The hunt goes on for these illusive imbalances; but their existence is pure speculation, inspired by those who advocate drugs" (p. 35).
• "Although medication advocates often speak with seeming confidence about how psychiatric drugs can correct biochemical imbalances in the brain, they are merely indulging in pure speculation.  There's little evidence for the existence of any such imbalances and no way to demonstrate how drugs would affect them if they did exist" (p. 34).
• "Often, patients are told, 'It's biological and genetic.'  Never mind that there's no substantial evidence that any psychiatric diagnoses have a physical basis" (p. 93).
  
• "Precisely because there is so little scientific backing for the use of psychiatric drugs, mystification and slogans are often communicated to doctors by drug advertising, and then to patients by doctors" (p. 112-123, underline added).
• "Indeed, we should suspect that any psychoactive drug - any drug that affects mental function - tends to produce irreversible changes in some if not most people.  What hope can we have that bathing the brain in a psychiatric drug will actually improve the overall function of this mysterious organ?  Almost none.  In fact ... most of what we know about the various neurotransmitters has been gathered by studying how psychiatric drugs disrupt or spoil their functioning" (p. 9 - underline added).
• "Advocates of psychiatric drugs often claim that the medications improve learning and the ability to benefit from psychotherapy, but the contrary is true.  There are no drugs that improve mental function, self-understanding, or human relations.  Any drug that affects mental processes does so by impairing them" (p. 97-98).
• "Despite a hugely successful promotional campaign by drug companies and biological psychiatry, the effectiveness of most or all psychiatric drugs remains difficult to demonstrate.  The drugs often prove no more effective than sugar pills, or placebos - and to accomplish even these limited positive results, the clinical trials and data that they generate typically have to be statistically manipulated" (p. 37).
• "But isn't psychiatry science?  Isn't faith in psychiatry based on facts?  On research?  Can't we 'trust in research'?  The sad truth is that, in the field of psychiatry, it is impossible to 'trust in research.'  Nearly all of the research in this field is paid for by drug companies and conducted by people who will 'deliver' in the best way possible for those companies.  ... Sadly, even well-informed people too often put their faith in psychiatry and psychiatric research.  It is the same as putting their faith in a drug company" (p. 189-190).
• "...emotional suffering cannot be dulled without harming other functions such as concentration, alertness, sensitivity, and self-awareness" (p. 36).
• "All psychiatric drugs can cause problems during withdrawal" (p. 16).  And the longer you take a psychiatric drug, the more difficult your withdrawal will be.
• "...many adverse drug effects are difficult to distinguish from emotional problems" (p. 24).
• "Contrary to claims, neuroleptics have no specific effects on irrational ideas (delusions) or perceptions (hallucinations).  Like all other psychiatric drugs, they have the same impact on healthy animals, healthy volunteers, and patients - namely, the production of apathy and indifference" (p. 77).
• Neuroleptic drugs cause brain damage evidenced by a movement disorder called tardive dyskinesia, but "Neuroleptics actually suppress the symptoms of tardive dyskinesia while the disease is developing.  ... The rates of TD [tardive dyskinesia] are extremely high.  Many standard textbooks estimate a rate of 5% - 7% per year in healthy young adults [who are taking neuroleptic drugs].  The rate is cumulative so that 25% - 35% of patients [taking neuroleptics] will develop the disorder in 5 years of treatment.  Among the elderly [taking neuroleptics], rates of TD reach 20% or more per year.  For a variety of reasons, including the failure to include tardive akathisia in estimates, the actual rates are probably much higher for all patients" (p. 78).
• So-called antipsychotic or neuroleptic drugs cause a fatal disease called neuroleptic malignant syndrome in up to 2.4% of people taking them.  "Using a low-end rate of 1 percent, Maxmen and Ward (1995, p. 33) estimate that 1,000 - 4,000 deaths occur in America each year as a result of neuroleptic malignant syndrome.  The actual number is probably much greater" (p. 79).
• Neuroleptic, also known as antipsychotic or major tranquilizer drugs "subject almost every system in the body to impairment.  Research, including a recent study, indicates that these drugs are toxic to cells in general" (p. 81).
• Clozaril ... was banned in some European countries because it caused so many fatalities; but the escalating power of drug companies subsequently led to its approval by the FDA" in the United States (p. 82).
• If you are pregnant, psychiatric drugs you take will cross into the baby's bloodstream "and from there, to enter the unborn infant's brain.  Similarly, psychiatric drugs enter the mother's milk and thus also affects the nursing infant's brain" (p. 26).
• "...women who take lithium during pregnancy expose their infants to an increased rate of heart defects" (p. 26).
• "Some physicians try to reassure pregnant or nursing mothers about their baby's safety while they are taking psychiatric drugs.  But there is no scientific basis for offering this reassurance in regard to any drug that affects the brain" (p. 84).

This book is a well-documented, well-written, recent (1999), exposé of the health care quackery called biological psychiatry, particularly psychiatric drugs.
      On specifically how to go about stopping taking psychiatric drugs, Drs. Breggin & Cohen say "The general rule recommended by some practitioners is to taper off in 10 percent decrements - usually every seven to ten days" (p. 126).  That means you do it in ten separate steps.  They suggest the last ten percent may need to be divided into a series of smaller steps and that if you are an older person who has "been taking tranquilizers daily for over twenty years ... a withdrawal period of two years is not unusual" (p. 137).  If you are taking more than one psychiatric drug each day, they recommend going off the drugs one at a time, that is, continuing your usual dose of your other drugs while you taper off one of them.  How do you decide which drug to discontinue first?  They say if "you're taking drug 'A' to counteract the side effects of drug 'B' ... you should probably start withdrawal with drug 'B'" (p. 136).  While they recommend you withdraw from psychiatric drugs with the help of a health care professional, they acknowledge that "most people who come off psychiatric drugs have successfully done so on their own, without active clinical supervision" (p. 113 - italics in original).
      I was disappointed to find nothing in this book about a problem that is central to the subject of the book: forced psychiatric drugging of imprisoned or "hospitalized" persons, and the enactment of forced outpatient psychiatric drugging laws in the majority of the states of the U.S.A., exemplified by Kendra's Law in New York.  Like many of us in the ex-patient's or "psychiatric survivor's" movement, I was once imprisoned or "hospitalized" and forced to take a psychiatric drug - Thorazine.  I was psychologically entirely normal at the time, even if I was very unhappy about the loss of the relationship with the woman I loved and about being on scholastic probation in college, leading to my parents deciding to force me into what they mistakenly thought would be "therapy": Since I refused to seek "therapy" voluntarily, their only way to force me into "therapy" was committing me to a "hospital" against my will.  The day I was incarcerated (or "hospitalized"), after the hospital staff got through asking me questions for their paperwork, I was permitted to walk around awhile in the hallways and rooms in the place I'd been imprisoned, exploring my new surroundings.  But for no apparent reason, after awhile a nurse approached me with a hypodermic needle in her hand and told me she had a shot for me my doctor had prescribed for me.  "I haven't even seen a doctor" I told her.  She seemed to realize I was correct, and she looked a little embarrassed when I asked the name of the doctor who had supposedly ordered the shot: She had no idea who he was.  But none of that mattered to the hospital staff.  She went away but was back a little while later with a large orderly, later joined by another, to force me to submit to the injection.  They also did not care when I told them I hadn't yet had a hearing or trial to determine if my commitment was justified or not, that I was being held only on a pretrial commitment order, and that it was wrong for them to force me to take a drug before I'd had a chance to go to court to present my arguments against committing or "treating" me against my will.  Because of involuntary "hospitalization" laws in every state, and "outpatient commitment" laws in 40 or more states of the U.S.A. that exist for the purpose of forcing people to take psychiatric drugs or face repeated imprisonment in psychiatric "hospitals," those of us who because of our past experience of it fear forced administration of these harmful drugs need advice about how to protect ourselves from it.  All Drs. Breggin & Cohen say on this subject is: "Do not let anyone pressure you into starting or continuing psychiatric drugs.  As a competent adult, you have the ethical and legal right to make your own decisions about taking psychiatric drugs.  ... Your decisions about taking or rejecting drugs need to be made without coercive pressure from doctors" (p. 29).  While I agree with this statement, it is obvious many, apparently most, state legislators, judges, psychiatrists, and psychiatric hospital staff members do not.  What us victims of psychiatry need is a strategy for avoiding forced psychiatric drugging.  Drs. Breggin & Cohen do not offer one in this book.
      There may not be a reliable way to protect yourself from forced psychiatric drugging, but here are two ideas: One is to hire a lawyer to write a "Declaration Regarding Mental Health Treatment," also known as an "advance directive," in which you say you want to receive no psychiatric drugs (or physical restraint or shock treatment) if you ever are declared mentally ill or incompetent, with a certification by a psychiatrist attached stating that you were mentally competent at the time you made the Declaration.  This will undermine the argument that you would consent to "treatment" if only your thinking were not clouded by mental illness.  Another strategy is to maintain a relationship with a psychiatrist who opposes coercive "treatment" who will testify for you if you become a victim of psychiatric oppression such as forced "hospitalization" or psychiatric assault such as forced psychiatric drugging.  A lawyer recently advised me it probably needs to be a psychiatrist, not a psychologist.  Perhaps in states where psychologists are permitted to commit people against their will, a psychologist's testimony would be adequate.
      In a rational world where human rights were respected, forced psychiatric drugging would not happen.  In a rational world where human rights were respected, none of today's psychiatric drugs would be used by anyone, voluntarily or involuntarily.  Perhaps books like Your Drug May Be Your Problem will help some of us start thinking rationally about psychiatric drugs.

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See the Bazelon Center for Mental Health Law website for information about advance directives.

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