Yet again I am in the throes of quitting caffeine. I have sort of resigned myself to the fact that I will probably never quit for good until at least I have the time to really take the months and months it might need to get my mental sharpness back. I have quit caffeine 2 other times in the recent past and even after like 2 months I felt mentally so much slower and duller. Just one cup can give it all back. For now I just quit to give my liver a short break from what I have decided is a damn powerful drug.

Given the dullness, all I was able to do today was lounge around the house as the rain poured reading what is really a remarkable book, a large portion of which is also about drugs. More specifically it was about the effect of psychiatric drugs on the mind and the murky and downright ethically questionable relationship between the pharmaceutical companies, drug trails, and doctors. The book is Mad in America by Robert Whitaker. Anyone who is on psychiatric drugs, knows someone on them, or is just generally interested in this issue should go and buy a copy of this book that will leave you depressed, angry, and disgusted at the mental health profession even if you are already pretty depressed, angry, and disgusted as I am. I did not think I could get any more upset but alas, that is not the case.

The book catalogues the treatment of the mentally ill in America from the 1800s onwards noting how societal currents and economic and professional interests have shaped a field that has more often than not been one of severediscipline and punishment instead of healing and care. Whether it was fueled by eugenic theories of human beings (which legitimated such practices as electroshock therapy, lobotomies, and forced sterilizations), the sickening hubris of a professional group looking for legitimacy in a field in which “the real and the good” means medication, or the profit seeking of large pharmaceuticals who will skew clinical trails to paint rosy pictures of a “new” schizophrenia medication that reaps enormous profits thanks to patent protections, the psychiatric profession in America has been one of negligence, explicit torture of patients during medical trials, bad science, secrecy, and loathsome practices. Yet this pathetic and dangerous history has been hidden well behind the cloak of “science and medicine.” Whitaker unveils a portion of this history though you get the sense there is a lot more hidden.

The first half of the book is about common medical therapies which spanned the gamut–blood letting, insulin induced comas, electroshock therapy (apparently now making a comeback especially in developing nations), and the infamous lobotomy now widely seen as a barbaric practice inflicting irreversible damage on the brain. What Whitaker succeeds in is making us rethink whether supposed anti-psychotic drugs whether older ones like Haldol or newer atypicals are also causing side effects and brain damage that lie along the same axis as the supposedly barbaric lobotomy. The side effects of such drugs are not unlike the schizophrenia they were supposed to cure:

Fifteen years of investigation into dopamine function in schizophrenics had produced a rather disturbing truth. Researchers had speculated that schizophrenics naturally suffered from overactive dopamine systems but found that this wasn’t so. As John Kane, a well-known researcher at Long Island Jewish Medical Center in New York confessed in 1994, “a simple dopamingeric excess model of schizophrenia is no longer credible…” Yet investigators had found that the drugs hindered dopamine function and also caused a pathological increase in dopamine receptors in the brain, the very abnormality hypothesized to cause schizophrenia in the first place. In a sense, the drugs were agents that turned a normal brain into a schizophrenic one. P. 198

Basically anti-psychotic drugs alter the uptake of neurotransmitters like dopamine and newer ones work on serotonin and others too. As a result, your body lacking dopamine sort of freaks and goes into dopamine receptor overdrive creating a lot more receptors since it is not getting the correct does of dopamine. In the long run of being on the medication, ones’ brain chemistry and functioning is absolutely altered. Going off the drugs is like withdrawing from heroin… cold turkey. That is, it hurts bad. It not only causes intense physical withdrawal symptoms but can also cause even more intense psychotic responses although it is not necessarily a relapse but a drug induced withdrawal symptom. Those people who have a psychotic episode and are never put on an anti-psychotic are much less likely to suffer from another attack than those that are put on such drugs, especially for the long term. More information on the dangerous side effects of psychiatric drugs can be found here on Peter Breggin’s website with some warning and insights on how to safely stop taking them.

But since the damage is induced by a pill instead of the very physical process of surgery the question of permanent damage can be and has been elided. It is just a pill, a little pretty pink pill as opposed to some massive drills careening into ones skull. The barbarism of the pill seems like a joke compared to that of lobotomy. But just because the treatment is in the form of a pill as opposed to drill does not mean that the supposed treatment is anymore humane and therapeutic. Unfortunately, the other thing that Whitaker makes clear is that most of the clinical trails are so doctored, so fudged, that assessing the therapeutic nature and adverse side effects of drugs is no easy feat. Bad science and bad faith create dark halls of occlusion and collusion in the psychiatric field, a field that is supposed to treat those who already suffer from forms of darkness and despair. What is given in the form of a pill as opposed to forms of shelter, security, and therapy often seem to add darker shades to black as night darkness. Even such news about needing to revamp the mental health care system does not inspire too much hope, at least today after finishing the book and off of caffeine.