Gøtzsche claims that half a million people over the age of 65 die every year as a result of psychiatric medication. No specific figures are cited by him to support this claim. He further claims that most tests are biased to show illusory benefits from drugs used for psychiatric care and that suicides are “under-reported”.
There’s no doubt that whether Gøtzsche’s claims are accurate or not, they do echo a broad public distrust of Big Pharma’s most lucrative range of products. Many people, including myself, have expressed total disbelief in the “suicidal thoughts side-effect” of some drugs. How can suicidal thoughts be a normal thing? How can this side effect be acceptable? What sort of chemistry causes suicidal thoughts? Wouldn’t it make more sense to prevent this response?
If the logic and ethics of modern psychiatric medicine are obscure to say the least, Gøtzsche has taken a stand. If not directly supported by other experts, he does drive to the heart of the reaction against a lot of expensive pharmacology. The results of medication, their efficacy or otherwise, are hotly disputed. Over-medication, particularly of children and old people, is a seriously contested issue within the psychiatric profession.
The problem is that Gøtzsche’s claims are pretty much alone in terms of support within the profession, which bodes ill for any serious discussion of his views. While many professionals routinely express deep reservations about medication, they’re not claiming that these medicines kill large numbers of people.
One of his most sensitivity-rousing claims is that ADHD drugs may do actual brain damage, as suggested by animal tests. ADHD medication is loathed in some circles for its apparently infinite prescription for any and every childhood disorder. This claim adds a lot of napalm to an already explosive issue.
Gøtzsche claims that it would be possible to stop using almost all psychotropic medications without doing any harm, thereby improving general health. That argument isn’t likely to sit well with those psychiatrists prescribing medications, supposedly in good faith, for their patients. Telling the whole psychiatric profession that it’s harming its patients is bound to cause a backlash, and could distort a rational argument regarding his claims. It’s easy to see how a defensive reflex could derail any move towards actual studies, for example.
The response so far has been a range of disagreements, some qualified disclaimers, and not a lot of hard evidence.
Gøtzsche is no stranger to controversy, and seems to have a track record of stirring up debate in some very important areas. He’s also claimed that mammograms are harmful, stating that for every 3 or 4 lives saved, 9 lives are lost by this method of testing. To put it mildly, that’s not what anyone wants to hear, but that’s what he said.
He also raised the alarm regarding painkillers and other prescription drugs in a recent visit to Australia. He pointed out that the claims of “anti-inflammatory” drugs were not supported by clinical evidence. Pain management drugs are widely used in Australia, and his comments also included remarks about other prescription medications, including antidepressants.
The bottom line for taking his claims seriously regarding psychiatric drugs is going to have to be direct support from verified studies. While it’s good to see a senior academic taking a stand against medical practices which are frankly hated by many people, the need is for proof. While appreciating his apparent guts in taking on so many of the sacred cows and related bull of modern medicine is sure to appeal to the crowd, the screaming need is for solid evidence.
I think it’s fair to say that most professionals would be quite prepared to consider any findings in support of better ways of managing medical and psychiatric conditions. I also think it’s fair to say that these professionals can’t be expected to overturn their training and years of practice on the say-so of one man without backup information.
He has, however, to his credit, raised issues which must be addressed and put them squarely in the face of the pharmaceutical industry and the medical profession. Over diagnosis, over medication, and iffy pharmaceuticals are very important issues, acknowledged as major problems. Let’s hope that the quality of debate lives up to the seriousness of the situations.
