CEP - Council for Evidence-based Psychiatry
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DO PSYCHIATRIC DRUGS TARGET AN UNDERLYING DISEASE?
Just like other substances that affect brain chemistry (such as illicit drugs), psychiatric drugs produce altered mental states. They do not 'cure' diseases, and in many cases their mechanism of action is not properly understood.
WHAT'S WRONG WITH GIVING PSYCHIATRIC DRUGS TO CHILDREN?
Use of psychiatric drugs in children and adolescents has been rapidly expanding across the developed world. The potential long-term damage these drugs can have on developing brains has not been properly assessed. Furthermore, there is now some evidence that increased use of medication within this age group is leading to worse long-term outcomes.
WHAT ARE THE RISKS OF SHORT-TERM USE OF PSYCHIATRIC DRUGS?
Psychiatric drugs can have effects that include mental disturbance, suicide, violence, and withdrawal syndromes. These can be misdiagnosed as new psychiatric presentations, for which additional drugs may be prescribed, sometimes leading to long-term use of multiple different psychiatric drugs in the same person.
HOW ARE PSYCHIATRIC DIAGNOSES MADE?
Psychiatric diagnostic manuals such as the DSM and ICD (chapter 5) are not works of objective science, but rather works of culture since they have largely been developed through clinical consensus and voting. Their validity and clinical utility is therefore highly questionable, yet their influence has contributed to an expansive medicalisation of human experience.
DO PSYCHIATRIC DRUGS CURE A CHEMICAL IMBALANCE?
Psychiatric drugs have often been prescribed to patients on the basis that they cure a 'chemical imbalance'. However, no chemical imbalances have been proven to exist in relation to any mental health disorder. There is also no method available to test for the presence or absence of these chemical imbalances.
WHAT'S WRONG WITH THE INDUSTRY CONDUCTING ITS OWN TRIALS?
The majority of psychiatric drug trials are conducted and commissioned by the pharmaceutical industry or those who have extensive ties with them. This industry has a long history burying negative results, and of manipulating research to highlight positive outcomes.
WHAT IS THE RELATIONSHIP BETWEEN PSCYHIATRY AND THE PHARMACEUTICAL INDUSTRY?
Ties between doctors and the pharmaceutical industry are particularly widespread in psychiatry. In the UK psychiatrists do not have to report to any agency or authority how much industry income they receive each year.
ARE PSYCHIATRIC DRUGS PROPERLY REGULATED IN THE UK?
The UK regulator of psychiatric drugs (the MHRA) is entirely funded by the pharmaceutical industry, and employs ex-industry professionals in key leadership positions. Such conflicts of interest could lead to lenient regulation that places commercial interests above patient protection.
WHY DO PSYCHIATRIC DRUGS HAVE WITHDRAWAL SYNDROMES?
Withdrawal from psychiatric drugs can be disabling and can cause a range of severe physical and psychological effects which often last for months and sometimes years; in some cases, withdrawal charities report, it may lead to suicide.
IS THERE RESEARCH SUPPORTING THE LONG-TERM USE OF PSYCHIATRIC DRUGS?
There has been little research on the long-term outcomes of people taking psychiatric drugs. The available studies suggest that all the major classes of psychiatric drugs add little additional long-term benefit, and for some patients they may lead to significantly worse long-term outcomes.
DO ANTIDEPRESSANTS WORK?
Studies have found that antidepressants have no clinically significant benefit over placebo pills (inert pills) in the treatment of mild to moderate depression, while they provide some benefit for severe depression, at least in the short term. Recent research also suggests that antidepressants may be associated with a risk of increased mortality, at least among the elderly.
CURING A CHEMICAL IMBALANCE?
Although scientists have been testing the chemical imbalance theory's validity for over 40 years - and despite literally thousands of studies - there is still not one piece of direct evidence proving the theory correct. The chemical imbalance theory, in relation to any mental health disorder is thus unsubstantiated, yet a societal belief in chemical imbalances, largely owing to effective pharmaceutical marketing, remains prevalent today.
ARE PSYCHIATRIC DIAGNOSES HELPFUL?
Most people assume that psychiatry is just like any other branch of medicine, with objective tests for diagnoses and drug treatments that cure real diseases. In reality, however, psychiatric diagnoses and treatments differ enormously from diagnoses and treatments for say cancer or diabetes, since, for mental disorders, there are no known biological 'diseases' for psychiatric drugs to 'treat'.
ARE THERE ANY PROVEN BIOLOGICAL CAUSES FOR PSYCHIATRIC DISORDERS?
There are no known biological causes for any of the psychiatric disorders apart from dementia and some rare chromosomal disorders. Consequently, there are no biological tests such as blood tests or brain scans that can be used to provide independent objective data in support of any psychiatric diagnosis.
