Tag Archives: medication

Drugs and Violence

By Dr David Laing Dawson

In medicine, when we find something that works we overuse it. That is as true of antibiotics, anti-inflammatories, and blood pressure drugs as it is for psychiatric drugs.

And this means that some people who really didn’t need the drug in the first place may be suffering unnecessary side-effects. Over time medicine usually corrects with broad studies and new guidelines.

(Although it is as difficult for doctors to convince a patient that he needs to exercise rather than take Prozac, as it is to convince a mother that her child’s cold and earache will run its course with or without antibiotics.)

But to blame psychiatric drugs for violence and murder is patently ridiculous.

In fact, if one extrapolates from the murder rate trends around the world, or just within large Canadian cities, one could make a case for the wide prescription of anti-depressant and anti-psychotic medication being the source of less violence in our societies.

Murder rates in the middle ages were shockingly high by all estimates. Similarly throughout the 1800’s.

In Toronto and Montreal the murder rates climbed from 1900 into the 1960’s, peaking in the mid 70’s and then declining ever since.

The powerful psychiatric drugs were introduced in the 60’s but mostly used within hospitals and outpatient clinics of hospitals. Wider use developed in line with the reduction of psychiatric hospital beds and the introduction of newer drugs in the 1970’s and 1980’s: the so-called atypical anti-psychotics (Risperdal, Seroquel eg) and the SSRI’s for anxiety and depression (Prozac onward).

The increasing use of these drugs within the community and less ill population, when charted, is a reverse image of the declining murder/homicide rates.

Many other factors are at play as well, of course, so I cannot make a case for these drugs specifically being responsible for the declining rate of homicides, but I can from this data be confident that wide-spread use of these medications is NOT increasing the homicide rate.

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The first group of antidepressants were introduced in the 1950’s, again primarily in hospitals, outpatient clinics and for severe depression. (Imipramine, Amitriptyline)

Prozac, the first SSRI antidepressant was introduced in 1989. Currently 86 people per 1000 in Canada take an antidepressant, usually an SSRI or NSRI medication.

(note both the highest suicide rate and the lowest consumption of antidepressants falls to South Korea)

Similarly the first antipsychotics (Chlorpromazine etc.) were introduced in the late 1950’s/early 60’s and were used primarily within the mental hospital population. The second generation only became available in the 1980’s. Currently a little over 1% of the American population takes anti-psychotic medication.

If one considers the percentage of the population that suffers from severe mood disorders it is reasonable to say that the antidepressants are being somewhat over prescribed.

On the other hand if one considers the percentage of the population suffering from a psychotic disorder (schizophrenia, bipolar disorder, psychotic depression, autism with psychosis) the anti-psychotic medications are being underutilized.

But, either way, to blame these medications for violence or homicide in 2018 is ridiculous, as the data clearly demonstrate.

 

I Thought I Was Too Smart for Schizophrenia

By Erin Emiru (nee Hawkes)

I have schizophrenia, they tell me. They line up my symptoms and thrust the diagnosis in my face. So here are your pills.

When I stop taking those medications I lose my grip on reality, but I don’t know this. They – my psychiatrist, a Security guard, the police – bring me to the hospital (again) and I am told (again) that I have schizophrenia.

No, I don’t. People with schizophrenia don’t have a Master’s degree in Neuroscience. I’m simply too intelligent to have schizophrenia, right?

Then why do rats eat my brain, why do Voices yell at me, and why am I being stalked by a homicidal man with a sniper gun (I’ve got proof)? I assume it is normal. I don’t have any friends and I have withdrawn from my family so no one but Them (doctors, nurses – everyone in league with the Enemy) diagnose me, treat me. So here are your pills.

I remember my first antipsychotic. I was in the psychiatric hospital after a failed suicide attempt and, after drawing me out, my psychiatrist decided to start me on risperidone. She did not tell me what it would do. Soon, my Voices were quieter, quieter, quieter. Rats stopped chewing and the sniper stopped tracking me. Wow, I thought. Those were symptoms? That was schizophrenia? The scientist in me knew it wasn’t a simple placebo effect, since I had had no idea what those little pills were going to do. I became open to the idea that I might have schizophrenia.

Yet repeatedly, over the next half-dozen years, I would leave the hospital quietly, only to be forcibly returned after “decompensation due to medical noncompliance.” That is, I fell into the oh so common trap of thinking: “I am doing well. I don’t need these pills any more. I’m cured.” Round and round the revolving door.

You would think that after all of this, I would surely realize that I had schizophrenia. I didn’t, though. I was under the heavy spell of anosognosia: the physiological inability to recognize that one has an illness. It is common, and strong, in schizophrenia. But in me, equally strong was a scientist. So, experiment number one: recall that first antipsychotic? Well, it did strange things, things I was not expecting.

My second hypothesis: maybe I was just in it for the attention. When psychotic and certified in the hospital, I would bash my head against the concrete wall until both it and I were bloody; that bled the brain-eating rats out. It also earned me restraints, physical and chemical, which I raged against. I screamed and kicked and cried but the strong Security guards tying me up and the nurses with injections (rat-laden!) for me always won. That was attention, I reasoned. So I decided to do it. Bang head, fight restraints, scream over injections… it was a good show, but it felt foreign. I was an actor, not a true patient, that time, making me realize that all the other times had actually felt real.

Then there were the Voices that harassed me continually. They yelled at me to kill myself, forbade me to buy even a coffee, and hissed at me if I dared talk to anyone. When these receded with medication, I later – when everything schizophrenic seemed out of focus – I attempted a third experiment: I tried to create Voices. I thought really hard but to no avail. All I could generate was the “little voice in my head” that everyone experiences from time to time.

Finally, convinced I was too smart to have schizophrenia (an idea of mine echoed by an arrogant psychiatrist), I fought to keep an A+ average at university. I earned prestigious scholarships (two NSERCs, a Michael Smith scholarship, and various others). That’s not something someone with schizophrenia does, right? No; there are other people with schizophrenia who attain graduate-level education. It is very hard, but it can be done, particularly when the person is stable on medication.

So a neuroscientist with schizophrenia. I tried so hard to prove I was immune to schizophrenia, but because of my experiments, I am convinced. It was a relief of sorts: an explanation, a treatment, a hope. It came to prove not that I didn’t have the disorder, but that I can live beyond it. For me, medication is key; taking it reliably, the master key. And I become a person with schizophrenia who is well.

This blog first appeared in Huffington Post on March 17, 2013. Erin Hawkes (now Erin Emiru) is the author of When Quietness Came: A Neuroscientist’s Personal Journey With Schizophrenia published by Bridgeross and available in print and e-book format.