Thursday, April 8, 2010

The fall-out from Dr. Nancy C. Andreasen's bombshell

From an interview with well-known neuroscientist and psychiatrist Dr. Nancy Andreasen which appeared in Sept. 2009 in the New York Times:

Q. AND WHAT HAVE YOU FOUND?

A. I haven’t published this yet. But I have spoken about it in public lectures. The big finding is that people with schizophrenia are losing brain tissue at a more rapid rate than healthy people of comparable age. Some are losing as much as 1 percent per year. That’s an awful lot over an 18-year period. And then we’re trying to figure out why. Another thing we’ve discovered is that the more drugs you’ve been given, the more brain tissue you lose.

Q. WHAT EACTLY DO THESE DRUGS DO?

A. They block basal ganglia activity. The prefrontal cortex doesn't get the input it needs and is being shut down by drugs. That reduces the psychotic symptoms. It also causes the prefrontal cortex to slowly atrophy.

Q. WHAT ARE THE POLICY IMPLICATIONS OF THIS FINDING?

A. Implication 1: that these drugs have to be used at the lowest possible dose, which often doesn’t happen now. There’s huge economic pressure to medicate patients very rapidly and to get them out of the hospital right away. Implication 2: we need to find other drugs that work on other systems and parts of the brain. Implication 3: whatever medications we use need to be combined with more nonmedication-oriented treatments, like cognitive or social therapies.


Where do we go from here? Dr. Andreasen, by her own admission, sat on her findings for two years. Findings, might I add, the substance of which consumers have been complaining about for years. Our opinion, of course, is considered "anecdote" by people smarter than we are, such as Dr. Andreasen. I can quibble about her findings, because there is also something called the "plastic brain" which is a concept that wasn't in much vogue a decade ago. The plastic brain, unlike the brain set in concrete, is adaptive and will find solutions and neuronal pathways around problems.

If Dr. Andreasen's research will stick for the next decade or so until it is overthrown by yet another biochemical explanation for mental illness, then the service she has provided is that she has armed you with "scientific information" from a well-know U.S. researcher that you can take to your doctor and demand either no drugs and better alternative treatments to help you through this, or else medications only for the period of crisis and in low doses.

The Bonkers Institute for Nearly Genuine Resarch provides a look at the drug-addled schizophrenic brain. Before you feel like ending it all when you see this image, keep in mind that the brain is plastic and that science is unreliable.

4 comments:

  1. So far, it doesn't look like the bombshell has had any further impact. I've had consumers reply to me, after I'd referenced this research, that this certainly was a mistake, "bad science", and/or that they'd only believe it, if their own shrink told them it was true - which is an understandable defence mechanism, especially when someone's been on these drugs for a decade+. On the other hand, I see the "experts" continue to talk about the brain-damaging effects of "psychosis", and about "schizophrenia" to be an illness that, if untreated (with drugs, of course), has your brain functioning, especially cognition, deteriorate, and that shrinks your brain. So, hardly any chance that the "expert" will confirm the consumer of this research to be trustworthy.

    I think, I've mentioned it before: Almost three decades of untreated (=undrugged) crisis on/off haven't done any damage to my brain, unless you regard increased intensity from crisis to crisis a sign of brain damage, and not of a brain that is perfectly well-responding to the unconscious' need to make itself heard...

    I can imagine the "experts' " (and society's) argument if ever this research is acknowledged in a broader sense: Oh, but the illness is so much more horrible than a little brain shrinkage! These drugs save lives!" There's, as far as I know, one person here in Denmark, who filed a complaint about Zyprexa, which had given him diabetes. The complaint was dismissed. If you suffer from an illness like "schizophrenia", you have to live with a side effect like diabetes, the Danish Patients' Complaint Board explained its decision. The person in question died a few months later. He didn't die from "schizophrenia". He died from complications of diabetes.

    And btw, Nancy C. Andreasen mentions it herself in the interview: What we really need is not a paradigm shift, but new drugs, that, hopefully, don't have this "side" effect. Never mind that there's no way of predicting what kind of side effects the new wonder drugs will turn out to have, and that, actually, it is unlikely that any substance will come into consideration that doesn't shrink the brain, sooner or later, more or less, as it's not a side effect, but the effect.

    ReplyDelete
  2. I am very skeptical of the damaged brain argument, even when people wave so called "proof" in my face. I mean, come on, if someone wants to measure my brain activity when I am thinking about sex (which is very little these days), my brain is going to look different, too. Dr. Andreasen is like the rest of them who think that a new drug is going to solve the problem, while completely overlooking the fact that it will only create a different and possibly more sinister problem (it that is possible).

    ReplyDelete
  3. I have a problem with what Nancy Andreasen calls her policy implications. Lowering the dosage certainly wouldn't hurt while using some of these drugs heavily certainly does hurt. Developing other drugs that effect different areas of the brain...? Isn't that how we came to this pass in the first place? Then she goes onto suggest drug treatment in combination with non-drug treatment. I don't think anybody should be given these harmful drugs against their will and wishes. I also think we need to be even more innovative, and look into treatments that don't involve using drugs. (These are drugs, before you call them them medication, look at what she says they do, and tell me how the heck what they do relates to medicine!?) The search-for-the-perfect-drug kick Dr. Andreasen is on resembles the same type of thinking that keeps these dangerious drugs, and the companies behind them, going.

    ReplyDelete
  4. Whatever happened to Carl Jung (or even Sigmund Freud)? Scratch beneath the surface of most psychiatrists these days and it's only about finding the "right" drug. Consumers are rarely consulted about what is best for them.

    ReplyDelete

I am no longer approving comments. All I ask is that you be respectful of others and refrain from using profanity.