RxISK

Making Medicines Safer for All of Us

Challenging My Doctor to Disclose

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This recently published US strategy on Suicide Prevention epitomizes all that is going wrong in medicine today. It is stuffed full of references to Shared Decision Making, Informed Consent and Lived Experience. Stuffed full of token words, window-dressing, tick-boxing.

It will increase rather than reduce suicide rates.

It is clear that the people behind this, and increasingly in charge of clinical medicine, do not want your Lived Experience if it includes the experience of harms on meds.  They do not what your involvement in Shared Decision Making if your priorities lie anywhere other than in taking more and more meds.

We, on the receiving end of this brutality, plead for Informed Consent.  Informed Consent is not the answer it once was. Doctors readily hand out lists of possible effects on meds but view these as someone with a serious nut allergy views May Contain Nuts labels. (Footnote).

In practice lists of side effects and even Black Box Warnings are nothing anyone pays heed to – these are viewed as companies and regulators covering their backs.

Anyone reading this. who has had a bad experience on any kind of prescription medicine, knows, although maybe hasn’t put it in words, that we need a drastic change from current arrangements.  We need to switch from what gets called Informed Consent to what this post is calling Disclosure.

You the reader may have a better word than Disclosure.  The need is something that establishes whether our Doctor has Skin in the Game, which Informed Consent forms don’t tell us.

This post maps out the current Status Quo and the Background that has brought us to this position. It then offers two versions of a series of points that need to be put to your doctor seeking a Disclosure from them.

Why do you need it?  In the immortal words of L’Oreal advertising – ‘Because You’re Worth It’.

The Status Quo

Your doctor, provider, prescriber likely appears pleasant and helpful. Services everywhere increasingly endorse Shared Decision Making, Informed Consent and the need to take Lived Experience into account and encourage healthcare staff to be pleasant and wish you a nice day.

Informing you about medicines means telling you what the scientific literature says. Rational people are expected to consent to treatment in line with this literature, embodied in what gets called Guidelines or Standards of Care.

Asking your doctor to deviate from a Standard of Care and support your perception that a treatment has harmed you, however, can trigger a transition from pleasant to nasty. Sensing this might happen, many of us say nothing.

RxISK created RxISK reports to try and make this easier by giving you a report to bring to your doctor showing a score supporting your hunch there is a basis to your view you are suffering an adverse event – see Getting Engaged to a Doctor.

The hope was this would level the playing field.  Thousands of people have filled these reports. This informs them which is great.  It has also led to lots of articles on problems drugs cause that you have helped put on the map.  But very few folk have been brave enough to bring the report to their doctor and let us know what happened then.

The difficulty in engaging doctors has meant we have not been able to realize another RxISK hope which was to build a map of decent doctors. If we had been able to, or if we still can, get something like a Map going we might be able to nudge other doctors/prescribers down this siding with you path less travelled.

Why the problems?

When things go wrong, prescription-only medicines create a Stockholm Syndrome scenario. See Medical Kidnap and Better to Die RxISKing it.  In Stockholm Syndrome, the last thing we want to do is annoy our captor, the person who controls our exit from the tricky and maybe dangerous situation we now find ourselves in.

What most of us fail to realise is that it is not only those of us harmed by a medicine who are in this situation – our doctor/captor is also.  There are snipers on the roofs of all the surrounding buildings ready to pick him/her off if s/he shows any signs of deviating from the script written for her/him.  S/he has no incentive to take our side.

Prescription-only creates an arranged marriage. Our Systems, as in the Suicide Strategy above, pay lip service to the need for a decent relationship, which should reduce the risk of Infidelity. With normal infidelity, it is more difficult to repair things after the event. Prescription only makes our doctors more police than healers and like police they are even less likely to feel the need to ask either for permission beforehand or forgiveness afterwards.

This disclosure form aims at supporting a Relationship Based Medicine rather than what is often termed Evidence Based Medicine.

Some points to bear in mind:

  • Many doctors know, on some level, they are as trapped as you by factors outlined below.  Most of them are just like most of us – inherently decent.  If things go wrong the issues are likely to be system issues best tackled by you and them working together.
  • If the drugs are as safe and effective as they and you are being told, who needs expensive prescribers like doctors? Rather than challenging them, this offers a chance to call on them to save their jobs by agreeing medicines are risky and good care needs a skilled physician made of the right stuff to manage these risks.
  • We and our doctors both over-estimate treatment benefits. This is partly because endless media propaganda suggests doctors can fix anything.  A recent boss of a major medicines safety body, who should have known better, thinks doctors can even convert men into women and vice versa – without anything going wrong.  If someone like this can think this, it is no surprise many of us think so too and end up pushing doctors to fix us. We can be part of the problem.
  • It’s a terrible wake-up moment – and start of a nightmare – when things go wrong transitioning or whatever and the System completely denies that anything it has done has caused the problem
  • Both doctors and patients these days are strangely inclined to view bureaucrats (FDA/EMA etc) as God when in fact these bureaucrats have no training in how to establish whether a drug can harm and do not get involved.  In practice, this means the bureaucrats take the company side.
  • Nine out of Ten drugs doctors prescribe are for mild conditions or risk factors. You are not going to have a heart attack or stroke if you don’t take a statin, even if your cholesterol is high, or commit suicide if you don’t take an antidepressant, even if your depression rating score is high.
  • Companies scaremonger to get you on meds. The scares are mythical and we desperately need more ordinary folk and doctors to stand up to this bullying.
  • Doctors are often incentivized by the companies they work for to get you on meds they would not take themselves.
  • If your antennae detect other people in the room besides you and your doctor, you are almost certainly right – see Strangers in the Room and Potentially Inappropriate Deprescribing.

Background

Both street drugs and prescription medicines are unavoidably hazardous chemicals. The quality of the information that comes with prescription medicines is supposed to transform these chemicals into medicines.

Until 30 years ago this information stemmed primarily from medical and patient experience, reported in medical journals or in Drugs Bulletins.  But for over 2 decades, we and our doctors have been Cancelled.

Companies and medical bodies claim the only valid information on drugs comes from studies usually called Randomized Controlled Trials (RCTs).

The studies on prescription medicines are run almost entirely by companies.  They are not RCTs designed to inform clinical practice.

Company studies are better termed Randomized Controlled Assays (RCAs).  They are designed to obtain a license to make a product claim – this drug is an antidepressant or anti-diabetic.

RCAs are designed to demonstrate a change that allows bureaucrats (FDA/EMA) to license a claim about one effect your drug has on average ignoring hundreds of other effects it has. They are not designed to map the range of problems your drug can cause. In these assays, serious problems that occur more often than the effect companies call a benefit commonly disappear.

Companies write the labels and patient information sheets and pretty well every other bit of the information on their drugs, either directly or indirectly and in so doing they make every effort to avoid deterring you from seeking the ’benefit’ that keeps them healthy but may kill or injure you.

Almost no RCAs submitted to regulators show a drug works in the sense of saving lives.  The ‘benefit’ is usually a change in some blood value or on some rating scale.  More people are injured or die in these studies than truly benefit.

Yes you read that right.  If you want to know more – the academic version is Randomized Controlled Assays – the less referenced version is in Health’s Illusions I Recall.

RCAs will often appear to be written by distinguished academics from the best universities but are in fact written by ghostwriters. Studies with negative results in which serious injuries have occurred on treatment regularly claim the drug worked and was safe. These adverts are published in leading medical journals – they are worthless to companies unless they appear in the best journals.

Journal editors and FDA often know the write up is Fake but say nothing. Why? Because neither view it as their job to say anything.  Whose job is it?  The medical profession should clear up this mess but doctors have gone missing in action – especially medical journals run by professional medical bodies like the British Medical Association or the Massachusetts’s Medical Society – see Silencing Doctors and Vampire Medicines.

Guideline making bodies proudly proclaim that the standards of care they put in place are based on the best evidence – on RCTs. The Guidelines for Prescription Drugs are based on RCAs.

Because doctors prescribe, they are the consumers, the people who buy the drug. The rest of us swallow as ordered rather than make a balanced consumer decision. Vast amounts of money are put into shaping medical minds and companies view doctors as rarely having a thought in their heads not put there by them or a competing company.

There may be the occasional doctor capable of grasping this reality but as with Sodom and Gomorrah – it would be difficult for Lot to find 10 who do – see If I Find You Ten Just Doctors..

This puts doctors in a state of moral hazard. They do not suffer the adverse effects of drugs they ‘consume’. They risk censure from their colleagues or management if they warn us about hazards or agree with us about a harm. There are no incentives for them to warn or support us.

Soldiers in the military injured by vaccines, drugs like Lariam and other drugs, facing medical and military denial of their injuries, created a marvellous term to cover this – Sanctuary Trauma.

Fifty years ago, most medical care was acute medical care with a doctor or hospital responding to an acute medical problem we brought to them.  Now 90% of medical input comes from services reaching out to us and giving us problems we didn’t know we had, mostly don’t need to know we have, and, even if we perhaps should know about it, treatment may not be needed.

As a result of this, Prescription Drugs are now the leading cause of disability and death. The risks are growing as we consume ever more of them, an increasing number of which may be difficult to stop, but we never get told about Symptoms on Stopping (SoS).

As a result of this, we have a Polypharmacy Pandemic which is leading to falls in Life Expectancy and Reproductive Replacement Rates across the Developed World.

The incentives need to change.

Disclosure

Informing me with May Contain Nuts lists of problems and assuming if I go ahead with treatment that I  have Consented is no longer good enough.  Like everyone else I know, I never read lengthy Terms and Conditions statements – life would cease if we read these.

What I need to know is how my doctor is likely to react when his/her Skin is in the Game – when I have a problem on treatment .

As a patient I need to know my doctor’s:

  • Willingness to prioritize my welfare.
  • Willingness to acknowledge that neither they nor I are being told the truth about prescription medicines.
  • Willingness to accept I am likely to be correct if I report problems happening to me – even if these are not in the drug’s label.
  • Sources of information on prescription medicines. If they express confidence in the medical literature or guidelines, even if they otherwise appear decent I need to avoid or beware of them.
  • Views on the role of their clinical experience in shaping their view of a drug. Unless they outright say the best information they have on meds comes from people they have seen harmed by them, they are unlikely to agree I am having the problems I know I am having.
  • Willingness to agree that many medicines, not just psychotropic drugs, can produce effects after stopping that may be severe and long-lasting.
  • Views on what to do if I don’t respond to a first antihypertensive, hypoglycemic, antidepressant or whatever, they put me on.  I don’t want a doctor who will raise the dose of the drug, or add another medicine. I want one who will stop the treatment and after a pause will discuss with me whether a trial of something entirely different is warranted (a different therapeutic principle).

Science recognizes individuality. I am likely to be quite different to the last case of whatever my doctor has seen. A reasonable doctor should agree that:

  • I am in a privileged position to comment on a drug’s effects on me.
  • The scientific approach to the effects a drug is having on me is for us to come to a consensus as to what is happening me.
  • It is a religious and not a scientific approach to quote the medical literature or guidelines at me when we are attempting to establish what is happening me on a treatment.
  • If I suffer injuries from a treatment I’ve been put on and need to be hospitalized as a result, this is a medical failure that needs recognition as a failure if we are to move forward with decency.
  • I need to know my doctor can recognize drug toxicity and recognize that it is common.
  • I need a doctor who accepts that stopping a medicine is the best way to manage toxicity.
  • I need to know my doctor agrees that a diagnosis of a functional neurological disorder (FND) or any functional disorder is rarely if ever appropriate and should never be made if there is a possibility that the problem is a drug induced problem.
  • If after a frank conversation about what is happening me, my doctor and I disagree, s/he will not detain me in hospital because of my supposed crazy or somatizing views and will not enter phrases such as ‘lack of insight’ in my medical records.

Benefit-Risk

When it comes to making a Benefit-Risk determination, only I can make it. For example OCD can respond to an SSRI or to Nicotine/Smoking.  Some people will get a distinct benefit from Nicotine but not from an SSRI.  We all know what the long-term hazards of Nicotine are. No one researches the long term hazards of psychotropic drugs, but we know antipsychotics shorten lives more than Nicotine.

If I benefit from Nicotine for OCD, but not from an SSRI, I are best placed to decide if this benefit warrants the risks?

Third Parties

Some drugs like SSRIs pose a risk to others who are not on them. They may trigger homicide or change my personality in a way that leads to marriage break-up.

Ozempic and related drugs, SSRIs, isotretinoin, finasteride and a growing number of medicines can kill libido. This may be an issue for both me and my partner.

Many of these drugs can also affect fertility – wiping out my sperm counts if I am male. Such effects are an issue for the entire country.

None of this gets talked about.

The landscape of third party issues needs rethinking.  We may need to discuss including my family in any conversations.  For instance most SSRI drugs instantly numb the genitals of most people – does this need to be discussed with parents before starting treatment in teenagers, who may find it embarrassing to mention to parents and may be scared by what they find on the internet?

Many of our treatments, not just psychotropic drugs can produce significant personality changes that do not show up in a 5 or 10 minute clinic visit.  Disinhibition may give a doctor a seriously misleading impression.

Keeping me and others safe may require an outreach to my family or others. I may not want any concern for my privacy to cause me to lose my marriage or my job.

Footnotes

Thanks to Dee for the May Contain Nuts idea

These are not new issues – there is a RxISK post from a decade ago – Getting Engaged to a Doctor. The idea of switching from Informed Consent to Disclosure is new and came from Johanna.

Commitment

Harriet had a big input to this draft and generated this Commitment Card

I want to work on my health in an equal, collaborative relationship with my doctor.

Before we commit to working together, I’d like check if we are a match by getting your answers to the following questions/statements. Please answer honestly. If we don’t fit, it’s better we end the relationship before it begins.

  1. My perceptions of what I am experiencing, including the effects of medication, are and will be the primary source of knowledge in our relationship.
  2. Where might your clinical experience map onto my personal experience of my health and reactions to treatment?
  3. Where do company studies fit into our relationship?
  4. Where do guidelines fit into our relationship?
  5. Do you agree all prescription medicines are poisons and our challenge is to bring good out of their use.
  6. Doctors commonly misdiagnose toxic reactions to drugs as relapse or a new condition – do you?
  7. Do you agree that treating a toxic reaction with pills or labelling it with a diagnosis other than drug toxicity – a diagnosis like FND – is not helpful.
  8. Do you agree drugs can cause problems long after they have left our system.
  9. If I decide against taking a treatment you recommend, will you respect my decision, even if you believe that I am exposing myself to greater risk by refusing your recommendation.
  10. Your role is to help me live the life I want to live not to get me to live the life you or others might think I should live.
  11. You will give me a copy of every entry you make in my records.

Challenging the Media to Disclose

In the comments below – go down to comments 23-24 – Peter Selley introduced new angle which deserves and will get a post in its own right – Challenging the Media to Disclose.

The need to Challenge the Media – very obvious once it is articulated – stemmed from an article on Excess Mortality during the Pandemic period.

 

 

Reader Interactions

Comments

  1. This Segment covers Disclosure, May Contain Nuts, Stockholm Syndrome

    Challenging This Doctor to Disclose

    Harriet –

    8. Do you agree drugs can cause problems long after they have left our system.

    Question:

    Wendy Burn CBE (She/her)
    @wendyburn

    Does anyone know what happens if someone on an SSRI experiences genital numbness and stops the SSRI immediately? Does it resolve? Or still go on to #PSSD?

    Answers:

    https://x.com/wendyburn/status/1797360756763070757

    Wendy Burn CBE (She/her)@wendyburn

    I’m sorry.

    Wendy Burn CBE (She/her)@wendyburn

    Awful. I hope they can find some way of helping.

    Wendy Burn CBE (She/her)@wendyburn

    At least they are trying.

    Wendy Burn CBE (She/her)@wendyburn

    Sorry to hear this.

    Wendy Burn CBE (She/her)@wendyburn

    I would like to know if stopping immediately helps but sounds as if it doesn’t.

    Wendy Burn CBE (She/her)@wendyburn

    I’ve seen lots of people with sexual dysfunction on antidepressants and as you say it resolves when they are stopped. PSSD seems different and is associated with genital numbness.

    Wendy Burn CBE (She/her)@wendyburn

    No drug is safe and many side-effects only emerge when lots of people are taking them.

    Wendy Burn CBE (She/her)@wendyburn

    It has been suggested that it may be the action of SSRIs at sodium channels in the cell membrane. Same thing reported with finasteride and isotretinoin.

    IASP.org.uk | Iatrogenic Suicide Prevention
    @IASPorguk

    You ignored PSSD and did nothing to address it during your entire tenure @rcpsych

    Wake up Wendy, you should be the expert.

    Reply

    • It would be laughable if it were not so serious.

      Yesterday I attended a funeral and took the opportunity – when asked how I am – to mention if anyone had heard the word akathisia – no one had. As time went on I got the feeling this akathisia stuff I was going on about maybe a sign I was getting unwell again – I was invited to a relatives home “anytime” as if I need – if not to be looked after – an eye kept on me to make sure I stay normal.

      Reply

      • I was very lucky in that my partner, ex partner because of Seroxat, used to bring home piles of books from a Paisley library. Long in to the night we would be reading Scott and Cherry-Gerrard, the stories of the South Pole expeditions. Our little child became an avid reader, her father introduced me to hundreds of books, and as a Canadian, his choices, always gave me a thrill, his life was thrilling in itself flying all over the world, I always thought he was awesome.

        We had twenty years of excitement – an airline in Hong Kong, our and his Canadian parental visits, a home in Scotland, a big Labrador, a big boat, and a child.

        When the whole Seroxat thing, lasting a few years, put us under such extreme pressure that my entire life was turned upside-down, it significantly affected every single relationship in my life, from my partner to my friends, to my very elderly mother and most disastrously to our child.
        If only my dad has been alive, he was most astute.

        The wrecking bowl of the doctors, nurses and a psychiatrist, was not laudable.

        After life completely disintegrated, the hardest part, without question, was trying to put a lid on it.
        I could not, would not, draw attention to myself.

        That was the worst journey in the world –

        The Worst Journey in the World is a 1922 memoir by Apsley Cherry-Garrard of Robert Falcon Scott’s Terra Nova expedition to the South Pole in 1910–1913. It has earned wide praise for its frank treatment of the difficulties of the expedition, the causes of its disastrous outcome, and the meaning of human suffering under extreme conditions.

        Reply

        • “We had twenty years of excitement – an airline in Hong Kong, our and his Canadian parental visits, a home in Scotland, a big Labrador, a big boat, and a child.”

          Quite something Annie. It must have been horrific and very scary to then get akathisia as a result of some ignorant bully, drug fraud, gas lighting psych, the imbalance of power abuse and then to leave you changed forever. But my words do not anywhere near the reality and injustice. We are just two, imagine how many thousands who had have no idea what happened.

          Reply

  2. I belong to several statin skeptic groups of Facebook. People are always posting things like this:

    “I took a statin and I experienced dreadful toxic reactions, and so I stopped taking it. Now how do I lower my cholesterol?”

    Let’s see now. You took a drug to shut down an essential metabolic pathway, and you experienced dreadful toxic reactions. So why do you still think shutting down this pathway is a good idea?

    Reply

  3. PETER HITCHENS: The obsession with ADHD has led to a growing drug crisis in which normal human behaviour now has to be treated by pills

    https://www.dailymail.co.uk/news/article-13498551/obsession-ADHD-growing-drug-crisis-normal-human-behaviour-treated-pills.html

    Are we drugging ourselves out of our right minds? Our age has seen many miracle drugs turn out to be flops at best and disasters at worst.

    And if anyone doubts it, they should watch the BBC’s searing drama-documentary Dopesick about the OxyContin painkiller frenzy in the U.S.

    That pill was ruthlessly marketed as a harmless but mighty breakthrough in the treatment of pain. But it was horribly overprescribed until it was killing its users and ­ruining lives by the thousand.

    I think we may be facing another damaging pill crisis. And it is to do with the medications prescribed for attention deficit hyperactivity ­disorder (ADHD), a complaint that has grown

    in extent like a mushroom cloud over the past few decades.

    To see the problem, you don’t even have to share my suspicions about ADHD. Once, we smacked troublesome children, and everyone thought it was normal. Now we view that with horror and shame.

    Instead, we drug the young with powerful mind-altering chemicals, and almost everyone thinks that this is normal and right.

    These days, saying that any ­problem is linked to ‘mental health’ will usually cause almost all heads to nod in agreement. Taking potent drugs is ‘neurodiversity’ so you can’t criticise it.

    That is bad enough. But now the belief that normal human behaviour can, and should, be controlled by pills has spread to include adults.

    In the U.S., adult ADHD diagnoses have overtaken those among ­children. A huge black market in ADHD drugs has developed, just as the pills have grown harder to obtain legally.

    It is not so bad here yet, but it is getting rapidly worse. The Nuffield Trust think-tank recently warned that demand for ADHD assessments is increasing so fast that the NHS can’t keep up.

    This adult ADHD is different from the childhood version. Generally, children are said to have the ­condition because parents and teachers judge the child’s behaviour to be a problem. This means adults can stop worrying that the bad behaviour might be their fault. But for those over 16, a diagnosis can lead to generous welfare handouts.

    As Dr Max Pemberton has pointed out in The Mail on Sunday, Personal Independence Payments worth nearly £300 million each year are now going to people diagnosed with ADHD (the ­families of those under 16 get a different form of support).

    Whatever the reason, adults nowadays increasingly choose to seek an ADHD diagnosis themselves, and in such growing numbers that there is now a shortage of ADHD pills in the UK.

    Last year, the BBC’s Panorama found that some private doctors in this country were rather worryingly flexible about their ADHD diagnoses. In one private clinic, staff examined the would-be patient (an undercover BBC reporter) online. They concluded that he had the condition. Alas for them, an NHS psychiatrist, after a lengthy in-person examination, had determined that he did not suffer from it.

    It seems likely that quite a few people have worked out that, by going private, they can get ADHD drugs.

    Why is this? In some cases those involved think a diagnosis, and the drug that goes with it, actually help them to live better.

    Recently, one such adult went very public.

    The Times told the story of a London woman in her 50s who believes she has adult ADHD and wants to take drugs for it. But that’s a tiny part of her story. She openly admits she has illicitly obtained Concerta tablets, which are normally available only on prescription.

    She explains that she has done this because she thinks she has a ‘scattered and chaotic mind’. This is beautifully expressed but plenty of us could surely say this of ourselves, from time to time.

    She recounts that, ‘The first time I felt the effects of the dinky, pale blue cylindrical pill containing the stimulant compound methylphenidate, I knew this could be life-changing for me. I could see efficiency with work, money, time-keeping and the dreaded life admin improving.’

    Well, that is what she says, and it is not especially surprising. Concerta, though not an actual amphetamine, is very similar to amphetamines. And amphetamines are famous for making their users feel good — to start with, anyway.

    Drugs of this kind are notorious both as pleasure-enhancers and as ways of overcoming tiredness and accomplishing hard, dull tasks.

    They were widely used in World War II by soldiers on both sides, trying to stay alert. They have long been taken by students struggling through tough exams.

    The trouble is, they are rather bad for you, physically and ­mentally, as well as being habit-forming. The common side-effects of Concerta are nervousness, trouble sleeping, loss of appetite, weight loss, dizziness, nausea, vomiting or headache.

    Amphetamines have, for many years, been illegal or heavily regulated in many countries.

    They are listed as Class B here, which means you can, in theory, go to prison for five years for possessing them illegally.

    This is because of their damaging long-term effects. Japan is especially strict, following a ­serious post-war crisis, in which mass use of these drugs during the war and the American ­occupation was linked with ­delinquency and crime.

    Their legal use as medicine has led to their illegal use as pleasure drugs. In the U.S. it is quite common for ADHD drugs to be sold on the black market for ‘recreational’ use, in which they are crushed, snorted, injected or smoked by people in search of a high.

    So what are we to make of ADHD Woman’s breezy admission that she had obtained these tablets illegally?

    It’s pretty unlikely that the police will call, but shouldn’t we be worried anyway? She says: ‘I’d acquired the pills via a friend who has them prescribed by a private doctor for her child. She gave me a few as an act of kindness and I couldn’t ask again. This little exchange was, of course, illegal.’

    But the confession doesn’t end there. She has now found a new supply, but this time it is Dexedrine (once again originally supplied to treat a friend’s child).

    This drug was the favourite of the dissolute journalist Hunter S. Thompson, until he later switched to cocaine, on his long road to self-destruction.

    Once again, it has severe side-effects, and it is widely abused by people who do not have prescriptions for it. But, amazingly, we now give Dexedrine to schoolchildren. Users of Concerta may be alarmed to learn from ADHD Woman that it is more potent than the notorious Dexedrine.

    As she puts it: ‘It’s a bit milder than Concerta and the effects don’t last as long. The result is more or less the same, though. I get stuff done. My mind is clear; I stop thinking so much.’

    But she is still thinking about the drugs. She cannot face going on the dark web for more. Instead, she has heard about a ‘dodgy pharmacist’ who sells prescription drugs under the counter.

    Whatever has happened to us, that educated, professional adults are openly talking about illicit drug-taking as if it were somehow normal, acceptable and right? She says she really wants to be told: ‘It’s not your fault’.

    Isn’t that the problem? Drugs lift the burden of responsibility from our backs, but they exact a price. They persuade us that we no longer have the free will to choose.

    It is that devil’s bargain that turned OxyContin into a national disaster of crime and misery.

    Could ADHD be leading us, by a longer and prettier route, to a similar destination?

    Reply

  4. Not so ‘Gratifying’

    Mark Horowitz
    @markhoro

    Review on antidepressant (AD) withdrawal in @lancetpsychiatry is misleading in several ways and and should not be seen as ‘gratifying’ as it underestimates the risk of withdrawal by focusing on short term industry trials

    http://bit.ly/3yQmSw9 http://bit.ly/4b5YELT 1/n

    Thread

    21/n

    https://x.com/markhoro/status/1798485359417847937

    Antidepressant withdrawal symptoms experienced by 15% of users, study finds

    https://www.theguardian.com/society/article/2024/jun/05/antidepressant-withdrawal-symptoms-experienced-by-15-of-users-study-finds

    Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis

    https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00133-0/fulltext

    expert reaction to systematic review and meta-analysis of discontinuation symptoms after stopping antidepressants

    A study published in The Lancet Psychiatry looks at antidepressant discontinuation symptoms.

    https://www.sciencemediacentre.org/expert-reaction-to-systematic-review-and-meta-analysis-of-discontinuation-symptoms-after-stopping-antidepressants/

    Antidepressant withdrawal affects one in six people

    BBC News

    https://www.bbc.co.uk/news/articles/c3ggv7zvzw3o

    One out of every six people have symptoms when they stop taking antidepressants – fewer than previously thought, a review of previous studies suggests.

    The researchers say their findings will help inform doctors and patients “without causing undue alarm”.

    ‘High risk’

    Consultant psychiatrist and fellow of the Royal College of Psychiatrists Dr Paul Keedwell said people planning to stop their medication should always seek medical advice.

    “Firstly, depending on your mental-health history, there might be a high risk of relapse of
    your depression,” he said.

    “Sometimes a relapse of depression can be confused with withdrawal symptoms.

    “Secondly, unpleasant withdrawal symptoms can be largely prevented with proper medical supervision.

    “It is important to say that withdrawal symptoms are not dangerous and the risk of experiencing them at some future date should not be a reason for refusing antidepressant treatment.

    “The pros and cons of treatment should always be discussed with your doctor.”

    Reply

    • Mark H is absolutely right on the above point. Some withdrawal problems are likely universal on these drugs. Significant withdrawal problems almost certainly affect more than half of those on treatment. Enduring effects of one sort or another affect a very large number of people also.

      D

      Reply

      • I have problems with temperature change from cool to hot, is this also an issue being I did not have this problem before psych drugs. It has become such an issue I have had to buy an expensive air conditioner and ultra quiet DC motor fans.

        Reply

        • Chris

          Yes in all likelihood this temperature dysregulation is linked to your prior treatment. I hope to get a lecture I gave two weeks ago up on the system next week which might explain how this happens

          D

          Reply

          • Even though our Kidnapped Daughter has been off all the forced and unnecessary psychotropic drugs for some 11 years, her temperature regulation remains disabled.

            Inability to adjust to hot weather or a warm interior environment is one of many remaining iatrogenic injuries. Might this be hypothalamic damage?

            Looking forward to reading your lecture.

          • hello,
            I’ve gradually discontinued Seroquel, and the temperature sensitivity from
            cold to hot was unreal. It was also the same with sweating, my feet were sweating constantly, also while driving, my palms were wet.

    • ‘It is clear that the people behind this, and increasingly in charge of clinical medicine, do not want your Lived Experience if it includes the experience of harms on meds. They do not what your involvement in Shared Decision Making if your priorities lie anywhere other than in taking more and more meds.’

      No clearer demonstration of this than the self-serving antics of Psychiatry Inc. this week – vis-à-vis the lead product in their brand portfolio, antidepressants.

      First off, the methodologically flawed and financially conflicted tosh Annie pounced on – a flagrant attempt to minimise associations of dependence and withdrawal with antidepressants.

      Only Tony Kendrick had the integrity to point out the methodological undoings of the research: trial duration 12 weeks or less in 36/79 studies, efficacy not ‘discontinuation’ studies that happened to observe patients in end of trial wash-out period. And NO PATIENT REPRESENTATION.

      https://www.sciencemediacentre.org/expert-reaction-to-systematic-review-and-meta-analysis-of-discontinuation-symptoms-after-stopping-antidepressants/

      Just when you thought this shameless manipulation couldn’t get any worse, along comes Carmine Pariante, claiming, ‘The myth that antidepressants are addictive has been debunked – they are a vital tool in psychiatry’. Yes, the Guardian – again.
      https://www.theguardian.com/commentisfree/article/2024/jun/08/antidepressants-addictive-has-been-debunked-psychiatry-depression-withhdrawal-symptoms

      Um, Carmine old chap, there never was a myth that antidepressants are addictive. We see you – peekaboo – rewriting history to subvert a truth – antidepressants cause dependence and withdrawal. They are naughty drugs. Viz this from D:

      In the 1980s, prior to marketing, healthy volunteers in phase 1 studies of SSRIs, however, had become dependent on SSRIs and were left anxious and depressed afterwards.8 Within three years of paroxetine being on the market, there were more reports in Britain about dependence on it than there had been in 20 years from all benzodiazepines combined 9’.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160790/

      So the question is what are they up to? Or, to adapt the words of Louis Heren (former Deputy Editor of the Times), a line misattributed to Jeremy Paxman, ‘Why are the bastards lying to me’.

      My guess, given the timing, is that this is an obvious corporate drive for funding from the next government. To use a D-word, they are endeavouring to SANCTIFY antidepressants, the lead product (even though mostly rx by primary care) in their brand portfolio, to look like a valuable investment.

      Never more have patients needed FULL DISCLOSURE AND COMMITMENT to be safe. Truth is – most patients don’t even know they need it.

      Reply

  6. Assisted suicide for people suffering from so-called “mental illness” is back in the news.

    https://www.telegraph.co.uk/news/2024/06/08/dutch-euthanasia-healthy-children/?fbclid=IwZXh0bgNhZW0CMTEAAR1j9JAOetQqZ4IxcLVEsRuWFK4bYTudKA9krYLQ3jB9HXxsqegbBoI2j4w_aem_Adu_Zphlep39gGrXBCK8RZLaaqduEs4o0YWYb8ccLIHlfjRtS5G4-zzqvVRKnPSAodq3mRbBHYeoR1oGr5rw4uFc

    “Treatments including medication, therapy, intensive inpatient treatment and electroconvulsive therapy (ECT) failed. She is so numb from medication that she cannot do the things that used to bring her joy, such as take her children to the zoo, ride horses, or walk the family dog. Her world has been sapped of colour by her illness – either she is in a black hole of depression or a numb haze, dulled by medication, and everything is grey. ‘Most of the time, I feel flat,’ she says. She requested euthanasia in March this year.”

    You just said it yourself. The neurotoxins you are giving her have robbed her of the ability to feel joy. Of course she wants to kill herself.

    ““The years that followed were dominated by treatments, medication and hospital admissions,” she says. By the time she was 15, Milou was depressed, struggled seriously with self-harm, and was given a diagnosis of BPD, which manifests in emotional instability, impulsive behaviour and unstable relationships. (Her mother believes the diagnosis of BPD was inaccurate, and Milou was actually suffering from post-traumatic stress disorder.) During this period, she was sexually assaulted, which only came out when Milou was an inpatient in hospital.”

    We are a society that offers young girls who have been raped, in lieu of meaningful help, pills known to cause worsening depression and suicidality. Then, when they become depressed and suicidal, we offer them more pills, then more pills, and finally we offer them assisted suicide.
    This is monstrous.

    Reply

  7. Just the other day there was an essay in the Guardian which contained this pearl fo wisdom from prof. Carimine Pariante:

    “For those they do help, antidepressants undoubtedly improve depression and reduce the risk of suicide.”

    This is a breathtakingly mendacious statement. In trials bought and paid for by the drugmakers, MOST of the dead bodies are on the treatment arm. If so-called “antidepressants” are preventing suicide in some patients, they are causing suicide in a greater number of other patients.

    Reply

    • “It is not propaganda’s task to be intelligent, its task is to lead to success”.

      Joseph Goebbels. Reich Minister of Propaganda.

      Reply

      • Tim

        This is a fabulous quote. Goebbels has a lot of great quotes that makes you think he understood the business but this was one I had not heard before.

        I will be posting two lectures this week – one on DH called Truth, Trust and Health focusses on the role of the military in health, including health propaganda – the US military in particular who have managed to keep invisible by not having a Show Off like Goebbels tell people the secrets of the profession.

        David

        Reply

  8. Latching on to that old Chestnut ‘are addictive’ does not make for ‘Wise Counsel’ …

    “experience tells us that only a small minority of people experience disabling symptoms when they stop them. The largest ever study on the topic has confirmed this.”

    “should be reassured by the very low incidence of severe discontinuation symptoms.”

    Robert Howard
    @ProfRobHoward

    I’m with Carmine here and thank him for a balanced piece that will help people to make some sense of some of the noise about antidepressants. But, I imagine that some who adhere to what has become an increasingly polarised ideology, will have spluttered on their breakfast coffee.

    Robert Howard@ProfRobHoward12h

    Replying to @KenV54 @SameiHuda and 2 others

    The ANTLER trial showed what happens when you stop antidepressants. Most people do fine but patients more likely to become depressed again than if allowed to continue. The antis don’t like this study.

    https://nejm.org/doi/full/10.1056/NEJMoa2106356

    David Nutt@ProfDavidNutt

    now the correct analysis shows the hysteria about antidepressant addiction was unwarranted

    Push, Push, Push ……….

    https://x.com/ParianteLab

    Carmine M. Pariante@ParianteLabJun 8

    Replying to @wendyburn

    Thanks Wendy – the @rcpsych has always offered thorough clinical advice on how to stop antidepressants.

    Lade Smith CBE@DrLadeSmith

    Depression is life-changing and can be terminal. Fear of ADs may interfere with access to effective treatment. This is a MUST read.

    recovery&renewal reposted

    Dr John Read@ReadReadj Jun 9

    Are you serious? That is a blatant rewriting of history. Your shameless lies are embarrassing. But will make @rpsych and your drug company backers very happy.

    FACTS DO STILL MATTER.

    Reply

  9. It is now generally agreed that there has been excess mortality in most countries since Covid was contained and throughout the time of widespread vaccination to protect against it i.e. 2020 ,2021 ,2022.

    Apparently no body knows why. (?)

    Challenge your doctors and politicians to disclose.

    Reply

    • Peter is in part referring to

      Mostert S, Hoogland M, Huibers M, et al. Excess mortality across countries in the Western World since the COVID-19 pandemic: ‘Our
      World in Data’ estimates of January 2020 to December 2022. BMJ Public Health 2024;2:e000282. doi:10.1136/bmjph-2023-000282

      https://bmjpublichealth.bmj.com/content/2/1/e000282

      I was surprised to see this published in anything to do with BMJ. It took over 9 months from submission to publication – nearly as bad as Study 329.

      Pertinent to this thread – BMJ (not BMJ public health) had an important article on antidepressant withdrawal which they managed to block the publication of.

      The post is Challenging My Doctor to Disclose – We also need a Challenging My Media to Disclose. My media – yes well BMJ is supposedly owned by doctors through the BMA and should be disclosing why they publish and don’t publish certain things. Children of the Cure is one of the few books that takes you behind the scenes to show you what can go on in BMJ.

      This applies also to the G and NYT who will happily take Pariente style guff without questioning it but will not touch the possibility that there could be any problems with our drugs or vaccines – where is the coverage of this sensation Public Health article?

      The G and NYT and BBC need up front Disclosure. It could simply be: We will never publish anything on the adverse effects of drugs – as Richard Smith put in print to me 15 years ago when faced with damning Lilly documents about Prozac and suicide.

      There could be a degree of nuance added – like We believe in Numbers Based Medicine – anything else is misinformation – which we feel duty bound not to report.

      When it comes to health, the Daily Mail feels a lot more honest that the Guardian or NYT.

      Peter Selley’s comment is so important that I will also include a link to the article it hinges on at the bottom of the Challenging Post – itself under a Challenging the Media sub-heading

      D

      Reply

  10. Challenging the Media to Disclose –

    This is the first time the Daily Mail, have ‘closely mentioned’ Covid vaccines –
    Innocuous little sentence, mid–article

    ‘They cannot definitively rule out the Covid vaccines as playing a role, but believe the evidence supporting the virus theory to be much stronger.’

    Rare and ‘unusual’ cancers are emerging after the Covid pandemic – and doctors fear an unlikely culprit is to blame

    https://www.dailymail.co.uk/health/article-13502221/rare-cancers-covid-pandemic-effects-theory.html

    Nigel Farage@Nigel_FaragJun 5

    Today the Telegraph reported Covid vaccines may have helped fuel rise in excess deaths. At last others are waking up to the need for a full, immediate inquiry into vaccine harms.

    Nigel Farage@Nigel_FarageJan 11, 2023

    I have been highlighting “excess deaths” on my GB News show for some time now. We need a full public inquiry.

    Dr Aseem Malhotra@DrAseemMalhotraJun4

    BREAKING

    FRONT PAGE TELEGRAPH ‘

    Covid jab may have led to rise in excess deaths’ FINALLY mainstream media acknowledgement in U.K.

    We did it

    Covid vaccines may have helped fuel rise in excess deaths

    https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/

    Writing in the BMJ Public Health, the authors from Vrije Universiteit, Amsterdam, said: “Although Covid-19 vaccines were provided to guard civilians from suffering morbidity and mortality by the Covid-19 virus, suspected adverse events have been documented as well.

    Dr Aseem Malhotra@DrAseemMalhotraJun 6

    BREAKING :

    2 prominent BBC broadcast journalists contacted me in the past 24 hrs acknowledging that I was right with my concerns on the link between excess deaths and the covid jab

    Reply

  11. Today – Mark Steyn in court vs. Ofcom – hugely important

    Mark Steyn reposted

    Dr Naomi Wolf
    @naomirwolf

    Preparing to support @MarkSteynOnline tomorrow at his Royal Court hearing against @Ofcom . One basis of @OfCom ’s action against him (there are two shows at issue) is that the facts I presented that our experts surfaced from the Pfizer documents, cause ‘harm’. Sadly for the UK, much of the world has found out what
    @OfCom still seeks to suppress.

    @guardian @Telegraph @DailyMailUK

    will you be there tomorrow at 10:30 am? Matter of great public interest.

    Mark Steyn
    @MarkSteynOnline

    …it seems faintly absurd that it is necessary to litigate this matter at all. The official narrative enforced by @Ofcom – that the vaccines are 100 per cent “safe and effective” – is now obsolete and indefensible; the principal British vaccine has been withdrawn worldwide; and

    https://x.com/MarkSteynOnline

    See you in court! Mark Steyn bites back at Ofcom

    By Kathy Gyngell
    https://www.conservativewoman.co.uk/see-you-in-court-mark-steyn-bites-back-at-ofcom/

    You really couldn’t make it up, could you?

    What of their duty to ensure that audiences are not ‘materially misled’ by government/official statistics and evidence? What pit of lies did that disappear down? What of the material claims parroted by the broadcast media on the 500,000 Covid death projections (not true), on vaccine safety (not true), on informed consent (not true), and very specifically on the BBC’s repeated all-clear vaccine safety reassurance for pregnant women? Mark has his own devastating examples below. In fact the examples are so numerous and so routine they would risk overwhelming a proper commission of inquiry.

    Read Kathy’s, punch-by-punch, account…

    Reply

  12. Thank you for sharing this. It needs to be widely read: by both lay and professional folk.

    UK psychiatry seems to have become ever more defensive. The defensive behaviour has reached the level where patients [or former patients] who dare to mention any harmful effects of interventions are name-called and stigmatised. The abuse of power has reached a level where some [very senior] psychiatrists will ‘re-diagnose’ people they have never met on social media. Simply to ‘win’ an ‘argument’. Surely nothing could be more unethical. The Royal College of Psychiatrists has done NOTHING about this and indeed seems to ‘support’ members whose online behaviour is unprofessional and stigmatising.

    So thank you again David, Dee and Harriet for this post. It is time to restore balance.

    Reply

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