America's Other Drug War: 

The Truth About Psychotropic Drugs

It is a disquieting time on the mental health and medication front.  A young coed with no history of mental illness killed herself after completing a clinical trial of a new drug to treat depression.  The Food and Drug Administration became alarmed by reports that SSRI’s like Prozac and Zoloft may increase suicidal feelings in children and adolescents. There are reports of growth retardation in children taking Ritalin. And pharmaceutical companies refused to share the details of failed clinical trials on the grounds that they are trade secrets.

The need for accurate information on the safety and efficacy of these drugs is at an all time high. Americans have the highest rate of psychotropic drug use in the world.  Central nervous system stimulants and depressants, including drugs such as Xanax and Prozac, became the largest selling category of drugs in the United States in the year 2000. And, perhaps even more shocking, according to testimony before the United States Congressional Committee on Education and the Workforce, 90% of all the Ritalin in the world is consumed by persons in the United States.

Though many of these drugs have performed what some consider to be miracles, these recent reports – some true, some exaggerated, some simply misleading – are indicative of the crucial need to educate the public on not only the benefits but on the dangers as well.  Unfortunately, however, most doctors are only marginally trained in the effects of psychotropic drugs. “As a result, consumers must take responsibility to arm themselves,” says Cindy Cooke, author of From Turmoil to Tranquility. “There is a lot of misinformation floating around out there regarding emotional distress and the drugs that are prescribed to relieve anxiety, depression, and ADHD.   And in this case, what you don’t know can hurt you.”

Central to the issue is the nature of the brain, mind and body, and how we react to medications, especially psychotropic ones.  Recent research by neuroscientists such as Joseph LeDoux, Antonio Damasio, and Candace Pert has demonstrated that each of the billions of cells of the brain, as well as the body itself, has “a mind of its own.”  In the same way the body automatically regulates our temperature, blood chemistry, and heartbeat, brain cells work together, moment by moment, to produce and maintain the level of neurotransmitters the body believes is optimal for functioning.

When confronted by psychotropic drugs that enhance the activity of certain neurotransmitters, the brain often reacts by shutting down the body’s natural production of that neurotransmitter, as if to say, “we have enough, already.” If taken for a long period of time, the brain may actually begin to destroy some of its own receptor sites in a desperate attempt to reduce the effects of the medication. When patients decide to discontinue the drugs, especially if they do so suddenly, the natural level of neurotransmitters is sometimes so low that patients have extremely severe reactions, often feel that they are going crazy, and may even have to be hospitalized. This process, called drug rebound, is responsible for many of the reported side effects of the drugs, and needs to be understood before anyone discontinues their use. 

Consumers also need to know how to read and interpret the news articles that describe research results on various drugs. 

¨Knowing how long the clinical trial lasted, for example, is critical to determine if there are long-term side effects. 

¨Knowing if there are any long-term studies – several years or more – will help consumers know if the drug has beneficial or detrimental effects beyond the first 6-8 weeks in which most drugs are tested.

¨Knowing if the trials used a placebo with side effects will help you discover whether the reported improvement was actually the result of the real drug.  It turns out that even in double blind studies, when placebos without side effects are used, both doctor and patient can usually figure out which they are getting. 

¨Knowing the difference between the number of persons who reported improvement of their symptoms while taking the placebo versus the active ingredient drug – the difference is sometimes very small – will give consumers a better idea of the real effectiveness rate of the drug.  If 58% of those taking the placebo reported improvement compared to 63% of those taking the real drug, for example, the difference, while statistically significant, may by the consumer be evaluated as not worth the risk or expense. 

“Just understanding that our body often responds to medications in significant ways, often opposite to what is desired, will help us know what questions to ask and better protect ourselves and our families,” said Cooke. 

These same kinds of responses are not confined to psychotropic drugs.  As was recently reported by CNN, the routine consumption of over-the-counter pain killers can shut down the production of pain relieving endorphins and produce headache rebound when aspirin is discontinued suddenly. In addition, children taking antibiotics actually experience more ear and respiratory infections and relapses than those who do not because antibiotics actually deplete the number of good bacteria that typically strengthen the immune system.  For full recovery, these good bacteria must be replaced at the end of a course of antibiotics.  Though the body will usually bounce back of its own accord in time, especially in the case of rapidly recurring infections, it can need the help of commonly available, over-the-counter probiotics.