CCHR Says FDA Must Correct Widespread Misinformation: Antidepressant Withdrawal Symptoms Are Not Short and Mild for Many Patients

Posted on January 29, 2024 by cchrstl

Recent research and antidepressant users’ lived experience show that antidepressant withdrawal symptoms may be severe and long-lasting. Patients and their prescribers need accurate information on withdrawal risks and tapering guidance from the FDA.

by CCHR National Affairs Office

A mounting body of evidence has found that many patients who attempt to stop taking antidepressants experience physical, mental, and emotional withdrawal symptoms that are more severe and longer-lasting than the conventional medical view of mild symptoms lasting only two to three weeks.  It is long past time for the U.S. Food and Drug Administration (FDA) to address this issue, correct the widespread misinformation, and issue guidance to prescribers on how to discontinue antidepressants, says the Citizens Commission on Human Rights (CCHR), an international mental health watchdog organization.

Even though withdrawal symptoms have been documented for more than 40 years for older antidepressants and for more than 30 years for newer generation antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), there is still a lack of scientific studies of withdrawal.

While some people may experience mild, short-lived withdrawal symptoms, for others the symptoms may be so severe and long-lasting that normal functioning is impossible, even when the antidepressant dosage has been tapered slowly and gradually.

A 2019 study revealed that more than half (56%) of people who attempt to come off antidepressants experience withdrawal symptoms, with nearly half (46%) of them describing those symptoms as severe.  The researchers also found that it is not uncommon for the withdrawal effects to last for several weeks or months.

A separate study pegged the average duration of withdrawal symptoms at 90.5 weeks for SSRIs and 50.8 weeks for serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants.

There is also evidence of a growing number of long-time users who have been unable to come off their antidepressants because of the debilitating withdrawal symptoms they experienced when trying to stop.  

“Some 15.5 million Americans have taken antidepressants for at least five years,” according to science reporter Benedict Carey, writing in the New York Times in 2018.  “The rate has almost doubled since 2010, and more than tripled since 2000.”

“What you see is the number of long-term users just piling up year after year,” said Dr. Mark Olfson, a professor of psychiatry at Columbia University, quoted in Carey’s article.

Antidepressant withdrawal symptoms include anxiety, dizziness, headache, flu-like symptoms, nausea, insomnia, irritability, hallucinations, muscle tremors, electric shock-like sensations (“brain zaps” or “body zaps”), mania, emotional blunting, and sexual dysfunction that can be long-lasting or even permanent.

A new study focused on the emotional and social effects of withdrawal.  Researchers found that withdrawal had a significant negative impact on the emotional and social functioning and overall well-being of those going through withdrawal from antidepressants.  More than half of the study participants said their relationships were negatively affected, such as by angry outbursts.

Psychiatrist Joanna Moncrieff, M.D., recently co-authored an article about why antidepressant withdrawal should be taken seriously.  Moncrieff with colleagues previously conducted the landmark 2022 study which found no scientific support for the theory that depression is caused by a chemical (serotonin) imbalance in the brain.

The recent article points out that updated guidelines have been issued by British medical authorities, advising that after long-term use, antidepressant users wanting to stop should be tapered off the drugs gradually over months and sometimes years, with the dose reduced by smaller and smaller amounts, known as “hyperbolic tapering.”  The U.S., however, has not yet updated its guidance, which still recommends stopping the drugs relatively rapidly, the authors report.

CCHR calls on the FDA to address this issue and provide updated guidance on discontinuing antidepressants, as well as updated antidepressant prescribing information.  Patients and their prescribers need accurate and complete information on the risks associated with discontinuing antidepressants so they can make fully informed decisions about starting or stopping the drugs.  Some 45 million Americans are currently taking antidepressants.

The FDA should also update its antidepressants webpage for consumers, which only mentions “withdrawal symptoms” once, listing them as a “less common” side effect.

WARNING:  Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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CCHR Calls Out Psychiatric Association’s Nondisclosure of Conflicts of Interest Among Psychiatrists Who Revised “Psychiatric Bible”

Posted on January 22, 2024 by cchrstl

Citizens Commission on Human Rights says American Psychiatric Association’s unwillingness to provide full disclosure of pharmaceutical companies’ payments to psychiatrists involved in developing the latest edition of the Diagnostic and Statistical Manual of Mental Disorders prevented public scrutiny of industry influence.

by CCHR National Affairs Office

Psychiatrists who worked on the latest edition of the so-called “bible of psychiatric disorders” received more than $14 million in industry payments from pharmaceutical or medical device companies, but until now that information was kept from public scrutiny.  The American Psychiatric Association (APA), which published the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) in 2022, chose not to publicly disclose the industry-related financial conflicts of interest. 

To collect and analyze that information, a team of researchers turned to the Centers for Medicare & Medicaid Services’ Open Payments database, which contains data on payments made by drug and medical device companies to physicians and teaching hospitals.  Data from Open Payments can be used to assess how physicians may be influenced by industry compensation.  For their study, the researchers examined industry payments made from 2016 to 2019 to those who subsequently worked on the DSM-5-TR.

They found that 60% of the psychiatrists who served in some capacity in the preparation of the DSM-5-TR received industry compensation, mostly for travel and consulting.  But more than one in three received income for other reasons, such as for their research or for speaking on behalf of pharmaceutical companies.  The latter is widely recognized as an especially egregious conflict of interest because the speakers are basically marketing pharmaceutical companies’ drugs.

By dollar amount, 71% of the funds paid by pharmaceutical and medical device companies to DSM-5-TR psychiatrists was funding or payments for their research, a clear financial conflict of interest.

“Conflicts of interest among panel members of DSM-5-TR were prevalent,” the researchers concluded.  They pointed out that the impact of pharmaceutical company payments on physicians’ behavior and prescribing practices can lead to overdiagnosis and overtreatment of patients.

“Additionally, it is important to emphasize that the problem of overdiagnosis is not limited to the inclusion of new disorders in the Diagnostic and Statistical Manual of Mental Disorders,” they wrote.  “Even seemingly small changes to the manual (e.g., to [symptoms] of previously included disorders) can have a substantial impact on increasing the number of people who would receive a diagnosis and increasing the number of people prescribed drugs.”  The study was published January 10 in The BMJ.

More fundamentally, the DSM has long been under attack for the lack of scientific basis for its “mental disorders,” which psychiatrists voted into existence in an attempt to imitate the biomedical model used in the field of medicine. 

In 2013, psychiatrist Thomas Insel, M.D., then-director of the National Institute of Mental Health, publicly stated that there is no objective basis for psychiatry’s mental disorders and that “the weakness of the [DSM] is its lack of validity.”  In other words, there is no way to precisely identify or “diagnose” any psychiatric disorder.

Nevertheless, without any scientific validity, the DSM’s subjective “mental disorders” continue to be used to “diagnose” patients and prescribe powerful psychotropic drugs as treatment.  Some 77 million Americans are currently taking psychiatric drugs. 

Hundreds of research studies and warnings from international drug regulatory agencies have warned about the risks of serious side effects when taking or stopping psychotropic drugs.

Beyond the adverse effects of the drugs, a recent study found that psychiatric diagnoses and treatment with psychiatric drugs were linked to negative outcomes in patients’ lives, including lower income, increased unemployment, and a greater likelihood of being single and living alone.

The Citizens Commission on Human Rights calls out the American Psychiatric Association for its unwillingness to provide the public with full disclosure of the extent of pharmaceutical companies’ payments to psychiatrists involved in the development of the DSM-5-TR – a disclosure that magnifies the DSM’s true function as providing cover for the unscientific labeling of patients with fake “mental disorders” in order to treat them, all too often with psychotropic drugs that may harm them.

WARNING:  Anyone wishing to discontinue or change the dose of a psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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Benzodiazepine Use Linked to Miscarriage; Stopping the Drugs After Long-Term Use Increased Risk of Fatality, New Research Finds

Posted on January 15, 2024 by cchrstl

Mental health watchdog CCHR presses for DEA reclassification of benzodiazepines due to risks of physical dependency and addiction.

by CCHR National Affairs Office

The use of benzodiazepines during pregnancy increases the risk of miscarriage, new research has indicated.  A separate study unexpectedly found that long-term benzodiazepine users face a greater risk of dying after discontinuing the drugs than continuing to take the drugs, calling into question long-term benzodiazepine treatment.  Researchers involved in the studies advised prescribers to carefully consider these potential harms when making treatment decisions about whether to start patients on benzodiazepines.

Benzodiazepines are a class of psychiatric drugs used as treatment for anxiety, panic attacks, and insomnia.  Commonly prescribed benzodiazepines include Xanax, Klonopin, Ativan and Valium.

Studies on an association between benzodiazepines and miscarriage were limited until recently.  Researchers in Taiwan analyzed health and birth certificate records to identify pregnancies that ended in miscarriage between 2004 and 2018, looking for a potential association with benzodiazepine use. 

They found that the risk of miscarriage was 69% greater for those taking benzodiazepines than those who were not.  The increased risk of miscarriage was found with all commonly used benzodiazepines.

“The use of benzodiazepines during pregnancy was associated with an increased risk of miscarriage,” wrote lead author Lin-Chieh Meng, MS, of the Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan.  The study was reported in JAMA Psychiatry.

There also had been no studies dedicated to investigating the risk to benzodiazepine users of discontinuation until recently.  A new study unexpectedly found that long-term benzodiazepine users face a greater risk of death from discontinuing than continuing the drugs.  The incidence of death from any cause over the year following discontinuation of benzodiazepine use was 5.5% as compared to 3.5% for those who did not stop taking the drugs.  This equates to a risk of mortality 1.6 times greater for those who discontinued benzodiazepines than for those who did not, the researchers wrote.

Compared to those who continued benzodiazepines, those who stopped also faced greater risks of suicidal ideation, suicide attempt or self-inflicted injury, nonfatal overdose, and emergency department use, the researchers found. 

“It is possible that, having become physiologically dependent on benzodiazepines, patients experience adverse outcomes from withdrawal,” they wrote, reporting in JAMA Network Open.

These results are especially concerning in light of what the researchers say is “interest in reducing long-term benzodiazepine prescribing given harms associated with use.” 

From 2015-2016, over 10% of U.S. adults reported benzodiazepine use at some time in the prior year, and use had been increasing over the prior two decades.  In 2019, an estimated 92 million benzodiazepine prescriptions were dispensed from U.S. outpatient retail and mail-order pharmacies, according to the U.S. Food and Drug Administration (FDA).

The medical literature has extensive evidence of the risks associated with benzodiazepine use, including drowsiness, fatigue, weakness, impaired coordination, impaired memory, confusion, irritability, and decreased sex drive.  The U.S. Drug Enforcement Administration (DEA) lists the effects of the drugs on the mind as amnesia, hostility, irritability, and vivid or disturbing dreams.

Discontinuing the drugs can be dangerous.  The FDA warns that “stopping benzodiazepines abruptly or reducing the dosage too quickly can result in serious withdrawal reactions, including seizures, which can be life-threatening.” 

The FDA further advises that even when the benzodiazepine dosage is decreased gradually, patients may experience abnormal involuntary movements, anxiety, blurred vision, memory problems, irritability, insomnia, muscle pain and stiffness, panic attacks, and tremors.  More serious withdrawal symptoms include seizures, hallucinations, mania, psychosis, depression and suicidal thoughts.  Withdrawal symptoms can last many months, the FDA says.

Along with an increasing number of benzodiazepine users is a growing number of overdoses and overdose deaths.  After opioids, benzodiazepines are the prescription drugs most involved in overdose deaths.  In 2020, as benzodiazepine-involved overdose deaths reached a record high in the U.S., the FDA updated the black box warning on the package inserts for benzodiazepines to include warnings about “the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions.” 

In light of the FDA’s updated warning about dependence and addiction, the Citizens Commission on Human Rights (CCHR) has called on the DEA to align with the FDA and change the classification of benzodiazepines, which are still classifed as Schedule IV drugs.  Schedule IV drugs are defined by the DEA as “drugs with a low potential for abuse and low risk of dependence.”  The classification is clearly at odds with the FDA’s findings.

WARNING: Anyone wishing to discontinue or change the dose of a benzodiazepine or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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CCHR Urges Doctors to Heed New Study Indicating Placebo Effect, Not Antidepressant, Improved Teens’ Depression

Posted on January 8, 2024 by cchrstl

Teens guessing they were taking an antidepressant led to substantial improvement, while actual treatment with the drug did not, researchers found.

by CCHR National Affairs Office

Prescribing an antidepressant to depressed teens is challenged by a new study finding that the drug’s apparent effectiveness is accounted for by the placebo effect.  Because antidepressants carry the risk of serious adverse effects, including suicide and violence, the Citizens Commission on Human Rights (CCHR) is urging doctors who are prescribing antidepressants to heed recent studies indicating the drugs may be doing more harm than good. 

Researchers in Australia and the U.K. who conducted the study cited concerns about the rising number of children and adolescents being prescribed antidepressants, given the questionable effectiveness and known harms of the drugs.

“There has been a significant rise in the use of antidepressants throughout the world in recent decades, with dramatic increases among children and teenagers, despite concerns about a heightened risk of suicidality, the influence of financial interests and general concern about the use of drugs in children,” wrote lead author Jon Jureidini, a child psychiatrist at the Critical and Ethical Mental Health Research Group at the University of Adelaide in Australia.

In the study, researchers addressed the fact that outcomes of clinical trials testing whether drugs are effective can be influenced by the placebo effect, whereby participants’ beliefs about whether they are receiving the actual drug or fake treatment (placebo) can affect results and inflate any apparent effectiveness of the drug. 

Using data from an influential previous study of treatments for depressed teens, in which the drug given for treatment was the antidepressant fluoxetine (commonly sold as Prozac), the study focused on the accuracy of participants’ guesses about whether they were getting the drug or a placebo and to what extent that influenced their outcomes. 

The researchers found that those depressed teens who guessed they were taking the antidepressant, regardless of whether they guessed correctly or not, improved more than those who were actually given the drug.  What’s more, adolescents who thought they were on the antidepressant but were actually given a placebo experienced the greatest improvement. 

“Treatment guess strongly predicted outcomes and may have led to the exaggeration of drug effectiveness in the absence of actual effects,” the researchers concluded.  The study was published in the Australian & New Zealand Journal of Psychiatry.

One of the researchers involved in the study, British psychiatrist Joanna Moncrieff, M.D., was previously an investigator and lead author in the landmark 2022 study that found no scientific basis for the theory of a chemical imbalance in the brain, presumed to be the cause of depression and a rationale for prescribing antidepressants to correct that supposed imbalance.

For years, psychiatrists promoted the theory, which received considerable coverage in psychiatric and psychopharmaceutical journals.  However, despite decades of brain research, Moncrieff found there is no conclusive evidence of a chemical imbalance or other brain abnormality causing depression for antidepressants to fix, which calls into question the prescribing of antidepressants.

Known adverse effects of antidepressants include weight gain, nausea, insomnia, agitation, emotional blunting, sexual dysfunction, suicide and violence.  An analysis of the FDA’s Adverse Event Reporting System in 2010 found that 31 out of 484 prescription drugs were disproportionately associated with violence, and 11 of those 31 were antidepressants.  On discontinuing antidepressants, patients may experience withdrawal symptoms that can be severe.

Because of the risk of serious side effects and the lack of effectiveness of antidepressants, 31 prominent British medical professionals, researchers, patient representatives, and politicians, including Moncrieff, recently published an open letter in the prestigious British medical journal, The BMJ, calling for the U.K. government “to commit to a reversal in the rate of prescribing of antidepressants.”

WARNING:  Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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CCHR Renews Call for Laws to Prohibit Restraining Children with Drugs After Use in Psychiatric Facilities Rose 141%

Posted on January 1, 2024 by cchrstl

Young, male, Black, and economically disadvantaged children were disproportionately restrained with antipsychotic drugs.

by CCHR National Affairs Office

The use of antipsychotic drugs to chemically restrain agitated children who are hospitalized for mental health conditions rose 141% in recent years, largely as a result of more pediatric admissions to psychiatric facilities, a new study reports. Young, male, Black, and economically disadvantaged children were disproportionately administered pharmacological restraint. The study did not investigate how many of these children were taking mind-altering psychotropic drugs, whose side effects could have led to their hospitalizations and agitation.

Searching a health records database for pediatric patients aged 5 to 17 years admitted to the medical units of 43 children’s hospitals for mental health conditions from 2016 through 2021, researchers focused on children who were administered any of five antipsychotic drugs intravenously or by injection, presumably for acute agitation. The researchers acknowledged this was a narrow definition of pharmacologic restraint.

They found that one of every 33 mental health hospitalizations of children involved restraint with antipsychotic drugs. Researchers noted that another study using a broader definition of pharmacologic restraint found that one in eight children’s mental health hospitalizations involved sedation with psychotropic drugs.

Overall, the number of days antipsychotics were used to restrain children increased by 141%.  Males, Blacks, children aged 5 to 8, children who were economically disadvantaged, and children covered by public insurance were disproportionately subjected to the drugging.

“The observations noted in this data set…are suggestive of racial and socioeconomic disparities within pharmacologic restraint use in the United States,” wrote Benjamin Masserano, MD, of the pediatrics department at University of Texas Southwestern in Dallas, lead author of the study, which was published in Pediatrics.

The number of days of pediatric mental health hospitalizations increased 138% during the period studied, continuing a trend over the past two decades. Researchers cited a previous study which found that the rise in hospitalizations of children for psychiatric conditions was five times greater than the increase in pediatric admissions for any reason between 2005 and 2014.

Since psychiatric diagnoses and emergency procedure laws used for hospitalizations rely on subjective assessments, which lack any objective basis or scientific validity, it is far too easy to admit children to psychiatric facilities for mental health treatment. Allen Frances, M.D., professor emeritus of psychiatry at Duke University School of Medicine and chairman of the task force for the 4th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders,  put it this way: “There are no objective tests in psychiatry – no X-ray, laboratory or exam finding that says definitively that someone does or does not have a mental disorder.”

Once children are too easily admitted, the hospital environment itself might bring on agitation, the researchers observed, which increases the likelihood of restraints.

The researchers, however, did not investigate a link between psychotropic drug use and pharmacological restraint. Some 6.2 million children in the U.S. under the age of 18 are prescribed powerful, mind-altering psychiatric drugs, which carry the risks of serious side effects that include agitation, anxiety, aggression, mania, hallucinations, psychosis, violence and suicidal thoughts and action.

These adverse effects, suffered by children taking the drugs prescribed to them as mental health treatment, can lead to the hospitalizations and agitation that result in chemical restraint. The antipsychotic drugs used to restrain the children also carry these side effects. As the researchers further cautioned, any restraint “can be associated with significant medical and psychiatric complications” and so make children’s mental and physical health conditions worse.

In 2021, the World Health Organization (WHO) issued guidance on ending all coercive mental health treatment, including forced admission to psychiatric facilities, restraints, seclusion, forced drugging, and nonconsensual electroshock. WHO stated that its opposition to nonconsensual mental health treatment extends even to individuals in mental health crisis, who “are at a heightened risk of their human rights being violated, including through forced admissions and treatment…. These practices have been shown to be harmful to people’s mental, emotional and physical health, sometimes leading to death.”

The Citizens Commission on Human Rights (CCHR) has been a global leader in the fight to eliminate coercive and abusive mental health practices and has specifically called for laws to prohibit physical and chemical restraints. CCHR has long pushed for widespread adoption of a Mental Health Declaration of Human Rights, which lays out fundamental human rights in the field of mental health to ensure the right to one’s own mind and the right to be free from forced mental health treatment.

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Holiday Blues? Research Finds Alternatives That Avoid Questionable Benefit and Known Side Effects of Antidepressants

Posted on December 25, 2023 by cchrstl

Research validates the effectiveness of trusted social connections, exercise, proper diet, enough sleep and other non-drug approaches for handling depression.

by CCHR National Affairs Office

Managing the holiday blues can be a challenge for those missing a loved one, dealing with burdensome family issues, or feeling overwhelmed by the demands of an increased level of holiday activity. Researchers studying depression have shed new light on approaches for turning things around that don’t involve prescription drugs.

Antidepressants, which may be prescribed for depression, have been found in recent research studies to have questionable benefit over dummy pills for adults, older people, or children. Antidepressants also carry the risk of adverse effects that include weight gain, nausea, insomnia, agitation, emotional blunting, sexual dysfunction, suicide and violence.  On discontinuing the drugs, patients may experience withdrawal symptoms  that can be severe.  Patients can discuss any concern about these risks with their prescriber.

The main rationale for prescribing newer generation antidepressants – to fix a supposed lack of serotonin or other brain chemical presumed to be the cause of depression – has been challenged by recent research which concluded that, after decades of brain research, there is still no scientific evidence to support the theory.

Because the drugs have questionable benefit and carry the risks of significant side effects, researchers have been exploring and finding scientific support for non-drug approaches to depression.

Studies have indicated that exercise can significantly reduce depression symptoms in children and teens, and that even relatively small amounts of physical activity were associated with a substantially lower risk of depression in adults and the elderly.

The largest synthesis of data from research studies to date on the effect of exercise on depression found that exercise is as effective as antidepressant drugs or psychotherapy and should be offered as a treatment alternative. “Exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option,” researchers wrote.

Talking with a trusted friend or other social interaction is not just a good idea if you’re feeling low, but may be the best way to lower the risk of depression setting in, according to recent research.  Individuals with more supportive or more frequent social contact have fewer symptoms of depression, with face-to-face interaction more beneficial than by phone or video.

Still other research points to the antidepressant value of getting enough sleep, especially for children, and of eating a healthy diet.  Attending religious services was found to decrease the risk of suicide in adults and improve the mental well-being of teens. Having a hobby was also associated with fewer depression symptoms and better mental health.

The Citizens Commission on Human Rights (CCHR) recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and emotional symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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Under International Pressure, Psychiatrists Forced to Confront Ending Coercive Mental Health Practices

Posted on December 18, 2023 by cchrstl

New evidence of the extent of and harm from involuntary mental health treatment emerges, as efforts continue to minimize or end the coercion.

by CCHR National Affairs Office

Calls by international health and human rights organizations to end the use of coercive practices in mental health treatment have resulted in new research reports and recommendations to psychiatrists on how to move towards zero coercion.

In a groundbreaking report issued in 2017, the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health called for the elimination of nonconsensual mental health treatment, stating: “Coercion in psychiatry perpetuates power imbalances in care relationships, causes mistrust, exacerbates stigma and discrimination and has made many turn away, fearful of seeking help within mainstream mental health services.”

The psychiatric practices targeted for eradication include involuntary institutionalization, the forcible administering of psychiatric drugs, the use of mechanical and chemical restraint and seclusion, and nonconsensual electroconvulsive therapy (ECT, or electroshock).

In 2019, the Council of Europe (COE) adopted a resolution that called on its member nations “to immediately start to transition to the abolition of coercive methods in mental health settings.” The resolution cited evidence pointing to the “overwhelmingly negative experience of coercive measures, including pain, trauma and fear.” The COE further stated: “Involuntary ‘treatments’ administered against the will of patients, such as forced medication and forced electroshocks, are perceived as particularly traumatic. They also raise major ethical issues, as they can cause irreversible damage to health.”

More recently, the World Health Organization (WHO) issued guidance in 2021 advising countries to end coercive mental health practices, which it said are used “despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm and even death.” The WHO guidance extends its call for prohibiting coercion even to those experiencing acute mental distress, noting that individuals in mental health crisis “are at a heightened risk of their human rights being violated, including through forced admissions and treatment.”

Explaining its stand, WHO’s guidance states: “People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected. Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress.”

As a result of these calls for reform, evidence has emerged that at least some psychiatrists are confronting the harm of coercive practices and looking to reform those practices.

In an article recently published in Psychiatric Rehabilitative Journal, psychiatrists reported on interviews with patients who were not allowed to make decisions about their own mental health treatment, but were subjected involuntarily to treatment decided by others.  Analysis of the interviews showed patients strongly rejected the substitute decision makers, felt strong stigma because of their exclusion from the decision-making, and struggled to regain their autonomy.

A new study, published in The Lancet, investigated whether the implementation of three of 12 guidelines issued by the German Association of Psychiatry in 2018 to reduce coercive treatment was effective. The 12-month study, comprising 54 German psychiatric wards, found that the use of coercive measures dropped by nearly half (45%) over the course of the study in wards whose staff received ongoing support for implementing the guidelines. Even in the wards acting as the control group, whose staff only received an initial workshop presentation of the study, coercive measures declined by 28%.

Italian and Swiss psychiatric researchers recently investigated to determine the prevalence of the use of mechanical restraint, which is “an extremely debated topic,” they wrote. Mechanical restraint restricts a patient’s freedom of movement without their permission, typically in a psychiatric setting by strapping the person’s arms, legs and torso to a table. The finding that 14% of the psychiatric patients – one in every seven – had been put in mechanical restraint during in-patient treatment at the Italian psychiatric unit being studied led the researchers to call for methods of limiting the practice. “It is time for national and international guidelines on [mechanical restraint] in psychiatric patients,” they urged. The study was published in Medicina.

Peter Gotzsche, M.D., director of the Institute for Scientific Freedom in Copenhagen, recently wrote about an autistic 24-year-old who, after being wrongly subjected to mechanical restraints and forced drugging in a Danish psychiatric ward, took his case to the European Court of Human Rights. The court had previously ruled that the continued mechanical restraint of another Danish psychiatric patient after he was completely calm was a violation of the European Convention on Human Rights’ prohibition against inhuman or degrading treatment. As a result of the more recent case, the Danish Psychiatry Act was amended in 2021 so that guards watching a patient in mechanical restraint must make notes on the patient’s condition every 15 minutes and release the patient as soon as they are calm.

As an aside, Gotzsche wrote: “In Iceland, seclusion and restraint were abolished in 1932 and never used again. That year, psychiatrist Helgi Tomasson took the shackles, straightjackets and other physical restraints that existed in the mental hospital, Kleppur, and burnt them in a furnace – all except one set, which he sent to the Parliament where it is still on display. This should be done in all countries.”

Years before the current movement to end coercive psychiatric practices, Citizens Commission on Human Right (CCHR) co-founder, the late professor of psychiatry and humanitarian Thomas Szasz, M.D., advocated an end to forced psychiatric treatment. Considered by many scholars and academics to be psychiatry’s most authoritative critic, Dr. Szasz wrote: “Increasing numbers of persons, both in the mental health professions and in public life, have come to acknowledge that involuntary psychiatric interventions are methods of social control. On both moral and practical grounds, I advocate the abolition of all involuntary psychiatry.”

CCHR has been a global leader in the fight against the coercive and abusive use of involuntary commitments, seclusion and restraints, psychiatric drugs, and electroshock. In 1969, CCHR issued a Mental Health Declaration of Human Rights that laid out fundamental human rights in the field of mental health to ensure the right to one’s own mind and the right to be free from forced mental health treatment.

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Despite Claims of Safety, Electroshock Caused Memory Loss in Majority of Teens in New Study, CCHR Warns

Posted on December 11, 2023 by cchrstl

Researcher says study failed to show the safety or efficacy of electroconvulsive therapy.

by CCHR National Affairs Office

Despite ongoing claims from psychiatrists that electroconvulsive therapy (ECT, or “electroshock”) is safe and effective, research continues to indicate otherwise.

John Read, Ph.D., at the School of Psychology, University of East London in London, England, points to a new study from China that reported a “high response rate and safety” from ECT administered to 110 adolescents. In fact, the data showed that the majority of the participants experienced memory loss following the procedure, according to Read.

“What is especially concerning about this particular study is that it reports that 76 of the 110 teenagers (69 %) suffered ‘memory impairment’ after the ECT,” he wrote, reporting in the Journal of Affective Disorders.

“When even the psychiatrists themselves acknowledged that 69% have impaired memories as a result, this does not indicate a treatment with a ‘high’ degree of safety,” he advised.

How the loss of memory function was measured was not disclosed in the Chinese study, but the assessment was apparently done by the psychiatrists who conducted the study. Read speculates that the rate of memory impairment could have been even higher if the measuring had been done by independent evaluators using validated cognitive tests.

The study lacked a control group receiving placebo (general anesthesia but not the electric shock), which is the same shortcoming found in all ECT studies since 1985, according to Read.

The study also did not include any follow-up beyond the end of treatment, which Read has found is typical of ECT studies.

“So, contrary to the claims of the [study’s] authors, little can be concluded about [ECT] efficacy,” Read wrote.

While the study reported that side effects, including memory loss, were “transient,” without any follow-up “the psychiatrists had no basis for making such a claim,” Read observes.

He cites studies that have found that persistent or permanent memory loss occurs for between 12% and 55% of adults who receive electroshock treatment. He notes that the American Psychiatric Association acknowledged in 2001 that “evidence has shown that ECT can result in persistent or permanent memory loss.”

According to the U.S. Food and Drug Administration (FDA), electroshock can cause brain damage, cognitive impairment, permanent memory loss, prolonged or persistent seizures, worsening psychiatric symptoms, cardiovascular complications (including heart attacks), breathing complications and death.

ECT shoots up to 460 volts of electricity through brain tissue to induce a grand mal seizure, the most serious type of seizure, which can last up to 30 minutes.

Psychiatrists still do not know how ECT is supposed to “work,” how much voltage it will take, or how many sessions of ECT to administer. It is a matter of trial and error with human lives.

Psychiatrists may recommend ECT for deeply depressed patients, but the risk of suicide remains highly elevated after patients receive electroshock treatment. The odds of patients committing suicide in the year after receiving electroshock is not significantly statistically different from the odds of those who did not receive it.

The World Health Organization and the Office of the United Nations High Commissioner for Human Rights recently issued guidance advising that “people being offered ECT should also be made aware of all its risks and potential short- and long-term harmful effects, such as memory loss and brain damage.” The organizations also called for legislation to prohibit the procedure for children.

The Citizens Commission on Human Rights (CCHR) advocates a total ban on ECT and continues to raise public awareness about the brain damage it causes. To date, more than 134,000 people have signed the CCHR online petition to ban ECT.

CCHR recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental or behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

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Heart Disease Risk Increases the Longer ADHD Drugs are Taken, Study Finds

Posted on December 4, 2023 by cchrstl

Researchers advise prescribers to keep monitoring patients on ADHD drugs for symptoms of heart disease.

by CCHR National Affairs Office

A new study has found that the longer individuals take drugs for so-called attention-deficit hyperactivity disorder (ADHD), the higher their risk of heart disease, particularly high blood pressure and artery diseases. This greater risk was similar for children, adolescents and adults. The study advises doctors to consider the risks when making treatment decisions.

Researchers involved in the study noted that clinical trials have found increases in heart rate and blood pressure associated with both stimulant and nonstimulant ADHD drugs. The new study investigated whether those heart-related effects led to clinically significant cardiovascular disease over time.

Using the health records of all individuals living in Sweden aged 6 to 64 who had a diagnosis of ADHD or were prescribed an ADHD drug between 2007 and 2020, the researchers found that the length of time the users took the drugs was associated with a statistically significant increase in the risk of heart disease, particularly high blood pressure and artery diseases, as compared to those not taking the drugs.

“Longer cumulative duration of ADHD medication use was associated with an increased risk of CVD [cardiovascular disease] compared with nonuse,” wrote lead author Le Zhang, Ph.D., at the Karolinska Institutet in Stockholm, Sweden.  The study was e-published ahead of print in JAMA Psychiatry.

The researchers found that the risk of heart disease increased rapidly over the first three years of taking ADHD drugs, for a cumulative 3-year increased risk of 8%, after which the risk increased 4% each year. These increases in risk were similar for all ages and regardless of the gender of the individual taking the drugs. The risks were also greater with stimulant-type ADHD drugs. The researchers advised prescribers to keep monitoring patients who are taking ADHD drugs for symptoms of heart disease.

“Monitoring becomes even more crucial considering the increasing number of individuals engaging in long-term use of ADHD medication,” Zhang wrote.

Currently, over 9 million Americans are taking ADHD drugs, with one in three of them children under the age of 18. Concerns have been raised about the overdiagnosis of ADHD and the prescribing of ADHD drugs, especially to children, after some studies have suggested the drugs do more harm than good.

Recent research has found that commonly prescribed stimulant-type ADHD drugs do not improve cognitive ability, enhance academic performance or provide any long-term benefit to children and teens.

A diagnosis of ADHD for teens is associated with lower self-esteem, worse social behavior, and a significantly increased risk of self-harm, especially in those diagnosed with ADHD early in life (6-7 years of age).

Statistics from the National Poison Data System from January 2018 to September 2020 show that the number of cases of self-harm, including suicide attempts, using prescription stimulants averaged 213 a month for teenagers aged 13-19 and 71 a month for young adults aged 20-29.

The frequency with which children and teens have the drugs given to them incorrectly is rising steeply, leading to a quadrupling of related calls to poison control centers over the past two decades, with children under 6 years of age at greatest risk of a serious medical outcome from the errors.

The stimulant-type ADHD drug methylphenidate, sold under brand names including Ritalin, Concerta, Adderall and Vyvanse, has been linked to depression in children and teens.

Methylphenidate is classified by the U.S. Drug Enforcement Administration (DEA) as a Schedule II controlled substance, in the same category as cocaine, morphine, and opium.  The DEA defines controlled substances as “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”

The U.S. Food and Drug Administration (FDA) recently acted out of concern over prescriptions for stimulant drugs at near-record highs in the U.S., after rising by 45% from 2012 to 2021.  It required new black-box warnings in the prescribing information for the stimulant drugs prescribed for ADHD “to address continuing concerns of misuse, abuse, addiction, and overdose of the prescription drugs,” and “to clearly inform patients, caregivers and healthcare professionals of these risks.” The boxed warning is the most serious warning the FDA can require for prescription drugs.

Even more fundamentally, ADHD is a label subjectively applied to a collection of behaviors common to children. A “diagnosis” of ADHD has no scientific basis – no lab tests, brain scans or any other scientific proof of it, making it a label that is far too easy to pin on children.

The late psychologist Keith Conners conducted the first formal trials on methylphenidate. He later realized that ADHD diagnoses were out of control and called ADHD misdiagnoses “a national disaster of dangerous proportions.”

The Citizens Commission on Human Rights (CCHR) urges the FDA to take stronger action to protect Americans, especially children and teens, from the risks of abuse, addiction, overdose, and other serious harms now linked to prescription stimulants.

WARNING:  Anyone wishing to discontinue or change the dose of an ADHD drug or any other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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CCHR Calls on Congress to Align U.S. with International Human Rights Standards and End Coercive Mental Health Treatment

Posted on November 27, 2023 by cchrstl

Research indicates coercive practices negatively impact physical and mental health, often compounding a person’s existing condition.

by CCHR National Affairs Office

The Citizens Commission on Human Rights (CCHR) calls on Congress to pass legislation to align the U.S. with international human rights standards by ending coercive mental health treatment and implementing a human rights-based approach to mental health services.

The United Nations Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, recognizes the need for major reforms to protect and promote human rights in mental health treatment.  To help countries achieve those reforms, the World Health Organization (WHO) issued its “Guidance on Community Mental Health Services” in 2021.

“Countries need mental health services that reject coercive practices, that support people to make their own decisions about their treatment and care, and that promote participation and community inclusion,” WHO advised.

Coercive mental health practices include forced admission to psychiatric facilities, forced drugging, physical or chemical restraint and seclusion, and involuntary electroconvulsive therapy (ECT, or “electroshock”). WHO also advised addressing “the power imbalances that exist between health staff and people using the services.”

WHO stated that its opposition to involuntary mental health treatment extends even to those experiencing acute mental distress. The report noted that individuals in mental health crisis “are at a heightened risk of their human rights being violated, including through forced admissions and treatment…. These practices have been shown to be harmful to people’s mental, emotional and physical health, sometimes leading to death.”

In October, the World Health Organization (WHO) and the Office of the United Nations High Commissioner for Human Rights (OHCHR) jointly issued a publication, Mental Health, Human Rights and Legislation, to provide a blueprint for laws that promote human rights in mental health and end the human rights violations and forced treatment in mental health services that are made possible by current laws.

“Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common,” their news release stated.

The United Nations-affiliated entities advise a complete overhaul of mental health systems by U.N. member countries, including the United States. “Our ambition must be to transform mental health services, not just in their reach, but in their underlying values, so that they are truly responsive to the needs and dignity of the individual.”

The WHO/OHCHR report points out the harm of non-consensual mental health treatment in worsening an individual’s condition. “A growing body of evidence sets out how coercive practices negatively impact physical and mental health, often compounding a person’s existing condition while alienating them from their support systems,” the report says.

This view is backed up by research indicating that forced hospitalization for mental health treatment is both ineffective and harmful to mental health. A recent study found no benefit  to patients’ mental health condition and no reduction in their risk of suicide after receiving nonconsensual mental health treatment.  Another indicated that psychiatric in-patients were actually more likely to attempt suicide after release if they were admitted and treated against their will, as compared to those who were not.

The World Health Organization and the Office of the United Nations High Commissioner for Human Rights issued a blueprint for laws promoting human rights and ending forced treatment in mental health services that is made possible by current laws.

The Citizens Commission on Human Rights has been a global leader in the fight to eliminate coercive and abusive mental health practices. CCHR has long pushed for widespread adoption of a  Mental Health Declaration of Human Rights, which lays out fundamental human rights in the field of mental health to ensure the right to one’s own mind and the right to be free from forced mental health treatment.

CCHR’s co-founder, the late professor of psychiatry and humanitarian Thomas Szasz, M.D., advocated an end to nonconsensual psychiatric treatment. Considered by many scholars and academics to be psychiatry’s most authoritative critic, Dr. Szasz wrote: “Increasing numbers of persons, both in the mental health professions and in public life, have come to acknowledge that involuntary psychiatric interventions are methods of social control. On both moral and practical grounds, I advocate the abolition of all involuntary psychiatry.”

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