More Harm than Good

Last Wednesday, King’s College London hosted its 52^nd Maudsley Debate, with the premise that This house believes that the long term use of psychiatric medications is causing more harm than good.

The debate was so popular that many of the audience had to watch on a video link in a nearby lecture theatre.

I was not at the debate myself, but was able to watch it on YouTube, where it is still available. Unfortunately, the recording “stutters” in some places, so that odd words are missed here and there.

The first person to speak for the motion was Professor Peter Gøtzsche (left), Director of the Nordic Cochrane Centre in Copenhagen, and author of the book Deadly Medicines and Organised Crime. He had already written an article entitled Why I Think Antidepressants Cause More Harm than Good last year for The Lancet.

Peter explained how the original clinical trials were skewed by drug companies, and how the results differed markedly from the results of studies carried out at the Cochrane Centre.

Peter claimed that only about 2% of the prescriptions were necessary, for “the most acute situations,” and that it was necessary to set up withdrawal clinics for those who had become dependent on psychiatric drugs.

Peter was followed by the first speaker against the motion, Professor Allan Young (right), who is Professor of Mood Disorders at the Institute of Psychiatry, Psychology & Neuroscience at King’s College.

Allan stated that psychiatric drugs can be: “Just as beneficial and effective as treatments for other common, complex conditions,” and that there are regulators to ensure that harmful drugs are withdrawn.

Allan also claimed that Lithium had been shown over the years to be “efficacious”, and that it had “reduced suicide rates.” (Current evidence shows that this assertion is flawed).

The second speaker for the motion was Professor Sami Timimi (left), a consultant psychiatrist who is also Visiting Professor of Child & Adolescent Psychiatry at the University of Lincoln.

Sami said that there was some evidence that psychiatric drugs can do good in the short-term. In the long-term, however, whereas there is “plenty of evidence” that they can cause harm, there is no evidence to justify exposing people to the risk of harm. Sami said that “It seems that the widespread use of psychiatric medication these days is the result of good marketing, and not good science.”

Sami continued by saying that: “Bodies like the Royal College of Psychiatrists have a scientific and moral duty to do something. If they won’t, they are in danger of becoming part of the problem rather than what they should be, which is a strong advocate for patients and those who serve them.”

The final speaker, who was against the motion, was Mr John Crace (right), who is a political journalist for The Guardian.

John started by saying that he was “ no big fan of Big Pharma,” and that he took only generic forms of medication. He spoke of his experiences as a patient who had been treated with psychiatric medication, and maintained that it had helped him.

There followed a number of questions and comments from the audience. Most of the ensuing arguments centred around “studies”, as you’d expect from the three participants who have all been involved in research. However, the tone of the debate then changed when Allan became rather petulant on the subject of his conflicts of interest. Allan has received payment from several pharmaceutical companies, including Lundbeck, makers of Citalopram, and Eli Lilly (Fluoxetine). He made comparisons with the money that Peter Gøtzsche will earn from his next book (left), to be published in September.

In his summing-up, Peter used the time to say that he was campaigning for the ban of forced treatment, and concluded by referring to the harm caused by psychiatric drugs, particularly when it came to the deaths of old people.

Allan used his time to read a statement in which he claimed that other members of the Cochrane Centre cast doubts on the validity of Peter’s evidence.

For the record, the result of the debate was 136 – 66 in favour of those who agreed that psychiatric drugs do more harm than good.

The debate caused varied reactions on Twitter and YouTube, and in online medical magazines such as Pulse.

John Crace wrote a review of the debate in The Guardian the next day entitled “While the psychiatrists argue about antidepressants, I’ll keep taking them”, where he described the debate as a “bearpit”.

Author Dr James Davies (right) of the Council for Evidence-Based Psychiatry (CEP) called the debate “a cause for hope” and wrote:

“For the last past 30 years those of us critical of the overprescribing and harms of psychiatric medications have been on the losing side, in the face of a powerful industry-backed medical model that has crowded out alternative voices and visions. The real importance of Wednesday’s Maudsley Debate is that is symbolised what the critical community has been sensing for some time now – that the tide is finally turning. The people and institutions who were once isolated, unconnected and struggling against an evidence base favouring the status quo, can now, at a click, possess the evidence revealing that what we were sold as solid as beyond dispute is nothing of the sort.

“Last night the Maudsley Debate brought into the heart of establishment psychiatry powerful evidence and arguments that the long-term use of psychiatric medications is causing more harm than good – and evidence clearly won on the night. This is a cause for hope and optimism. But of course we must remain cautious, a single debate won’t change the world, but what it has done put the debate squarely on the map – it has finally be legitimised as a valid debate by at leading psychiatric institution, something that has not happened before.”

Related Articles:

Antidepressants and the Politics of Health

The Council for Evidence-based Psychiatry

How Antidepressants Ruined Luke’s Life

Hope in Copenhagen

Mental Health Disability: the Antidepressant Connection