We’ve all wished for it at one time or another. It may have been with your son who can’t sit still in school, your niece who was throwing a temper tantrum, or a child who wouldn’t stop crying on that redeye flight. Wouldn’t it be nice to pull out a tranquilizer dart and "poof" turn that little Tasmanian devil into a calm, quiet, sleeping beauty?
Adult Side Effects of Antipsychotic DrugsOur collective focus on the quick fix makes it easy to ignore the long-term impact of a drug-based intervention. We have data showing that antipsychotic drugs cause high blood sugar, excess fat accumulation around the waist, low levels of good cholesterol (HDL), high levels of triglycerides, and increased blood pressure in adults.
Recent Study Sheds LightA recent study suggests children face the same risks as adults from these drugs. Children between the ages of six and eighteen were randomized into three groups. Each group was given one of the following ‘second-generation’ antipsychotic drugs: olanzapine, risperidone, or aripiprazole. All subjects had behavior problems and at least one psychiatric diagnosis, such as ADHD. None had ever taken antipsychotic drugs before.
Fat Is Fat … Right?One of the fascinating developments in our understanding of chronic disease is that the anatomical distribution of fat matters. To sum up a still-developing story, fat distributed in the abdomen around the organs (visceral fat) is much more dangerous than fat just below the skin (subcutaneous fat). Thus, two people with the same amount of body fat may have very different health risks based on where their fat is stored. In short, excess body fat is a risk factor for disease, but if that fat is distributed in the visceral region, it confers an additional independent risk for cardiovascular disease, diabetes, certain cancers, high blood pressure, and abnormal cholesterol.
Why Are These Drugs Given to Children in the First Place?In the pediatric population, the majority of antipsychotic drugs are actually not given to treat psychosis, as the name implies. Surprisingly, they are generally prescribed to treat behavioral disorders. For example, only 2.8 percent of the subjects in this study actually had symptoms consistent with psychosis (some further percentage of whom were likely already treated with a stimulant known to induce psychosis). The remaining 97.2 percent had behavioral symptoms deemed unacceptable by the school, family, or both.
Do We Really Practice Evidence-Based Medicine?Robert Whitaker, a medical journalist, and author writes that the field of psychiatry is experiencing an institutionalized form of cognitive dissonance—a conflicted psychological state that occurs when new information challenges deeply held beliefs. In the context of this article, long-held beliefs about the safety and efficacy of antipsychotic drugs are being challenged by new data showing their dangerous side effects and overall ineffectiveness. In general, people resolve this conflicted state “by sifting through information in ways that protect their self-esteem and their financial interests.”
Psychiatry, as an institution, is doing just that. Sifting through data to suit their needs. Research that shows psychiatric drugs in a negative light often gets swept under the rug as being biased, of poor quality, or otherwise uninformed. There is little acceptance for anything that goes against that status quo. The goal is no longer to seek better treatment protocols but to protect the power, prestige, and financial interests of the psychiatric institution. Unfortunately, in this state, evidence-based medicine cannot be practiced.