That question is at the heart of the new documentary, "Medicating Normal."
- The directors of the new documentary, "Medicating Normal," want psychiatrists to require informed consent when writing prescriptions.
- Long-term effects of antidepressant usage do not have to be documented for FDA approval.
- Big Think talks to producer/director Wendy Ratcliffe and film subject, Angela Peacock.
EarthRise Podcast 93: Medicating Normal (with Angela Peacock & Wendy Ratcliffe)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a687fe66beb23c435464e7ad203757ca"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/CKUQkUd_ljw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>During our talk, Peacock is seated next to director and producer, Wendy Ratcliffe. Co-director Lynn Cunningham was initially inspired to pursue this topic when a family member's health deteriorated after 15 years of psychiatric medication. A Harvard graduate and star athlete, this family member is now on disability and exhibits poor mental health. </p><p>This brings up a question modern psychiatry rarely confronts: Why are prescription drug rates and rates of anxiety and depression increasing? If the former worked, shouldn't the latter be in decline?</p><p>That's not what's happened. Ratcliffe decided to produce "Medicating Normal" after reading Robert Whitaker's 2010 book, "Anatomy of an Epidemic." (Whitaker is featured in the film and was recently <a href="https://bigthink.com/mind-brain/antidepressants-dangers" target="_self">featured in my column</a>.) For over three years, the crew followed five people (including Peacock) around as they dealt with the terrifying health consequences of medication dependence. </p><p>"These medicines are causing an epidemic of disability," Ratcliffe says. When I ask what she learned about the pharmaceutical industry while making the film, her eyes light up. She shakes her head in disbelief. </p><p style="margin-left: 20px;">"I'm totally shocked by the FDA process: medications that are designed to be taken for many years or even a lifetime, to get them approved they only have to be shown to work better than a placebo over three to six weeks. There is no obligation to test these drugs for long-term side effects. I was shocked to discover that pharmaceutical companies pay for most of the research on their own drugs. They design the research to get the result that they want. When they don't like the result of the trial, they throw it out."</p><p>Whitaker told me about the original trial for the benzodiazepine, Xanax. At four weeks, it outperformed the placebo. At eight weeks, however, there was no discernible difference between the placebo and Xanax. By 14 weeks, the placebo outperformed Xanax. To get around this inconvenient data, Upjohn only reported the four-week data. The FDA approved the drug. </p><p>That was in 1980. In 2017, <a href="https://www.statista.com/statistics/781816/alprazolam-sodium-prescriptions-number-in-the-us/" target="_blank">25 million Xanax prescriptions</a> were written. </p><p>Pharmaceutical companies understand how to get FDA approval. Like oil companies, they're clueless when tragedy strikes. They don't know how to deal with the long-term side effects of their drugs, so they ignore them. Ratcliffe says the doctors she talked with weren't trained in tapering protocols or educated about the negative impact of the drugs they prescribe. The reflexive response is another drug, not an honest investigation of the drugs themselves.</p>
Wendy Ratcliffe and Lynn Cunningham at the premiere of Medicating Normal at the Santa Barbara International Film Festival.
Credit: Wendy Ratcliffe<p>This is the process that led to Peacock being prescribed 18 drugs at once. The side effects, she confirms, are not minor.</p><p style="margin-left: 20px;">"From a patient standpoint, I thought dizziness meant I had to get up slowly. The dizziness I experienced coming off of antidepressants and benzodiazepines was like, I can't walk. It was like walking on the Grand Canyon in high heels on a tight wire."</p><p>Though the final benzodiazepine nearly killed her, Peacock finally abandoned all drugs in 2016. Today, she feels old parts of herself coming back, but she's not yet whole. She's not sure she'll ever be. Currently living in her RV, she travels around the country educating former vets and promoting the documentary. Unlike her time on prescription drugs, she now has a mission.</p><p>"The way we bring people home from war and then put them on drugs is not right," she says. She is doing her best to change that fact. </p><p>Both women agree on an important point: psychiatry needs informed consent. The problem, Ratcliffe says, is that "psychiatry lobbying groups feel that informed consent impedes their ability to prescribe." She compares the industry to the NRA: any criticism is treated as a potential keystone that, if removed, will take out the entire system. In reality, all patients are asking for is honesty about how these drugs interact in their bodies. </p><p>We don't know the long-term effects because pharmaceutical companies don't have to study them. If the industry isn't required to disclose these effects, and psychiatrists remain ignorant of the real damage being done to some of their patients, informed consent remains an intangible dream with no pathway to reality. </p><p>As Whitaker writes in "Anatomy of an Epidemic," antidepressants don't treat chemical imbalances—they create them. Over 2,500 years ago, doctors recognized melancholy as a natural part of life—one that, as Schuyler and others realized, goes away with time. Yet for a growing number of Americans, depression will never fade because they weren't informed about the potential consequences of the prescription they were handed. They never know what they're being told to swallow. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Researchers at the Max Planck Institute have pinpointed a neurological trend in those genetically predisposed with depression.
- The left hypothalamus is enlarged in those genetically predisposed to suffer from depression.
- The worse the form of depression is, the larger the hypothalamus.
- While no cure for this enlargement is yet known, researchers now know where to focus their efforts.
Jessica Orrico / Unsplash<p>In fact, those with more severe forms of depression exhibited even larger hypothalamuses. And while medication might treat the symptoms, it made no difference on the size of the brain region that matters most.</p><p>The hypothalamus is part of our brain's limbic system, which plays a major role in emotion, behavior, motivation, and memory. Evolutionarily speaking it is often referred to as our "reptile brain," the idea being that it links us down the ladder to the fight-flight-freeze mechanisms inherent in all mammalian (and earlier) life. Specifically, the hypothalamus controls our body temperature, hunger and thirst, and circadian rhythms. It is also the conductor linking our nervous system to our endocrine system, the loop that floods our body with cortisol when stressed. </p><p>Unfortunately, the researchers do not know what this physical correlation means or how to treat it. But the discovery of an enlarged region is a start. By pinpointing therapies to reduce its size, which in normal humans is about the size of a penny, there could be a reduction of severity in relationship to depression.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a>.</em></p>
Researchers at the American Chemical Society examine whether or not cough medicine has scientific merit.