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Pills aren't always the answer

Anti-depressants can depress people. And anti-psychotics can keep people psychotic. This, in a nutshell, is what Robert Whitaker accidently discovered.

Anti-depressants can depress people.

And anti-psychotics can keep people psychotic.

This, in a nutshell, is what Robert Whitaker accidently discovered.

The American medical journalist was writing a series for the Boston Globe on abuses psychiatric patients experienced in research studies, when he came across an interesting piece of science.

In 1999, the World Health Organization published a study that found people struggling with schizophrenia in developing countries had much better recovery rates than those in developed countries.

This piqued Whitaker’s interest.

Developing countries have less medical care, so why were their psychiatric patients better off?

What Whitaker discovered is that developing countries did not have the funds or resources to keep people on anti-psychotics long term.

And this, it turns out, was a good thing.

“We think medications fix chemical imbalances in the brain, curing depression,” said Whitaker.

“But this story fell apart in 1985.”

Science has never linked chemical imbalances with mental health problems, he said.

“The biological causes of mental disorders are still unknown.”

But chemical imbalances have become such “a standard metaphor for why people take depression drugs or antipsychotic drugs,” said Whitaker.

“The storytelling forces within the psychiatric (field) have kept this myth alive.”

This myth sells medication, he added.

“Chemical imbalances have been reborn as a marketing device for drugs like Prozac.”

Most patients struggling with depression and mental health who discover they don’t have a chemical imbalance are surprised and feel a little betrayed, said Whitaker.

“I mean, we don’t say, you have to take drugs for a hole in your heart, when you don’t have a hole in your heart.”

If antipsychotic and antidepressant drugs are not addressing imaginary chemical imbalances, what do they do?

This was Whitaker’s next question.

By now, this nosey medical journalist was making a name for himself.

And he wasn’t very popular with Big Pharma.

But Whitaker kept digging.

The more research he did, the more disturbing the findings.

Turns out, doctors aren’t sure what antipsychotics and antidepressants do to the brain.

“They know the drugs modify the brain,” he said.

But they still don’t know what is wrong with their patients’ brains in the first place.

“So these drugs aren’t designed to fix the problem,” said Whitaker.

“They just modify the brain and hope it will produce a therapeutic response.”

In some cases the drugs do seem to help, he said.

Over the short-term, patients on antipsychotics and antidepressants do better than patients on placebos, he said.

But over the long-term, it’s a very different story.

From 1980 through 2007, the National Institute of Mental Health did a 15-year study on the long-term effects of medication on schizophrenic patients.

“They expected the patients who weren’t taking medication would do poorly,” said Whitaker.

But the results turned all previous assumptions on their head.

In those 15 years, patients who were off their medication had a 40 per cent full recovery rate.

While patients on antipsychotics drugs had a five per cent recovery rate.

But this discovery barely made a ripple.

The National Institute of Mental Health didn’t publicize it’s findings, said Whitaker.

“Had the results has been the opposite, it would have been front-page news,” he added.

Whitaker linked to the study on his webpage, but was told by the journal that originally published it to take it down.

A similar study by the University of Calgary was done on antidepressants.

“It found that those on antidepressants were depressed 19 weeks of the year, while those not taking medication were depressed for nine,” he said.

Whitaker is not an “anti-med guy.”

Pills have their place, he said.

“It’s just we need to look at the long-term outcome data - which is really bad.”

Science needs to be honest, said Whitaker.

“Doctors need to admit these pills are not fixing chemical imbalances.”

Instead, governments should invest more money in psycho-social care, he said.

“Then we’d see people getting well.”

Whitaker was in the Yukon last month to talk about his findings.

And the territory’s housing crisis quickly made its way into his narrative.

“If people have shelter problems, we need to help with shelter,” he said.

“We need to help people lead healthier lives, exercise, eat better, access counselling, talk to therapists - we need to get people more socially involved.”

Pills are not a cure-all, he said.

“We see the most robust recoveries in (mental health) on people who go off medication, or never went on it in the first place.”

There’s lots of mental-health stress in the Yukon, said Whitaker, who was invited north by the Second Opinion Society.

“And it’s not just biological, it’s people not functioning well in their environment.”

Before writing a prescription, “we need to change these people’s environment and offer them shelter, food and supports,” he said.

“Only after that should we start looking at medication.”

To learn more about Whitaker’s work visit

Contact Genesee Keevil at