Critical Psychiatry Textbook, Chapter 16: Is There Any Future for Psychiatry? (Part One)

Editor’s Note: Over the next several months, Mad in America is publishing a serialized version of Peter Gøtzsche’s book, Critical Psychiatry Textbook. In this blog, he discusses the myths perpetuated by mainstream psychiatrists and the dishonest way they respond to critics. Each Monday, a new section of the book is published, and all chapters are archived here.

The industry has bought doctors, academics, journals, professional and patient organisations, university departments, journalists, regulators, and politicians. These are the methods of the mob.
—Richard Smith, previous editor of BMJ^6:viii

What makes this book new and worth your attention? The answer is simple: the unique scientific abilities, research, integrity, truthfulness, and courage of the author. Gøtzsche’s experience is unequaled.
—Drummond Rennie, editor of JAMA^6😡

These are extracts from the forewords to my 2013 book about organised crime in the drug industry.⁶ I have shown in this book that you cannot trust the randomised trials, the drug industry, or the psychiatric leaders. The editors say in their forewords to my 2013 book that I can be trusted but, more importantly, I have tried to document what I say so you can make up your own mind.

You cannot even trust the drug regulators. As David Healy has pointed out, in contrast to drug agencies, airline pilots are critically concerned with our safety because if we go down, they do too.⁶¹⁷ There is widespread corruption in the FDA at the highest levels, including several commissioners,⁶ and in 2009, nine FDA scientists wrote to President Obama about this.^618,619 In 2012, it was revealed that FDA management had installed spyware on the computers of five scientists who had alerted the FDA to safety problems to no avail and therefore had informed the politicians.⁶²⁰

It must be very tempting for drug companies to bribe officials at drug agencies. There is an enormous amount of money at stake and the approval of a new drug can be the difference between life and death for a company. In 2012, Danish Lundbeck and its Japanese partner Takeda submitted vortioxetine, an SSRI, for regulatory approval in the United States.⁶²¹ Lundbeck’s blockbuster, escitalopram, was running out of patent, and the company would receive a $43 million milestone payment from Takeda if FDA accepted the drug.

It is paradoxical that, while drug firms don’t trust each other, drug agencies are supposed to trust the entire industry because they cannot review more than a tiny fraction of the mountains of documents they receive.⁶²² The regulators don’t even check that everything is included. I have found numerous examples that whole appendices or many pages in the middle of a report were missing,^279,326 and also of missing cases of suicidality,²⁷⁹ in clinical study reports of placebo-controlled trials submitted to European drug regulators for marketing approval.

Psychiatry’s narrative is that drugs are very often needed, both in the acute phase and long-term to prevent relapse; that specific drug treatments have been known for about 65 years;^18:232 that the drugs are generally effective and safe; and that the new psychiatric drugs are highly beneficial.^18:307

The truth is that none of the many psychiatric drugs have specific effects; the drugs rarely have clinically relevant effects and are therefore rarely needed, not even in the acute phase; an effect on relapse has not been demonstrated; and the drugs are far from being safe. There is an epidemic of overdiagnosis and overtreatment with psychiatric drugs to such an extent that, based on the most reliable research I could find, I estimated that psychiatric drugs are the third leading cause of death, after heart disease and cancer.^7:12,7:307

The denial of the facts in the psychiatric profession is massive. In 2011, a group of prominent psychiatrists wrote:⁶²³

“Persistent, untreated depression produces a type of neurodegenerative disorder, associated with synaptic changes … Similar to poor control of blood sugar in diabetics, poor control of symptoms in Major Depression is associated with worse long-term outcome and greater overall disability … antidepressants prevent relapses … 53% of the placebo patients relapsed, whereas only 27% of drug-treated patients relapsed … After the FDA issued a black warning [sic] against antidepressants … there has been a concomitant increase in actual suicide … There have been concerns regarding whether certain antidepressants may cause suicides. We now know this is a myth largely fuelled by the media … Newer studies of children do not confirm an increase in suicidal ideation … Naturalistic studies show that the incidence of the suicide rate tends to go down as the incidence of antidepressant treatment goes up.”

I fail to understand how Stefan Leucht, who has published much good research and is an editor in the Cochrane Schizophrenia Group, could co-author this harmful nonsense. It shows that the collective delusions and denial in psychiatry hit even the best psychiatrists. It is very tragic for the patients, their relatives, and psychiatry itself.

A 2012 newspaper article written by four leading Danish psychiatrists called Behind the Myths About Antipsychotics was similarly tragic.⁶²⁴ They wrote that most patients suffering from schizophrenia have disturbances in the dopamine system; the genes are by far most important (about 70-80%); large international registry studies show that patients with schizophrenia who are not treated with psychosis drugs are at higher risk of dying prematurely than patients who are in treatment; numerous studies have documented that the risk of new psychotic episodes and a more severe course of the disease is increased if patients stop taking psychosis drugs; that they found no indications that polypharmacy with psychosis drugs increases mortality in their large study; and that large register-based studies in Denmark and Finland show that concomitant treatment with several psychosis drugs is not associated with increased mortality.

Leading psychiatrists constantly tell the public such nonsense, which is dangerous for their patients. They claim that psychosis pills reduce mortality when the truth is the opposite, and they happily continue their Titanic course towards the iceberg, which they refuse to see.

Here is a patient story from one of the psychiatrists’ university hospital in Copenhagen.^7:277 A patient was admitted with mania, and although he asked not to be treated with drugs, he received forced treatment with olanzapine. In his own words: “At discharge, when I had been declared cured after my first-episode mania, I tried to behave well, fearing that I might not be released. The psychiatrist forcefully urged me to continue with olanzapine. I didn’t dare tell her that I had spat out most of the pills in the washbasin and therefore asked, for the sake of appearances, for how long she thought I should take the drug? For the rest of my life, she replied, because I had a chronic disease, with a great risk of relapse, and I should not be afraid of the harms.”

The reason why the patient didn’t take the drug was that he had read the newspaper article I published in January 2014 about ten harmful myths in psychiatry, which also exists in English,¹⁸⁹ and he has been well ever since without drugs.

The same day my article about the ten myths appeared, Thomas Middelboe, chairman of the Danish Psychiatric Association declared in the same newspaper, on its website:⁶²⁵ “Antidepressant drugs protect against suicide.” A month later, 16 Danish professors in psychiatry responded to my article⁶²⁶ without mentioning my name, just like one was not supposed to mention the evil Voldemort’s name in Harry Potter. They wrote that a number of studies show that treatment with psychosis drugs increase longevity, compared with no treatment.

I have given many examples in this book that leading psychiatrists have no problem with claiming the exact opposite of the truth. In 2005, Steven Sharfstein, then president of the American Psychiatric Association, wrote that “Pharmaceutical companies have developed and brought to market medications that have transformed the lives of millions of psychiatric patients.”⁶²⁷ Sure, but not for the better. He added that “Big Pharma has helped reduce stigma associated with psychiatric treatment and with psychiatrists.”

Is there any hope for a specialty like this? I have heard critical psychiatrists say that their leaders suffer from cognitive dissonance, as what they see and hear doesn’t influence them. Many books have documented that the psychiatric leaders have given up rational thinking for the benefits they acquire themselves from supporting a totally sick system. Even psychiatrists who have used monstrous overdoses of psychosis pills are allowed to practice.^8:143 Why don’t our politicians care that incompetent psychiatrists kill hundreds of thousands of their patients every year (see Chapters 7 and 8)? Or that the lives of many millions of children get destroyed?

Psychiatric drugging of children is a form of child abuse that should be prohibited, with rare exceptions. We are not allowed to beat our children but are allowed to destroy their brains with drugs. We medicalise the conflicts that arise between parents and children, and methylphenidate has become the modern version of the cane. This is a flagrant abuse of a faulty disease model.

Little has changed in recent years. If you google what causes ADHD, you can find this misinformation from the UK National Health Service, directed toward the public and last reviewed in December 2021:^10:39,628

“ADHD tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition … Research has identified a number of possible differences in the brains of people with ADHD from those without the condition … Other studies have suggested that people with ADHD may have an imbalance in the level of neurotransmitters in the brain.”

The drugged child’s brain cannot develop in its intended manner but develops in response to a toxic internal environment. The stigmatisation and loss of self-esteem, which often follows psychiatric diagnosis and treatment, is especially ominous in children who have yet to shape their personalities, and it can hamper future opportunities even without considering the potential brain damage caused by the drugs. Children may learn to view themselves as physically or genetically disabled, with impaired self-determination and increased feelings of helplessness.⁵²⁶ This cruelty must be stopped.

Imagine if a virus suddenly appears that makes people sleep 12-14 hours a day and move around slowly and become emotionally disengaged.^5:207 Some gain 30 kg of weight, their blood sugar and cholesterol go up, and they develop diabetes. People infected die substantially earlier than other people, some kill themselves, and parents panic over the thought that their children might also contract this horrible disease. Scientists find out that the virus blocks a multitude of receptors in the brain—dopaminergic, serotoninergic, muscarinic, adrenergic, and histaminergic—which lead to compromised brain function. MRI studies find that the virus shrinks the cerebral cortex, which is tied to cognitive decline. A terrified public clamours for a cure.

Such an illness has hit millions of children and adults. It is not a virus. It is Eli Lilly’s bestselling psychosis drug, olanzapine (Zyprexa). But since it is a drug, we do nothing. Drugs are taboo.

The only hope we have is if people protest so vigorously that it becomes an unstoppable revolution.

In 2017, a young Swedish psychiatrist, Joakim Börjesson, came to Copenhagen to do research with me.⁴²⁸ He became very impressed during his medical studies when a psychiatrist told the students that they knew so much about the brain and the drugs that they could use drugs that were specifically targeted to work on a disorder’s biological origin, the so-called chemical imbalance idea. He found it so fascinating that he decided to become a psychiatrist.

Joakim is cleverer than most of his colleagues. After having read books by Robert Whitaker and me, he realised that he had been totally fooled and considered leaving psychiatry.

In January 2018, he arranged a session in Göteborg during the annual conference for 150 Swedish psychiatrists in training where I debated with clinical pharmacologist and professor Elias Eriksson about SSRIs.^8:147

During the session, I mentioned that Eriksson had entered a secret agreement with Lundbeck against his university’s rules, which meant that Lundbeck could prevent publication of his research if they didn’t like the results. I said this because Eriksson routinely “forgets” to declare his conflicts of interest, but I was immediately stopped by the chair. Later, the Ombudsman criticised the university for covering up the affair.⁶²⁹

What is typical for debates with people who try to defend a sick system also happened this time. Eriksson broke the rules for the debate, he lied, and he used dirty tricks in his attempts at convincing the audience that I could not be trusted. Joakim informed me that Eriksson had said before the session that he had the intention to “‘reveal that Peter Gøtzsche is a charlatan’ during his lecture. We then discussed this for about an hour and I fruitlessly tried to convince him to adhere to the rules for the debate with no success.”

Eriksson claimed that none of the harms of the pills were irreversible; that they were not addictive; that criticism of the pills was “ideologically founded”; and that their use according to the critics was the result of a worldwide conspiracy that included psychiatrists, researchers, authorities and drug companies. Five months earlier, when I debated with Eriksson on Swedish radio, he said the pills helped dramatically and prevented suicide.

After the meeting, I was told that many psychiatrists had not understood my explanations about depression pills causing suicide. When I present the same slides for a lay audience, they always understand them. The psychiatrists don’t want to understand what is too painful for them.

In 2013, when Robert Whitaker was invited to speak at a meeting in Malmö that child psychiatrists had arranged, other psychiatrists intervened and got control of the meeting. They requested that he should only speak about the dopamine supersensitivity theory and not present any data on long-term outcomes.

When he arrived, Bob was told that Eriksson would be his opponent, and he spent his time denouncing Bob in an unbelievably dishonest fashion. In Bob’s own words: “The whole thing was a disgusting setup that stands out for its complete dishonesty, from start to finish.” Eriksson declared that he considered Bob to be a “charlatan who tortures patients.”

I had planned on coming, but Eriksson declared that he would not participate if I showed up.

It is strange how psychiatry’s apologists constantly call their opponents charlatans or worse and use strawman arguments. None of us have ever postulated anything about a “conspiracy.”

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To see the list of all references cited, click here.