Brain & Drugs
  • Psychiatry Good and Bad

    Drug Bias

    Psychiatry in recent years has focused on the biochemistry of neurotransmitters, as revealed by drug action in experimental animals. Chemical theories of depression, for example, are often over-simplifications, based on observations of altered neurotransmitter synthesis and function in the brains of mice and rats. It has not been possible to study the living chemistry of the human brain; hence, we do not really know how relevant animal data is.

    The study of antidepressant drugs remains an abstract contribution to our general understanding that different brain systems utilize different chemical transmitters in highly organized, complex circuits to produce our mental states and behavior. The increasing use of antidepressant and other psychotropic drugs, is not, however, a favorable trend

    The root intellectual problem with psychiatry is that there is no coherent infrastructure of knowledge about what humans do, how they do it and why they do it. There is too little real biology in psychiatry. The use of drugs to modify brain function passes as biology but is not linked to any coherent understanding of brain function. Since the notions of drug interaction with the brain are all abstractions, arriving from research on animal brains, these ideas are disconnected from the biological reality lived by patients day after day. Psychiatrists, for example, will add chemicals to patients daily input of chemicals but show little or no interest in other chemicals that that the patient is inhaling and ingesting.

    I am convinced, for example, that the food intake of a person has a determining effect on the way their brain functions, but some psychiatrists are hostile to this insight. A reasonable approach, in my view, is to examine and modify a patients diet, improve nutrition and remove toxic chemicals in the air before prescribing drugs, but psychiatrists rarely take this approach. The use of psychotropic drug use would appear to be somewhat rational and regulated, but is largely an improvisatory and amateurish exercise rather than a coherent application of biological knowledge. You could argue that the use of drugs to modify brain function has some benefits for some patients, but prescription drug use can cause dysphoria, mental and neurological disorders. You could easily argue that the negative effects of psychotropic drugs exceed benefits.

    Too many patients receive prescriptions for multiple psychotropic drugs, a scrambled eggs kind of psychopharmacology. A simple rule of thumb for patients is that one well-chosen psychotropic drug has a chance of being beneficial long-term; more than one drug at a time will usually cause brain function to deteriorate. Several drugs at once confuse the mind, may be dangerous and may cause death by accident or suicide.

    "Nearly 90,000 adults go to emergency rooms each year for side effects of psychiatric medications, and a few specific drugs may be to blame for 57% of those visits. The study estimated that sedatives and anxiolytics were most often to blame, causing nearly 31,000 annual emergency department visits. Following those, antidepressants account for more than 25,000 visits, antipsychotics for nearly 22,000, lithium salts for 3620 and stimulants for 2779. The ten drugs that were implicated in most of the emergencies are the following, according to the research team: zolpidem tartrate (Ambien), a sedative; quetiapine fumarate (Seroquel), an atypical antipsychotic; alprazolam (Xanax), an anxiolytic; lorazepam (Ativan), a sedative and anxiolytic; haloperidol, an antipsychotic; clonazepam, a sedative and anxiolytic; trazodone, an antidepressant, anxiolytic and sedative; citalopram hydrobromide (Celexa), an antidepressant; lithium salts, a mood stabilizer; and risperidone, an antipsychotic." Hampton et al of the US Centers for Disease Control and Prevention in Atlanta, Georgia. Ten Drugs Cause Majority of ER Visits in Adults for Adverse Psych Med Effects. JAMA Psychiatry 2014

    Biologists, on the other hand, think in terms of populations, food supply, seasons, weather, and social-behaviors, and do field studies which reveal patterns of adaptation to specific environments. The biologist sees every living creature connected to and interacting with his/her environment. Anyone who has worked with animals or fish in closed environments knows how critical environmental conditions and diet are in determining both the behavior and the physical status of the residents. When a fish in an aquarium displays psychotic behavior, you do not call a fish psychiatrist; you check the oxygen concentration, temperature, and pH of the water. You have to clean the tank and change the fish diet.

      • You are viewing the Brain Drugs at Alpha Online. Understanding the human brain is essential to become a well-informed, modern citizen. Responsible adults need to become better informed about prescription drugs and exercise constraint when seeking and accepting prescriptions that alter brain function. The topics online are from the book, Human Brain, by Stephen Gislason MD, a physician-writer who is good at making complex subjects more understandable.

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