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Whitfield, 2010 Psychiatric Drugs as Agents of Trauma


Punarbhava
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This is an excellent excerpt and a must read.

 

The article covers the following topics and more:

 

- "Drug Stress Trauma Syndrome".........."how psychiatric drugs can act as traumatizing agents and make patients worse".

 

- how legal drugs can often be similar to illegal drugs but often have more toxic effects.

- how psych drug WD effects can last for months or sometimes years.

 

 

The International Journal of Risk and Safety in Medicine Volume 22, Number 4 / 2010 Pages 195-207 Online Date Wednesday, November 17, 2010

 

Psychiatric Drugs as Agents of Trauma

by Charles I. Whitfield, MD

 

Abstract at http://iospress.metapress.com/content/17668000738187w6/?p=e6d7f3443fb34573a02efa158cf61751π=0 PDF excerpt http://barbara-whitfield.blogspot.com/2010/12/psychiatric-drugs-as-agents-of-trauma.html and http://www.mediafire.com/download.php?c2hd3cwrr3wc3r5

 

Drawing on the work of numerous psychiatrists and psychopharmacologists and my own observations, I describe how most common psychiatric drugs are not only toxic but can be chronically traumatic, which I define in some detail throughout this paper. In addition to observing this occurrence among numerous of my patients over the past 20 years, I surveyed 9 mental health clinicians who had taken antidepressant drugs long-term. Of these 9, 7 (77%) experienced bothersome toxic drug effects and 2 (22%) had become clearly worse than they were before they had started the drugs. Based on others' and my observations I describe the genesis of this worsened condition which I call the Drug Stress Trauma Syndrome. These drug effects can be and are often so detrimental to the quality of life among a distinct but significant minority of patients that they can no longer be considered trivial or unimportant. Instead, they are so disruptive to many patients' quality of life that their effect becomes traumatic, and are thereby agents of trauma. These observations and preliminary data may encourage others to look into this matter in more depth.

 

 

 

From the pdf excerpt:

1. Introduction

Depending on how we look at it, trauma can be simple, complex, or somewhere in between. In its simpler form it is any serious injury to the body, often resulting from an accident or violence and sometimes from a drug or medical procedure. Beyond the body, psychological trauma often results from an event that causes great distress or an emotional wound leading to psychological injury [18, 28, 52], and which may also result from a drug or medical procedure. Psychological trauma often accompanies physical trauma. Trauma can result from natural disasters such as earthquakes, fires, floods, hurricanes and severe storms that often cause death, injury, and property damage. These are usually single events that involve fewer of the confounding and complicating variables present in so many other kinds such as combat trauma and child maltreatment and neglect, including physical, sexual, or emotional abuse, bullying, domestic violence, or the witnessing of any of these [12, 13, 39–41, 49].

 

Any of these traumas may lead to one of the three main variants of posttraumatic stress disorder (PTSD) [11, 45, 50], including classical, complex and sub-variant PTSD, summarized in Table 1. In this article I add a fourth kind by describing how psychiatric drugs can act as traumatizing agents and make patients worse, which I call the Drug Stress Trauma Syndrome (DSTS), described below. After taking one, and usually more psychiatric drugs over time, many people end up feeling more distressed. They may experience a worse quality of life than they did before they started taking the drugs [6, 7, 21, 25, 26, 33, 35, 46, 47, 49–51]. First, it will be useful to describe and contrast the drugs in context with common illegal drugs according to their risk and toxicity.

 

2. Illegal drug toxicity

Illegal drugs often have toxic effects on our body and mind [24, 31, 38]. There are also legal system consequences for simple possession and use in most countries. Having worked in the field of addic- tion medicine since 1974 and psychiatry since 1980, I rank illegal drugs in order of the most toxic and dangerous: 1) phencyclidine (PCP, “Angel Dust”) is number one. In decreasing order of toxicity, I rank 2) amphetamines, including methamphetamine, as second. Then 3) cocaine, another stimulant, and not much different than amphetamines, but with a detrimentally short half-life. Fourth, is 4) heroin, a painkiller like morphine and the other opiates – all with several toxic effects. Next are 5) psychedelic drugs (erroneously called “hallucinogens”). And finally, 6) cannabis (marijuana) is probably the most used illegal drug today, with the toxic effects of over-sedation or “dumbing down” (which most legal and illegal psychoactive drugs also commonly cause), lung irritation and damage, dependence/addiction and withdrawal symptoms. Like all these drugs their illegality, way of use (ingesting, snorting, smoking or injecting), and lifestyle add more to their toxicity.

 

As toxic as these six kinds of drugs are, and not to discount their dangers, to keep it in perspective, in the USA the legal drugs alcohol and nicotine disable and kill 25 times more people (about 500,000 yearly deaths) than all of these illegal drugs combined [36].

 

3. Legal drug toxicity: How might psychiatric drugs make you worse?

Just because a drug may be legal, i.e., approved by the FDA or the equivalent worldwide and readily available from the medical and psychiatric system (physicians, nurses, pharmacists and the like) does not make them any less toxic than the illegal drugs listed above. In fact, some of the legal psych drugs are as or more toxic [1, 6, 7, 26, 33–35, 44, 49–51]. Psychiatrist and psycho-pharmacologist Peter Breggin wrote in 2008 [6, 7], “People commonly use alcohol, marijuana and other non-prescription drugs to dull their feelings. Usually they do not fool themselves into believing they are somehow improving the function of their minds and brains. Yet when people take psychiatric drugs, they almost always do so without realizing that the drugs ‘work’ by disrupting brain function, that the drugs cause withdrawal effects, and that they frequently result in dangerous and destructive mental reactions and behaviors” (my italics).

 

....

Also in 1999 psychiatrist and psycho-pharmacologist David Healy and Richard Tranter described reactions to taking psychiatric drugs, including their withdrawal, as pharmacological stress diathesis syndromes [22]. They said, “Recent descriptions of discontinuation syndromes following treatment with antidepressants and antipsychotics, in some cases long lasting, challenge both public and scientific models of addiction and drug dependence. Antipsychotic and antidepressant drug dependencies point to a need to identify predisposing constitutional and personality factors in the patient, pharmacological risk factors in the drug and aspects of therapeutic style that may contribute to the development of stress syndromes. The stress syndromes following antipsychotics also point to the probable existence of a range of syndromes emerging within treatment. The characteristics of these need to be established” (my italics). Similarly, psycho-pharmacologist Ross Baldessarini and AC Vignera have called these psychiatric drug effects pharmacologic stress, iatrogenic pharmacologic stress, and drug discontinuation-associated stress [2, 3, 4].

 

....

Sooner or later, the patient either stops taking or forgets to take the drug, and for most psychiatric drugs, one of the most common toxic effects begins to occur–drug withdrawal symptoms. If the withdrawal symptoms are bothersome enough, the patient usually contacts their prescribing clinician or physician who should – but usually does not – recognize them as being in drug withdrawal. Instead, they tend to misinterpret the symptoms as a re-emergence or worsening of the patient’s original possible misdiagno- sis’ symptoms or signs [53]. With this misinterpretation, or second misdiagnosis, they commonly then prescribe a higher drug dose−or a different or stronger drug. They usually give the patient no education or insight on withdrawal symptoms, and again, no serious yet appropriate psychotherapy or counseling [6, 7, 33, 48–51].

 

The now-vicious cycle continues. Over time, the patient may become progressively more dysfunctional in their personal life, job, relationships, finances and/or with the legal system. As part of the DSTS, they often become physically ill, with one or more rushed and expensive emergency department visits, medical or psychiatric hospitalizations, violence, arrests, family dysfunction, relationship breakups, increasing medical costs and mounting debt. Eventually, similar to people with advanced alcohol or drug dependence, they may hit a “bottom”.

 

This phenomenon, process and iatrogenically- and pharmacologically-induced condition is what I have come to call the Drug Stress Trauma Syndrome (Table 3). Using definitions of each of its four terms, I show a simpler summary that explains why I chose its terminology of DSTS in Table 4.

 

....

8. Healing from DSTS

Complex features. This painful syndrome is not usually easy to recognize and diagnose. It usually cannot be readily seen in a 5 to 15 minute medication follow-up check by a physician – which is the usual time approved by the health insurance industry, aka “managed care”. If government-run medicine takes hold in the USA, it will get worse. It takes enough time to recognize the many dimensions of DSTS, which usually requires the taking of a careful and thorough initial history from the patient. Then it will likely take a number of follow-up visits and psychotherapy sessions, coordinated with a physician with expertise in treating PTSD and helping people slowly detoxify from psychiatric drugs. Many affected patients won’t be able to recognize that it is the drugs that are making them worse due to their lack of knowledge and the spellbinding effects of the drugs.

 

For the person who has DSTS or similar symptoms, negotiating their recovery may seem like trying to walk through a mind field. They usually have to deal with multiple people: Clinicians, health insurance and payers, family (some of whom may want them to stay “mentally ill”), friends, community, and other authority figures. Navigating all these requires a self-commitment and focus on recovery, with ongoing patience and persistence. Some several thousand traumatized and damaged patients and their families have brought successful lawsuits against the drug makers, especially for drug-caused completed suicides, diabetes, birth defects and addictions [29].

 

Based on my long experience assisting many patients with it, to help someone heal from DSTS the clinician usually has to first realize that the patient may have it. The patient may also eventually have to self-diagnose it. The clinician then helps them gradually (over months or longer) decrease the dose of the psychiatric drugs and eventually stop taking them. If appropriate, they may also consider referring the patient to a psychotherapist or counselor who knows how to assist with trauma recovery and if indicated, alcohol and other drug dependence recovery [14, 16, 17, 30]. The patient learns to tolerate the emotional and physical pain of withdrawal from the drugs and grieving any trauma effects. They will need to get the right nutrition, attend any appropriate self-help meetings such as AA, NA, ACA, CoDA, EA, or AlAnon, all while being patient and persistent over months and sometimes years. This is similar to the recovery approach that I have outlined in my other books, including especially My Recovery [48]. For more details, see Chapter 15 in Breggin’s Brain Disabling Treatments in Psychiatry [6] and Chapter 12 on Stopping Psychiatric Drugs in my book You May Not be Mentally Ill [51].

 

....

11. Conclusion

These effects of psychiatric drugs are so common and detrimental to the patient that they can no longer safely or accurately be called “side effects”. Instead, they are more appropriately called toxic effects. To recognize and make the diagnosis of DSTS when it exists will take an open minded and aware clinician who has a high index of suspicion for the possibility of its presence. It will take a clinician who can transcend their indoctrination by the drug industry and its influences that psychiatric drugs are as safe and effective as they have advertised and promoted. These drugs’ effects can be and are often so detrimental to the quality of life of so many patients that they can no longer be considered trivial or unimportant [1, 6, 7, 19, 25, 26, 33–35, 37, 47–51]. Instead, they are so disruptive to many patients’ quality of life that their effect becomes traumatic, and are thereby agents of trauma.

I hope that this article and its observations and preliminary data will encourage others to look into this matter in more depth.

Edited by Altostrata
added excerpt

To Face My Trials with "The Grace of a Woman Rather Than the Grief of a Child". (quote section by Veronica A. Shoffstall)

 

Be Not Afraid of Growing Slowly. Be Afraid of Only Standing Still.

(Chinese Proverb)

 

I Create and Build Empowerment Within Each Time I Choose to Face A Fear, Sit with it and Ask Myself, "What Do I Need to Learn?"

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  • 10 months later...
  • Administrator

Dr. Whitfield contacted me and requested to be added to our list of recommended doctors.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus

Excellent paper. Thank you, Punarbhava.

 

One of Whitfield's books can be read on line (The Truth About Depression), although I'm not sure if all of it is there:

 

http://books.google.com/books?id=OeAfaa6C5iIC&pg=PA237&lpg=PA237&dq=the+truth+about+depression+C.L.+Whitfield&source=bl&ots=7w1d7_se56&sig=abMUpoi9DOh-UukSCdAc7Rfw4j0&hl=en&sa=X&ei=9k-PT5W0OobH6QGg75WIBA&ved=0CC4Q6AEwAg#v=onepage&q&f=false

 

He's written quite a few, among them Not Crazy, which looks really interesting.

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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  • 1 year later...

Wow I love this as it states all the things I suspected and say but could not prove.  I feel something like hope or joy or relief... I am not sure it is more than I could have hoped for yet not enough as the knowledge is not yet applied.  Still it is a wonderful thing to see it here a good start.

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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This is a breath of fresh air... late but better late than never.  Now we have this knowledge I long suspected how do we get it applied?

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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"11. ConclusionThese effects of psychiatric drugs are so common and detrimental to the patient that they can no longer safely or accurately be called “side effects”. Instead, they are more appropriately called toxic effects."

 

I was very toxic on my psyche drug combos and had to visit numerus physicians wondering why I was this ill (not one doctor realized it was the drugs). I successfuly tapered but ended up with a iatrogenic illness. I can only hope more and more is written to educate others on the dangers of psychiatric drugs.

Unable at this time to correspond by private message.

 

Link to my Introduction thread: http://survivingantidepressants.org/index.php?/topic/2477-aria-my-psych-journey/

Reading my psychiatric records: http://survivingantidepressants.org/index.php?/topic/5466-drugged-crazy-reading-my-psychiatric-records/

My Success Story is listed under "Aria's Recovery".

 

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I wonder, is Drug Stress Trauma Syndrome a recognized diagnosis in the US? 

I am not a medical professional and nothing I say is a medical opinion or meant to be medical advice, please seek a competent and trusted medical professional to consult for all medical decisions.

 

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  • 1 year later...

I was just re-reading part of this, and wanted to add the link to the full document in case others wanted to read it:

 

http://api.ning.com/files/pZzle5EfYAxuI94soYCY-bakX27IT7*lRfEVU-L5*HJNMbVFpFeZsasNyvZWqHiPjc0yE8LreRAMJEjJrKPw3WjiOsoTj-wL/IJRSM_Whitfield_PsychiatricDrugsAsAgentsOfTrauma.pdf

I am not a medical professional and nothing I say is a medical opinion or meant to be medical advice, please seek a competent and trusted medical professional to consult for all medical decisions.

 

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