Is Zuzu’s Place against Medication?

To begin to answer this, consider that most members would agree with the Freedom Center’s answer to the same question:

No. … We believe in personal choice and empowerment as opposed to paternalism and control. We believe individuals should, with support and true informed consent, find out what works best for them. We believe that the existing “informed consent” of the psychiatric system is basically a sham. For informed consent to be authentic, everyone should have access to accurate information about “mental illness” and the real nature and toxicity of psychiatric drugs; that real alternatives to drugs should be funded and available; and that people should be actively helped to reduce and or go off psych drugs if that is what they want.

So does Zuzu's Place have an "official" drug policy?

Consistent with principles of personal choice and empowerment, the drug policy of Zuzu's Place is as follows:

  • At Zuzu's Place---just like in any other private home---the members of the cooperative are free to make their own decisions about their treatment (or lack of treatment), as well as about the form that such treatment does or doesn't take.

  • Because most of the members of the Zuzu's Place cooperative have been subjected to covert and/or overt (and, not infrequently, abusively violent) coercion to take neuroleptic medication, the co-op has adopted a drug-free culture. This means that:

    • All members of the co-op must be able to participate in a cooperative community and to avoid acting in a manner that compromises the safety of the community. People who are using neuroleptics (NLPs) and are "drugged up" to the point that the NLPs interfere either with their ability to live safely or with their ability to participate in a cooperative community would not be able to live at Zuzu's Place.
    • People at Zuzu's Place want to be able to live in their own home without having someone suggest that they need or should take medication. Uninvited or unwelcome "medication talk" is considered the equivalent of verbal threats or abuse, i.e., it is not allowed.

What's the problem with neuroleptic drugs?

Utilizing the medical model, psychiatric survivors have typically been told that they have a lifelong "brain disease" that must be treated with powerful, mind-altering (and brain damaging) neuroleptic drugs (NLPs). Though we cannot resolve the debate about medication and its efficacy or danger, we must acknowledge that this now traditional approach should, at least, be questioned, and that there is a profound empirical basis for such questioning.


Warning!

A guide to coming off psychiatric drugs.  Click to download.Though the empirical evidence (presented or linked to on this and other Yoism pages) shows that most people would do better if never given neuroleptic drugs, and that (given their dangerous side effects) most people should not be kept on them for very long, withdrawal from neuroleptics can be destabilizing and dangerous. The human body adjusts or becomes accustomed to drugs that are taken regularly. Abrupt withdrawal from such drugs and other substances can cause problematic reactions, e.g., DT's when withdrawing from alcohol and convulsions when withdrawing from barbiturates. Just so, withdrawal from the regular use of psychiatric drugs can pose serious dangers. If you are taking such drugs and wish to withdraw, it may be very important to obtain guidance from folks who know how to do so safely. Here is a link to an informational web site put together by people who have gone through (or supported those who have gone through) withdrawal from psychiatric drugs.
 



The following is a summary of some of the key questions that have been raised by the empirical evidence. It is taken from a memo by attorney James Gottstein, entitled "Opposing Forced Drugging."

The underlying assumption about the benefits of the drugs needs to be directly challenged . . . PsychRights has pulled this evidence together (to a large extent directly from the sources cited in Mad in America and will provide whatever assistance it can to "make the case." ... This evidence includes:

  • "An Approach to the Effect of Ataraxic Drugs on Hospital Release Rates," American Journal of Psychiatry, 119 (1962), 36-47 (Release Rates Study), which found that "drug treated patients tend to have longer periods of hospitalization."
  • "Relapse in Chronic Schizophrenics Following Abrupt Withdrawal of Tranquillizing Medication," British Journal of Psychiatry, 115 (1968), 679- 86 (Relapse Study). This National Institute of Mental Health study found relapse rates rose in direct relation to neuroleptic dosage--the higher the dosage patients were on before the drugs were withdrawn, the greater the relapse rates.
  • "Comparison of Two Five-Year Follow-Up Studies: 1947 to 1952 and 1967 to 1972," American Journal of Psychiatry, 132 (1975), 796-801 (Comparison Study). The Comparison Study "unexpectedly" found that psychotropic drugs did not appear indispensable and the data suggests neuroleptics prolong social dependency."
  • "Dopaminergic Supersensitivity after Neuroleptics: Time-Course and Specificity, Psychopharmacology 60 (1978), 1-11 (Supersensitivity I). Supersensitivity I reports that prolonged use of the neuroleptics studied, except clozapine, cause an increase in dopamine receptors in the brain) which results in a supersensitivity.
  • “Neuroleptic-induced supersensitivity psychosis,” American Journal of Psychiatry, 135 (1978), 1409-1410 (Supersensitivity II). Supersensitivity II found that the "tendency toward psychotic relapse" is caused by the medication itself and that this and other deleterious effects could be permanent.
  • “Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics,” American Journal of Psychiatry, 137 (1980), 16-20 (Supersensitivity III). Supersensitivity III confirmed that neuroleptic use leads to psychotic relapse when it is discontinued.
  • "The International Pilot Study of Schizophrenia: five-year follow-up findings," Psychological Medicine, 22 (1992), 131-145 conducted by the World Health Organization (WHO I). WHO I compared outcomes between patients with schizophrenia in developed and poor countries and found that that patients in the poor countries (where neuroleptic use was uncommon) "had a considerably better course and outcome than [patients] in . . . developed countries. This remained true whether clinical outcomes, social outcomes, or a combination of the two was considered."
  • "Schizophrenia: manifestations, incidence and course in different cultures, A World Health Organization ten-country study," Psychological Medicine, suppl. 20 (1992), 1-95 (WHO II) confirmed WHO I's finding and concluded "being in a developed country was a strong predictor of not attaining a complete remission." [Exc. 84].
  • "Empirical Correction of Seven Myths About Schizophrenia with Implications for Treatment," ACTA Psyciatrica Scandinava, 1994: 90 (suppl 384): 140-146 (Schizophrenia Myths) states in its abstract:

    This paper presents empirical evidence accumulated across the last two decades to challenge seven long-held myths in psychiatry about schizophrenia which impinge upon the perception and thus the treatment of patients. Such myths have been perpetuated across generations of trainees in each of the mental health disciplines. These myths limit the scope and effectiveness of treatment offered. These myths maintain the pessimism about outcome for these patients thus significantly reducing their opportunities for improvement and/or recovery. Counter evidence is provided with implications for new treatment strategies.

    * * *

    Myth Number One in Schizophrenia Myths is "Once a schizophrenic always a schizophrenic:" Evidence: Recent worldwide studies have . . . consistently found that half to two thirds of patients significantly improved or recovered, including some cohorts of very chronic cases. The universal criteria for recovery have been defined as no current signs and symptoms of any mental illness, no current medications, working, relating well to family and friends, integrated into the community, and behaving in such a way as to not being able to detect having ever been hospitalized for any kind of psychiatric problems.

    * * *

    Myth Number 5 in Schizophrenia Myths is "Patients must be on medication all their lives. Reality: It may be a small percentage who need medication indefinitely . . . Evidence: There are no data existing which support this myth." [Exc. 91].
  • A Critique of the Use of Neuroleptic Drugs," by David Cohen, Ph.D., in From Placebo to Panacea, Putting Psychiatric Drugs to the Test, edited by Seymour Fisher and Roger Greenburg, John Wiley and Sons, 1997, a comprehensive review of the scientific evidence regarding the safety and efficacy of neuroleptics (Cohen Critique). The Cohen Critique's summary of the scientific efficacy evidence included:

    • The ability of neuroleptics (NLPs) to reduce "relapse" in schizophrenia affects only one in three medicated patients.

    • The overall usefulness of NLPs in the treatment of schizophrenia is far from established.
  • The Cohen Critique also discusses an analysis of 1,300 published studies which found neuroleptics were no more effective than sedatives.
  • The side effects of these drugs are also addressed:

    [T]he negative parts [the side effects] are perceived as quite often worse than the illness itself. . . . even the most deluded person is often extraordinarily articulate and lucid on the subject of their medication. . . . their senses are numbed, their willpower drained and their lives meaningless.
  • Concluding, Dr. Cohen states:

    Forty-five years of NLP use and evaluation have not produced a treatment scene suggesting the steady march of scientific or clinical progress. . . . Unquestionably, NLPs frequently exert a tranquillizing and subduing action on persons episodically manifesting agitated, aggressive, or disturbed behavior. This unique capacity to swiftly dampen patients' emotional reactivity should once and for all be recognized to account for NLPs' impact on acute psychosis. Yet only a modestly critical look at the evidence on short-term response to NLPs will suggest that this often does not produce an abatement of psychosis. And in the long-run, this outstanding NLP effect probably does little to help people diagnosed with schizophrenia remain stable enough to be rated as "improved" -- whereas it is amply sufficient to produce disabling toxicity.

    A probable response to this line of argument is that despite the obvious drawbacks, NLPs remain the most effective of all available alternatives in preventing relapse in schizophrenia. However, existing data on the effectiveness of psychotherapy or intensive interpersonal treatment in structured residential settings contradicts this. Systematic disregard for patients' own accounts of the benefits and disadvantages of NLP treatment also denigrates much scientific justification for continued drug-treatment, given patients' near-unanimous dislike for NLPs. Finally, when social and interpersonal functioning are included as important outcome variables, the limitations of NLPs become even more evident . . .

    The positive consensus about NLPs cannot resist a critical, scientific appraisal.

The evidence is also now showing that the so-called "atypicals" are really no more efficacious, nor less dangerous than the older neuroleptics.
  • "Effectiveness and Cost of Olanzapine and Haloperidol in the Treatment of Schizophrenia: A Randomized Controlled Trial," by Robert Rosen heck, MD; Deborah Perlick, PhD; Stephen Bingham, PhD; Wen Liu-Mares, PhD; Joseph Collins, ScD; Stuart Warren, JD, PharmD; Douglas Leslie, PhD; Edward Allan, MD; E. Cabrina Campbell, MD; Stanley Caroff, MD; June Corwin, PhD; Lori Davis, MD; Richard Douyon, MD; Lawrence Dunn, MD; Denise Evans, MD; Ede Frecska, MD; John Grabowski, MD; David Rogers Orders (Mass) Memo Page 8 Graeber, MD; Lawrence Herz, MD; Kong Kwon, MD; William Lawson, MD; Felicitas Mena, MD; Javaid Sheikh, MD; David Smelson, PhD; Valerie Smith-Gamble, MD; for the Department of Veterans Affairs Cooperative Study Group on the Cost-Effectiveness of Olanzapine, JAMA. 2003;290:2693-2702. Conclusion: Olanzapine does not demonstrate advantages compared with haloperidol (in combination with prophylactic benztropine) in compliance, symptoms, extrapyramidal symptoms, or overall quality of life, and its benefits in reducing akathisia and improving cognition must be balanced with the problems of weight gain and higher cost.
  • "Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis," by Geddes J, Freemantle N, Harrison P, Bebbington P., BMJ (British Medical Journal) 2000 Dec 2;321(7273):1371-6 After a systematic and rigorous statistical analysis it was found that "There is no clear evidence that atypical antipsychotics are more effective or are better tolerated than conventional antipsychotics."
  • "Happy birthday neuroleptics! 50 year later: la folie du doute," by Emmanuel Stip, European Psychiatry 2002 ; 17 : 1-5. In this paper, Dr. Stip asks the following questions: "After 50 year of neuroleptic drugs, are we able to answer the following simple questions: Are neuroleptics effective in treating schizophrenia? Is there a difference between atypical and conventional neuroleptics? How do the efficacy and safety of newer antipsychotic drugs compare with that of clozapine?" There are a lot of interesting comments Dr. Stip makes about the lack of answers to these and other questions, but perhaps the most interesting is: "At this point in time, responsibility and honesty suggest we accept that a large number of our therapeutic tools have yet to be proven effective in treating patients with schizophrenia." He also notes: "One thing is certain: if we wish to base psychiatry on EBM [Evidence Based Medicine], we run the genuine risk of taking a closer look at what has long been considered fact."
To read about the marketing deceptions used by the pharmaceutical companies and how this clear evidence has been and is being purposely misconstrued, see this discussion that begins with excerpts from the already classic video of Tom Cruise on the Today Show.