/, Health, Psychotherapy/Anti-Depressives: Some rather depressing news

Anti-Depressives: Some rather depressing news

I’ve never liked the word ‘depression’. The Victorians referred more accurately to chronic sadness as ‘melancholia’.

Psychiatry has struggled for decades to find a chemical solution by which to ‘treat the brain’ in order to alleviate this awful problem.  Success has been hard to come by and both the psychoanalytic school of thought and the anti-psychiatry movement have always maintained that ‘depression’ will always need to be treated non-chemically as it is a ‘dis-ease’ of the mind rather than a sickness of the brain. Unfortunately this usually involves that most precious of medical commodities – time. Putting a pill in a patient’s mouth to treat their brain is much more time-efficient than trying to interact with their minds so the latest batch of antidepressives, called SSRIs were hailed as a major breakthrough and marketed with typical aggressive confidence.

Reports such as Kirsch et al suggesting these drugs were generally no better than placebo were ‘heard’ and then conveniently swept under the table. As I reported here, the prescription of these drugs in the UK went through the roof – after these warnings. Now a major report in a Scientific American, a respected scientific journal  has had the guts to take the lid off Pandora’s box and what has come out is less than pretty.

I drew attention to the fact that homeopaths who therapeutically listened to their patients for hours before prescribing very safe medicines to them were being roasted alive by critics who maintained homeopathy was a waste of NHS money. When I pointed out that the NHS budget for these controversial anti-depressives was at least 20x that of ALL  homeopathic medicines prescribed on the NHS, they either ignored me or jeered at me continuing to bleat the populist medical ‘wisdom’ espoused by the so-called ‘sceptics’ of homeopathy and natural medicine. Hate to say ‘I told you so’ (not really) but I did! See here.

Now this article in Scientific American referencing an article in the British Medical Journal should make them hang their heads in shame and mirrors to all of us how little they actually care about patients. No doubt they will have little interest in this post or the article it refers to and will aim further kicks at the NHS ‘wasting money’ on homeopathy where doctors listen intently  and patiently to their patients’ accounts of both physical and psychological symptoms as an important part of the process.

Hypocrisy rules! Perhaps it always has.

 

 

 

By | 2016-02-04T16:21:44+00:00 February 4th, 2016|Current Affairs, Health, Psychotherapy|9 Comments

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9 Comments

  1. paul February 4, 2016 at 6:12 pm - Reply

    I am not sure if is hypocrisy or just a mindset that is unable to see anything other than its own perspective? Reading much of what skeptics write they do appear to be entrenched in their world view. Hypocrisy to me is more about pretending to be holier than thou. Most skeptics do actually believe they are holier than thou. The articles you refer to are part of an increasingly tragic situation. The medical system is failing, especially in the area of mood and thought disorders. Mental health systems are at breaking point and staff are no longer able to provide the care and support needed to what appears to be ever increasing numbers of people presenting with difficulties. What do people do in these situations? They by nature retreat into what they know and most medical systems will revert to the easiest answer which is the prescription pad.

  2. Dr. Kaplan February 7, 2016 at 3:56 pm - Reply

    I agree. The hypocrisy is only when they talk about money and the NHS.

  3. robin frost November 1, 2016 at 8:54 pm - Reply

    Not really- hypocrisy would be where those refusing to allocate the NHS budget to alternative medicine/homeopathy on the basis that it is not proven/ doesn’t work then privately seek treatment by alternative medicine. What you mean is that they don’t understand, or are ill informed or cowardly or are being bribed. I am none of the above and I need to see you Brian; will call to make an appointment!

  4. Adzcliff December 20, 2016 at 8:21 pm - Reply

    Hi Paul

    You said this:

    “Most skeptics do actually believe they are holier than thou. The articles you refer to are part of an increasingly tragic situation. The medical system is failing, especially in the area of mood and thought disorders.”

    If this is genuinely your position, how is it not too a position of skepticism? Why is it okay to accept clinical evidence to accuse psychiatry of failing, but evidence-based criticism of other therapeutic modalities is to be ‘holier than thou’? Genuine question.

    Thanks.

    • Dr. Kaplan December 21, 2016 at 12:18 pm - Reply

      There are the facts about groups of medicines, facts about money, facts about policy statements and facts about how this debate has been conducted.

      The clinical effect of antidepressives and homeopathic medicines – as measured solely by randomised clinical trials (ie crucially not by outcome studies) – remains contraversial: FACT

      The money spent by the NHS on just one group of antidepressives (SSRIs) is at least (probably much more now) 20x the NHS money spent on homeopathic medicines: FACT

      Both groups of medicines have been under some scrutiny by various groups of investigators and both have come under cricism: FACT

      BUT:
      * Only homeopathy has been compared to witchcraft, been insulted, demeaned, have it’s practitioners accused of ‘praying on the vulnerable’ etc
      * Only homeopathy has had a star chamber-like ‘investigation’ into it by a parliamentary select committee.
      * Only homeopathy has had whole organisations created to undermine it and have it removed from the NHS altogether.
      * Anti-homeopathic organisations have managed to persuade some private insurance companies not to pay for homeopathic treatment by doctors while having nothing to say (or don’t care) about psychiatrist prescribing unproven SSRIs

      I called this ‘hypocrisy’ but as has been pointed out below, this is not really hypocrisy. What this is clearly an example of is vicious, cruel and unfair double standards being applied to homeopathy while a much bigger financial concern, psychiatry is given a free pass. SSRIs are made by Big Pharma and well protected by Big Money; homeopathy has none of that protection, it’s main case being that it is used successfully (in the opinion of its users) by hundreds of millions of people worldwide.

      • Adzcliff December 22, 2016 at 10:40 pm - Reply

        Here we go, as promised:

        “Only homeopathy has been compared to witchcraft, been insulted, demeaned, have it’s practitioners accused of ‘praying on the vulnerable’ etc.”

        I think I’ve pointed out before this isn’t true. Psychiatry bashing is alive and well in critical mental health and survivor circles. Just spend some time browsing the relevant literature and discussion forums and you will find psychiatry accused of pseudoscience, iatrogenia, professional arrogance, corruption, abuse, negligence, profiteering, quackery, and compared to astrology and the catholic confessional.

        “Only homeopathy has had a star chamber-like ‘investigation’ into it by a parliamentary select committee.”

        Questionable. Not a select committee granted, but the Council For Evidence-Based Psychiatry recently sponsered a Westminster All-Party Parliamentary Group for Prescribed Drug Dependence to discuss evidence of the link between the rise in disability claimants and the record level of antidepressant prescribing. So a parliamentary event looking specifically at the possible harms caused by psychiatry; I recommend watching it.

        “Only homeopathy has had whole organisations created to undermine it and have it removed from the NHS altogether.”

        Questionable. Organisations such as Asylum and the Anti-Psychiatry Coalition appear to actively campaign for the complete abolition of psychiatry, which seems much more extreme that just trying to place it outside of the publically-funded health and social care system. There are also many more organisations whose raison d’etre is to subject psychiatry to varying levels of ethical and scientific scrutiny: take the Critical Psychiatry Network, ISPS, Hearing Voices Network and Community/Critical Psychology groups.

        “Anti-homeopathic organisations have managed to persuade some private insurance companies not to pay for homeopathic treatment by doctors while having nothing to say (or don’t care) about psychiatrist prescribing unproven SSRIs”

        Fair enough. I don’t know much about this, but could well imagine that psychiatry has had a much easier ride than its evidence-base warrants from a health insurance perspective.

        I would still be interested to know of any critical-minded homeopaths producing book titles analogous the following in critiquing the beliefs and practices of their own profession: “The Myth of Mental Illness”, “The Myth of the Chemical Cure,” “The Bitterest Pills”, “Toxic Psychiatry”, “Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life”, …to name a tiny few. Seriously, who are the critical homeopaths? I honestly can’t think of a single one…

        Many thanks.

        • Dr. Kaplan December 23, 2016 at 1:02 pm - Reply

          A lot of points to answer:
          Psychiatry bashing: Psychiatry is alive and well and being heavily funded on NHS. Words and accusations are one thing. Whole organisations with questionable financing behind them, campaigning to end NHS homeopathy is quite another

          Unproven psychotropic drugs vs. homeopathy: Sales of SSRI have gone through the roof since GPs have been warned about their use. Psychiatrists on the NHS and private are doing fine financially – thank you very much – as are manufacturers of their unproven meds.

          Re: ‘I don’t know much about this, but could well imagine that psychiatry has had a much easier ride than its evidence-base warrants from a health insurance perspective.’ Thanks for acknowledging the gross double standards that have been applied with the much bigger financial concern being protected and the smaller one thrown to the dogs. This is my main point really.

          Re: Your last paragraph: Yes I know Szasz et al well. And yes homeopathic doctors have done this. eg. One of my teachers an ex-consultant at the RLHIM who used alternative medical approaches but was also sceptical about a lot of ‘Alternative’ medicine. See brief note on him here: https://en.wikipedia.org/wiki/Anthony_Campbell_(physician)

          Have a good Xmas

          Brian

      • Adzcliff December 23, 2016 at 11:36 am - Reply

        And I may be wrong on this, but if we are talking about ‘free passes’, it may be that the homeopathic industry manages, undeservedly, to avoid accusations of unbridled capitalism that Big Pharma does not. Last time I looked, the UK’s largest homeopathic retailer, Holland & Barret, was owned by the multi-national Carlyle Group – the largest private equity firm in the world – that also enjoys profits from pharmaceuticals and the weapons industry. In terms of influence in Government, I think George W. Bush was on their board for some years into his presidency. I’m not sure what market share Boots occupy, but there’s another multi-billion dollar homeopathic retailer that also produces, wholesales and retails in pharmaceuticals (and we can be pretty sure here that Boots’ interest in homeopathy is entirely motivated by market demand). I appreciate that Boiron (the World’s largest homeopathy manufacturer) is eclipsed by its Big Pharma competitors with their multi-billion dollar turnovers, but with yearly turnovers of €608 million, you can hardly call it a cottage industry (not saying you did of course). Add Boiron alongside all the other homeopathic manufacturers, then I’m fairly confident we could call it a billion dollar industry. (A billion dollar industry may still be tiny compared to a multi-billion dollar industry, but it’s still a billion dollar industry, and a giant compared to all the multi-million dollar industries, which aren’t to be sniffed at.)

        There we go, I will leave you in peace. Enjoy your Christmas (and thank you for posting these more critical conversations on your blog).

  5. Adzcliff December 21, 2016 at 5:19 pm - Reply

    Thanks for this Dr Kaplan.

    We have debated before about the value of scepticism in thinking and talking about psychiatric and alternative medicine, and your answer here goes well beyond my very specific question to Paul (who may or may not ever read it). My genuine question was more about how he decides when sceptism does and doesn’t apply in thinking about different therapeutic beliefs and modalities. However, your reply is tantalizingly provocative, so will drop you an answer later when I have more time.

    Regards

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