Academic journal article Ethical Human Psychology and Psychiatry

Confronting Risk about Antidepressants for Children

Academic journal article Ethical Human Psychology and Psychiatry

Confronting Risk about Antidepressants for Children

Article excerpt

I first met Dr. Peter Breggin in 1992 when he gave a workshop in Reno, Nevada, on the toxicities of psychotropic medications. The workshop was cosponsored by the Reno V.A. Medical Center and the Department of Psychiatry and Behavioral Sciences at the University of Nevada School of Medicine. The events leading up to this workshop suggested that Dr. Breggin was a unique figure in psychiatry. A couple of weeks before the workshop, someone from the American Psychiatric Association contacted the director of the hospital to tell him that it was unwise to allow Dr. Breggin to present his workshop because his views were dangerous and outside of mainstream psychiatry. The director arranged a conference call with the APA representative and the organizers of the workshop. Though I was not in the room, I was later told by someone who was that during the course of the conference call, the director told the caller that the risks of medication treatment were a timely and important topic. He also told the caller that the hospital and the medical school supported academic freedom and would not cancel the workshop. The only concession the director made was to agree to a debate at the end of the workshop on the balance of risk and benefit for psychotropic drugs. Dr. Breggin's workshop went on as scheduled and resulted in the largest turnout of any workshop ever sponsored by the Reno V.A. Medical Center. Over 300 professionals (nurses, psychologists, counselors, and psychiatrists) attended, and many others were turned away at the door because the conference exceeded capacity. Dr. Breggin's presentation was passionate and data-based. The postworkshop debate with a prominent local psychiatrist was spirited and energized the crowd in attendance. The consensus was that Dr. Breggin handily won the debate.

What I learned from watching these events unfold was that there was a hunger among professionals for information about the risks of psychotropic medications. Although information was widely available on efficacy, the scientific literature had important gaps on the hazards of such treatment. Dr. Breggin's book Toxic Psychiatry (Breggin, 1991) helped to fill this gap in a way that no publication before it had done. In fact, the Department of Psychiatry and Behavioral Sciences, chairman at the time encouraged the entire faculty to read the book. I remember reading the book cover to cover prior to the Reno workshop and feeling I had been exposed for the first time to an exhaustive accounting of the risks of commonly used psychotropic medications. I realized that it was impossible to conduct a true risk-benefit analysis of any intervention with adequate information only about benefit and inadequate information about risk. I had been trained in a "first do no harm" model of treatment, and this concerned me. I also learned that powerful forces could intervene to try to disrupt the flow of such information if it threatened corporate interests.

This experience contributed to a shift in my interests away from benefit alone to the balance of risk and benefit of treatments for depression (e.g., Antonuccio, Burns, & Danton, 2002; Antonuccio, Danton & DeNelsky, 1995; Antonuccio, Danton, DeNelsky, Greenberg, & Gordon, 1999; Antonuccio, Danton, & McClanahan, 2003). I learned the importance of standing up for the data no matter whose ox is gored. I learned to appreciate my colleagues at the Reno V.A. Medical Center and at the Department of Psychiatry and Behavioral Sciences at the University of Nevada School of Medicine for their integrity and their support of academic freedom. In addition to finding him a warm and thoughtful individual, I came to respect Dr. Breggin's courage and stamina as a pioneer in the important and politically charged area of psychotropic medication risk. He was willing to answer any questions, and he would not shy away from a debate with anyone on the topic of psychotropic medications. His position was that the risks of these medications almost always outweighed the benefits. …

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