Byline: DR JOANNA MONCRIEFF

BIPOLAR disorder has become the 'fashionable' mental health diagnosis -- helped, no doubt, by the fact that many celebrities, including Catherine Zeta-Jones and Sinead O'Connor, have said they, too, are sufferers. But as a new book reveals, the readiness with which so many people are being diagnosed as bipolar means they're needlessly prescribed heavy-duty drugs -- with serious consquences for their health. . .

PSYCHIATRISTS are interested in drugs because we use a lot of them. Most people who visit a doctor for a mental health problem will come away with a prescription for at least one.

The most powerful and controversial are the antipsychotics. Heavyweight tranquillisers, they transformed the treatment of schizophrenia 60 years ago.

But remarkably for drugs designed for a relatively small number of very disturbed patients, antipsychotics are now among the most profitable drugs in the world, just behind statins and on a par with diabetes medications.

Indeed, newer versions of the drugs, such as Zyprexa and Seroquel, have become some of the most profitable drugs in history.

In the last ten years, prescriptions for antipsychotics for adults in Europe have increased exponentially.

But only a minority of these prescriptions will have been for schizophrenia, suggests the evidence, which would mean antipsychotics are no longer used only to treat severe mental disturbance, but have broken into the mainstream. This rapid expansion of their use may be good news for the pharmaceutical companies, but often it's far from being in the best interests of patients and we should be worried about their increasing use.

For while antipsychotics can be useful for those who are severely psychotic, these are dangerous drugs. The growing popularity of antipsychotics has occurred partly because of the newly fashionable diagnosis of bipolar disorder.

Once considered rare and seriously disabling, bipolar disorder has been transformed -- under pharmaceutical industry influence -- into a vaguer notion of 'mood swings' that can apply to almost anyone.

As a result, if you now visit your GP with depression or anxiety or if you have symptoms such as irritability, and moodiness, there is a significant possibility you will be given a diagnosis of bipolar disorder and prescription for an antipsychotic.

Worryingly, the drugs have also been suggested as a preventative measure in young people who are not psychotic, but might be 'at risk', and have been widely prescribed to elderly patients with dementia.

Nearly 18 per cent of the total antipsychotic drugs in Europe are prescribed for bipolar disorders And these drugs are harmful. I first became aware of how harmful they can be when as a junior doctor 20 years ago I worked in one of those vast asylums that was in the process of being closed down.

Some of the old inmates were still shuffling stiffly and aimlessly along the endless corridors. They looked heavily doped up and it struck me that the drugs hadn't returned patients to normality, as we were told they did.

I got a strong feeling that as a doctor I was not being told the whole story about antipsychotics.

The text books had almost nothing about the experiences of the people who took them.

I was determined to find out more about their effect.

THE MYTH OF A 'CHEMICAL IMBALANCE'

WHEN these drugs were discovered -- more than 60 years ago -- they were widely embraced The average expenditure bipolar by psychiatrists.

Unlike the straitjacket or electric shock therapy, they were said to treat not just the symptoms of schizophrenia -- dulling the voices and the visions -- but also to correct the underlying disease.

They did it, said leading researchers, by reversing a 'chemical imbalance' in the brain (although the evidence never really stacked up -- a rival, and I believe far more plausible, theory said the drugs worked by damping down brain activity, but this was rapidly forgotten. …