Psychiatric Medicines Are Overprescribed and Should Not Be the First Choice


Before we begin this article, I would like to note a disclaimer: Everything mentioned in this article is for informational purposes only – nothing constitutes health care advice. Please consult with your physician before changing any treatment protocol and ask your physician to work with you. If your prescribing physician is unwilling to work with you, you may want to consider looking for another licensed physician who will.

According to the Citizens Commission on Human Rights, a non-profit, non-political, and non-religious mental health industry watchdog, over 78 million (M) Americans are prescribed at least one psychiatric drug [1]. That is, nearly a quarter of the American population is taking some psychiatric medication. These drugs include ADHD (attention deficit hyperactivity disorder) medication (9.6M), antidepressants (44M), antipsychotics (12M), anti-anxiety drugs (32M), mood stabilizers (24M), and newer generation psychotherapeutics (1.2M) [1].

Skeptics may state, “What’s the issue? If people have a mental illness and are prescribed medication, why should the number of people be considered, since one must be prescribed these products by a doctor?”

Allen Frances, professor and Chairman of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine, explained, “‘Mental illness’ is terribly misleading because the ‘mental disorders’ we diagnose are no more than descriptions of what clinicians observe people do or say, not at all well-established diseases” [2].

A person merely describing their day-to-day life or a tough day they had may prompt their doctor to prescribe psychiatric medication. “Virtually anyone at any given time can meet the criteria for bipolar disorder or ADHD. Anyone. And the problem is everyone diagnosed with even one of these “illnesses” triggers the pill dispenser, noted Dr. Stefan Kruszewski, a graduate of Princeton University and Harvard Medical School. He has over 30 years of clinical and teaching experience in the psychiatry field [2].

And pharmaceutical companies likely know this, as drug companies need to sell pharmaceuticals to survive continually. This dilemma means companies are incentivized to invent new disorders so they can develop new medications. Much too often, this leads to psychiatric medication being created to medicalize a perfectly normal emotional process, such as bereavement [the grieving process]. Perhaps the clearest example of this is the industry's medicalization of menopause, a completely normal female process [3]. "In the shadows of this overmedicalization, the pharmaceutical industry is meeting unexpected resistance to its attempt to sell women the next profitable 'disease,' […] yet widespread and growing scientific disagreement exists over both its definition and prevalence," explained The BMJ in a 2005 study [3].

As a result, America faces an issue: the over-prescription of psychiatric medication.

In 2012, the American Psychological Association noted the growth in inappropriate prescribing of these medications. The article pointed out that a significant number of patients claiming to benefit the medicine do not benefit from the drug's active pharmacological effects but are benefiting from the placebo effect of merely taking a pill [4]. Indeed, a 2008 study investigated the clinical trials of four antidepressants and found no significant difference between the medications and placebos for mild to moderate depression, and the benefits of the drugs were "relatively small even for severely depressed patients" [5].

Another issue to consider is that in randomized controlled trials that show a clear benefit of psychiatric medications, those studies are significantly plagued with publication bias [6]. For example, a study published in Family Practice found that if a pharmaceutical company funds a randomized controlled trial, it is significantly more likely to report a positive effect than if it was funded by a non-industry source [7]. This suggests that a pharmaceutical company may not publish a study if it shows that their product is ineffective [8].

Since the benefits of these medications are likely overclaimed, their adverse side effects are also presumably understated. These effects can range from physical effects – fatigue, blurred vision, gastric disorders, headaches, dizziness, sexual dysfunction, risk of cardiac diseases, and weight gain – to worsened or new psychological symptoms. These include anxiety, suicidal ideation, and even increase suicide attempts [9]. In many cases, these side effects are significant enough to make up to 50% of patients stop taking their antipsychotic medication [10]. And in other cases, additional medication is prescribed to medicate the prescription’s adverse effects, which is a common phenomenon dubbed the psychiatric prescribing cascade.

Last year (2019), the Lown Institute, a nonpartisan think tank that incentivizes healing over profits, published the story of a patient who experienced a “prescribing cascade” firsthand [11]. Initially, the patient was prescribed an SSRI (Zoloft), which caused erectile dysfunction. He was then prescribed another antidepressant (Wellbutrin). Within a couple of months, he lost motor control of his body and would bang his head against the wall, which his nurse practitioner attributed to bipolar disorder. His nurse saw the problem, not as an effect of the drugs, but something that existed in the patient. She then prescribed additional antipsychotics to tame the effects. Still, the patient claimed he felt more depressed because of the combinations and cross titration between the medications than before when he first sought help. The patient changed providers for ten years, and at his peak, the patient was on five psychiatric medicines at once.

These stories are far too familiar – stories where a patient is far worse off after taking psychiatric medication than before.

The American health care system fosters this issue too. While it is illegal for pharmaceutical companies to give physicians kickbacks for prescribing medication, it is legal for companies to give money to doctors to promote a medicine [12]. Plus, it is much easier and more lucrative for a doctor to get health insurance reimbursements for drug treatment than recommending psychotherapy or (especially in this case) recommending natural supplementation and potential alternatives to psychiatric medication.

(If you are curious whether your doctor is funded by a pharmaceutical company, you can search your doctor here and investigate their financial relationships with the industry.)

Still, the right to prescribe it also the right to unprescribe. Doctors and providers should be reminded of the ethics that underly their profession. The Greek physician Hippocrates is considered to be the father of modern medicine. His oath, the Hippocratic Oath, famously called on practitioners to uphold individual ethics: “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course” [14]. Hippocrates profoundly believed it was the physician’s duty to protect life, not claim it. His beliefs stand as a reminder that even in 400BC, doctors needed to be reminded that their loyalty should be for the patient and their patient’s health, not some pharmaceutical company.

Nevertheless, it is hard for a doctor to follow the Hippocratic Oath and continuously and unequivocally prescribe psychiatric medications when, now, nearly 50% more people die of psychotropic medication overdose than heroin overdose [15].

Today, naturally oriented researchers, physicians, and scientists are researching holistic approaches to psychotropic drug withdraw [16] [17]. In a 2019 study, researchers split twelve patients into two groups: A) patients who sought to taper off their psychotropic medication and B) patients who sought mood support for protracted withdrawal symptoms. Their doctor individually treated both groups over several months. As they began to take less and less medication, they were given supplements to help detoxify their gut and promote nutrition.

“Vitamin and mineral supplementation (such as iron, methylated and activated B vitamins, and vitamin D3) was also consistently used to promote stable mood by providing cofactors for neurotransmitter and hormone synthesis, as well as increasing nutritional status to allow other physician health processes to take place,” noted the study.

“The basis for the dietary recommendations presented in this case series is to promote a healthy gut microbiome and decrease systemic inflammation, ultimately promoting increased levels of energy, mood, and cognition.” The researchers also recommended avoiding gluten, a protein found in wheat that increases systemic inflammation and promotes intestinal permeability, and dairy, which may also cause inflammation.

After the initial thirty-day protocol, up to four years later, these patients enjoyed a medication-free status, decreased symptoms, and a shift to a positive and fulfilling mindset.

This study is proof that there is another way. Doctors should not immediately prescribe psychiatric medication when their patients say they had a bad day. Instead, the doctor should first recommend lifestyle and dietary changes and recommend nutritional supplementation. Further, if a patient is interested in discontinuing their medication, they should insist that their provider works with them. And if their doctor says there is no other way, I would recommend presenting this study to the doctor, because it is proof that there is another way.

If you have questions about any nutritional supplements, please feel free to call our office at 800.726.1834.