Over the years as a psychiatrist I've evaluated innumerable cases of individuals who have been driven over the edge by psychiatric drugs. Many of these men, women and children were evaluated for legal cases but others were not. When I was re-evaluating about a hundred of these real-life stories for my latest book, Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime, I began to see a pattern that I call medication spellbinding. Technically, the new scientific concept is called intoxication anosognosia: not knowing that you are intoxicated.
Medication spellbinding has four basic effects.
First, people taking psychiatric drugs rarely realize how much the drugs are impairing them mentally or emotionally. They often do not recognize that they've become irrational, depressed, angry, or even euphoric since beginning the medication.
Second, if they do realize that they are having painful emotional feelings, medication spellbinding causes them to blame their feelings on something other than the drug. They may get angry at their husbands, wives or children, and become abusive. Or they might blame themselves and become suicidal. Often they confuse the harmful drug effect with their emotional problems and attribute their emotional distress to "mental illness."
Third, medication spellbinding makes some people feel that they are doing better than ever when in reality they are doing much worse than ever. In one case, a man who was high on a combination of an antidepressant and a tranquilizer happily went on a daylight robbery spree in his hometown wearing no disguise. Another otherwise ethical citizen happily embezzled money while documenting the details in easily accessible company computer files. Both men thought they were on top of the world.
Fourth, some people become so medication spellbound that they lose control of themselves and perpetrate horrendously destructive actions. My book opens with the story an otherwise kind and gentle man who became agitated on an antidepressant and drove his car into a policeman to knock him down to get his gun to try to kill himself. In another case, a ten-year-old boy with no history of depression hung himself after taking a prescription stimulant for ADHD. He documented the dreadful unfolding events while speaking in a robotic monotone into his computer.
Particularly striking to me, of those who have survived, none of the people I have evaluated has ever perpetrated again after stopping the offending medication. There has been zero recidivism in the cases I have evaluated and who have stopped taking the medication.
Similar effects can occur from alcohol and street drugs. When a person's drunk, he might think he's the life of the party when he's the death of it. And of course, alcohol and street drug intoxication are associated with a great deal of crime and violence. But there is a difference between the effects of taking alcohol or other drugs on your own and taking drugs prescribed by a physician. Most people believe that their doctor would never give them anything that could make them violent, suicidal, or just plain crazy. Often the doctor reassures the unwitting patient that he needs to take more of the drug that's driving him over the edge.
The law in most states recognizes the difference between taking an intoxicating substance on your own and being prescribed one by a physician. If you do something irresponsible under the influence of alcohol or an illegal drug, the law is likely to hold you responsible. It is called a voluntary intoxication. You should have known better than to get intoxicated and you should have foreseen the consequences. But if you've been prescribed a drug, especially without being given any warnings about the risks, that's called an involuntary intoxication. You're not aware of the risks and dangers; you're simply following your doctor's prescription by taking something that's supposed to help you. The law looks more sympathetically on involuntary intoxications. Many states allow for a defense of not guilty because of an involuntary intoxication.
It's important to understand that all psychoactive substances impair higher brain function and with that they impair judgment. People who are a little tipsy on alcohol or a little high on marijuana may experience it as enjoyable. Similarly, people who take psychiatric drugs may experience relief from emotional anesthesia or an artificial high on an antidepressant, tranquilizer, or stimulant. Or they may get some relief from the lobotomizing effect of an antipsychotic drug or the blunting impact of a mood stabilizer. In every case, the seeming improvement is a manifestation of brain dysfunction, and judgment is always impaired.
I am not critical of the occasional and responsible use of legal recreational drugs like alcohol. But I do not believe that a drug can help people solve their personal problems. Psychiatric drugs -- like all psychoactive substances -- work by impairing brain function, and when we're under stress and have problems to solve we need a fully functioning brain and mind. We need to be able to take complete responsibility for ourselves and to think through our problems with rational clarity. All psychiatric drugs impair those higher mental functions.
Instead of mind-altering drugs, we need courage, determination, self-discipline, and sound principles to face and overcome our personal problems. Counseling and therapy can help many people, but the contest is not between psychiatric drugs and psychotherapy -- it is between drugs and all of the many ways in which people learn to overcome emotional suffering and to triumph in life, including love, family life, devotion to the community, principled living, and spirituality.
Peter R. Breggin, MD, is a psychiatrist. His latest book, now in paperback, is Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime (St. Martin's Pres, 2008). His website is www.breggin.com and his email is psychiatricdrugfacts.com.
The Conscience of Psychiatry: The Reform Work of Peter R. Breggin, M.D. is the first biography of Dr. Breggin's work. Edited and sponsored by the International Center for the Study of Psychiatry and Psychology, it will be published in the fall 2009. Advance orders with an audio bonus can be purchased only on www.breggin.com.