Drugs can only help - not hurt, doctors say

An Oregon doctor has taken issue with comments from a spokesperson for the MAD Pride movement who argued that new anti-psychotic drugs can be dangerous.

Chuck Areford, a long-time health worker in the Oregon area, made his comments in a July 10, 2008 blog post on Coping with Life.

Richard Staggenborg, a board certified psychiatrist working for the Department of Veterans Affairs in Oregon, said Areford makes some highly debatable, "if not flatly false," assertions about the risks vs. benefits of antipsychotic medications.

Staggenborg said he only perfunctorily acknowledges the risks of discontinuing these medications without medical supervision before going on to argue essentially that they should never be prescribed.

"His entire thesis undermines the credibility of the doctors under whose supervision he states patients should adjust their medication," he said. "The effect is to encourage them instead to make decisions to stop their medications on their own or on the advice of well-meaning but misinformed nonmedical experts such as himself."

He challenged Areford's assertion that “the life expectancy of those treated in mental health centers has plunged to an appalling 25 years less than average (since the introduction of atypical antipsychotics).”

Rispiridone, he said, the oldest antipsychotic in widespread use, was not introduced until 1993. "Clearly, this remarkable claim is based on extrapolation from highly questionable assumptions," he said.

Staggenborg said it is "indisputably true" that some of these medications have substantial risks of metabolic side effects, such as high cholesterol and increased risk of diabetes. But others have not been clearly linked to these problems, he said, despite the mandatory Food and Drug Administration class warnings.

"These risks have to be balanced against the devastating consequences of schizophrenia and bipolar disorder, the illnesses for which they are most clearly indicated," he said. "One of these risks is a substantially increased chance of suicide in untreated mania, bipolar depression or schizophrenia. Treatment of these conditions has been shown to reduce suicidality and therefore would be expected to increase life expectancy."