Blog des AK Psychiatriekritik der NFJ Berlin

Monat: August, 2012

A “Crisis in Psychiatric Research and Practice”

The full text of “Clinical Judgment in Psychiatry: Requiem or Reveille?” has been made available for free by the Nordic Journal of Psychiatry. The article, which author Giovanni Fava calls “probably the most radical criticism of evidence-based medicine so far,” examines the role “of clinical phenomena that do not find room in customary taxonomy” in the context of a field which increasingly regards clinical judgment as “non-scientific and obsolete.”


Seroquel- AstraZeneca settles with South Carolina


The S.C. Attorney General’s Office has secured a $26 million settlement against the multi-billion pharmaceutical company AstraZeneca for violating the state Unfair Trade Practices Act by willfully misleading consumers on the potentially serious side effects of the anti-psychotic drug Seroquel.

The settlement order was filed Aug. 22 and is the third award, and final case against anti-psychotic drug manufacturers in South Carolina, that the Attorney General’s Office has prosecuted since 2009. The cases began under former Attorney General Henry McMaster, who contracted with the Spartanburg law firm of Harrison, White, Smith and Coggins to prosecute the case on behalf of the state. The Spartanburg firm then contracted with two other firms in Columbia and Houston to assist with the litigation, which continued under Attorney General Alan Wilson.

In the lawsuit order, the company agreed to pay $26 million, which includes $20 million in damages and restitution to the state, $5 million in penalties and $1 million in trial costs. In 2010, AstraZeneca had $5.3 billion in worldwide sales including $3.75 billion in the U.S.

Bryan Stirling, deputy attorney general, said the settlement is fair to the state. A portion of the funds will go into the general fund, some will go to Medicaid and other funds to insurance companies.

Stirling said the Attorney General’s Office sued on behalf of the state and the state agencies that paid additional funds because of the medication side effects.

AstraZeneca did not admit any wrongdoing or violation, but agreed to pay the sum to resolve the state action, according to the order signed by Circuit Court Judge Roger Couch.

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„After years of costly litigation, we decided that settling this case was the appropriate way to resolve the matter and allow the company to focus on our core mission of delivering meaningful medicines to patients,“ according to a statement issued by Tony Jewell, AstraZeneca senior director of corporate communications.

The lawsuit maintains that AstraZeneca violated the state’s Unfair Trade Practices Act by willfully misleading consumers of Seroquel, a second generation anti-psychotic drug, on the risk of diabetes, high blood pressure, weight gain and other serious health risks. AstraZeneca was aware of the risks, but failed to include a warning for the potential for weight gain and diabetes in its warning label for many years, the lawsuit states.

After Seroquel was launched, the U.S. Food and Drug Administration sent letters to AstraZeneca in 1998 and 1999 warning of the „false and misleading campaign in its promotion of Seroquel,“ the lawsuit states.

The FDA noted the following false and misleading statements: claims that Seroquel is effective in mental conditions including bipolar disorder and schizoaffective disorder; AstraZeneca’s claims as to how Seroquel works and that the drug was safer and more effective than first generation anti-psychotics.

The FDA also cited the company for failing to disclose risks and important warnings including neuroleptic malignant syndrome, a life-threatening neurological disorder caused by an adverse reaction to neurological or anti-psychotic drugs; tardive dyskinesia, a disorder of involuntary, repetitive muscle movements; orthostatic hypotension, sudden low blood pressure; and seizures in its labeling.

The lawsuit alleges that even after the 1999 letter, the labeling was still misleading and the federal agency again admonished AstraZeneca in 2006 for false and misleading marketing.

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The lawsuit was based on Unfair Trade Practices Act violations that the Seroquel package insert through Jan. 26, 2009 was willfully, deceptively and misrepresented and/or concealed the drug’s dangerous side effects.

This case marks the third successful case prosecuted by state Attorney General’s Office against manufacturers of second-generation anti-psychotics. The first case against Eli Lilly settled for $45 million and Circuit Court Judge Roger Couch ordered a $327 million in damages last year following a jury verdict against Janssen Pharmaceuticals Inc., a subsidiary of Johnson & Johnson, for the anti-psychotic drug, Risperdal. Janssen has appealed that award.

The Risperdal award is believed to be the largest in the state’s history against a company found to have violated the state’s Unfair Trade Practices Act.

According to AstraZeneca, another similar case is pending in Mississippi involving Seroquel.

The company has settled similar cases in New Mexico, Utah and Montana this year.

Postpsychiatry -Reaching beyond the technological paradigm in mental health

Lecture by psychiatrist & philosopher Patrick Bracken in Forum for existential psychology & therapy, at University of Copenhagen, 18/4 2012

The History and Future of Our Psychiatric Survivor Movement

by MadinAmerica

Those who profess to favor freedom and yet deprecate agitation are people who want crops without plowing up the ground…Power concedes nothing without a struggle.  It never has and it never will.

Frederick Douglass, who wrote this 150 years ago, was a self-educated escaped slave who became the 19th century’s most prominent black leader. His words still inspire me, and so do the courage and authenticity of his life.  I write this article guided by his example.

Brothers and sisters, I want to tell you a little movement history which I am sure many of you don’t know. A lot of it happened before some of you were even born. It sounds so strange to say that.

The first group in our modern movement that I know of was the Insane Liberation Front in Portland in 1970. Although they did not last very long, they did get some attention from the local left and the alternative media. Howie the Harp, who went on to do a lot of other important things in our movement, visited them and was inspired. He came back to New York City and started the Mental Patients Liberation Project.

A few months after the MPLP was formed, I read in an alternative newspaper that they were going to have a protest at Bellevue Hospital. You can imagine my reaction to that. Bellevue, where I was tortured with shock at age six. I was already political, and had been active in the civil rights movement and my union.

So of course I jumped right in. We were at the tail end of all the liberation movements of the Sixties, and the media then were open to hearing about these things. Within a few weeks, I found myself on local talk radio, speaking for the MPLP, along with Judi Chamberlin, who soon became my first wife.

While all this was going on, groups started sprouting up all over the place, Boston, Philadelphia, San Francisco, Vancouver, even in places like London and Amsterdam, though we in America didn’t know about them yet. It was a time full of excitement and public attention and hope.

I left New York and was with the Mental Patients Association in Vancouver for a while. I had removed all the props that I had protected myself with, my middle-class job, my stable housing, and even my marriage, to live in another country and do my movement work, with only my pathetic little savings and no income.

Soon I went to San Francisco and got involved with the Network Against Psychiatric Assault, which had just started in 1974. I was staying with my friends Jan and Barry.        I turned on their TV and there was Leonard Frank, with his Old Testament persona (if you ever met him, you would know what I mean), standing in front of some shock shop during a demonstration, saying in his booming voice SHOCK TREATMENT IS AN OUTRAGE!

I turned on the radio, and there was Wade Hudson talking about forced treatment on KPFA. I just said to myself, WOW.

This is what happened when we were doing what all other movements for liberation had done. Especially here in the Bay Area, probably one of the most progressive places in the country, we were recognized by the left as an oppressed group whose interests should be supported. They saw us that way because we acted that way.

I left San Francisco and helped organize the second Conference on Human Rights and Psychiatric Oppression in Kansas. We survivors organized it every year on a shoestring. I went around the country by bus all summer, sleeping on living room floors and worse, telling people in each city what people in other places were doing. Meeting a real person who had seen all this was very exciting to people, much more than just reading about it.

The conference was a great success. It had an incredible tone of caring about and supporting one another, and I was given a lot of credit for that.

After the conference, I was burned out, and if I had not (obviously) known better, I would have wound up on a psych ward. But I had the option of going to the Vancouver Emotional Emergency Center, a place like Soteria House, and it helped me a lot. I wound up living in Bellingham, Washington, a college town thirty miles south of the Canadian border, where Judi and I organized a group called Counterpsychiatry, which drew quite a few idealistic students, and the attention, once again, of the local left and the alternative media there.

After a year, I returned to San Francisco and worked again with NAPA, which continued to do a lot of work around shock treatment, with plenty of media coverage, and plenty of people involved, as usual. During this time, they were able to get the California legislature to pass a bill they advocated for that made it much harder to force shock on people. Governor Jerry Brown signed it.

NAPA organized an around-the-clock “sleep-in” at Brown’s office in Sacramento, protesting conditions at the state hospitals. We stayed there for a month. Some politicians called for us to be forcibly removed, but Brown actually defended us, saying we had the right as citizens to petition the government about our grievances. During that time, Brown met with us at the home of the state’s Director of Health. We showed him the film “Hurry Tomorrow,” an expose of conditions at Metropolitan State Hospital. Richard Cohen, the filmmaker, is a strong supporter of our movement, After seeing the film, Brown commissioned an investigation into conditions at the state hospitals.

It is worth mentioning that Brown, after many years, is now the governor for the second time. But our movement in California, as a result of being bought off by the mental illness system, is now too weak to take advantage of the fact that we might have a powerful supporter of our cause in the Governor’s office.

In 1982, many things converged, and we were able to put a ban on shock treatment on the Berkeley ballot. It passed overwhelmingly, with the support of our mayor and the local progressive political party, which I had been working with for several years. Our movement was well-known by then, and we were taken seriously by the moderate left there, who even invited me to write the mental health plank of their platform. We got national media coverage almost nonstop, and I thought we were really making progress, and we were.

The shrinks thought so too. Soon after the vote, Leonard showed me a copy of the Psychiatric News, the American Psychiatric Association’s newspaper of record. They were interviewing all candidates for office in the APA, and one of the questions asked was “What do you think are the biggest problems of the profession today?” EVERY SINGLE ONE OF THEM mentioned “the lack of respect the public has for us,” as the Berkeley vote showed. And I nearly jumped up and down, and said to myself, we’re winning, we’re winning!

And we were. But the shrinks figured it out. In 1985, the first “Alternatives” conference was held in Baltimore, lavishly funded (by our standards) by the NIMH, and featuring such things as board and care residents bussed in to stand around and make it look as if there was an even bigger number of participants than there were. Of course if you have the money to pay people to come, it isn’t hard to look credible.

This is what totalitarian governments do, round up people from the countryside to have “spontaneous” demonstrations in favor of whatever dictator is in power.

At the NIMH conference, I met Wendy, a new, young, up-and-coming leader who had organized a thriving group in New Mexico. Wendy had been locked up as a teenager, and we instantly bonded. We both realized quickly that the conference was a disaster for our movement.

I should have tried as much as I could to fight what was happening then, but my excuse was that I was in law school, and eventually I was going to win some big cases like Brown vs. Board of Education that would get us our legal rights, Yeah, right. The real reason was that I was too cowardly, confronted with the power of that system we used to fight.

Later that year, the last national conference that we controlled was held in Burlington, Vermont. The local group did a good job, and we were addressed by the Mayor of Burlington, Bernie Sanders, who now as you know is a U.S. Senator and probably the most progressive member of Congress. But one of the main people responsible for the NIMH taking us over was there. He came with a helper, and together they systematically disrupted almost every workshop we had.

In the face of this, and the raw power of the mental illness system, people became completely demoralized, and that was the last conference we ever had. My ex-wife/comrade/friend Wendy still says she was amazed at how little money it took to destroy our movement.

So now, we are not a human rights movement any more, but the “recovery movement,” whatever that may mean. This “movement” is not controlled by the people who have suffered under the mental illness system, but by that very system. We don’t address ourselves to the general public any more, but to the people who provide the funding. We are now invisible to the media, and to the public. Our legal rights have deteriorated, with vicious outpatient commitment laws in almost every state. We don’t fight them, because we are the “recovery movement,” a branch of the mental illness system. Bigotry against us is the worst it has ever been. In spite of the fact that tens of millions of people in this country have been inmates of psych wards, almost none of them have heard of us, and we give them no motivation to want to join us.

Compare this to every other American movement for liberation in the last half-century. You can hardly find a woman, or a black person, or a gay person, or a member of any other oppressed group, who is not aware that there is a movement for them, and whose consciousness has not been changed for the better because of their movement.

And because we don’t really fight for anything, our people are still being tortured. Hundreds of thousands of children are having their lives ruined by people like Doctor Biederman, while our alleged movement has nothing to say. Our brothers and sisters are being drugged and shocked, their self-esteem and even their very lives destroyed, while our government-appointed “leaders” talk about “initiatives” and “wellness.”

And the people who are responsible for this are rewarded, while the folks who made the sacrifices to get this movement started are put down as “negative.”

People, aren’t you tired of this? Aren’t you disgusted with these “leaders” who benefit from doing the work of the people who have abused us?

Isn’t it time we did something about it?

As I have been in contact with more and more people who share the vision of a movement that stands for something more than grants from SAMHSA, one thing I have noticed is the need for us to get to know each other, to form a network so people who want a real movement can support one another. Sometimes folks haven’t even heard of other activists who might be just one state away.

We can start to take back our movement from the opportunists and the mental illness system by connecting with one another and realizing we aren’t alone. We need to find the best ways to make that networking happen.

We have been hurt by one of the most destructive social institutions in America, and who but us is going to be the main force to fight back? We have the power of our moral authority, but I don’t think people realize that. I read horror story after horror story on our email lists and Facebook pages. But we seem to resist the full truth: that we have been the victims of crimes against humanity. If we want these horrors to stop we need to understand that ourselves, before we can convince anyone else.

The money handed out by SAMHSA encourages us to trivialize our experience, to pretend that what was done to us was perhaps just a mistake, not really so bad. We better believe that, or at least say it, or the money will be gone. Anyone who makes any substantial criticism of the system SAMHSA is there to protect will be thrown into the outer darkness.

We have to make our own decisions based on our own interests, not on the interests of the people who are paying to keep us off the streets. Until we do that, as our movement’s recent history has shown, we will get nowhere and even go backwards.

But as Martin Luther King said nearly fifty years ago, in Why We Can’t  Wait, “The old order ends, no matter what Bastilles remain, when the enslaved, within themselves, bury the psychology of servitude.”

Yes, we have to get rid of the servile mentality that the mental illness system and its funding encourages. As long as we continue to think of ourselves that way, we will continue to be invisible and defeated. But as Doctor King said, once we think of ourselves with confidence, and pride that we have survived, we will win.

Our work will not be easy. We will not be paid to take away the power of this evil system. We will be denounced by the people who are benefiting from the way things are now. We will not be given awards as ”Advocate of the Year” by NAMI or some drug company.

We will have to stick together, and to model among ourselves the kind of society that we want to see, where people’s lives are more important than making money and buying things, and everyone is respected.

And I know these words may sound like cliches, but we must learn again to see one another, not as part of someone’s bureaucratic empire, but as brothers and sisters, to be cared about and nurtured and cherished.

A Brief History of Soteria Vermont

Steven Morgan, Soteria Vermont project manager, reflects on working with psychosis. Soteria Vermont is a project of the Vermont state government, which seeks to be a leader in mental healthcare. When Hurricane Irene washed away Vermont’s state mental hospital, Vermont’s government chose to replace it with a network of smaller, community-based and alternative approaches to mental health care. Citizens of Vermont are legally entitled to alternatives to psychiatric medication; Soteria Vermont will be the second replication in the United States (after Alaska’s) of Loren Mosher’s Soteria project which demonstrated in the 1970’s the efficacy of housing people with first psychotic breaks with sympathetic non-professionals as housemates, in the style of R.D. Laing’s Kingsley Hall. The original Soteria was dedicated to using little or no psychiatric medication, and to using that only in the short term to stabilize a crisis.