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Your Drug May Be Your Problem
How and Why to Stop Taking
Psychiatric Medications
Revised and updated edition, 2007

Peter R. Breggin, M.D.
David Cohen, Ph.D.

Contents

Preliminary
Psychiatric Drugs - Much Easier to Start Than to Stop
The Limits of Psychiatric Drugs
"Your Drug May Be Your Problem" - But You May Be the Last to Know
Adverse Effects of Specific Psychiatric Drugs
Personal and Psychological Reasons for Not Using Psychiatric Drugs
Why Doctors Tell Their Patients So Little?
Plan Your Drug Withdrawal
How to Stop Taking Psychiatric Drugs?
Withdrawal Reactions from Psychiatric Drugs
10  Withdrawing Your Child from Psychiatric Drugs
11  Understanding Your Therapist's Fears About Nonuse of Drugs
12  Guidelines for Therapists Who Do Not Advocate the Use of Psychiatric Drugs
13  Psychological Principles for Helping Yourself and Others Without Resort to Psychiatric Medications
14  Appendices

Detailed Contents

Preliminary
    0.1  Front Page
        0.1.1  Back Page
    0.2  Advance Praise for "Your Drug May Be Your Problem"
        0.2.1  Candace Pert, Ph.D.
        0.2.2  Loren Mosher, M.D.
        0.2.3  Bertram P. Karon, Ph.D.
        0.2.4  Steven Rose, Ph.D.
        0.2.5  John Horgan
        0.2.6  Thomas J. Moore
        0.2.7  Kate Millett
        0.2.8  Tony Stanton, M.D.
        0.2.9  Alberto Fergusson, M.D.
        0.2.10  Milton F. Shore, Ph.D.
        0.2.11  Fred Bemak, Ph.D.
        0.2.12  Douglas C. Smith, M.D.
        0.2.13  Clemmont E. Vontress, Ph.D.
        0.2.14  Wolf Wolfensberger, Ph.D.
        0.2.15  Rhoda L. Fisher, Ph.D.
        0.2.16  Steven Baldwin, Ph.D.
        0.2.17  Thomas Greening, Ph.D.
        0.2.18  Thomas J. Scheff, Ph.D.
        0.2.19  David H. Jacobs, Ph.D.
        0.2.20  Al Siebert, Ph.D.
        0.2.21  Jay Haley
        0.2.22  Paula J. Caplan, Ph.D.
        0.2.23  William Glasser, M.D.
    0.3  Gratitude and Dedication to Wives
    0.4  A Warning Concerning the Use of Psychiatric Drugs
    0.5  Introductions to the New Edition: Scientific Confirmations of the First Edition
        0.5.1  Introduction by Peter Breggin
            0.5.1.1  The FDA Finally Recognizes Antidepressant-Induced Suicidality
            0.5.1.2  Confirming Over-Stimulation
            0.5.1.3  Antidepressant-Induced Suicidality in Adults
            0.5.1.4  The FDA Resists the Facts
            0.5.1.5  Antidepressant Withdrawal Acknowledged
            0.5.1.6  Do Antidepressants Have Any Positive Effects?
            0.5.1.7  New FDA Disclosures about Stimulant Drugs for Treating ADHD in Children
            0.5.1.8  A New Concept: Spellbound by Psychiatric Drugs
        0.5.2  Introduction by David Cohen
            0.5.2.1  The Internet and Drug Information
            0.5.2.2  The Drug Industry Exposed and Re-Exposed
            0.5.2.3  Drugs for Schizophrenia, Depression, and Bipolar Disorder - A Bust
            0.5.2.4  Medications and Prescribers Out of Control
            0.5.2.5  Conclusion
    0.6  Introduction: What Is Your Ultimate Resource?
        0.6.1  Our Final Resort
        0.6.2  Resort to Drugs
        0.6.3  Seeking Relief
        0.6.4  What Suffering Tells Us
        0.6.5  The New Ultimate Resource
        0.6.6  What Do We Really Know About How Our Brains Work?
        0.6.7  The Science Behind Psychiatric Drugs
        0.6.8  Are There Biochemical Imbalances?
        0.6.9  What Do We Really Know About Psychiatric Drugs and the Brain?
        0.6.10  What If We Treated Our Computers the Way We Treat the Brain?
        0.6.11  What This Viewpoint Does to Us
        0.6.12  Herbal and "Natural" Remedies
Psychiatric Drugs - Much Easier to Start Than to Stop
    1.1  A Few Minutes That Can Become a Lifetime
    1.2  Reasons to Stop Taking Psychiatric Drugs
    1.3  How This Book Can Help
    1.4  More Reasons to Stop Taking Drugs
    1.5  If Someone You Care About Is Taking Psychiatric Drugs
    1.6  An Independent Decision
The Limits of Psychiatric Drugs
    2.1  How We Learn What Drugs Do
    2.2  How Current Drugs Affect Animals and People
    2.3  Can We Test for Biochemical Imbalances?
    2.4  Causing, Not Curing, Biochemical Imbalances
    2.5  More Flaws in the Myth of Biochemical Imbalances
    2.6  Anesthesia of the Soul
    2.7  What Does "Improvement" Mean in the Context of Psychiatric Drugs?
    2.8  The Limits of Psychiatric Drugs in General
    2.9  The Limits of Drugs for Helping in Emotional Crises
    2.10  People Are Better Than Pills - Even for the Most Disturbed Patients
    2.11  Conclusion
"Your Drug May Be Your Problem" - But You May Be the Last to Know
    3.1  The Variability of Individual Responses to Drugs
    3.2  "Creeping" Adverse Effects
    3.3  The Risk of Permanent Brain Dysfunction Caused by Psychiatric Drugs
    3.4  Physicians Urge Long-Term Use Without Justification
    3.5  The Special Danger of Psychiatric
Drugs

    3.6  Adverse Effects on How You Think, Feel, and Act
        3.6.1  Drug-Induced Toxic Psychoses
        3.6.2  Trust Your Own Perception of Yourself - Up to a Point
        3.6.3  Common Adverse Effects on Your Thinking, Feeling, and Behaving
    3.7  You May Be the Last to Know
Adverse Effects of Specific Psychiatric Drugs
    4.1  Growing Recognition of the Dangers of Psychiatric Drugs
    4.2  Drug-Induced Toxic Psychosis and
Toxic Delirium

    4.3  Drug-Induced Mania
    4.4  Children at Grave Risk for Antidepressant-Induced Mania
    4.5  Estimated Rates for Drug-Induced
Mental and Neurological Disorders

        4.5.1  Anti-Manic Agents: Lithium
        4.5.2  Stimulants
        4.5.3  Benzodiazepine Tranquilizers: Xanax, Valium, Ativan, Klonopin, and Others
        4.5.4  Tricyclic Antidepressants: Elavil
        4.5.5  Prozac-Like Antidepressants: Prozac
        4.5.6  Monoamine Oxidase Inhibitor (MAOI) Antidepressants: Parnate
        4.5.7  Antipsychotics or Neuroleptics
    4.6  Adverse Effects Caused by Specific Psychiatric Drugs
        4.6.1  Stimulants
        4.6.2  Antidepressants That Especially Stimulate Serotonin
        4.6.3  Tricyclic Antidepressants
        4.6.4  Atypical Antidepressants
        4.6.5  Monoamine Oxidase Inhibitor (MAOI) Antidepressants
        4.6.6  Benzodiazepines Prescribed for Anxiety and Insomnia
        4.6.7  Non-Benzodiazepines Prescribed for Anxiety and Insomnia
        4.6.8  Lithium, Anticonvulsants, and Other "Mood Stabilizers"
        4.6.9  Antipsychotic (Neuroleptic) Drugs
    4.7  Tardive Dyskinesia Caused by Antipsychotics
    4.8  Neuroleptic Malignant Syndrome
    4.9  Antipsychotic Withdrawal Psychoses
    4.10  Other Harmful Antipsychotic Effects
    4.11  Medications Used to Treat Drug- Induced Abnormal Movements
    4.12  Psychiatric Drugs During Pregnancy and Nursing
Personal and Psychological Reasons for Not Using Psychiatric Drugs
    5.1  A Natural Aversion to Taking Mood-Altering Drugs
    5.2  Other Common Concerns About Taking Psychiatric Drugs
    5.3  Convincing You That You're "Mentally Ill"
    5.4  Defining Intense or Painful Emotions as Illness
    5.5  How Psychiatry Takes Advantage
    5.6  Good Therapy Versus Psychiatric Diagnosis and Medication
    5.7  Maintaining Your Mental Faculties
    5.8  Being in Touch with Your Feelings
    5.9  The Placebo Effect
    5.10  Psychological Dependence on Drugs, Doctors, and Medical Solutions to Personal Problems
    5.11  Learning to Live Without Drugs
Why Doctors Tell Their Patients So Little?
    6.1  Encouraged Not to Tell
    6.2  Where Was the FDA?
    6.3  Getting Information to You
    6.4  FDA Approval Does Not Mean That a Drug Is Safe or Even Highly Effective
    6.5  Whose Risk and Whose Benefit?
    6.6  Serious Dangers Can Surface for the First Time After Years of Use
    6.7  Recognizing the Limits of FDA Approval
    6.8  How Adverse Effects Go Unreported
    6.9  No Guarantee of Long-Term Safety
    6.10  The Media
    6.11  What Do Doctors Know?
    6.12  Doctors' Attitudes Toward Informing Patients
Plan Your Drug Withdrawal
    7.1  Decide for Yourself
    7.2  Try to Get Help from an Experienced Clinician
    7.3  How May a Clinician Help?
    7.4  Informing Your Doctor of Your Intentions
    7.5  Stay in Charge of the Withdrawal
    7.6  The Best and the Worst to Expect from Your Doctor
    7.7  Set Up a Support Network
    7.8  How a Friend Can Help
    7.9  Support Networks on the Internet
    7.10  Know What Coming of Psychiatric Drugs Might Entail
    7.11  Anticipate Withdrawal Reactions
    7.12  Understand What Influences the Ease of Withdrawal
        7.12.1  Look Out for the Return of Your Original Problems
        7.12.2  Anticipate the Possibility of a Long Withdrawal Period
        7.12.3  Be Prepared to Change Your Routines
        7.12.4  Expect Reawakened Feelings
        7.12.5  Handling Disrupted Sleep
        7.12.6  Dealing with Strong Reactions from Friends and Family
        7.12.7  Don't Overreact to Anger and Guilt
        7.12.8  Be Flexible About Withdrawal
        7.12.9  Set Up an Action Plan
    7.13  Facing the Fear of Withdrawal
How to Stop Taking Psychiatric Drugs?
    8.1  Gradual Withdrawal Is Its Own Protection
    8.2  Why Gradual Withdrawal Is Better Than Sudden Withdrawal?
    8.3  Remove Drugs One at a Time
    8.4  Which Drug Should Be Stopped First?
    8.5  Special Considerations During Withdrawal
    8.6  How Fast Should You Withdraw?
    8.7  How to Divide Individual Doses
Withdrawal Reactions from Psychiatric Drugs
    9.1  Beware Illicit Use
    9.2  Your Doctor May Not Know
    9.3  When Am I Having a Withdrawal Reaction?
    9.4  Denial of Withdrawal Reactions
    9.5  Defining Physical Dependence
    9.6  Withdrawal Reactions Can Cause "Significant Distress"
    9.7  "Withdrawal" or "Discontinuation"?
    9.8  Benzodiazepine Withdrawal Reactions
        9.8.1  The Discontinuation Syndrome
        9.8.2  The Doctor's Involvement in Withdrawal
    9.9  Antidepressant Withdrawal Reactions
        9.9.1  Tricyclic Antidepressant Withdrawal Reactions
        9.9.2  MAOI Withdrawal Reactions
        9.9.3  Withdrawal Reactions from Antidepressants that Stimulate Serotonin
        9.9.4  Atypical Antidepressant Withdrawal Reactions
    9.10  Stimulant Withdrawal Reactions
    9.11  Lithium and Anticonvulsant Withdrawal Reactions
    9.12  Antipsychotic or Neuroleptic Withdrawal Reactions
        9.12.1  Three Types of Antipsychotic Withdrawal Reactions
        9.12.2  Withdrawal from Atypical Antipsychotics
        9.12.3  "Relapse" or "Withdrawal"?
        9.12.4  When to Withdraw from Antipsychotics?
        9.12.5  How Long Should Antipsychotic Drug Withdrawal Take?
    9.13  Antiparkinsonian Withdrawal Reactions
    9.14  How Gradual Is "Gradual Withdrawal"?
    9.15  Overview of Psychiatric Drug Withdrawal Reactions
10  Withdrawing Your Child from Psychiatric Drugs
    10.1  Special Precautions
    10.2  Your Child's Previous Experience with Withdrawal
    10.3  Rebound and Withdrawal Effects
    10.4  Identifying the Source of Potential Problems
    10.5  Focusing on Problems in the Family
        10.5.1  Suppressed Maturation
        10.5.2  Learning New Parenting Skills
        10.5.3  Learning to Give More Attention
        10.5.4  The Father's Special Role
        10.5.5  Paying Attention to Your Child's Feelings and Wishes
    10.6  Focusing on Problems at School
        10.6.1  If Your Child Is Inattentive
        10.6.2  If Your Child Is Underachieving
        10.6.3  If the School Insists
    10.7  Withdrawing from Multiple Drugs or Multiple Daily Doses
    10.8  When to Start Withdrawal
11  Understanding Your Therapist's Fears About Nonuse of Drugs
    11.1  When Your Therapist Says You Need Drugs
    11.2  Therapists Are People, Too
    11.3  So Many Kinds of Therapy
    11.4  What to Do When the Therapy Is Failing
    11.5  What Do We Have Faith In?
    11.6  Therapists Are Losing Faith in Themselves
    11.7  The Exaggerated Fear of Lawsuits
    11.8  Faith in Ourselves Versus Faith in Medication
    11.9  Understanding Your Therapists Fears
    11.10  Personalities and Power
        11.10.1  Biological Psychiatrists
        11.10.2  Psychotherapists
12  Guidelines for Therapists Who Do Not Advocate the Use of Psychiatric Drugs
    12.1  Suggested Guidelines
    12.2  Stand Up and Be Counted
13  Psychological Principles for Helping Yourself and Others Without Resort to Psychiatric Medications
    13.1  Principles of help
        13.1.1  Identify and overcome your self-defeating feelings of helplessness
        13.1.2  Focus on your unique emotional reactions to a crisis or stress
        13.1.3  Be glad you're alive, and find someone else who is glad the both of you are alive
        13.1.4  Avoid getting into "emergency mode", and reject desperate interventions or extreme solutions
        13.1.5  Resist the impulse to have something done to or for you, and instead seek help in strengthening yourself
        13.1.6  Don't drug your painful feelings
        13.1.7  Bear in mind that most emotional crises and suffering build on a chain of earlier stresses and trauma
        13.1.8  Avoid inviting other people to take over for you
        13.1.9  Be kind to anyone who is trying to help you, including your therapist
        13.1.10  Know that empathy and caring lie at the heart of any helping relationship
        13.1.11  Remember that we heed each other!
        13.1.12  Realize that emotional crises and suffering are opportunities for accelerated personal growth
    13.2  Conclusion
14  Appendices
    14.1  Appendix A: Psychiatric Medications in Common Use
        14.1.1  Antidepressants
            14.1.1.1  Selective Serotonin Reuptake Inhibitors (SSRIs)
            14.1.1.2  Other Newer Antidepressants
            14.1.1.3  Older Antidepressants (partial list)
        14.1.2  Stimulants
            14.1.2.1  Classic Stimulants
            14.1.2.2  Others
        14.1.3  Tranquilizers and Sleeping Pills
            14.1.3.1  Benzo Tranquilizers
            14.1.3.2  Benzo Sleeping Pills
            14.1.3.3  Non-Benzo Sleeping Pills
        14.1.4  Antipsychotic Drugs (Neuroleptics)
            14.1.4.1  Newer (second- or third-generation or atypical) Antipsychotics
            14.1.4.2  Older Antipsychotic Drugs
            14.1.4.3  Antipsychotics Used for Other Medical Purposes
        14.1.5  Lithium and Other Drugs Used as "Mood Stabilizers"
            14.1.5.1  Off-Label or Unapproved Mood Stabilizers
    14.2  Appendix B: About the Authors
        14.2.1  Peter R. Breggin, M.D.
            14.2.1.1  Books by Peter R. Breggin, M.D.
        14.2.2  David Cohen, Ph.D., L.C.S.W.
            14.2.2.1  Books by David Cohen, Ph.D.
    14.3  Appendix C: The International Center for the Study of Psychiatry and Psychology
        14.3.1  International Counselors of Social Workers, Psychiatrists, Psychologists & Educators
    14.4  Appendix D: The Alliance for Human Research Protection
    14.5  Lengthy Bibliography