Cheerful Curmudgeon » Pyschology

Are Psycho-Active Drugs Ineffective and Dangerous?

Art Zemon — Sun, 17 Jul 2011 13:28:02 +0000

There seems to be mounting evidence that psycho-active drugs are no more effective than placebos; that they may cause real harm; and that the belief that many mental illnesses are caused by chemical imbalances in the brain has never been proven but has been forwarded by the drug manufacturers.

I was most persuaded by Irving Kirsch’s work. Drug companies only publish the studies which are favorable toward their drugs, though they submit all studies to the FDA. The FDA does not publish the negative studies either, considering them to be proprietary information. Kirsch obtained the studies for six anti-depressant drugs from the FDA through a Freedom of Information Act request. The drugs were Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor. He found that these drugs were only slightly more effective than placebos and did not have a “dose response curve,” i.e., that higher doses did not do more that lower doses. That is very unlikely in a drug that actually does something. He then compared these drugs to “active placebos,” things which cause side effects such as a dry mouth but which do nothing more, and found that the drugs were exactly as effective as the active placebos.

It is very troubling that, “a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association’s most recent clinical guidelines [in the DSM] for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies.”

Finally, it is most disturbing that many the psycho-active drugs cause significant side-effects (including shrinkage of the frontal cortex) which in turn cause more psychotic symptoms which are in turn treated with additional psyo-active drugs.

Take a look at two articles that I think are well worth the read. First, Al Jazeera’s Mass psychosis in the US looks at the rising rates of treatment with anti-psychotic drugs in the US. This class of drugs has become the most prescribed in the country, surpassing drugs that treat both high cholesterol and acid reflux. Much of the background for that article comes from the New York Review of Books article, The Epidemic of Mental Illness: Why?, by a former editor of the New England Journal of Medicine.

I would love to hear your reactions.

Safety Drivers

Art Zemon — Wed, 09 Sep 2009 03:15:36 +0000

The reactions to the mid-air collision last month between an airplane and a helicopter over the Hudson River in New York City have me thinking about safety in airplanes and safety in cars. For those unfamiliar with the details, just before noon on August 8, a six person airplane and an eight person helicopter came together in the air over the Hudson River; the nine people on board the two aircraft died in the ensuing crash. This was a terrible tragedy and my heart goes out to the families and friends of the nine people who lost their lives.

Immediately (as in, within a couple of hours) after the accident, the calls-to-action to improve safety in the “VFR corridor,” the name of the airspace where the collision occurred, began. These calls took many forms, from the sensational TV news reporters and politicians who demanded that the VFR corridor be closed and the helicopter tourist business be shuttered to the FAA which convened a New York Airspace Working Group panel to review everything from airspace structure to pilot training to air traffic controller practices. The focus has been on safety much more than on blame, and that’s a good thing.

Compare this to the common reaction to a driving accident: If the accident is big enough to make the news, the key reporting points are a) what happened, and b) who caused it or blame. Rarely do we react to an automotive accident with an urgent need to prevent future accidents in the same place and of the same type. We may well get to this point, of course, but only after several accidents have happened. A city might install a traffic light at an intersection, for instance, but only after several accidents have occurred at the intersection.

According to the Air Safety Foundation, the August 8 collision was the first accident of this type (airplane and helicopter) over the Hudson River in ten years. It may well have been the only accident ever. What is the cultural difference between flying and driving that we demand safer flying, even after a single accident, yet we accept car accidents as the daily norm?

Pilots place safety first. The Federal Aviation Regulations stipulate biennial “flight reviews,” essentially flying tests, by FAA certificated flight instructors. Fail the review and you don’t fly until you get some training and are “passed” by the flight instructor. Beyond that, the flying culture strongly encourage all pilots to participate in on-going training such as the FAA’s WINGS Pilot Proficiency Program. This, in turn, builds on the assumptions that none of us are perfect and that all of us can learn from others’ mistakes and can become better, safer pilots. We actively seek out and study stories of bad situations, not to assess blame but to learn and improve our skills. Even more to the point, most of us regularly fly with a safety pilot, asking the safety pilot to critique our performance. I try to get up once a month, though it is sometimes as infrequently as every three or four months, with either Jack or Linda. On these flights, I expect them to be vocal with me about anything I do that is less than perfect. Some of the training is during the flight; some during a debriefing afterwards. I always come away from these flights having learned valuable lessons.

We act differently with our cars, though. Most of us are deeply offended if anyone suggests that we might need to take either a written test or a driving test when renewing our driver’s license. We never volunteer for recurrent training on driving. One of the best ways to make a friend angry is to suggest that he or she do something differently while driving. Why? I think because driving is more important to us, on a personal level, than safety. We judge that we are “safe enough” that we don’t need to stress about driving safely any more. What is most important is that we preserve our “right” to drive, pretty much at any cost.

I think our priorities are a little mixed up and I have a suggestion. First, bear with my while I share a few figures with you.

In 2005, 43,510 people died in the US in fatal car crashes.
That same year, another 2,699,000 people were injured in the US in car crashes.
In 2005, the latest year for which the NTSB reports aviation statistics, 563 people died in the US in fatal aviation accidents.
That same year, another 723 people were injured in US aviation accidents.

Consider again our reactions as a society to aircraft accidents and to traffic accidents. Now take it to a personal level: How do you react to aviation accidents versus fatal car crashes? Are your reactions congruent with the numbers of people killed and injured in each type of accident?

Here is my suggestion to improve traffic safety, to reduce the number of deaths and injuries.

I’m not a perfect driver. Join me in admitting that you aren’t perfect, either.
Get a friend to act as your safety driver for an hour. Go drive around. As you drive, talk to your safety driver about what you are seeing, what you are thinking, and how you are making your decisions. Invite your safety driver to give you constructive criticism on how you might improve your driving.

It’s that simple. Imagine how many fewer people would die if we took driving safety as seriously as we take flying safety.

Programming Feeds the Mad Scientist

Art Zemon — Mon, 04 May 2009 12:49:36 +0000

I have been writing a new program, having a ball doing it, and it has brought to consciousness something which I have not thought about for years: There is a bit of Dr. Henry Frankenstein in me. I love to create things which do stuff autonomously and, when I create these things, bigger is definitely better.

My current creation has lots of parts, including:

A daemon (I love that word, all the more since daemon’s are useful and not evil at all) which runs all the time and wakes up once a minute to see if anything interesting has happened and decide whether it should do something.
A script which watches for people to click special links in email messages. It leaves a “note” for the daemon, telling it that a human being received the email and did something. Cool; my program is making humans do things!
A script which watches for secret messages sent from another program on another computer. This script also leaves notes for the daemon, telling it that the other computer is set up and running and ready to do a human being’s bidding.

The daemon gets to do all sorts of fun things, including summoning new (virtual) computers into existance and turning them loose on the world. In the end, the daemon even gets to kill off the computers. The daemon spends real money (hopefully, this part does not get out of control!) with a real multi-national company. And as the daemon works, it attracts the attention of people at four different companies, all of which are very interested in what this little beastie is doing.

Not bad for a creation which only exists in the virtual world inside a computer. If you see me walking around with a smug smile on my face, now you know why.