Journalist and author Robert Whitaker used to think it was unethical for doctors to take schizophrenia patients off their medication. Having cofounded a publishing company in the 1990s that reported on clinical trials, he likened the removal of antipsychotic drugs to taking a diabetic off insulin. And that’s how he covered this issue in a Pulitzer Prize–nominated series of freelance articles for the Boston Globe in 1998.

“I had completely conventional beliefs,” Whitaker recalled in a phone interview with the Georgia Straight from a Seattle hotel room. “I had written that we were gaining a lot of understanding into the biological causes of psychiatric disorders. At some point, I had written that these drugs fixed chemical imbalances in the brain.”

He explained that the Food and Drug Administration approves drugs if manufacturers can prove that their products can have a positive effect—exceeding that of a placebo—on a symptom of a disease. Whitaker said a problem arises in that psychiatric drugs are often taken on a long-term basis, and the results over several years aren’t always available to government regulators. In addition, pharmaceutical companies focus on short-term effects rather than long-term outcomes for patients to convince the public of the drugs’ efficacy. But the more Whitaker examined research studies—and particularly those that weren’t financed by the manufacturers of prescription drugs—the more skeptical he became about antipsychotic medications.

“Are these drugs effective over the short term? There’s a lot of robust literature saying yes,” Whitaker said. “Once people are on medications, do they relapse at a great rate when they come off? No question. But it’s also real clear that there is an absence of literature showing that they improve the long-term course of schizophrenia. That’s number one. That’s openly acknowledged. And when you dig into the outcomes literature in detail and go through the history, what you find—at the very least—is there is a significant subset of people who would do better off the medications.”

Whitaker stated that this will seem radical to many laypeople. However, he emphasized that it is abundantly clear to anyone who reads the research literature. He documents much of this in his weighty 2010 book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness (Crown Publishers).

“This is not meant to be a medical-advice book,” Whitaker emphasized. “It’s not in any way meant to be directed at people to say ”˜You should or should not be taking medications.’ I am personally convinced they have a place in psychiatry’s toolbox.”

His book chronicles a staggering increase between 1987 and 2007 in the diagnosis of mental illness and the use of psychiatric drugs in the United States. Over that period, there was a doubling in the percentage of people with mental-health disabilities receiving supplementary security income or social security disability income. “In the short span of twenty years, the number of disabled mentally ill children rose thirty-five fold,” he writes.

Whitaker questioned whether the dramatic increase in psychiatric drugs in recent years is benefiting not only people with schizophrenia, but also those diagnosed with bipolar disorder and depression. “I think we really need to look at these long-term outcomes and see what the science is telling us,” he told the Straight.

In 2007, University of Illinois psychologist Martin Harrow published a paper in the Journal of Nervous and Mental Disease after studying 64 schizophrenia patients over a 15-year period. In his book, Whitaker notes that 40 percent of those not taking psychiatric drugs were in recovery, and more than half were working. Only 28 percent had psychotic symptoms. Just five percent of those taking anti-psychotics were in recovery, and 64 percent were psychotic.

Whitaker said that when this study was published, the National Institute of Mental Health did not send out a news release or feature it on its website. He also mentioned that the American Psychiatric Association didn’t promote the study.

“Regardless of what you think that may mean or what explanations there might be, that’s information that the public should know, right?” Whitaker stated. “You darn well know if it was reversed—and the recovery rate was 40 percent for those on [medications] and five percent for those off—the psychiatric establishment would be promoting that information. It would be saying, ”˜See? We have evidence that our medications dramatically improve the long-term course.’ ”

Anatomy of an Epidemic also focuses a great deal of attention on antidepressants, citing the research of British psychiatrist David Healy, among others. Healy landed a prestigious job at the University of Toronto in 2000, only to have it revoked after he spoke publicly about how certain antidepressants elevated the risk of suicide. “He was not seen as an outsider; he was not seen as someone who had an axe to grind,” Whitaker said.

Yet Healy was still punished, according to Whitaker, which was a wake-up call to others in the psychiatric profession about the consequences of speaking frankly about this topic.

Robert Whitaker will speak at 7:30 p.m. on Sunday (May 15) at the Unitarian Church (949 West 49th Avenue), and at 7 p.m. on Monday (May 16) at the Vancouver Public Library’s central branch.