Given the conviction among psychiatrists that madness is an illness no different from a bacterial infection or cancer, the main treatment is drugs. Unfortunately, a quarter of patients are not helped by them at all and around 15 per cent of all schizophrenics eventually commit suicide. Where the drugs do work, the reduction in symptoms is not large, only a 15 per cent to 25 per cent decrease.
Perhaps we should not find this surprising since researchers have barely the faintest of ideas why these drugs work or what precisely is different about the chemistry of a schizophrenic's brain from a normal person. Just as no schizophrenia genes have so far been identified despite decades of false claims, no specific neurotransmitters have been positively implicated. In his new book Madness Explained, clinical psychologist Richard Bentall presents worrying evidence regarding the use of drugs. Physical side-effects include hand tremors and stiffness found in one quarter of patients, loss of sexual capacity in a third and in half, a large weight gain resulting from purely drug-induced carbohydrate cravings.
Using the drugs doubles the risk of heart failure and may be fatal, reducing white blood cells and inducing muscular rigidity, fever and fluctuating consciousness. The psychological effects can be pretty awful as well, including severe restlessness, depression and total loss of motivation. Given these horrible consequences and that about one quarter of patients will have no reduction in symptoms, it is remarkable that psychiatrists have not developed ways of predicting who these will be in advance. Instead, the drugs are automatically doled out to everyone.
Worst of all, it was not until 1990, 40 years after the drugs were first introduced, that anyone bothered to check if the dosage mattered. That study showed that the greater the dose, the worse the side-effects. Yet to this day, psychiatrists still routinely dole out dangerously high doses.
But what's the alternative, I hear you cry? A recent review of 25 studies showed that working with relatives of schizophrenics produced 20 per cent less relapses. Plus various psychotherapies have been shown to help the patient. At the moment, nurses and family members are coerced by psychiatrists to regard mad delusions literally as nonsense. This ignores the body of evidence proving that the symptoms are often meaningful reflections of life lived in some very difficult families.
Drugs in moderate doses have their place. But it is time that conventional psychiatry, with its persistent claim to be scientifically based, gave way to this evidence in both its research and treatment methods. 'One drug size fits all' is no longer just unintelligent and ignorant, it is unethical.