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More and more off-label, criminal use of antipsychotics

    Antipsychotic use is dramatically increasing and beyond psychosis symptoms

    The use of antipsychotics is rapidly increasing and most of it is ‘off-label’, non-approved use.

    The use of antipsychotics as a general “chemical restraint” is dramatically increasing over decades. This increase is far exceeding any evidence of an increased diagnosis of psychosis symptoms and most of it is ‘off-label’ – prescribed for non-approved use.

    In the UK a study found that antipsychotic medication usage doubled between 2000 and 2014 from 0.5% to 1.2% of the population. At the same time, no commensurate increase in psychosis symptoms occurred. 1

    In the United States visits to a medical facility of persons aged 0 to 20 years that included prescription of an antipsychotic medication increased from approximately 201,000 in 1993-1995 to 1,224,000 in 2002 – a 6-fold increase. Examination of regional statistics found that this increase was NOT due to an increased psychosis diagnosis and in one instance it was found that non-psychosis usage of antipsychotics was as high as 77%. 2

    In Australia, it is estimated that 40–75% of antipsychotic use among adults and 36–93% of use among children is considered off-label or being used to treat a condition that the drug was not originally intended for. 3

    Antipsychotics cure nothing – the chemical straightjacket

    While approved for the ‘treatment’ of schizophrenia and bipolar disorder there are now a host of other not approved ‘uses’ which can include: Anxiety, Attention-Deficit Hyperactivity Disorder, Dementia and Severe Geriatric Agitation, Depression, Eating Disorders, Insomnia, Obsessive-Compulsive Disorder, Post-traumatic Stress Disorder, Personality Disorders, Substance Abuse, and Tourette’s Syndrome. 4

    It should be noted, however, that antipsychotics are simply extreme tranquilizers. The drugs are being used as a catch-all to suppress symptoms in a range of diseases – the chemical straightjacket, but cure nothing.

    Criminal use of potentially severely damaging antipsychotics

    Antipsychotics are known to produce a range of adverse and often appalling side effects.

    To use damaging antipsychotics to suppress symptoms in non-psychosis diagnoses is way beyond immoral and in the realm of the criminal.

    Their use in the treatment of schizophrenia and bipolar disorder is often cautioned with statements that the use must be weighed against the effect on the patient of the disease itself. In other words, it is acknowledged that the drugs can produce disastrous side effects for patients and yet is the only alternative in treatment of severe mental illness (not an endorsement but simply all that psychiatry has provided as a treatment). 5 6

    “The use of antipsychotic medications entails a difficult trade-off between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects.” Adverse Effects of Antipsychotic Medications. American Family Physician. 2010. 7

    Take just one example of adverse reactions to antipsychotics: brain damage and shrinkage. This is a controversal subject where a) it has been proven that antipsychotics do result in shrinkage of areas of the brain and b) it is observed that other damage to the brain due to antipsychotics can be occuring but the extent has never been completely researched and c) the potential that severe mental illness such as schizophrenia itself can change brain structure (again never completely researched). 8 9

    So, left with antipsychotics as a very poor choice to begin with, psychiatry does a trade off of brain damage from antipsychotics versus brain damage from the disease itself.

    To then use damaging antipsychotics to merely supress symptoms in non-psychosis diagnoses (such as eating disorders, adhd, insomnia, etc. etc.) is way beyond immoral and in the realm of the criminal.

    Such is the legacy of psychiatry.

    Further references:


    1. Shoham N, Cooper C, Lewis G, Bebbington P, McManus S. Schizophr Res. 2021. Temporal trends in psychotic symptoms: Repeated cross-sectional surveys of the population in England 2000–14
    2. Mark Olfson, MD, MPH; Carlos Blanco, MD, PhD; Linxu Liu, PhD; Carmen Moreno, MD; Gonzalo Laje, MD. JAMA Network June 2006. National Trends in the Outpatient Treatment of Children and Adolescents With Antipsychotic Drugs
    3. J Simon Bell Georgia C Richards Australian Journal of General Practice May 2021. Off-label medicine use: Ethics, practice and future directions
    4. National Library of Medicine. Off-Label Use of Atypical Antipsychotics: An Update
    5. Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018
    6. Voineskos AN, Mulsant BH, Dickie EW, et al. Effects of Antipsychotic Medication on Brain Structure in Patients With Major Depressive Disorder and Psychotic Features: Neuroimaging Findings in the Context of a Randomized Placebo-Controlled Clinical Trial. JAMA Psychiatry. 2020.
    7. John Muench. Ann M Hamer. Adverse Effects of Antipsychotic Medications. American Family Physician. 2010.
    8. J Sweeney. The Long-Term Effect of Schizophrenia on the Brain: Dementia Praecox? American Journal of Psychiatry. 2013.
    9. Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry. 201