Antipsychotics Often Prescribed Without Informed Consent

New research reveals that patients are often not given fully informed consent before being prescribed antipsychotics.

2
47

This article was written by Samantha Lilly and originally published by Mad in America, March 23, 2022

New research reveals that patients are often not given fully informed consent before being prescribed antipsychotics. The article, published by the Journal of Mental Health, reports on the challenges and realities of the prescribing process of antipsychotics (APs) for people with psychiatric diagnoses.

The article is written by John Read, professor of clinical psychology at the University of East London. Read examines how APs are prescribed from the perspective of patients:

“Even allowing for some forgetting by the respondents of what they were told, it seems the majority of prescribers are breaching the basic ethical principle of informed consent. The fact that hardly any of the 757 people were told about diabetes, sexual dysfunction, suicidality, potentially shortened life span, neuroleptic malignant syndrome (which is a life-threatening reaction to APs involving rapid onset fever and muscle rigidity), and none were told about withdrawal effects or reduced brain volume, might reasonably be described as negligent.”

The relationship between doctors and patients is a crucial touchstone to the service user’s perception of healing and betterment. Unfortunately, however, previous research indicates that prescribers rarely share the risks of taking and discontinuing psychiatric medication with their patients: what the adverse effects are, when is the right time to discontinue, and what withdrawal feels and looks like. These risks may be especially pronounced for antipsychotics.

One explanation is that the prescribers, too, are unaware of adverse effects, how to distinguish between withdrawal and relapse, and how psychiatric medications work. However, another explanation is that prescribers may feel that sharing psychiatric medication risks may deter patients from taking it or negatively affect outcomes.

An online questionnaire titled, The Experiences of Antidepressant and Antipsychotic Medication Survey, was disseminated via an online research company and social media. The inclusion criteria were: ‘I have been taking or have previously taken antipsychotic medication continuously for at least one month’; ‘I am aged 18 or older’; and ‘I am not currently compulsorily detained in a psychiatric hospital.’ Of the 2,346 individuals who responded to the survey, 757 were included in Read’s analysis.

Of those included, the majority of respondents were women (69.0%), with most hailing from the United States (71.5%), while the rest of the respondents were from 29 other predominantly white countries, e.g., Australia, the United Kingdom, New Zealand, Ireland, Denmark, Norway, and Spain. Six-hundred sixty-three (663) respondents provided their primary diagnosis. About 30% of respondents received a diagnosis of Schizophrenia Spectrum and Other Psychotic Disorders whereas about 28% were diagnosed with bipolar disorder and 25% a ‘Depressive Disorder.’ The remaining respondents received diagnoses of trauma, stress-related, or personality disorder (8.4%).

The participants were asked the following questions:

  • “Did the prescribing doctor tell you how the antipsychotic medication works?”
  • “Did the doctor inform you of any possible side effects?”
  • “Were you offered any other treatment options to consider as alternatives or additions to antipsychotics?”
  • “When you were first prescribed antipsychotic medication, how long were you told you could expect to take it for?”
  • “How would you describe your relationship with the doctor?”
  • “Overall, how satisfactory was the initial prescribing process for you?”

Each question produced notable results: in particular, 75.7% of respondents replied ‘no’ to the question, “did the prescribing doctor tell you how the antipsychotic medication works?” and those that responded “yes” articulated that they were told it alters or fixes a chemical imbalance in the brain.

In response to the question, “did the doctor inform you of any side effects” participants were most likely talked about weight gain and drowsiness/sedation/tiredness. But 70.5% were not told about any side effects, even though many are life-altering, such as diabetes and reduced brain size.

Meanwhile, about two-thirds of respondents (roughly 65%) were not given other treatment options. Those that were offered alternatives cited other psychiatric drugs, with women far more likely to be offered another prescription. Others remembered being offered a form of therapy or counseling; 29 participants mentioned electroconvulsive therapy (ECT) as another treatment option.

Over 70% of respondents were not told how long they would be on the medication or were told they would be on it indefinitely, and this was especially true for those with a psychiatric diagnosis.

Overall, Read found that the satisfaction with the doctor-patient relationship and initial prescribing process was low, especially if the participant had a psychosis diagnosis.

Notably, of those who were in the minority, that is, they were included in the prescribing process and given information about the side effects of their respective medication and given an understanding of how the medication works and for how long they ought to take it actually reported that the medication was more efficacious.

“Prescribers may fear that informing people about the adverse effects of APs would decrease the chances of their taking medication, thereby negatively influencing outcomes. This is a reasonable explanation given that few people would take something if told it might cause diabetes, reduced brain size, and shortened life span; but it is not an excuse for unethical practice. Psychiatrists may be reassured to hear those participants who were informed of adverse effects reported better outcomes.”

 

****

Read, J. (2022). How important are informed consent, informed choice, and patient-doctor relationships when prescribing antipsychotic medication? Journal of Mental Health. (Link)

2 COMMENTS

  1. In 1999 my father brought me into an asylum to get me help for insomnia. Big mistake. I was scared out of my mind, yes, literally; because I was in a scary asylum with what I used to think were dangerous people. I was so scared I even asked my dad to stay all night to protect me. Did they mistake this for schizophrenia? If so, its contrived , a convenient lie.

    Anyways, after a good night’s sleep, I was well rested and recuperated. But I met with a psychiatrist and in one, ten-minute session, he asked no questions said nothing and incorrectly labelled me and I won’t speculate, suffice it to say I suspect he had nefarious intent, ulterior motives.

    I feel the psychiatrist mistook my report of face pareidolia as something he could contextualize as perceptual abnormality (convincing lie). Because after I told him, ‘The way the streetlights and shadows played in the tree it looked like my professors face’, he immediately declared, with an evil smirk, “You have schizophrenia” . The only thing he ever said in the whole meeting.

    However, I was of sound mind and in control of my faculties and NOT presenting with any schizophrenia symptoms before, during or after the silent appointment. He did not even admit me for 1-4 weeks to go under the microscope, you know observation, it was a rush job! I categorically deny I had schizophrenia in 1999.

    In hindsight, I should have asked for a second opinion or rather I should have just marched right out of that asylum never looking back. I didn’t. I was complacent, didn’t see danger, it was a doctor after all, and doctors don’t harm?

    Instead, I started taking the Zyprexa obediently for ten to fifteen months on, then five months off, then back on for eleven months before finally quitting for twelve plus years in 2001/02 – 2013/14, the ‘good ole times’ I never had a problem during these years I was completely off psychiatric drugs.

    However, in 2001/02, after being admitted for being obstinate and uncooperative, my mind got very light-headed, cloudy, hazy, dizzy, and foggy, and I was drowsy, faint and weak, it also physically felt like there was a veil over my head and my eyes were glowing with light and projected two shining orbs six inches in front of my face.

    So, I went and lied down and fell asleep, after I woke up everything was relatively fine again. It was a weird experience. What happened? Was it kundalini, spiritual emergence? Were they testing a new drug on me in the hospital? In hindsight I suspect antipsychotics caused the problem. I don’t know.

    Was this a “false positive” psychosis? Yes. Because when I experienced my symptoms, I knew what to do with them, I went and laid down. And when this happened I knew it was happening. And you wouldn’t know you were in psychosis ; so it was AP induced psychosis.

    Facts:

    First, it wasn’t until after I had taken antipsychotics that this happened.

    Second, psychiatric drugs are psychotropic just like street drugs, psychotropic drugs change brain structures, they fry your brain.

    Third, new studies in the psychiatry research field show antipsychotics causing brain damage, not a biological disease .

    Fourth, it may be the drugs did this to me.

    But In 2019 a practitioner of medicine gave me a second opinion as follows, “You are not crazy… fear is where the schizophrenia comes from” , mimicry. Now that I think about it, he’s right because fear and a realistic response to circumstance are not mental illnesses and never were.

    Try to explain this to guild members and none of them will believe you. They believe every psychiatrist is 100% correct 100% of the time . So, instead of addressing my complaint and having misdiagnosis reassessed they get defensive , and attacked with the following; “ Oh… he has a cognitive deficit.” This is only so they can force me to take their poison.

    Funny thing the current 2022 psychiatrist is not the type of professional to determine cognitive deficit unless he was the one who administered the IQ test. And he didn’t give me an IQ test . So, how do you qualify cognitive deficit without an IQ test fabricate a lie. Well, I call it, ‘hocus pocus diagnosis’.

    I reiterate I never had a problem until after taking a psychiatric drug. Schizophrenia is NOT!, ‘my’ condition. So, if I don’t agree with their diagnosis , and I don’t believe I have their diagnosis , and I don’t . So, they accused me of having a gross lack of insight? It feels like Nazi reasoning.

    And the defamation keeps coming, thick and gooey:

    “He believes in aliens. Believing in aliens is delusional thoughts.” Wrong, if you consider the vastness of space then , yes!, aliens exist. Not saying little green men.

    “He believes he has a gift from God giving him God powers.” I neither said nor believe this allegation. I only said, ‘the TV show Ancient aliens makes me laugh, but every once and a while it makes you think’.

    “He has disassociated thoughts.” No , i just digress without mentioning it. And submit rough drafts without editing.

    “Borders on the grandiose.” Flat out bullshot, I don’t believe that.

    I categorically deny all their lies . And I emphatically challenged them to, do a test to show me I have all I am accused of. They just ignored me.

    But in 2019 a doctor gave me a second opinion , “You are not crazy , fear is where the schizophrenia comes from”; mimicry . Fear is not a mental illness.

    Anyways, now I have evidence of my own; thorough 2021 neuroimaging. My former family doctor explained my brain as, “Everything looks healthy and normal . Yet, they continue to push drugs on me .

    I’m afraid to stop taking drug because they may drag me in front of, what is called, a ‘consent to capacity board’ where they would recruit a family member to do their dirty work.

    However, what angers me the most is they never obtained informed consent in 1999. Had I known I would have never taken an antipsychotic , ever. The arbitraryness of the drug confounds me, in day.

  2. IN THE FIRST PLACE: A COMPLAINT

    In 1999 my father brought me into an asylum to get me help for insomnia. Big mistake.

    I was scared out of my mind, literally because I was in an asylum crawling with what I stigmatized at the time as, a bunch of wild, unpredictable, crazed and very dangerous homicidal lunatics. I even asked my dad to stay all night and protect me from being murdered. Did they mistake this for paranoia? Maybe.

    In 2019 a practitioner of medicine gave his second opinion as follows, “You are not crazy… fear is where the schizophrenia comes from.” Now that I think about it, he’s right because fear and a realistic response to circumstance are not mental illnesses and never were.

    Anyways, after a good night’s sleep, I was well rested and recuperated, I met with a psychiatrist and in one, ten-minute session, he asked no questions yet still incorrectly labelled me and I won’t speculate about his reasons, suffice it to say I suspect he had nefarious intent, ulterior motives.

    I feel the psychiatrist mistook my report of face pareidolia as something he could contextualize to (perpetrate a convincing lie) be perceptual abnormality, for the business because after I told him, ‘The way the streetlights and shadows played in the tree it looked like my professors face’, he immediately declared, with an evil smirk, “You have schizophrenia” and that was the only thing he said in the whole meeting.

    However, I was of sound mind and in control of my faculties and NOT presenting with any schizophrenia symptoms before, during or after the silent appointment. He did not even admit me for 1-4 weeks to go under the microscope, you know observation, it was a rush job! I categorically deny I had schizophrenia in 1999.

    In hindsight, I should have asked for a second opinion or rather I should have just marched right out of that asylum never looking back. I didn’t. I was complacent, didn’t see danger, it was a doctor after all, and doctors don’t harm?

    Instead, I started taking the Zyprexa obediently for ten to fifteen months on, then five months off, then back on for eleven months before finally quitting for twelve plus years in 2001/02 – 2013/14, the ‘good ole times’ I never had a problem during these years I was completely off psychiatric drugs.

    However, in 2001/02, after being admitted for being obstinate and uncooperative, my mind got very light-headed, cloudy, hazy, dizzy, and foggy, and I was drowsy, faint and weak, it also physically felt like there was a veil over my head and my eyes were glowing with light and projected two shining orbs six inches in front of my face. So, I went and lied down and fell asleep, after I woke up everything was relatively fine again. It was a weird experience. What happened? Was it kundalini, spiritual emergence? Were they testing a new drug on me in the hospital? Perhaps. My suspicion in hindsight is, that the antipsychotics caused the problem. I don’t know.

    Was this a “false positive” psychosis? Yes. Because when I experienced my symptoms, I knew what to do with them, I went and laid down. And when experiencing this, I knew it was happening, I was aware I was not in a good way, something was wrong. And you wouldn’t know you were in psychosis ; so a fake psychosis.

    Fact check; First, it wasn’t until after I had taken antipsychotics that this happened. Second, psychiatric drugs are psychotropic just like street drugs, psychotropic drugs change brain structures, they fry your brain. Third, new studies in the psychiatry research field are suggesting antipsychotics are the real culprits causing brain damage in schizophrenics, not a biological disease so the drugs drive you crazy. The drugs did this to me.

    Now there are serious problems, such as, no one believes me and instead of having the 1999 diagnosis reassessed, I guess it’s easier to accuse me of the following: “ Oh… he has a cognitive deficit.” Funny thing the current 2022 psychiatrist is not the type of professional to determine this unless he was the one who gave me the IQ test. Unfortunately, he didn’t bother to give me an IQ test he’s just playing make believe. Imagining things.

    I reiterate I never had a problem until after taking drugs, schizophrenia is NOT!, ‘my’ condition. So, if I don’t agree with their diagnosis , and I don’t believe I have their diagnosis , and I don’t so, they slandered me accusing me of a gross lack of insight?

    And the defamation keeps coming, thick and gooey:

    “He believes in aliens. Believing in aliens is delusional thoughts.”

    “He believes he has a gift from God giving him God powers.”

    “He has disassociated thoughts.”

    “Borders on the grandiose.”

    I categorically deny all their lies . And emphatically challenge them to do a test to show me I have anything at all. They ignore me.

    But in 2019 a doctor gave me a second opinion , You are not crazy , fear is where the schizophrenia comes from; mimicry . Fear is not a mental illness. Anyways, now I have evidence of my own; the thorough 2021 neuroimaging. My former family doctor explained my brain as, “Everything looks healthy and normal . Yet, they continue the ply arbitrary drug treatments on me , that I’m afraid to stop taking drug because they may drag me in front of, what is called, a ‘consent to capacity board’ where they would recruit a family member to do their dirty work, However, what angers me the most is they never obtained informed consent in 1999 . Had I known I would have never taken an antipsychotic , ever.