The chemical cosh

In 2008, with over $14 billion in sales, antipsychotics became the single top-selling therapeutic class of prescription drugs in the United States, surpassing drugs used to treat high cholesterol and acid reflux. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis. It is anything but a coincidence that the explosion in antipsychotic use coincides with the pharmaceutical industry's development of a new class of medications known as "atypical antipsychotics." Beginning with Zyprexa, Risperdal, and Seroquel in the 1990s, followed by Abilify in the early 2000s, these drugs were touted as being more effective than older antipsychotics like Haldol and Thorazine. By 2009 Seroquel and Abilify numbered fifth and sixth in annual drug sales, and prescriptions written for the top three atypical antipsychotics totaled more than 20 million.

Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed."

"Psychiatrists are particularly targeted by Big Pharma because psychiatric diagnoses are very subjective," says Dr. Adriane Fugh-Berman. In the age of aggressive drug marketing, she says, "Psychiatric diagnoses have expanded to include many perfectly normal people."

Marcia Angell, former editor of the New England Journal of Medicine, puts it more bluntly: "Psychiatrists are in the pocket of industry." and argues that if the new drugs are so effective, we should "expect the prevalence of mental illness to be declining, not rising."We are "simply expanding the criteria for mental illness so that nearly everyone has one."

What's especially troubling about the over-prescription of the new antipsychotics is its prevalence among the very young and the very old - vulnerable groups who often do not make their own choices when it comes to what medications they take.

Mental illness is now the leading cause of disability in children. The state of Florida's juvenile justice department in 2007, for example, bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children. Enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.

In addition to expanding the diagnoses of serious mental illness, drug companies have encouraged doctors to prescribe atypical anti-psychotics for Alzheimer's and other forms of dementia, as well as agitation, anxiety, and insomnia. In selling to nursing home doctors, sales reps reportedly used the slogan "five at five"—meaning that five milligrams of Zyprexa at 5 pm would sedate their more difficult charges. Selling a illness and its "cure" is little different from selling the latest fashion.

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SOYMB reads on the BBC that similar wrong prescription practices takes place in the UK with the Alzheimer's Society is issuing new guidance calling on doctors to think much harder before prescribing antipsychotics. Around 180,000 people with dementia are thought to be prescribed antipsychotic drugs in the UK. 80% of those prescriptions are said to be inappropriate. Long-term use of the drugs can make dementia symptoms worse, reduce the ability to talk and walk and increase the risk of stroke and even death. An independent report in 2009 that found the drugs killed around 1,800 patients a year. The Scotsman reported that local pharmacists have demanded a more central role in monitoring the drugs given to care home residents following growing concern over the use of medication in older people. In recent years a number of concerns have emerged over use of drugs among elderly people, including the so-called "chemical cosh".

We cannot argue that socialism will be a society without illness. In socialism we will still have some of the problems that make you feel miserable, scared, depressed or demented. Socialism is not a solution to all mental health problems, it is a solution only to those created by capitalist conditions of life, or to class conditions of life. While some of the problems are due to being human beings living within a social setting, others are due to being biological organisms, and as such will break down if we are damaged or just get old (e.g. aphasia, epilepsy, anger management problems, Alzheimer’s, front lobe syndrome, pharmacologically induced psychosis). There would be a reduced use of medication and an increased use of social therapy. We can certainly suggest that socialism will be a society without artificially-created illness — whether resulting from the stresses of capitalism or the bogus disease-marketing of the pharmaceutical companies. Healthcare would be conceived and administered, democratically by us, the people who brought socialism about. Globally, doctors, nurses, scientists and everyone at present involved in healthcare at the human level would act as guides.