Drug-Induced Ageing

These posts examine modern psychiatry from a critical point of view. Unfortunately, mainstream psychiatrists usually react badly to any sort of critical analysis of their activities, labelling critics as “anti-psychiatry,” whatever that is. Regardless, criticism is an integral part of any scientific field and psychiatry is no different. As it emerges, there is a lot to be critical about.

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In last week’s post, I mentioned how Bob Whitaker had compiled a list of advantages to exercise as a treatment for depression compared with disadvantages of drugs. His list of adverse effects of psychotropic drugs did not include akathisia or suicidal and homicidal ideas and impulses, which are probably the most serious side effects. Akathisia is a disabling inner sense in the limbs of having to keep moving. It is very troublesome and there is no way it can be controlled by will power. Most major psychiatric drugs can cause it, especially antipsychotic drugs and SSRIs. It can come on within a few days of starting the drug and may fade away or persist, often getting worse when the dose is changed, either up or down. This is a problem in public psychiatry because if a person gets agitated from psychiatric drugs, the invariable response is – more drugs. Which, of course, makes it worse, so they get more and more until everybody gives in in the face of such severe mental disorder and they call for ECT.

Akathisia is definitely not minor. I’m sure it has a lot to do with sudden, impulsive suicide bids in the first few weeks after a drug is started, and with inexplicable homicides. For example, there was a terrible case in the south-west of West Australia in 2018 when a 61yo man shot six members of his family and himself. Initially, there was a report that he had recently been diagnosed as depressed, almost certainly meaning he had been prescribed medication, but this report soon disappeared. However, it is now known that he was taking SSRI’s at the time of the incident. Akathisia can also start or intensify after the drugs are stopped, and can persist for years, as conservative Canadian psychologist and self-publicist, Jordan Peterson, has learned. His health is crumbling but that report comes from Hindustan Times, hardly standard reading outside India:

… (his daughter said) Peterson, 63, is suffering from a “psych med-induced neurological injury,” adding that his symptoms have persisted despite being off psychiatric medications for six years.

I suggest the reason you won’t get this in MSM in most parts of the West, as in the homicide above, is because they won’t mention complications of psychiatric drugs as it threatens drug company profits (when it comes to corporate profits, drug companies and the media are on the same side of the fence). Peterson, however, is a psychologist who has made a fortune from his self-help books and videos: why was he taking psychiatric drugs in the first place? I don’t know, I don’t follow him but it seems his little inspirational homilies didn’t quite work. Perhaps he should have stuck with exercise, which works well in most cases of mild-moderate “depression” (in quotes because there’s no such thing as mild depression, that’s just normal [1]; anybody who isn’t at least “mildly depressed” from watching the news these days needs to get a grip on reality). Exercise isn’t just good for the miseries, it’s also very effective in delaying the onset and retarding the progress of Alzheimer’s Disease. Fortunately, this has been studied quite extensively over years [2,3] even though nobody takes any notice of it. Finding a drug to prevent or even reverse Alzheimer’s would be the path to incalculable riches, so that’s where the research money goes. Financially, getting people to trot around their neighbourhood or stretch in the park isn’t in the same league.

There are two sorts of exercise, physical and cognitive, and two sorts of physical, aerobic and resistance-training. Exercise reduces blood viscosity and all sorts of nasty inflammatory chemicals [4], improves balance and coordination, thereby reducing falls and fractures, reduces diabetes and its myriad complications, gets sluggish bowels working without drugs and clears the bronichals, as my old grannie used to say. Aerobic exercise aims to improve cardiorespiratory fitness and get the blood pumping through those elderly arteries. The main aerobic exercises are walking and jogging, cycling and swimming. Resistance training means lifting weights but it doesn’t have to be a lot and doesn’t have to be heavy. It’s the persistence that counts. Twenty minutes of walking one day and weights the next is effective, especially if done in a social group and includes mental exercises such as crosswords and sudoku. All this is known to retard ageing: combined with a balanced diet, regular steady exercise is the most powerful anti-ageing factor known. Obviously, life style can accelerate ageing but it can also retard it. The earlier people start, the better the outcome but it’s never too late.

As I said, this has been known forever but there’s no money in it so nobody bothers with it. However, with the ageing population and shrinking workforce, they’ll have to otherwise we’ll have swarms of elderly disabled people in nursing homes and nobody to look after them. Keeping people out of nursing homes is very cost-effective, especially when the “treatment” costs nothing. The problem is that psychiatric research is only funded if it involves biology, so a recent report in the prestigious psychiatric journal Psychological Medicine was a bit surprising [5]. They were studying the relationship between a diagnosis of schizophrenia and the ageing process using a cohort from Dunedin, NZ, born in 1972-73 and followed since. This group has been extensively studied using a variety of (expensive) tests and the results are accepted as reliable.

It’s been known for many years that people taking major psychiatric drugs in the long-term, essentially meaning for life, die much younger than their undrugged peers [6]. In Australia, they lose about 19 years of life whereas in the US, where people commonly have larger doses and more drugs (polypharmacy), that figure is 25yrs. That’s a lot of life to lose, well over a quarter of your allotted span, to it’s important to know: is it the “disease” that kills them, or is it the treatment? They had only about 1000 subjects, which isn’t a lot for this type of study, but they were able to conclude that yes, people with schizophrenia age faster than the other people who acted as controls. By some fairly complex statistics, they decided this wasn’t due to family genes, to tobacco or to the drugs they had been prescribed. By exclusion, they concluded that it is the condition itself that causes people to age faster than their peers or siblings. This is important: psychiatry has a truly appalling record of mistreatment of the mentally troubled [7], up to and including the “euthanasia” program in Nazi Germany that killed several hundred thousand people – and, of course, failed to eradicate the “defective genes” that everybody believed were causing mental disorder.

However, there is one factor they failed to take into account: that what seems like accelerated ageing is actually an indirect result of the treatment. Psychiatric drugs are seriously unpleasant. They have a wide range of adverse effects, including emotional numbing and detachment, apathy and inertia. Socially, people taking them are mostly severely isolated, including from their families. Friends drift away, relatives lose interest or are too busy in their own lives. People on psychiatric drugs have little enthusiasm for anything and tend to sit around smoking and drinking Coke as there’s little else they can do and nobody to do it with anyway. So their health declines. They get fat, they develop Type II diabetes, their arteries clog and they die young after a life of misery and emptiness. If that’s caused by the drugs, then what we’re doing is no better than in the old days when they cut people’s brains to “cure their diseases.” This is critically important, especially for people taking drugs against their will or who have been misled by drug company advertising, which is practically everybody.

The paper on schizophrenia and ageing involved twenty researchers from around the world and clearly a lot of computer time. It reads as though they’re trying to find a link between premature ageing and the mental trouble, that they have a common biological cause. Of course they would, that’s what psychiatric researchers do, that’s how they get their money and get ahead. They concluded:

Our findings add to a growing body of evidence supporting the hypothesis that accelerated aging is present in schizophrenia, which may contribute to the higher risk and earlier occurrence of age-related diseases. Future clinical trials should examine whether interventions targeting aging-related diseases reduce morbidity among schizophrenia patients [5, p10].

Notice how they said further research should “target age-related diseases” and didn’t mention why these unhappy people were ageing rapidly. That is, we should study the outcome of premature ageing, such as diabetes and high blood pressure etc, but not the cause of the premature ageing process itself. Was this part of a conspiracy to conceal the bad effects of psychiatric drugs? Possibly, although author Gary Greenberg wasn’t so sure. In a review of his diatribe against DSM-5, titled The Book of Woes, he was asked: “Could you briefly summarize the problem, as you see it, of the relationship between pharmaceutical companies and psychiatrists?” He replied:

I don’t think there is a conspiracy in which drug companies pay doctors to create diseases for which they can then sell the cure. But who needs conspiracies when you have capitalism?

In fact, there was such a conspiracy involving Harvard psychiatrist Joseph Biederman (now deceased) and Johnson & Johnson, manufacturers of risperidone, but what he means is that people see what they want to see, they see what they’re rewarded to see. Each of us has a set of beliefs that guide our decisions through the day, but not all beliefs are equal. Some can be changed easily, as in “I used to like that song but I got bored with it,” while others are more like concrete foundations to our lives. We don’t like changing these as it seems we’re no longer the same person. You can see this in the US at present: about 35% of the electorate still support Mr Trump even though he’s doing everything he said he wouldn’t do and nothing that he said he would do. Their belief shapes their perception of reality but that’s not just because they’re idiots, we’re all inclined to do it. General practitioner and historian of science, Robert Youngson, said:

The whole history of science, right up to the present, is a story of refusal to accept fundamental new ideas; of determined adherence to the status quo; of the invention of acceptable explanations, however ridiculous, for uncomfortable facts; of older people of scientific eminence dying in confirmed possession of their life-long beliefs; and of painful readjustment of younger people to new concepts [8, p293].

He quoted the great Lord Lister who found the same thing:

I remember at an early period of my own life showing to a man of high reputation as a teacher some matters which I happened to have observed. And I was very much struck and grieved to find that, while all the facts lay equally clear before him, only those that squared with his previous theories seemed to affect his organs of vision.

This is what education is about, finding the “concrete slabs” that are messing with our thinking and replacing them (it’s also true of psychotherapy). I think this paper, on ageing and schizophrenia, is a clear example of how our beliefs shape our perceptions. As good reductionists, they want to find a biological cause for the observation that people with this diagnosis seem to age prematurely. They’re committed to the belief that all mental disorder is biological, so it simply doesn’t occur to them that a diagnosis could be the result of non-biological factors. In their minds, the mere fact of a diagnosis says “biology,” they’re incapable of thinking in any other terms. It’s like the diagnosis of anorexia nervosa. People say: “It has to be biological, they actually die while saying they need to lose more weight. That can’t possibly be psychological.” Really? What about all the young men who take drugs to get more muscle bulk? They die too, even after being told their habit is dangerous (brief video here). Morbid obesity is the same, they eat themselves to death. Others speed on motorbikes or cover themselves in tattoos or studs (ugly but not necessarily fatal) but that doesn’t prove it’s biological. You see the business model:

If it isn’t 100% normal, it’s an illness; if it’s an illness, it has a biological cause; if biological, we can make our name by discovering the cause so let’s get some grants and get started. Whoopee, fame and fortune here we come.

When it comes to the question of premature ageing in mental disorder, yes, it will require a long-term study so the sooner we get started, the better. However, we already know the answer: regular steady exercise of body and mind is the most powerful anti-ageing factor known. The bodies and minds of people on psychoactive drugs don’t get exercise as they’re too apathetic, so they age quicker than their undrugged siblings. But don’t be surprised: that’s what the drugs do, that’s why they were invented, to keep people obtunded and tractable [7].

Let’s assume we sort this out, will that resolve the issue? No, not at all. The problem isn’t just a matter of tidying a few loose ends, it’s the whole fabric of modern psychiatry. In the absence of a formal, articulated model of mental disorder, there is nothing to control psychiatrists. Society relies on their good intentions, which is not such a bright idea because it assumes they actually know what they’re doing. My case is that they don’t, they only think they know, so if this matter is sorted out, they will simply move camp a bit and start again, such as giving up on serotonin and starting on inflammatory chemicals from the bowel again (it was tried a century ago; it must be time for a rerun). Critical psychiatry ends up as a game of whack-a-mole, endlessly chasing after the leaders of the pack as they press ahead into unknown territory and leaving messes that can take many years to sort out, all without a single apology for lives ruined. There were hundreds of thousands of people who were sterilised or whose brains were cut in the completely wrong belief that this would help them or society. Nobody ever apologised.

References:

1. Horwitz AV, Wakefield JC (2007). The Loss of Sadness: how psychiatry transformed normal sorrow into Depressive Disorder. New York: Oxford University Press.

2. Meng YC et al (2018). Exercise Intervention Associated with Cognitive Improvement in Alzheimer’s Disease. Neural Plasticity. Article ID 9234105, https://onlinelibrary.wiley.com/doi/10.1155/2018/9234105.

3. Chen W-W et al. (2016) Role of physical exercise in Alzheimer’s disease (Review). Biomedical Reports 4: 403-407.

4. Tortosa-Martinez J, Clow A (2012) Does physical activity reduce risk for Alzheimer’s disease through interaction with the stress neuroendocrine system? Stress, 15(3): 243–261. DOI: 10.3109/10253890.2011.629323

5. Whitman ET et al (2026). Replicated evidence for an accelerated rate of whole-body aging in schizophrenia. Psychol Med. ; 56: e42. https://pubmed.ncbi.nlm.nih.gov/41656957/.

6. WHO (2016) Premature death among people with severe mental disorders. WHO/MSD/MER/16.5. https://www.who.int/mental_health/evidence/excess_mortality_report/en/

7. Harrington A (2020). Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness. New York: Norton.

8. Youngson, R (1988). Scientific blunders: a brief history of how wrong scientists can sometimes be. London: Robinson.

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My critical works are best approached in this order:

The case against mainstream psychiatry:

McLaren N (2024). Theories in Psychiatry: building a post-positivist psychiatry. Ann Arbor, MI: Future Psychiatry Press. Amazon (this also covers a range of modern philosophers, showing that their work cannot be extended to account for mental disorder).

Development and justification of the biocognitive model:

McLaren N (2021): Natural Dualism and Mental Disorder: The biocognitive model for psychiatry. London, Routledge. At Amazon.

Clinical application of the biocognitive model:

McLaren N (2018). Anxiety: The Inside Story. Ann Arbor, MI: Future Psychiatry Press. At Amazon.

Testing the biocognitive model in an unrelated field:

McLaren N (2023): Narcisso-Fascism: The psychopathology of right wing extremism. Ann Arbor, MI: Future Psychiatry Press. At Amazon.

The whole of this work is copyright but may be copied or retransmitted provided the author is acknowledged.