Do psychiatric medications do more harm than good?

Two recent stories in Scientific American have me contemplating, once again, the terrible possibility that psychopharmacology hurts more people than it helps.

Reporter Sarah G. Miller notes in “1 in 6 Americans Takes a Psychiatric Drugthat prescriptions for mental illness keep surging. As of 2013, almost 17 percent of Americans were taking at least one psychiatric drug, up from 10 percent in 2011, according to a new study. Miller elaborates:

Antidepressants were the most common type of psychiatric drug in the survey, with 12 percent of adults reporting that they filled prescriptions for these drugs… In addition, 8.3 percent of adults were prescribed drugs from a group that included sedatives, hypnotics and anti-anxiety drugs, and 1.6 percent of adults were given antipsychotics.”

This increase in medications must be boosting our mental health, right? Wrong. In “Is Mental Health Declining in the U.S.?,” Edmund S. Higgins, professor of psychiatry at the Medical University of South Carolina, acknowledges the “inconvenient truth” that Americans’ mental health has, according to some measures, deteriorated.

A 2013 study, Higgins writes, found that “the toll of mental disorders had grown in the past two decades, even as other serious conditions became more manageable.” He adds: “Suicide rates per 100,000 people have increased to a 30-year high. Substance abuse, particularly of opiates, has become epidemic. Disability awards for mental disorders have dramatically increased since 1980, and the U.S. Department of Veterans Affairs is struggling to keep up with the surge in post-traumatic stress disorder (PTSD).”

Higgins contends that “a lack of precision and objectivity in diagnosing and treating mental illness has stalled our progress. We must embrace new strategies in research and prevention to move forward.” He ends on an upbeat note. “None of this is to say that mental health workers and their patients should stop what they are doing,” he writes. “We all have success stories to tell.”

Like most psychiatrists, Higgins does not consider the possibility that medications might be contributing to the decline of mental health. That is, drugs for mental illness—although they undeniably help some people in the short term, leading to “success stories”–might produce net harmful effects for large populations over the long-term.

That is the disturbing thesis of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by journalist Robert Whitaker.  After reading Whitaker’s book and listening to him speak at Stevens in 2012, I wrote that “American psychiatry, in collusion with the pharmaceutical industry, may be perpetrating the biggest case of iatrogenesis—harmful medical treatment–in history.”

Far from seeing a persuasive rebuttal of Whitaker’s thesis, I keep seeing findings consistent with it, including the data cited by Higgins. It is time for mental-health practitioners in the U.S. and elsewhere to come to grips with the possibility that medications are doing more harm than good.

Johnn Horgan directs the Center for Science Writings. This column is adapted from one originally published on his ScientificAmerican.com blog, “Cross-check.”