MONITOR CLOSELY: Haloperidol can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in elevated risk of ventricular arrhythmias, including ventricular tachycardia and torsade de pointes, because of additive arrhythmogenic potential related to their effects on cardiac conduction. Haloperidol treatment alone has been associated with a number of reported cases of torsade de pointes and sudden death. The majority of cases involved intravenous administration or use of higher than recommended dosages. Lithium has also been reported to prolong the QT interval in some patients. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drugs involved and dosages of the drugs.

MONITOR CLOSELY: Although haloperidol and lithium have been used safely together in many patients, there have been a few reported cases of encephalopathic syndrome consisting of severe neurotoxic effects and extrapyramidal symptoms, followed by irreversible brain damage, associated with the combination. The mechanism is unknown.

However, psychiatrists need to be kept in check. Although monitored by professional bodies including the Royal College of Psychiatrists and the GMC they have not always been faultless in the process of self-regulation. They don’t have an especially good track record when it comes to overprescribing drugs for less severe disorders and they can cosy up a little bit too much to the pharmaceutical industry – for instance, antidepressants have been overprescribed for mild depression and in the US Ritalin for overactivity in children. Also, due to the socio-political nature of psychiatry, the considerable power that psychiatrists are given to compulsorily detain people for the treatment of mental illness has been misused - consider the political paranoia of McCarthyite America and Communist Russia.

(via Fisher, a prominent psychiatrist who is advising the Obama administration on mental health issues, has been on a personal mission for two decades to change the way wider society understands and reacts to mental illness. An advocate of the “recovery model” – which posits that a diagnosis of mental illness is not for life, and that people can recover completely – Fisher is an outspoken and controversial figure in the US, campaigning vigorously for the rights of people diagnosed with a mental illness. Much of what he does is rooted in his own experience. “Human rights doesn’t even begin to grasp it,” he says. “It goes much deeper than that.”—The Guardian)

In Opening Skinner’s Box Lauren Slater attempts to “celebrate as story” 10 famous psychological experiments; to bring them to life by understanding how they were thought up, how they were received by other psychologists, and what effects they had on the participants.

For more than a century, psychologists have desperately sought to have their discipline accepted as no less a science than biology, chemistry or physics. In the complicated physical world, considerable intervention is required to allow detection of reliable effects. Huge resources are devoted to screening particle interactions from unwanted forces, or biochemical reactions from impurities. To do the same in psychology requires some degree of artificiality, and even trickery, in the experimental set-up. But how much insight do we then gain into how people will behave outside the laboratory? What, anyway, is a “natural” environment for a contemporary person? And if the experimental method we wish to use is sufficiently destructive to prevent us from using it on humans, what do we learn from studies on our fellow mammals?

These and other intricacies are displayed in the chapter “Rat Park”, on perhaps the least known of the experiments discussed. In contradiction to theories proposing that addiction follows from the mere availability of certain drugs, Bruce Alexander created a rat utopia and observed how even “addicted” rats would turn to water rather than opiates. The experiment has a blatant political message: make our lives and life-space pleasant enough and we won’t need to resort to drugs. Even here, however, Slater keeps the ambiguity alive, questioning the relevance of the research for the human condition.

She can also retrieve something of value from the most morally suspect research, such as Egas Moniz’s lobotomy treatment. Moniz’s experiment, conducted in Portugal in 1935, is the only one of the 10 not to have taken place in America; and it rapidly found a home in the US. Yet it would be hasty to dismiss the 10 experiments as shaped completely by their location in the land of the free; many of the experimenters were European immigrants, or had immigrant mentors. Slater seems intrigued by the singularity of the experiments and fascinated by the psychology of the psychologists, most of whom she presents as a fairly insecure lot, unlucky in life and love. But in her personal engagement with the experimental work, she also seems to reveal much about herself.

There’s something provocative in her nature: time and again you tell yourself she won’t pursue that line of enquiry, ask that painful question, or take those pills. As part of her story of Stanley Milgram’s famous obedience experiments, where a large proportion of people were shown to be unable to resist instructions to deliver what they thought to be lethal electric shocks to their fellow man, Slater describes the psychologist’s final hours. Surely she won’t make the link between these fictitious shocks and the real ones the medics used to try to revive him after his final heart attack? Of course, she does.

This lack of restraint, although sometimes offensive, can also be admirable. How many us would dare to repeat a 1972 experiment to see how psychiatric hospitals treat people, by faking one single symptom - a voice in the head saying “thud” - and submitting ourselves for assessment on eight separate occasions? The results are, again, mixed. Slater is treated with kindness and respect, and rather than the weeks of incarceration David Rosenhan and his colleagues endured, she is given consultations and then released. The downside, however, is that after only 12 minutes of a psychiatrist’s time she emerges with a label from the Diagnostic and Statistic Manual on Mental Disorders (DSM) and prescriptions for anti-psychotic and anti-depressant drugs.

The Law Project for Psychiatric Rights (PsychRights.org) is a non-profit, tax exempt 501(c)(3) public interest law firm whose mission is to mount a strategic legal campaign against forced psychiatric drugging and electroshock in the United States. The public mental health system is creating a huge class of chronic mental patients through forcing them to take ineffective, yet extremely harmful drugs.

Currently, due to the massive growth in psychiatric drugging of children and youth and the current targeting of them for even more psychiatric drugging, PsychRights has made attacking this problem a priority. Children are virtually always forced to take these drugs because it is the adults in their lives who are making the decision. This is an unfolding national tragedy of immense proportions. As part of its mission, PsychRights is further dedicated to exposing the truth about these drugs and the courts being misled into ordering people to be drugged and subjected to other brain and body damaging interventions against their will.

Text
Photo
Quote
Link
Chat
Audio
Video