Sunday, April 21, 2013

Antipsychotics the New Weapon of Choice for American Soldiers

Prescriptions for antipsychotic drugs to American active-duty soldiers increased 1,083% from 2005 to 2011, according to a recent New York Times article. For the statistics-impaired, this is an almost 12-times increase. This increase occurred despite a steady reduction in combat troop levels since 2008. As a comparison, prescriptions for antipsychotic drugs to civilians increased 22% during this time period. The military attempts to screen out recruits with psychiatric disorders, so what’s the reason for this massive increase in antipsychotic drug prescriptions?

The article’s author speculates that antipsychotics are being prescribed off-label for use as sedatives. Prescriptions for other sedating drugs, such as benzodiazepines and anticonvulsants, also showed a large increase in this time period. There is weak evidence that antipsychotics are effective for PTSD. The evidence is stronger for SSRI antidepressants being effective for PTSD, but antidepressant prescriptions declined by almost 50% between 2006 and 2009. The author speculates that the military favors the quick-acting drugs versus the longer-acting antidepressants.

Have soldiers become more psychologically disturbed in recent years, which would explain the massive increase in prescriptions for sedating medications? It’s difficult to understand why. Iraq and Afghanistan have a unique set of challenges for soldiers’ mental health. Unlike past wars, where there was a dangerous front line and relatively safe zones everywhere else, the front line in Iraq and Afghanistan is everywhere. There is always the danger of encountering an IED, or being ambushed. But this was the case in 2005, so why did it increase so much between 2005 and 2011?

Along with the fear of death and injury, soldiers serving overseas experience additional stresses of being separated long distances from family and friends, and being in an unfamiliar and hostile environment. Those who are geomagnetically sensitive also suffer from being in a vastly different geomagnetic environment from which they grew up. But this was a problem in other foreign wars, when soldiers weren't as drugged as much as they are now.

The main purpose of using psychoactive drugs is for soldiers to escape from reality. This is the case for the legal prescribed drugs along with the illegal drugs. The different classes of drugs allow for soldiers to escape from reality in different ways. For example, psychedelic drugs like LSD or PCP create hallucinatory experiences. Opiates like morphine and heroin relieve physical and psychological pain. Benzodiazepenes like Valium and Xanax relieve anxiety. Alcohol has been used for thousands of years as a means for soldiers to escape reality. These drugs also impair soldiers in different ways, and some of them are highly addictive, so it’s important for the military leadership to keep drug use under control.

Based on the 12-fold increase in antipsychotic prescriptions to soldiers, the military leadership has apparently decided that these drugs are a safe and effective way for the soldiers to escape the horrors of their situation. Antipsychotics allow the user to escape from reality by blunting emotions and desires (antidepressants have a similar psychological effect, but are less effective than antipsychotics, and have less dangerous side effects). An irony is that although antipsychotics were designed to combat the delusions of schizophrenics, it’s a mass delusion among psychiatrists and other doctors who prescribe them that they are safe and effective in the long term. Antipsychotics have some of the worst side-effect profiles of any psychoactive drug (nicotine and alcohol are worse). One side effect of the older antipsychotic drugs (and to a lesser extent the newer ones) is a debilitating permanent condition known as “tardive dyskinesia”, i.e. involuntary body movements such as lip smacking, grimacing, and upper or lower limb movements. The newer ones are associated with serious metabolic disorders, including weight gain and type-2 diabetes. Their long-term effectiveness in treating schizophrenia, the condition they were originally designed and approved to treat, is questionable. Their long-term effectiveness in treating PTSD and other conditions afflicting soldiers is even more questionable. The fact that they cause a major reduction in emotion and motivation is not helpful for a soldier’s performance at his job.

One reason military doctors are gung ho about prescribing antipsychotics is that they are not addictive. But not addictive is not the same thing as safe or effective. They aren’t addictive because most people find the absence of emotions or desires unpleasant. This is the reason that people go off these drugs so frequently. This is the reason why they aren’t a viable long-term solution to psychotic disorders. Prescribing them off-label to soldiers as a sedative is bad medicine, and should be banned.

1 comment:

  1. Harry,
    Antipsychotics, not addictive? I wonder. They are very hard to withdraw from, even though, as you point out, peole don't crave them as they might cigarettes or cocaine. Still, the end effect for both is the same - very hard to withdraw from either group.
    Thanks for a good post.