MindFreedom Support Coalition is an international group of over 100 grassroots organizations that are working to oppose coercive psychiatric treatments and the dominance of Big Pharma in mental health. Fulfilling its role as an epicentre for the "mad pride" movement, MindFreedom has planned an Action Conference in Washington, DC, USA. The conference will feature action-oriented workshops rather than the usual lineup of speakers and passive audiences. By involving participants directly in campaigns and strategies, the organizers hope to encourage people to apply their know-how outside of the context of the conference and to continue resisting human rights violations in psychiatry on a day-to-day basis. To drive this point home, the events will culminate on May 2 with a street protest at the headquarters of Pharmaceutical Research and Manufacturers of America (PhRMA). The conference runs from April 29 to May 2 at the American University Washington College of Law. For more info, visit mindfreedom.org.

Letter from my third year

I am a third year pharmacy student. My education has included rigourous
training in statistical analysis and critically appraising publications
in medical literature such as randomized control trials, meta-analyses,
reviews, texts, as well as reports in lay media. As such, I have a
pretty high bullshit detector when I read anything to do with the
pharmaceutical industry and the pharmacologic treatment of disease

I agree that the evolution of massive pharmaceutical corporations is a
cause for concern. It would seem that the current trend in drug
development boils down to a branding competition between companies
which drives the development of designer drugs that may be no better
than standard, older therapies. This is something that health care
professionals, academia, and other consumer/patient advocacy groups
should monitor.

However, discussions of the evils of Big Pharma break down when lay
media tries to wade in on the analysis of appropriate pharmacological
treatment of disease states without previously undertaking a thorough
understanding of the issues at hand and a fair and unbalanced analysis
of published medical literature. The result is often sensationalized
misinformation that only serves to further confuse patients. This
problem is most often at its worst in the favourite topic of
pharmacologic treatment of major mood disorders such as depression.
Depression is a complex puzzle of differing subjective signs and
symptoms, the cause and treatment of which are still not well
understood. This is a disease state which has no objective markers the
way that hypertension (high blood pressure) or diabetes mellitus have.
The effect of serotonin and norepiniephrine on mood is not a black and
white road map. Therefore, when your author Richard DeGrandpre
oversimplifies the "serotonin=good, norepiniphrine=bad" scenario he
paints in 'Put Big Pharma on a Short Leash" he creates more confusion
than illumination.

When DeGrandpre gets into the comparison of serotonin reuptake
inhibitors (SSRI's) such as fluoxetine (Prozac (R)), tricyclic
antidepressants (TCA's) and the new class of dual
serotonin/norepinephrine reuptake inhibitors (SNRI's) like duloxetine
(Cymbalta (R)) and venlafaxine (Effexor (R)) he completely muddies the
waters. Yes, SNRI's work by a similar mechanism to TCA's, but they are
completely different chemically. Remember, our body is just one big
chemical machine, and a differenct molecule will exert a different
effect. Yes, TCA's have marked side effects due to the effect of
increased norepinephrine. They are also, unfortunately, associated with
a relatively narrow therapeutic window and are extremely toxic in
overdose. The implications are obvious - a patient being treated for
depression with a TCA has a mittfull of opportunities to carry out
suicide. They also interact with many other medications, making it
difficult to treat a patient with concommittant illnesses. Thus far,
SSRI's *AND* SNRI's are not associated with such toxicities, although
reports of inappropriate reactions to the medications such as psychotic
episodes resulting in suicide and homocide are alarming and must be
investigated by the medical community.

Additionally, SNRI's are not indicated as first-line therapy in the
treatment of depression, but may be effective in patients for whom
treatment with an SSRI and/or a TCA has failed. The message here is
this: people respond differently to different medications. If
pharmaceutical companies stopped investigating drugs that worked in
only a percentage of the population, those left without treatment would
(and do) hew and cry for additional therapies.

The issues of safety and thorough testing of a drug before it is
brought to market is also discussed forgetting a major caveat: it is
not ethical to conduct scientific trials in all patients including
children or pregnant women, nor is it feasible to test new drugs for
months at a time in large populations. This is why the testing of drugs
carried out pre-market in healthy volunteers does not end at market
introduction. Clinical trials using larger populations of more diverse
categories of patients plus case reports are crucial to thoroughly
assessing a medication. If we waited to be absolutely sure that a drug
had no adverse consequences in everybody, we would not have many drugs
at all, including antibiotics or insulin. It doesn't seem fair to not
be absolutely confident in drug therapy, but it is an unreasonable
expectation to have.

Furthermore, the word "generic" is often not used appropriately.
Generic refers to a drug manufactured by a non-innovator company that
is chemically equivalent to the innovator product. These drugs must
pass strict comparison trials that measure pharmacokinetics such as
time to effect and elimination rates, as well as observed efficacy.
Generics do not simply mean older drugs, although due to lengthy patent
protection for innovator products, that is what they usually are. They
are cheaper because the manufacturer has not spent the money to create,
patent, and market the drug, but they are no less effective. We
generally refer to a generic by the drug name (ie acetaminophen) and
the innovator product by its trade name (ie Tylenol).

The spread of misinformation in lay media is extremely frustrating. The
current movement by health care professionals in analysis of medical
reports and application of drug therapy is towards Evidence Based
Medicine (EBM). EBM requires a thorough and exacting analysis of case
reports, trials, meta-analyses, and other literature for relevance and
accuracy in order to assess the efficacy and appropriateness of
applying a specific therapy to an individual. Unfortuately, public
media still prefers to seize on the sensational and fails to report
accurately. When DeGrandpre cites reports in the Lancet, JAMA, and
others, he fails to reference appropriately, leaving me and all other
readers unable to easily access and assess the validity of these
reports. This kind of reporting is unacceptable in medical journals,
and should be unacceptable in any other purportedly truth-baring
publication such as Adbusters.

The issue that would be best analyzed by public media is the problem of
direct-to-consumer advertising - something Adbusters seems uniquely
suited to report on. DTC advertising is a factor in the inappropriate
prescribing precisely because patients expect a pill from their doctor
to cure what ails them. It is only after they experience an adverse
event that they question their medication use. This is a crucial piece
of the puzzle that is the overmedication of North America. Why don't
you investigate the overmarketing of herbals and the issue of patients
self-treating with either potentially toxic or ineffective therapies
and risking dangerous interactions with their current prescribed
medications? Additionally, the phenomenon that most physicians get the
majority of their drug information from promotional literature directly
from drug companies would be an excellent area to investigate.

In the future, if you are going to analyze the appropriate treatment of
disease states, due so in an unbiased and thoroughly educated manner,
or don't do it at all. Inaccurate and incomplete reporting makes the
job of ethical, educated, patient-oriented health care professionals
that much more difficult. Preferentially, pursue the stories the you
are most suited to report on.

Respectfully,
Cynthia Berry

Chemical Cocktail

From Prozac to perfumes, pharmaceuticals and personal care products (PPCPs) are discharged down household drains in agrochemical-comparable quantities. Often their ingredients survive sewage treatment and enter our streams and rivers, and sometimes they return through our faucets. What will this largely unregulated cocktail of dimly understood compounds do to our environment? What will it do to us? Nobody knows, but a growing number of scientists demand more research and more precaution, warning that the effects could be gradual rather than acute, mistaken as ‘natural’ until it’s too late.

The search for discharged PPCPs started only recently, triggered by a United States Geological Survey study and a 1999 article co-authored by EPA chemist Christian Daughton. “Scientists looked at the same small select group of pollutants for decades,” explains Daughton. “Anything that humans use has the potential to be a pollutant.”

The USGS study, released in 2002, found PPCPs – and many other previously unacknowledged pollutants – from sea to shining sea. Eighty percent of 139 urban waterways in 30 states were contaminated; of 95 targeted compounds, they found 82, with as many as 38 occurring in a single stream. The findings were sobering. Detecting individual compounds at low concentrations is a laborious and time-consuming task, often requiring scientists to develop new methods of analysis. In a sense, finding PPCPs is less an issue of their presence than our ability to measure them.

“There are 10,000 synthetic organic compounds that we use in our daily lives and industry,” says USGS scientist Michael Meyer, “and we’re just looking at a small fraction of them.”

While little is known about PPCP presence, their actual effects are understood even less.

Some PPCPs, including birth control pills and certain soaps, are endocrine disruptors, which can impair hormonal and reproductive processes. Antidepressants like Prozac can wreak reproductive havoc in fish and crustaceans, as can high blood pressure drugs. Musks used in perfume are highly toxic, and anti-epileptic drugs – which have been found in drinking water – can trigger cell death in developing human brains. How such compounds work in combination is anyone’s guess.

But while these biological possibilities are recognized, scientists have yet to identify the effects of PPCPs on aquatic ecosystems and human beings. Only in the last two years, says Daughton, has research on effects been published, and even that is skimpy. Such measurements are especially difficult. Impacts are likely to be subtle – and often we don’t know what to look for.

“Very few chemical stressors have just one effect. They have effects on all sorts of pathways in organisms, because pathways are all interconnected,” says Daughton. “That’s why it’s almost impossible to predict what types of effects you might find.”

Current US regulations on PPCPs are inadequate. They emphasize acute toxicity, rather than the low but pervasive concentrations found in sewer discharge. They also overlook regional variations in concentration – some compounds may be diffuse on average, but intense in particular locales. In coming years, more regulation may be suggested, but both the lobbying power of chemical manufacturers and the limitations of our monitoring capabilities make that a distant possibility.

“It’s amazing how little scientists know,” says Daughton. “That’s the takeaway lesson.”

Brandon Keim is a freelance writer and former editor of Genewatch.

Don’t stumble. Don’t fall. Lose your mental stride and you’ll end up depressed, bipolar or schizophrenic. You could wake up in a post-war mental ward feeling like your whole past is a hazy dream. And believe it, there are millions out there who know the story: gradually your motivation dims, your sleep becomes disturbed, and you lose clarity of mind. Then you’re in big fucking trouble, for there’s a threshold here, and once you’ve crossed over it’s tough as hell getting back. Sometimes meds help, or even institutionalization, but more often than not you become dependent on the drugs, and then there’s a second monkey on your back.

So how do you keep your mental life from crashing? Start by knowing what you’re up against. When Mexican immigrants arrive in the US, they are not as well-off as Americans, but their rates of mental dysfunction are considerably lower. Within a decade’s time, however, their problems with depression, anxiety and addiction nearly double, to the same levels as the general American population (about 32 percent).

These are the dangers of a toxic culture. Denying them won’t do you any good. What will help are simple things like not living alone and keeping close contacts with family and friends. Live more fully, live in the moment, live more slowly and live more locally. In the meantime, consider injecting your life with extra meaning by joining the mental-ecology movement.

To win the battle of the mind, we need nothing short of a mobilization on par with the ecology movement of the ‘60s. That movement began by redefining the meaning of nature. No longer was it viewed as just a playground for development and resource extraction, but as a living system of which we are a part. We mental environmentalists must launch a similar movement.

If we don’t, one morning we will wake up in a never-ending schizo dream.

Momentum Builds for the MindFreedom 2005
Action Conference and Protest.

Friday, April 29 to Monday May 2, 2005

American University Washington College of Law
Washington, D.C., U.S.A.

Momentum continues to grow for MindFreedom International's 2005 Action Conference entitled, "Activism for Human Rights in Mental Health: How the Law Can Support Grassroots Action for Human Rights in the Mental Health System."

The 2005 Action Conference will bring together key leaders, activists, allies and advocates in the field of human rights for people labeled with psychiatric disabilities. The conference is co-sponsored by American University Washington College of Law and MindFreedom International.

Today the conference planning committee announced the lineup of facilitators and opened up registration for the conference, which will take place at the American University Washington College of Law in Washington, D.C.

For your invitation to the conference complete with information about registration, agenda, transport, lodging and the protest, go to the ACTION CONFERENCE INFO CENTER at:

http://mindfreedom.org/mindfreedom/action_conference.shtml.

Facilitators include Robert Whitaker, award winning author of _Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill_.

David Oaks, Director of MindFreedom, said, "We are seeing a lot of interest in this conference and expect it to get even more exciting. This is not just another conference where lecturers address a passive audience. This is about participants uniting to self-organize campaigns together."

Conference Chair Krista Erickson, added "Space is limited to the first 150 people to pre-register, and pre-registration is required. If you are committed to rolling up your sleeves to win freedom in the mental health system please register soon. We kept the registration fee, which includes meals throughout the conference, as low and affordable as possible."

The conference will start Friday evening, 29 April, and take place all day Saturday, 30 May and Sunday, 1 May 2005. A nonviolent protest will be held at noon on Monday, 2 May 2005 at the Pharmaceutical Research and Manufacturers of America (PHRMA).

The conference has six facilitated tracks that will develop specific action and implementation plans.

** US Congress/Federal Government. The focus includes countering the improper influence of the psychiatric drug industry on the US government. Facilitators include: Dominick Riccio, PhD, Executive Director of the International Center for the Study of Psychology and Psychiatry (ICSPP).

** Public Education and the Media. Win media coverage of psychiatric practices that are routinely violating people's rights and subjecting them to harmful, ineffective -- even fatal -- drugs and procedures. Facilitators include: Robert Whitaker, author, and Laurie
Ahern with Mental Disability Rights International (MDRI).

** International: Work with The World Health Organization (WHO) and the United Nations (UN) to combat abuses internationally. Facilitators include: MindFreedom President, Celia Brown and MindFreedom Director, David Oaks.

** Choices In Mental Health. Develop, network and support humane and truly helpful alternatives to the mental health system. Facilitators include: Long-time organizer and MindFreedom co-founder and board member Janet Foner.

** How the Law Can Help Fight Forced Treatment. Fight the sham legal proceedings resulting in forced drugging and other horrors, such as forced electroshock, by combining the tools of the legal system and grassroots activism. Facilitators include noted attorney, James B. (Jim) Gottstein, Esq., of the Law Project for Psychiatric Rights (PsychRights).

** Open Track. This track welcomes suggestions for other actions by any conference participants to raise topics, ideas or concerns not covered by other conference tracks, especially voices from neglected and marginalized groups. Facilitators include dedicated
psychologist and MindFreedom board member, Al Galves, PhD.

For an invitation to the conference complete with information about registration, agenda, transport, lodging and the protest, go to:

http://mindfreedom.org/mindfreedom/action_conference.shtml.