Why Are Psychiatric Drug Side Effects So Severe?

Why are psychiatric drug side effects so severe? Recently, I complained to my psychiatrist that I felt like my heart was racing. She took my pulse, frowned, broke out her stethoscope, then ordered an electrocardiogram (EKG). The EKG came back abnormal, so the nurse practitioner overseeing it ordered another one. Both EKGs showed that I may have had a mild atrial heart attack. I see a cardiologist on Thursday. How could psychiatric drug side effects be so severe?

It reminded me of a lecture in fourth grade science class. Our teacher told us Eli Lilly had developed a cure for arthritis, but the side effects were worse than the arthritis so the medication had been pulled off the market. Yet when it comes to mental health medications, we tolerate some very severe side effects, such as a 36-year-old health nut having a heart attack. Why do we put up with this? Why are psych drug side effects so severe?

Some Common Psychiatric Drug Side Effects:
More than one psychiatric medication interferes with the heart. I’ve been on two known to cause heart problems. Many psychiatric medications cause weight gain, giving the consumer a choice between being fat and happy or thin and miserable. This weight gain can lead to diabetes, which has some serious, and sometimes fatal, complications.

Some psychiatric medications can cause wild mood swings. I had that reaction while on one drug, and my mood swings were so severe I could barely move due to a crushing depression. Another time, I was put on another drug to control tremors caused by my psychiatric drugs. If my therapist hadn’t been married to an Emergency Room doctor who realized my emotions were chaotic due to the drug, I probably would not be writing this column.

The neurological disorder tardive dyskensia is common as a severe psychiatric drug side effect; I’ve heard estimates that this irreversible condition afflicts one out of four psychiatric patients. Also common is restless leg syndrome, which can make sleeping difficult, which can lead to psychosis. Tremors are also common; it is not uncommon to see psychiatric inpatients rocking back and forth.

A social worker told me once that one of the antipsychotics I was on caused violent tendencies in one-third of all who took it. And finally, there’s the Food and Drug Administration-required “black box” warning that antidepressant medications can cause thoughts of suicide.

Now, imagine for a moment that an over-the-counter medication caused these effects. Imagine aspirin had death as a side effect. We’d never tolerate that. So why are psychiatric drug side effects so severe?

Is It the Stigma Attached to Mental Illness That Allows for Severe Psychiatric Drug Side Effects:
I’m not afraid of my heart problems because cardiac medicine, especially in Indianapolis, is very advanced. We can alter the heart rate with a medicine. We can do surgery on the heart. We can even transplant a heart. But this is not the case for psychiatry. When it comes to psychiatry, we are where cardiac medicine was 200 years ago.

Indianapolis is a medical research hotspot, and I see great advances in medication every day for every organ except the brain. Every field of medicine is making leaps and bounds except psychiatry. We’re even on the verge of curing Ebola, but we don’t understand the human mind. We are as terrified by mental illness as we were by Ebola, only we’re not willing to do whatever it takes to fight mental illness.

Why is this? I believe that it is because of the stigma attached to mental illness. By and large, we view it as a choice, and therefore not our problem. We see mental illness, whether it’s depression or substance abuse, as sin and not as sickness. So we frown on medical intervention and allocate very little money for research into mental illness. As a result, our treatment methods are somewhat barbaric compared to other medical fields (imagine the outcry if we hospitalized human immunodeficiency virus (HIV) positive people against their will), and as the old saying goes, “The cure is worse than the sickness.” We tolerate in psychiatry what we’d incarcerate for in cardiology.

What We Need to Reduce the Severe Side Effects of Psychiatric Drug Medication:
We need to view mental illness as just that, an illness that affects the brain. We need to treat it as the public health crisis it is. We need more money for treatment and more research into psychiatry. We need to be willing to do whatever it takes to ease the burden of those who suffer from mental illness, and the place to start is by developing medications that don’t run the risk of killing the patient.
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