However, the brakes are about to be put on this meteoric success following a recent warning from the US drug-regulating Food and Drug Administration (FDA). The warning states: “Risperdal has not been shown to be safe or effective in the treatment of patients with dementia-related psychosis” – better known as Alzheimer’s – a group comprising a fair proportion of annual sales, we imagine.

The warning follows on the heels of trials that discovered a significantly higher incidence of cerebrovascular reactions compared with placebo among 1230 elderly Alzheimer’s patients.

Interestingly, doctors in Canada were sent similar warning letters six months before their American counterparts. The letters were triggered by reports of 37 incidents of stroke-like events, including 16 deaths, associated with the drug.

But these warnings are nothing new. Earlier studies have been coming up with similar conclusions for some time, including one that linked 29 cases of stroke, plus four deaths, among a group of 764 Risperdal patients.

Common side-effects include anxiety, sleepiness, tremors, rapid heartbeat and tardive dyskinesia, or uncontrollable jerkiness of the facial and body muscles.

Despite the warnings, the manufacturer continues to push Risperdal through the various international regulatory bodies. Spain has just approved an injectable form, known as Risperdal Consta, a version that has also been approved for use in the UK and Ireland. It is designed to act over a two-week period.

We wonder if UK doctors are about to receive a similar warning letter or if they will, at the very least, restrict its use to schizophrenia, for which the drug was originally intended.

So, what is the evidence for this claim? The first neuroleptic medications were developed in the 1950s to relieve the hallucinogenic and paranoid symptoms of schizophrenia and other psychoses. Unfortunately, these drugs brought with them unwanted extrapyramidal (brain motor system) side-effects such as tardive dyskinesia, characterised by muscle stiffness, tics, tremors and other awkward movements.

Led by the introduction of clozapine (Clozaril), the umbrella name of ‘atypical antipsychotics’ became the calling card for this next generation of drugs – which also includes olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal). They have shown promise in suppressing the depressive and antisocial aspects of mental illness that had evaded the earlier drug treatments. And although these atypical antipsychotics each came with its own set of side-effects, the studies suggested that none were as serious as the antipyramidal effects described above (World J Biol Psychiatry, 2000; 1: 204-14).

However, this doesn’t mean that they are necessarily safer.

On reviewing the literature for both the modern and older antipsychotics, researchers noted dubious methodology in some cases – such as basing findings on non-matching dosages across several clinical trials. Overall, no marked advantages of atypical antipsychotics could be found in terms of efficacy, tolerability or mental function. Indeed, researchers warned that “the much promoted advantage of reduced risk of extrapyramidal symptoms with modern antipsychotic drugs needs to be balanced against other adverse effects” (CNS Drugs, 2005; 19 [Suppl 1]: 1-93).

The list of damaging – and sometimes life-threatening – side-effects seen with atypical antipsychotics is lengthy:

* Agranulocystosis (a low white cell count) – which increases susceptibility to infection. It is so commonly seen with clozapine that the drug is only prescribed as a last resort – and even then, only under strict (and expensive) monitoring (Int J Neuropsychopharmacol, 2005; 8: 311-3)

* Akathisia (extreme restless movements of the arms and legs) – an extrapyramidal symptom. In one recent case study, two patients developed this symptom after taking quetiapine (Psychosomatics, 2005; 46: 291-301)

* Cognitive problems – which, again, have been seen with quetiapine (BMJ, 2005; 330: 874)

* Depression – seen, according to one recent case report, in a schizophrenic patient taking quetiapine, suggesting that these atypical antipsychotics may contribute to or worsen the condition for which they are prescribed (Clin Neuropharmacol, 2005; 28: 133-5)

* Diabetes and weight gain (see box above)

* Hyperprolactinaemia (abnormally high levels of the hormone prolactin) – frequently seen (in 60 per cent of women and 40 per cent of men) with the older antipsychotics and prolactin-raising versions of the new breed (risperidone and amisulpride). Symptoms include the development of breasts in men, abnormal secretion of breastmilk, sexual dysfunction, infertility and menstrual disorders (Drugs, 2004; 64: 2291-314)

* Neuroleptic malignant syndrome (NMS) – a rare and potentially fatal condition, characterised by altered consciousness, fever, unstable blood pressure and muscular rigidity. NMS has been reported with clozapine, risperidone, olanzapine and quetiapine (Expert Opin Drug Saf, 2003; 2: 21-35)

* Pancreatitis – the findings for which suggest that clozapine, olanzapine and risperidone, in that order, can cause this potentially fatal disease (Pharmacotherapy, 2003; 23: 1123-30)

* Sexual dysfunction – found in a major Spanish study of 636 patients taking olanzapine (in 35.3 per cent), quetiapine (in 18.2 per cent) and risperidone (in 43.2 per cent). Risperidone also was shown to have the highest risk of reproductive side-effects (J Sex Marital Ther, 2003; 29: 125-47).

For alternatives to this dangerous family of drugs, consult WDDTY’s The Guide to Mental Health (UK price £6.95, including p&p). This book can be purchased through our website at: http://www.wddty.co.uk or by calling us on 0870 444 9886.

As a result, it was recommended for use only by patients suffering from schizophrenia – and then, only after all other antipsychotics had failed. In other words, it was a drug of last resort.

Since then, researchers from the University of Newcastle-upon-Tyne have been investigating a series of ‘unexplained’ deaths that occurred at five psychiatric hospitals in northeast England over a 12-year period. In all, 1350 deaths were investigated: 77 met the criteria for ‘probable’ and 27 for ‘confirmed’ unexplained and sudden deaths.

The deaths were associated with hypertension, ischaemic heart disease and the drug thioridazine. Among the thioridazine patients, the main cause of death was –
torsades de pointes.

Those patients fortunate enough not to develop torsades de pointes could, nevertheless, suffer a legion of other reactions, such as tardive dyskinesia (continual chewing motions with occasional darting movements of the tongue), lip smacking, signs of parkinsonism, difficulty in speaking or swallowing, restlessness, blurred vision, yellow eyes or skin, and nightmares.

Simon Thomas, who headed the Newcastle research team, told The Lancet: ‘Unless there’s a good reason for a patient to continue on thioridazine, it’s appropriate that other antipsychotic drugs be considered..’

But isn’t this what we were told over two years ago and, if so, why is the drug still so freely prescribed? Unfortunately, this was not a question that the researchers asked (Lancet, 2002; 360: 63).

Follow a low saturated fat diet. A large Swedish study examining the course and outcome of schizophrenia in eight national centres found that a high intake of total fat in the diet of any sort, particularly saturated (animal), worsened the course and outcome of the disease. One trend suggested that a high intake of unsaturated fat (from vegetables, fish and seafood) may be associated with improvement (Acta Pschiatr Scand, 1988; 78: 587-91).Eliminate caffeine. Three reports show that psychotic episodes were triggered by excessive caffeine use. Another study of caffeine use on a psychiatric ward showed that heavy caffeine users had more severe psychotic symptom (Behavioral Med, December 1980).

Lower copper levels. The clinical experience of doctors like Stephen Davies shows that many with schizophrenia or severel mental disturbances often have high blood or hair copper levels. Vitamin C, zinc, manganese and B vitamins can help to lower them.

Supplement a wholefood diet with the following vitamins: folic acid 2 mg; vitamin C, B6 (50 mg daily up to 500 mg three times daily), manganese, zinc (gluconate 15 mg daily with meals), niacin (B3) and possibly omega-6 fatty acids (evening primrose oil 500 mg, three capsules two or three times a day).

However, be wary of excesses of folic acid, and have reactions to excess niacin observed closely. American nutritionist Dr Leo Galland also found dramatic improvements (and some scientific evidence in the medical literature) for treatment with linseed (flaxseed) oil, 3T a day.

Excellent counselling. Many in psychiatry, believe, as Dr Peter Breggin does (Toxic Psychiatry, Fontana 1993) that some schizophrenics are experiencing a crisis of meaning over their personal identities possibly as a result of trauma. If this is so, then you need someone highly skilled whom you can trust to help you come to terms with your problems.

Support of loved ones. Make sure to surround yourself with people who can offer you love and support, and can work constructively to get you better.

According to Dr Yuri Khirgeyevic Nicolayev, who is widely regarded as the leading living naturopath, fasting helps the body to heal itself in three ways: by allowing the digestive tract to rest; by allowing the mobilization of detoxifying defence mechanisms; and by stimulating subsequent recuperation.

Dr Nicolayev has conducted research which demonstrates the usefulness of fasting in treating schizophrenia. In 1963, he studied 140 intractable schizophrenics who fasted from between 20 to 30 days. Some 44 of these found that their condition improved (YK Nikolayev, Controlled Fasting Cure of Schizophrenia, 1963, Moscow).

Fasting has been found to be helpful for arthritis sufferers. In one study, 20 patients with arthritis and a range of skin disorders, including atopic eczema, rosacea and psoriasis, were kept on a two week fast.

Afterwards, there were significant improvements in the skin complaints and substantial reduction in arthritic pain (H Lithell et al, Acta Dermat Venerol (Stockholm), 1983, 63; 397-403). In another study of rheumatoid arthritis sufferers, their grip strength and functional ability were all improved, and swelling and pain reduced after a week long fast (GF Kroker et all, Clin Ecol, 1984, 3; 137-144).

Fasting can reduce the length, severity and frequency of epileptic seizures (G Hoefel and M Moriarty, Am J Dis Children, 1924, 28; 16-24; WG Lennox and S Cobb, Arch Neurol Psych, 1928, 28; 16-24).

Heart patients can also benefit by abstaining from food. Fasting has been shown to be helpful in relieving a range of cardiovascular diseases, including raised cholesterol, high blood pressure and clogged arteries (TG Duncan et al, Ann NY Acad Sci, 1965, 131: 632-636; and GA Gresham, Atherosclerosis, 1976, 23; 379-391).

Fasting has been shown to be as, or more, effective than drug and other therapies for treating acute pancreatitis inflammation of the pancreas and the autoimmune disease acute glomerulonephritis. A randomized trial of 88 pancreatitis sufferers found that fasting was just as effective as treatment with the drug cimetidine, or by other forms of medical intervention (Digestion, 1984, 30: 224-230). The effect of fasting on glomerulonephritis was so dramatic that the authors of one study concluded that “all patients with acute glomerulonephritis should fast” to improve their prognosis (J Brod et al, Lancet, 1958, i; 760-763).

However, like any other form of therapy, fasting must be treated with respect. It should, therefore, be conducted only under the supervision of a qualified practitioner.

Harald Gaier

Harald Gaier is a registered naturopath, homeopath and osteopath

But some treatments may be worse than the disease. Antipsychotic drugs such as haloperidol and thioridazine have been found to affect the heart, causing severe heartbeat irregularities and even cardiac arrest.

In fact, life expectancy for schizophrenics has been decreasing as more patients are treated with drugs. Doctors have been warned to go easy on the dosages so as not to end up with a split heart in place of a split personality (BMJ, 2002; 323: 1070-2).

When my oldest child was 7 and had to have a shot to go back to school, he too underwent genital examination and was extremely uncomfortable. I asked the doctor if it was necessary. He said yes. I asked until what age it was necessary. He said until adulthood. Then he went on to say that oftentimes little girls are so uncomfortable that they have to transfer out to a female pediatrician. In the late 60s and early 70s, my mother found a pediatrician who also forced me to remove all my underclothes, lay on my back and spread my legs so that he could spread my vagina with his hands and get a “good look”. I never remember a visit forgoing this experience until I was well into my teens. No explanation was ever given to me, and my “panic attacks” prior to the visit were considered to be quite ridiculous. L B, Miami Springs, Florida…..Thank you for calling attention to this subject and for sending in photocopies from a medical textbook on physical examination of infants and children. It emphasizes that it isn’t essential that the child be completely undressed during the course of the examination only the part of the body being examined and that direct visualization of the vagina and cervix aren’t considered part of the ordinary physical examination.

Our advice would be for parents to avoid “well children” general examinations; to save doctor visits for times that something specific seems to be wrong, and then ask the doctor to only examine the relevant body part. If your child has something wrong with his plumbing requiring that his genitalia be examined, it would be wise for you to explain beforehand that the doctor is going to have a look at it and why, and perhaps for you to demonstrate it yourself so that your child is not taken by surprise. Of course make sure to always be present. If your child clearly doesn’t want it, never force or restrain him.

Such patients are almost never properly diagnosed. They have “graduated” to this condition through a number of previous levels of physical and mental distress. They often have thick medical files, filled with long lists of complaints, many of them seemingly of mental origin. In truth, their mental problems are basically physical problems, as they are directly caused by food/chemical allergy. Such patients are among the prime recipients of mood altering drugs, electric shock therapy and psychotherapy. However, none of this does much good. As time goes by, they tend to get progressively worse, as the general course of an untreated allergic illness is usually downward.

F. C. Donan and J. C. Grasberger (American Journal of Psychiatry, June 1973) studied schizophrenic patients, who on admission to a locked ward were randomly assigned to a cereal grain free, milk free diet. Schizophrenics on the milk and cereal free diet were able to be discharged from the hospital twice as rapidly as control patients. When wheat gluten was added secretly to the cereal free diet, it abolished this effect. This study, as well as Dohan’s previous findings, indicate that cereal grains may be involved in the pathogenesis of some schizophrenias.

W. H. Philpott (who published his findings in A Physician’s Handbook on Orthomolecular Medicine, Keats Publishing, 1977) studied a random sample of 53 hospitalized schizophrenic patients and found that 92 per cent were found to be allergic to at least one or more common substances, including wheat, corn, cow’s milk, tobacco and petrochemical hydrocarbons.

Numerous researchers have also demonstrated that so called psychiatric illness stems from a myriad of physical complaints, many caused by nutritional deficiencies. R. C. Hall and others (Arch Gen Psychiatry September 1980) gave a thorough physical examination to 100 patients admitted to a psychiatric hospital in order to find out if a physical cause could be found. Out of 100 patients 80 per cent were found to have a previously undetected physical illness. In 56 per cent of these the physical illness was thought to be causative or at least contributory to their psychiatric symptoms. Sixty one per cent of them showed an immediate clearing of their psychiatric symptoms as soon as their underlying physical disorder was treated.

“Schizophrenia” was found to be directly caused by such underlying physical disorders as folic acid deficiency, hypothyroidism, hyperthyroidism, severe anaemia, diabetes, malnutrition and hypoglycaemia. Some of the schizophrenics were also found to be suffering from allergic conditions and systemic candidiasis. Thirteen per cent of the patients were found to be substantially malnourished and had evidence of vitamin and other dietary deficiencies. Eight per cent got well by eating a proper diet with added nutritional supplementation alone, while the remaining 5 per cent required additional treatment.

These studies suggest that at least one quarter of patients lingering presently in psychiatric wards are not even mentally ill, but suffer from a physical illness which causes them various “mental” symptoms. I firmly believe that the majority of mental problems are often only chemical problems, and once the brain’s chemistry has been corrected, the “mental illness” is corrected as well. Whenever we are confronted with any mental or physical disorder of an unknown cause, we must always consider diet or allergy as a factor.

Excerpted with permission from An Alternative to Psychiatry (The Book Guild, 25 High Street, Lewes, Sussex).

Clozaril treats schizophrenia. Although it has been shown to control psychotic symptoms better than other drugs, it has also been shown to produce agranulocytosis, a potentially fatal blood disorder, characterized by a decrease in white blood cells, in 1 to 2 per cent of patients.

In response to an American Food and Drug Administration ruling, Sandoz came up with a ingenious scheme entitled the Clozaril Patient Monitoring System (CPMS).
Although the monitoring system does help to prevent risks of death from agranulocytosis, it also boosts the price of the drug per patient to $172 per week – that’s $9,000 a year – making it the most expensive drug in America.

Dr Carl Salzman of Harvard argues that independent treatment centres could handle the necessary monitoring and distribution required by the FDA without boosting the price of the drug or limiting its availability.