• 書籍

Brain-Disabling Treatments in Psychiatry

精神病學中的腦殘治療
下載來源: https://zh.1lib.tw/book/697762/ca4f98

第二版本

Second Edition

醫學博士 Peter R. Breggin 被稱為“精神病學的良心”，因為他努力改革心理健康領域，包括推廣關愛的心理治療方法，以及反對不斷升級的過度使用精神病藥物、壓迫性診斷和吸毒兒童、電擊、腦葉切除術、非自願治療和錯誤的生物學理論。

Peter R. Breggin, MD, has been called “the conscience of psychiatry” for his efforts to reform the mental health fi eld, including his promotion of caring psychotherapeutic approaches and his opposition to the escalating overuse of psychiatric medications, the oppressive diagnosing and drugging of children, electroshock, lobotomy, involuntary treatment, and false biological theories.

Breggin 博士自 1968 年以來一直從事精神病學的私人執業，首先在華盛頓特區，現在在紐約伊薩卡。 在他的治療實踐中，他治療個人、夫婦和兒童及其家人，而不使用精神藥物。 作為一名臨床精神藥理學家，他提供諮詢，並作為醫學專家積極參與刑事、醫療事故和產品責任訴訟，通常涉及精神藥物的有害影響。 他一直是涉及患者權利的具有里程碑意義的案件的專家。

Dr. Breggin has been in the private practice of psychiatry since 1968, fi rst in the Washington, D.C., area, and now in Ithaca, New York. In his therapy practice, he treats individuals, couples, and children with their families without resort to psychiatric drugs. As a clinical psychopharmacologist, he provides consultations and is active as a medical expert in criminal, malpractice, and product liability lawsuits, often involving the harmful effects of psychiatric drugs. He has been an expert in landmark cases involving the rights of patients.

自 1964 年以來，布雷金博士撰寫了數十篇科學文章和大約 20 本書。 他的許多著作包括有毒精神病學、樂於助人的心、與利他林對話、抗抑鬱藥事實書，以及與合著者 Ginger Breggin 合作的《與百憂解對話》和《反對有色人種兒童的戰爭》。 他即將在 2008 年初出版的書是藥物瘋狂：關於精神藥物引起的混亂、謀殺和自殺的真實故事。

Since 1964, Dr. Breggin has written dozens of scientific articles and approximately 20 books. Some of his many books include Toxic Psychiatry, The Heart of Being Helpful, Talking Back to Ritalin, The Antidepressant Fact Book, and, with coauthor Ginger Breggin, Talking Back to Prozac and The War Against Children of Color. His forthcoming book in early 2008 is Medication Madness: True Stories About Mayhem, Murder and Suicide Caused by Psychiatric Drugs.

在他職業生涯的不同階段，他比他的時代提前了幾十年，警告了腦葉切除術、電擊的危險，以及最近的抗抑鬱藥引起的自殺和暴力，以及許多其他最近承認的與精神科藥物相關的風險。 他的觀點已被世界各地的主要媒體報導，包括紐約時報和華爾街日報到時代和新聞周刊，從拉里金現場和奧普拉到 60 分鐘和 20/20。

At various stages of his career, he has been decades ahead of his time in warning about the dangers of lobotomy, electroshock, and, more recently, antidepressant-induced suicide and violence as well as many other recently acknowledged risks associated with psychiatric drugs. His views have been covered in major media throughout the world including The New York Times and The Wall Street Journal to Time and Newsweek, and from Larry King Live and Oprah to 60 Minutes and 20/20.

1972 年，布雷金博士創立了國際精神病學和心理學研究中心 (ICSPP; http://www.icspp.org)。 ICSPP 最初是為了支持他成功阻止腦葉切除術復甦而組織的，它已成為希望在心理健康領域提高道德和科學標準的有改革意識的專業人士和非專業人士的支持和靈感來源。 1999 年，他和妻子 Ginger 創立了 ICSPP 的同行評審科學期刊 Ethical Human Psychology and Psychiatry。

In 1972, Dr. Breggin founded the International Center for the Study of Psychiatry and Psychology (ICSPP; http://www.icspp.org). Originally organized to support his successful campaign to stop the resurgence of lobotomy, ICSPP has become a source of support and inspiration for reform-minded professionals and laypersons who wish to raise ethical and scientific standards in the fi eld of mental health. In 1999, he and his wife, Ginger, founded ICSPP’s peer-reviewed scientific journal Ethical Human Psychology and Psychiatry.

2002 年，儘管 Breggin 博士繼續參與 ICSPP 活動，但他們選擇了年輕的專業人士接管中心和期刊。

In 2002, they selected younger professionals to take over the center and the journal, although Dr. Breggin continues to participate in ICSPP activities.

Breggin 博士的背景包括哈佛學院、凱斯西儲醫學院、哈佛醫學院的教學獎學金、3 年的精神病學住院醫師培訓、2 年的國家心理健康研究所的工作人員分配以及多項教學任命，包括 在約翰霍普金斯大學諮詢系和喬治梅森大學衝突分析與解決研究所。

Dr. Breggin’s background includes Harvard College, Case Western Reserve Medical School, a teaching fellowship at Harvard Medical School, 3 years of residency training in psychiatry, a 2-year staff assignment at the National Institute of Mental Health, and several teaching appointments, including in the Johns Hopkins University Department of Counseling and the George Mason University Institute for Confl ict Analysis and Resolution.

Breggin 博士的網站是 http://www.breggin.com。

Dr. Breggin’s Web site is http://www.breggin.com.

精神病藥物、電擊和精神藥物複合物中的腦功能障礙治療

第二版

彼得·R·布雷金，醫學博士

Brain-Disabling Treatments in Psychiatry Drugs, Electroshock, and the Psychopharmaceutical Complex
Second Edition

Peter R. Breggin, MD

New York

出版商不保證或擔保此處描述的任何程序，並且未對此處包含的任何信息進行任何獨立分析。 出版商不承擔並明確否認任何獲取和包含作者提供之外的信息的義務。

The Publisher does not warrant or guarantee any of the procedures described herein and has not performed any independent analysis in connection with any of the information contained herein. The Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than provided by the author.

明確警告讀者考慮並採取此處描述的活動可能表明的所有安全預防措施，並避免所有潛在危險。

The reader is expressly warned to consider and adopt all safety precautions that might be indicated by the activities described herein, and to avoid all potential hazards.

對於因讀者使用或依賴本書所含信息而全部或部分造成的任何特殊、間接或懲戒性損害，出版商概不負責。

The Publisher shall not be liable for any special, consequential, or exemplary damages resulting in whole or in part, from the readers’ use of, or reliance on, the information contained in this book.

Copyright © 2008 Springer Publishing Company, LLC

All rights reserved.

未經 Springer Publishing Company, LLC 事先許可，不得以任何形式或任何方式（電子、機械、影印、錄音或其他方式）複製、存儲在檢索系統中或傳輸本出版物的任何部分。

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC.

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New York, NY 10036

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Acquisitions Editor: Sheri W. Sussman

Project Manager: Julia Rosen

Cover design: Mimi Flow

Composition: Apex Publishing, LLC

====================================================

Library of Congress Cataloging-in-Publication Data

Breggin, Peter Roger, 1936–

Brain-disabling treatments in psychiatry : drugs, electroshock, and the psychopharmaceutical complex / Peter R. Breggin. — 2nd ed.

Includes bibliographical references and index.

ISBN-13: 978–0–8261–2934–5 (alk. paper)

ISBN-10: 0–8261–2934–X (alk. paper)

1. Psychotropic drugs—Side effects. 2. Brain—Effect of drugs on.

3. Electroconvulsive therapy—Complications.
4. Iatrogenic diseases.

5. United States. Food and Drug Administration. I. Title.

[DNLM: 1. United States. Food and Drug Administration. 2. Mental Disorders—therapy—United States. 3. Brain Damage, Chronic—etiology—

United States. 4. Drug Industry—United States. 5. Electroconvulsive Therapy—adverse effects—United States. 6. Psychotropic Drugs—adverse effects—United States. WM 400 B833b 2008]

RC483.B726 2008

616.89’122—dc22

2007029727

Printed in the United States of America by Edwards Brothers, Inc.

==============================================================

警告

精神科藥物服用有危險，停止服用也有危險

WARNING

Psychiatric Drugs Are Dangerous to Take and Dangerous to Stop

本書中討論的精神科藥物比許多醫生和患者意識到的要危險得多，但在停藥過程中它們也可能變得危險。 簡而言之，開始服用精神科藥物是危險的，停止服用也是危險的。

許多人上癮，大多數人會產生戒斷症狀，這些症狀在情緒和身體上都令人痛苦，有時甚至危及生命。 精神科藥物的逐漸減量通常應在經驗豐富的臨床監督的幫助下逐步進行。

一本書不能代替個性化的醫療或心理護理，本書也不能作為治療指南。 它從科學、倫理、心理和社會的角度對精神病學中的生物治療進行了批判性分析。

彼得·R·布雷金，醫學博士

The psychiatric drugs discussed in this book are far more dangerous to take than many doctors and patients realize, but they can also become hazardous during the withdrawal process. In short, it is dangerous to start psychiatric drugs and dangerous to stop them.

Many are addictive, and most can produce withdrawal symptoms that are emotionally and physically distressing and sometimes life threatening. Tapering off psychiatric drugs should usually be done gradually with the aid of experienced clinical supervision.

A book cannot substitute for individualized medical or psychological care, and this book is not intended as a treatment guide. It provides a critical analysis of biological treatments in psychiatry written from a scientific, ethical, psychological, and social viewpoint.

Peter R. Breggin, MD

Professional Books by Peter R. Breggin, MD  (p. 7)

=============================

College Students in a Mental Hospital: Contributions to the Social Rehabilitation of the Mentally Ill (Jointly authored) (1962) Electroshock: Its Brain-Disabling Effects (1979)

The Psychology of Freedom: Liberty and Love as a Way of Life (1980) Psychiatric Drugs: Hazards to the Brain (1983)

Toxic Psychiatry: Why Therapy, Empathy and Love Must Replace the Drugs, Electroshock and Biochemical Theories of the “New Psychiatry” (1991) Beyond Confl ict: From Self-Help and Psychotherapy to Peacemaking (1992) Talking Back to Prozac (coauthor Ginger Breggin) (1994) Psychosocial Approaches to Deeply Disturbed Persons (coeditor E. Mark Stern) (1996)

Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Role of the FDA (1997)

The Heart of Being Helpful: Empathy and the Creation of a Healing Presence (1997)

The War Against Children of Color: Psychiatry Targets Inner City Children, Updated (coauthor Ginger Breggin) (1998)

Reclaiming Our Children: A Healing Solution to a Nation in Crisis (2000) Talking Back to Ritalin, Revised Edition (2001) The Antidepressant Fact Book (2001)

Dimensions of Empathic Therapy (coeditors Ginger Breggin and Fred Bemak) (2002)

The Ritalin Fact Book (2002)

Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications, Revised and Updated Edition (coauthor David Cohen) (2007)

Medication Madness: True Stories of Mayhem, Murder and Suicide Caused by Psychiatric Drugs (2008)

For Ginger Breggin

My wife, best friend, partner in life, most trusted advisor,

last human resort in all crises, and playmate

This page intentionally left blank

內容

前言：關於文字的一句話 xxiii

致謝二十五

簡介：確認第一版背後的科學 xxvii

科學的徹底更新 xxvii

對上一版的日益確認 xxviii

確認從 1983 年開始的長遠觀點 xxviii

精神病學狀況惡化 xxix
Contents

Preface: A Word About Words xxiii

Acknowledgments xxv

Introduction: Confirming the Science Behind the First Edition xxvii

A Thorough Update of the Science xxvii

Growing Confirmation of the Previous Edition xxviii

Confirming the Longer View Starting in 1983 xxviii

The Situation in Psychiatry Worsens xxix

第 1 章 精神科藥物的致殘、令人著迷的作用 1

腦殘四項基本原則 2

證實大腦四項基本原則的說明性研究 4

六項額外的腦殘原則 7

藥物魔法的生物學基礎 12

心理對藥物的影響 14

威權精神病學中的醫源性無助和否認 14

藥物治療與醫源性無助和否認的關係 15

精神和情緒上的痛苦通過生物精神干預進行常規治療

沒有已知的遺傳或生物原因 16

結論 19

Chapter 1 The Brain-Disabling, Spellbinding Effects of Psychiatric Drugs 1

The Basic Four Brain-Disabling Principles 2

Illustrative Research Confirming the Basic Four Brain-Disabling Principles 4

Six Additional Brain-Disabling Principles 7

The Biological Basis of Medication Spellbinding 12

Psychological Influences on Medication Spellbinding 14

Iatrogenic Helplessness and Denial in Authoritarian Psychiatry 14

Relationship Between Medication Spellbinding and Iatrogenic Helplessness and Denial 15

Mental and Emotional Suffering Routinely Treated With Biopsychiatric Interventions

Have No Known Genetic or Biological Cause 16

Conclusion 19

第2章 神經阻滯劑引起的失活綜合徵（化學腦葉切開術） 21

非典型抗精神病藥物是較弱的 D2 阻滯劑的神話 22

非典型抗精神病藥之間的差異示例 26

氯氮平（Clozaril） 26

利培酮（Risperdal） 28

干預有效性的臨床抗精神病藥物試驗 (CATIE) 29

失活綜合症 32

停用和藥物拼寫 33

失活剖析 34

腦葉切開術樣神經阻滯作用 34

非典型抗精神病藥 37

抗精神病藥物的社會控制 37

鎮壓療養院囚犯 37

在各種環境中停用人和動物 38

大腦的獨特功能 40
Chapter 2 Deactivation Syndrome (Chemical Lobotomy) Caused by Neuroleptics 21

The Myth That Atypical Antipsychotic Drugs Are Weaker D2 Blockers 22

Examples of Differences Among Atypical Neuroleptics 26

Clozapine (Clozaril) 26

Risperidone (Risperdal) 28

Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) 29

Deactivation Syndrome 32

Deactivation and Medication Spellbinding 33

The Anatomy of Deactivation 34

Lobotomy-Like Neuroleptic Effects 34

Atypical Neuroleptics 37

Social Control With Antipsychotic Drugs 37

Suppression of Nursing Home Inmates 37

Deactivating People and Animals in Varied Settings 38

The Unique Function of the Brain 40

第3章

抗精神病藥引起的痛苦，包括激動、絕望和抑鬱 43

對治療的抵抗力 44

急性肌張力障礙反應 45

神經安定藥引起的帕金森症的絕望 46

帕金森氏症作為腦殘治療的一個方面 48

靜坐不能的痛苦 48

抗精神病藥引起的抑鬱和自殺 51

與非典型抗精神病藥物相關的風險 52

強制問題 53

Chapter 3

Neuroleptic-Induced Anguish, Including Agitation, Despair, and Depression 43

Resistance to Treatment 44

Acute Dystonic Reactions 45

Despair in Neuroleptic-Induced Parkinsonism 46

Parkinsonism as an Aspect of Brain-Disabling Therapy 48

Anguish in Akathisia 48

Neuroleptic-Induced Depression and Suicidality 51

Risks Associated With Atypical Antipsychotic Drugs 52

The Issue of Coercion 53

第 4 章

由抗精神病藥引起的嚴重和潛在不可逆的神經系統綜合徵（遲發性運動障礙和抗精神病藥惡性綜合徵）

遲發性運動障礙 (TD)

TD的臨床表現

道明利率

非典型抗精神病藥導致成人 TD

非典型抗精神病藥導致兒童 TD

TD的歷史
Chapter 4

Severe and Potentially Irreversible Neurological Syndromes (Tardive Dyskinesia and Neuroleptic Malignant Syndrome) Caused by Neuroleptics  55

Tardive Dyskinesia (TD)  56
Clinical Manifestations of TD  56
TD Rates  57
Atypical Neuroleptics Cause TD in Adults  58
Atypical Neuroleptics Cause TD in Children  60
History of TD  61

通過持續的精神抑制治療掩蓋 TD 的症狀

錐體外系症狀作為未來 TD 的預測指標

老年人和其他弱勢群體

終止後復發、惡化和延遲發作

可逆性是罕見的

醫生和患者否認 TD

流行病的規模

遲發性肌張力障礙

遲發性靜坐不能

遲發性疾病的並發症

身體疲憊

心理痛苦

抗精神病藥戒斷症狀

抗精神病藥會上癮嗎？

其他不良反應

神經阻滯劑惡性綜合徵

神經阻滯劑誘發的神經系統綜合徵的生物學基礎

兒童和抗精神病藥

用抗精神病藥治療兒童抽動穢語

食品藥品監督管理局為兒童打開 TD 和 NMS 閘門

快死

結論

Masking the Symptoms of TD With Continued Neuroleptic Treatment 61

Extrapyramidal Symptoms As Predictors of Future TD 62

The Elderly and Other Vulnerable Populations 63

Relapse, Exacerbation, and Delayed Onset After Termination 65

Reversibility Is Rare 66

Physician and Patient Denial of TD 67

The Size of the Epidemic 67

Tardive Dystonia 68

Tardive Akathisia 70

Complications of Tardive Disorders 71

Physical Exhaustion 72

Psychological Suffering 72

Neuroleptic Withdrawal Symptoms 73
Are Neuroleptics Addictive? 73

Other Adverse Reactions 74

Neuroleptic Malignant Syndrome 75

Biological Basis of Neuroleptic-Induced Neurological Syndromes 78

Children and Neuroleptics 79

Treating Childhood Tourette’s With Neuroleptics 80

The Food and Drug Administration Opens the TD and NMS Floodgates for Children 81

Hurrying Death 82

Conclusion 84

第 5 章神經安定藥引起的神經毒性、腦損傷、持續性認知缺陷、癡呆和精神病 85

展示抗精神病藥引起的腦損傷和細胞死亡 85

PET 掃描 90

核磁共振成像 92

CT 掃描和神經心理學相關性 93

將遲發性運動障礙 (TD) 與腦損傷和癡呆症相關聯 94

腦研究數據總結 94

基於腦部掃描的遲發性癡呆率 94

臨床證據 95

TD 與認知功能障礙之間的早期相關性 95

遲發性精神障礙和遲發性癡呆 95

神經安定藥誘發的廣義認知功能障礙的意外發現 97

神經安定藥引起的兒童精神和行為惡化 98

否認 TD 患者的症狀是認知功能障礙的症狀 98

永久性腦葉切除術或停用 100

神經阻滯劑治療患者的遲發性精神病 100

精神病學避免面對遲發性精神病 101

遲發性靜坐不能和認知缺陷 103

人類和動物屍檢研究 103

抗精神病藥引起的腦損傷的動物屍檢研究 103

抗精神病藥引起的腦損傷的人體屍檢證據 104

嗜睡性腦炎的教訓 104

精神分裂症會導致癡呆嗎？ 107

精神病學否認神經阻滯劑誘發的癡呆症 110

治療急性錐體外系副作用的藥物 111

退出問題和知情同意 111

結論 112

Chapter 5 Neuroleptic-Induced Neurotoxicity, Brain Damage, Persistent Cognitive Deficits, Dementia, and Psychosis 85

Demonstrating Neuroleptic-Induced Brain Damage and Cell Death 85

PET Scans 90

MRI 92

CT Scans and Neuropsychological Correlations 93

Correlating Tardive Dyskinesias (TD) With Brain Damage and Dementia 94

Summary of Brain Study Data 94

Rates of Tardive Dementia Based on Brain Scans 94

Clinical Evidence 95

Early Correlations Between TD and Cognitive Dysfunction 95

Tardive Dysmentia and Tardive Dementia 95

A Serendipitous Finding of Neuroleptic-Induced Generalized Cognitive Dysfunction 97

Neuroleptic-Induced Mental and Behavioral Deterioration in Children 98

Denial of Symptoms in TD Patients As a Symptom of Cognitive Dysfunction 98

Permanent Lobotomy or Deactivation 100

Tardive Psychosis in Neuroleptic-Treated Patients 100

Psychiatry Avoids Facing Tardive Psychosis 101

Tardive Akathisia and Cognitive Deficits 103

Human and Animal Autopsy Studies 103

Animal Autopsy Studies of Neuroleptic-Induced Brain Damage 103

Human Autopsy Evidence for Neuroleptic-Induced Brain Damage 104

Lessons of Lethargic Encephalitis 104

Can Schizophrenia Cause Dementia? 107

Psychiatric Denial of Neuroleptic-Induced Dementia 110

Drugs to Treat Acute Extrapyramidal Side Effects  111

Withdrawal Problems and Informed Consent 111

Conclusion 112

第 6 章抗抑鬱藥標籤變更的最新進展 115

從一開始就有警告信號 116

SSRI 類 117

FDA 發現接觸抗抑鬱藥的兒童自殺率增加 118

容易表現出嚴重的不良反應；

難以發揮功效 119

最近的 FDA 錄取和警告 120

兒童和青少年自殺的最終類別標籤 121

興奮劑綜合症 122

新的 FDA 藥物指南 123

FDA 關於抗抑鬱藥誘發兒童自殺的最終決定 124

臨床試驗中沒有完成自殺 124

加拿大和英國監管警告 125

將自殺警告擴大到年輕人 126

FDA 幫助製藥公司 128

Paxil 對成年人來說是最危險的 129

現實生活中的風險比描述的要大得多 129

精神藥物複合體響應 130

美國神經精神藥理學學院 130

美國精神病學協會 132

抗抑鬱藥對兒童無效 133

所謂的替代療法 135

結論 135

第 6 章抗抑鬱藥標籤變更的最新進展 115

從一開始就有警告信號 116

SSRI 類 117

FDA 發現接觸抗抑鬱藥的兒童自殺率增加 118

容易表現出嚴重的不良反應；

難以發揮功效 119

最近的 FDA 錄取和警告 120

兒童和青少年自殺的最終類別標籤 121

興奮劑綜合症 122

新的 FDA 藥物指南 123

FDA 關於抗抑鬱藥誘發兒童自殺的最終決定 124

臨床試驗中沒有完成自殺 124

加拿大和英國監管警告 125

將自殺警告擴大到年輕人 126

FDA 幫助製藥公司 128

Paxil 對成年人來說是最危險的 129

現實生活中的風險比描述的要大得多 129

精神藥物複合體響應 130

美國神經精神藥理學學院 130

美國精神病學協會 132

抗抑鬱藥對兒童無效 133

所謂的替代療法 135

結論 135

Chapter 6 Recent Developments in Antidepressant Label Changes 115

Warning Signs From the Beginning 116

The Class of SSRIs 117

FDA Finds Increased Suicidality in Children Exposed to Antidepressants 118

Easy to Show Serious Adverse Effects;

Difficult to Show Efficacy 119

Recent FDA Admissions and Warnings 120

The Final Class Label on Suicidality in Children and Adolescents 121

The Stimulant Syndrome 122

The New FDA Medication Guide 123

The FDA’s Final Word on Antidepressant-Induced Suicidality in Children 124

No Completed Suicides in the Clinical Trials 124

Canadian and British Regulatory Warnings 125

Expanding the Suicide Warning to Young Adults 126

The FDA Helps Out the Drug Companies 128

Paxil Is the Most Dangerous for Adults 129

The Real-Life Risk Is Much Greater Than Described 129

The Psychopharmaceutical Complex Responds 130

The American College of Neuropsychopharmacology 130

The American Psychiatric Association 132

Antidepressants Lack Efficacy in Children 133

So-Called Alternative Treatments 135

Conclusion 135

第7章抗抑鬱藥引起的精神、行為和大腦異常137

焦慮抑鬱的風險 139

SSRIs 中藥物不良反應模式的相似性 140

與 SSRI 誘發的成人抑鬱和自殺相關的研究 141

SSRI 誘發的成人抑鬱和自殺的流行病學研究和臨床試驗 141

成人自殺的驗屍研究 145

NIMH 確認 SSRI 會導致自殺 145

成人躁狂、暴力和自殺的病例報告 145

SSRI 誘發的成人靜坐不能、自殺和攻擊性病例報告 148

SSRI 誘發的成人強迫性自殺和攻擊性病例報告 151

SSRI 誘發的成人冷漠綜合徵 152

識別成人和兒童的抗抑鬱藥誘發的強迫性暴力和自殺 154

SSRI 誘發的成人躁狂和攻擊行為的流行病學研究和臨床試驗 155

成人抗抑鬱藥誘導攻擊的研究 155

非雙相成人患者抗抑鬱藥誘發的躁狂症 157

成人雙相情感障礙患者的躁狂轉換（轉換）160

比較抗抑鬱藥誘發的躁狂症和自發性躁狂症 161

兩個標準來源中描述的抗抑鬱藥誘發的躁狂症 162

精神疾病診斷和統計手冊 162

成人重度抑鬱症實踐指南 164

與 SSRI 引起的兒童異常行為相關的研究 165

涉及兒童的臨床案例研究 165

涉及兒童的流行病學研究和臨床試驗 167

兒童抗抑鬱藥引起的冷漠 170

抗抑鬱藥真的有效嗎？ 172

老人 173

專業反應 174

潛在的抗抑鬱藥引起的腦損傷和功能障礙 174

永久性神經系統不良反應 174

大腦抵抗 SSRI 的影響 175

導致腦功能障礙和萎縮178

老年抗抑鬱藥 180

三環類抗抑鬱藥和腦損傷原理 182

三環類：比治愈自殺更多的原因？ 183

其他抗抑鬱藥 183

抗抑鬱藥戒斷反應，包括躁狂症 184

我的臨床和法醫經驗 186

討論：“毒品讓我這麼做”186

專家知道什麼？ 189

結論 190

Chapter 7 Antidepressant-Induced Mental, Behavioral, and Cerebral Abnormalities 137

The Risk of Agitated Depression 139

Similarity of Adverse Drug Reaction Patterns Among SSRIs 140

Studies Related to SSRI-Induced Depression and Suicidality in Adults 141

Epidemiological Studies and Clinical Trials of SSRI-Induced Depression and Suicidality in Adults 141

Coroner Studies of Adult Suicidality 145

NIMH Confirms That SSRIs Cause Suicidality 145

Case Reports of Mania, Violence, and Suicide in Adults 145

Case Reports of SSRI-Induced Akathisia, Suicidality, and Aggression in Adults 148

Case Reports of SSRI-Induced Obsessive Suicidality and Aggression in Adults 151

SSRI-Induced Apathy Syndrome in Adults 152

Identifying Antidepressant-Induced Compulsive Violence and Suicidality in Adults and Children 154

Epidemiological Studies and Clinical Trials of SSRI-Induced Mania and Aggression in Adults 155

Studies of Antidepressant-Induced Aggression in Adults 155

Antidepressant-Induced Mania in Nonbipolar Adult Patients 157

Manic Conversion (Switching) in Adult Bipolar Patients 160

Comparing Antidepressant-Induced Mania and Spontaneous Mania 161

Antidepressant-Induced Mania Described in Two Standard Sources 162

The Diagnostic and Statistical Manual of Mental Disorders 162

Practice Guidelines for Major Depressive Disorder in Adults 164

Studies Related to SSRI-Induced Abnormal Behavior in Children 165

Clinical Case Studies Involving Children 165

Epidemiological Studies and Clinical Trials Involving Children 167

Antidepressant-Induced Apathy in Children 170

Do Antidepressants Work at All? 172

The Elderly 173

Professional Reactions 174

Underlying Antidepressant-Induced Brain Damage and Dysfunction 174

Permanent Neurological Adverse Effects 174

The Brain Resists the Impact of SSRIs 175

Causing Brain Dysfunction and Shrinkage 178

Older Antidepressants 180

Tricyclic Antidepressants and the Brain-Disabling Principle 182

Tricyclics: More Cause Than Cure for Suicidality? 183

Other Antidepressants 183

Antidepressant Withdrawal Reactions, Including Mania 184

My Clinical and Forensic Experience 186

Discussion: “The Drug Made Me Do It” 186

What Do the Specialists Know? 189

Conclusion 190

第 8 章 用於雙相情感障礙的鋰和其他藥物 193

對躁狂症的鋰特異性聲明 193

對動物、嬰兒、患者和志願者的腦功能障礙 194

抑制對動物的影響 194

對正常嬰兒的抑製作用 195

對正常志願者的禁用影響 196

拒絕生命的錶盤 200

粉碎創意201

凱德支持腦殘假設 202

令人著迷和醫源性無助和否認 203

對中樞神經系統的毒性 203

認知缺陷的產生 203

急性器質性腦綜合徵 204

沉默：不可逆的鋰誘導神經毒性 204

低劑量維持治療中的神經毒性作用 205

常規鋰療法產生的異常腦電波 205

受損大腦的鋰破壞 206

腦損傷作為治療 206

對神經元和其他細胞的一般毒性 206

中毒腦細胞的“保護”和治療作用 207

鋰在急性躁狂症 210 中的相對無效性

鋰在預防躁狂發作方面的效果如何？ 210

鋰戒斷反應引起的躁狂和抑鬱 211

脫鋰的其他不良反應 212

飲用水中的鋰 212

其他所謂的情緒穩定劑 213

為什麼有這麼多“雙相”患者？ 214

結論 215

Chapter 8

Lithium and Other Drugs for Bipolar Disorder 193

Claims of Lithium Specificity for Mania 193

Brain-Disabling Effects on Animals, Infants, Patients, and Volunteers 194

Subduing Effects on Animals 194

Subduing Effects on Normal Infants 195

Disabling Effects on Normal Volunteers 196

Turning Down the Dial of Life 200

Crushing Creativity 201

Cade Supports the Brain-Disabling Hypothesis 202

Spellbinding and Iatrogenic Helplessness and Denial 203

Toxicity to the Central Nervous System 203

The Production of Cognitive Deficits 203

Acute Organic Brain Syndromes 204

SILENT: Irreversible Lithium-Induced Neurotoxicity 204

Neurotoxic Effects in Low-Dosage Maintenance Therapy 205

Abnormal Brain Waves Produced by Routine Lithium Therapy 205

Lithium Disruption of the Compromised Brain 206

Brain Damage As Treatment 206

General Toxicity to Neurons and Other Cells 206

The “Protective” and Therapeutic Effects of Poisoning Brain Cells 207

The Relative Ineffectiveness of Lithium in Acute Mania 210

How Effective Is Lithium in Preventing the Recurrence of Manic Episodes? 210

Mania and Depression As Lithium Withdrawal Reactions 211

Other Adverse Reactions to Lithium Withdrawal 212

Lithium in Your Drinking Water 212

Other So-Called Mood Stabilizers 213

Why So Many “Bipolar” Patients? 214

Conclusion 215

第9章抑鬱症的電休克療法（ECT）217

ECT毀掉的生活

ECT 研究中的突發新聞：休克治療導致不可逆轉的腦損傷和功能障礙 221

還是逃避事實222

ECT 研究中的更多突發新聞：休克治療導致自殺 223

其他突發新聞：ECT 無效 225

休克治療領域的又一戲劇性事件 226

美國食品藥品監督管理局和 ECT 227

1990年美國精神病學協會報告的政治

ECT、女性和記憶力減退 229

ECT 和老人 230

電擊造成的腦損傷 232

譫妄的產生（急性器質性腦綜合徵）232

ECT作為閉頭電擊傷233

死亡、自殺和屍檢結果 234

內存不足 234

ECT腦損傷的研究

腦部掃描 241

修改後的 ECT 242

腦殘原理 244

醫源性無助和否認，以及令人著迷的 246

圍繞 ECT 的長期爭議

需要禁止 ECT 249

結論 250

Chapter 9 Electroconvulsive Therapy (ECT) for Depression 217

A Life Destroyed by ECT 218

Breaking News in ECT Research: Shock Treatment Causes Irreversible Brain Damage and Dysfunction 221

Still Avoiding the Facts 222

More Breaking News in ECT Research: Shock Treatment Causes Suicide 223

Additional Breaking News: ECT Is Ineffective 225

Another Dramatic Event in the World of Shock Treatment 226

The Food and Drug Administration and ECT 227

The Politics of the 1990 American Psychiatric Association Report 228

ECT, Women, and Memory Loss 229

ECT and the Elderly 230

Brain Injury by Electroshock 232

The Production of Delirium (Acute Organic Brain Syndrome) 232

ECT As Closed-Head Electrical Injury 233

Death, Suicide, and Autopsy Findings 234

Memory Deficits 234

Studies of Brain Damage From ECT 237

Brain Scans 241

Modified ECT 242

The Brain-Disabling Principle 244

Iatrogenic Helplessness and Denial, and Spellbinding 246

A Long Controversy Surrounding ECT 246

The Need to Ban ECT 249

Conclusion 250

第 10 章

從注意力缺陷/多動障礙 (ADHD) 到雙相情感障礙：診斷美國兒童 253

ADHD/興奮劑市場 256

美國使用模式的轉變 256

全球市場 257

多動症診斷 258

診斷兒童雙相情感障礙 259

醫生如何學會診斷和治療所謂的躁鬱症兒童 259

制定兒童用藥指南 260

公眾強烈反對 262

越來越擔心不良反應 263

ADHD 診斷的後果 264

破壞性行為障礙 264

添加標準 264

羅素巴克利：合理化壓迫控制 265

一種隨心所欲的疾病266

TADD 267

多動症的批評 269

合併症和誤診270

多動症的假設物理基礎

ADHD：一種美國疾病？男孩的病 272

CHADD：製藥公司倡導者 272

母團的權力基礎 273

現場診斷275

學校心理健康篩查：最新威脅 275

道德、心理和社會危害 276

像閃亮的星星278

Chapter 10
From Attention-Deficit/Hyperactivity Disorder (ADHD) to Bipolar Disorder: Diagnosing America’s Children 253

The ADHD/Stimulant Market 256

Shifting Patterns of Use in the United States 256

The Worldwide Market 257

The ADHD Diagnosis 258

Diagnosing Bipolar Disorder in Children 259

How Doctors Learn to Diagnose and Medicate So-Called Bipolar Children 259

Developing Guidelines for Medicating Children 260

Public Backlash 262

Growing Concerns About Adverse Effects 263

Ramifications of the ADHD Diagnosis 264

Destructive Behavior Disorders 264

ADD Criteria 264

Russell Barkley: Rationalizing Oppressive Control 265

A Disease That Goes Away With Attention 266

ADD and TADD 267

Critiques of ADHD 269

Comorbidity and Misguided Diagnoses 270

The Supposed Physical Basis for ADHD 271

ADHD: An American Disease? A Boy’s Disease 272

CHADD: A Drug Company Advocate 272

The Power Base of the Parent Groups 273

On-the-Spot Diagnosis 275

Mental Health Screening in Schools: The Latest Threat 275

Moral, Psychological, and Social Harm 276

Like Shining Stars 278

第11章興奮劑引起的腦損傷、腦功能障礙和精神不良反應283

無效的治療284

多種不良反應 286

更極端的中毒反應293

托莫西汀 (Strattera) 295

Strattera 誘發的自殺 295

食品藥品監督管理局繼續將興奮劑的風險降至最低 296

再一次，太少，太遲了 298

美國精神病學協會的勝利 299

興奮劑依賴 300

關注緝毒局 301

納丁蘭伯特研究 303

興奮劑 303 的大腦致殘、令人著迷的效果

興奮劑引起的腦損傷和功能障礙 307

哌醋甲酯引起的腦萎縮

哌醋甲酯和苯丙胺引起的嚴重腦功能障礙

興奮劑引起的腦化學和顯微病理學異常 310

關於利他林 313 的最新不祥新聞

發育神經毒性 315

興奮劑引起的生長抑制 315

結論 316

Chapter 11 Stimulant-Induced Brain Damage, Brain Dysfunction, and Psychiatric Adverse Reactions 283

An Ineffective Treatment 284

A Wide Variety of Adverse Effects 286

More Extreme Intoxication Reactions 293

Atomoxetine (Strattera) 295

Strattera-Induced Suicidality 295

The Food and Drug Administration Continues to Minimize the Risks of Stimulants 296

Once Again, Too Little, Too Late 298

A Triumph for the American Psychiatric Association 299

Stimulant Dependence 300

Concern at the Drug Enforcement Administration 301

Nadine Lambert Studies 303

The Brain-Disabling, Spellbinding Effects of Stimulants 303

Brain Damage and Dysfunction Caused by Stimulants 307

Brain Atrophy Caused by Methylphenidate 307

Gross Brain Dysfunction Caused by Methylphenidate and Amphetamine 310

Abnormalities of Brain Chemistry and Microscopic Pathology Caused by Stimulants 310

The Latest Ominous News About Ritalin 313

Developmental Neurotoxicity 315

Growth Suppression Caused by Stimulants 315

Conclusion 316

第12章抗焦慮藥，包括Xanax和Halcion引起的行為異常319

麻醉學前沿研究證實了腦功能障礙 319

毒品320

腦功能障礙作為主要臨床效應 322

產生行為異常的機制 323

苯二氮卓類藥物 (BZ) 的不良反應 324

狂熱與憤怒的產生

抑鬱症和自殺的產生326

Halcion 和 Xanax 引起的認知、情緒和行為異常 327

來自食品藥品監督管理局的自發報告系統的證據 330

美國和英國的反應不同 334

BZ 使用中的其他風險 336

BZs 作為自殺的工具 336

對睡眠和腦電圖的影響 337

精神疾病診斷和統計手冊確認 BZ 誘發的持續性健忘症和癡呆症 338

研究表明 BZ 的持續性損傷和癡呆症

其他睡眠藥物 340

依賴和退出 341

結論 344

Chapter 12 Antianxiety Drugs, Including Behavioral Abnormalities Caused by Xanax and Halcion 319

Frontier Research in Anesthesiology Confirms the Brain-Disabling Principle 319

The Drugs 320

Brain Disability As the Primary Clinical Effect 322

Mechanisms for Producing Behavioral Abnormalities 323

Adverse Reactions to Benzodiazepines (BZs) 324

The Production of Mania and Rage 325

The Production of Depression and Suicide 326

Cognitive, Emotional, and Behavioral Abnormalities Caused by Halcion and Xanax 327

Evidence From the Food and Drug Administration’s Spontaneous Reporting System 330

American and British Responses Diverge 334

Other Risks in BZ Use 336

BZs As Instruments of Suicide 336

Effects on Sleep and the Electroencephalogram 337

The Diagnostic and Statistical Manual of Mental Disorders Confirms BZ-Induced Persistent Amnesia and Dementia 338

Research Indicating Persistent Impairment and Dementia From BZs 339

Other Medications for Sleep 340

Dependence and Withdrawal 341

Conclusion 344

第 13 章食品和藥物管理局 (FDA) 和國家心理健康研究所 (NIMH)：藥品公司倡導者 347

獲得批准上市藥物 349

在藥物上市前展示療效 350

為藥物創建標籤

藥物批准後監測 351

製藥公司的持續責任 351

在藥物上市前測試安全性 352

評估臨床試驗數據的更微妙的困難 356

FDA 批准過程中的其他被忽視領域 359

利潤動機 361

藥物上市後監測安全性 361

MedWatch（自發報告系統）的影響 363

從 MedWatch SRS 得出科學結論

四個審批系統故障366

未能識別神經阻滯劑惡性綜合徵 366

FDA 就遲發性運動障礙向工業界屈服 367

按摩數據：百憂解批准流程 369

落後於歐洲標準：Zoloft 370

鎳氫 373

Chapter 13 The Food and Drug Administration (FDA) and the National Institute of Mental Health (NIMH): Drug Company Advocates 347

Gaining Approval to Market the Drug 349

Demonstrating Efficacy Before the Drug Is Marketed 350

Creating the Label for the Drug 350

Monitoring After Drug Approval 351

Continuing Drug Company Responsibilities 351

Testing Safety Before the Drug Is Marketed 352

More Subtle Difficulties in Evaluating Clinical Trial Data 356

Other Neglected Areas in the FDA Approval Process 359

The Profit Motive 361

Monitoring Safety After the Drug Is Marketed 361

The Impact of MedWatch (the Spontaneous Reporting System) 363

Drawing Scientific Conclusions From the MedWatch SRS 364

Four Approval System Failures 366

Failure to Recognize Neuroleptic Malignant Syndrome 366

The FDA Caves In to Industry on Tardive Dyskinesia 367

Massaged Data: The Prozac Approval Process 369

Falling Behind European Standards: Zoloft 370

NIMH 373

第14章製藥公司的騙局377

依靠垃圾科學379

禮來和百憂解 380

禮來公司從一開始就知道百憂解的作用就像興奮劑 380

禮來（Eli Lilly）成功騙取法律制度 382

禮來 (Eli Lilly) 向美國食品和藥物管理局 (FDA) 承認百憂解經常導致抑鬱症 383

禮來 (Eli Lilly) 隱藏了百憂解誘發的躁狂症 384 的影響

禮來（Eli Lilly）證實並隱藏百憂解過度刺激 384

隱藏兒童百憂解誘發的躁狂和攻擊行為的風險 385

禮來（Eli Lilly）和 FDA 忽略關於百憂解 385 的攻擊性行為的報告

禮來（Eli Lilly）和 FDA 忽略關於百憂解 386 的自殺行為報告

禮來（Eli Lilly）在對照臨床試驗中隱藏使用百憂解增加的自殺率 386

禮來公司員工表達恥辱 388

禮來公司最早的研究中對百憂解的不良反應 389

禮來公司最早的動物研究中百憂解誘導的攻擊性 390

英國和德國監管機構詢問百憂解引起的刺激、激動和抑鬱 391

禮來 (Eli Lilly) 隱藏靜坐不能 392

禮來（Lilly）掩蓋百憂解戒斷反應 393

Zoloft 和 Paxil 394 的類似藥物批准問題

百憂解與單胺氧化酶抑製劑和色氨酸 394 的相互作用

百憂解與三環類抗抑鬱藥 395 聯用

禮來 (Eli Lilly) 深陷爭議，可能會危及生命 395

禮來公司努力隱藏致命藥物不良反應的數據 398

葛蘭素史克 (GSK) 和 Paxil 399

Paxil 過度刺激 399

拉庫宗案 400

Paxil 和 GSK 受到醫學期刊和外國藥品監管機構的批評 402

紐約州總檢察長對葛蘭素史克和 Paxil 403 採取行動

英國採取行動405

英國精神病學與美國精神病學 406

有總比沒有好？ 407

關於拼寫的最後一句話 408

Chapter 14 Drug Company Deceptions 377

Relying on Junk Science 379

Eli Lilly and Prozac 380

Eli Lilly Knew From the Start That Prozac Acts Like a Stimulant 380

Eli Lilly Successfully Bamboozles the Legal System 382

Eli Lilly Acknowledges to the Food and Drug Administration (FDA) That Prozac Frequently Causes Depression 383

Eli Lilly Hides the Implications of Prozac-Induced Mania 384

Eli Lilly Confirms and Hides Prozac Overstimulation 384

Hiding the Risk of Prozac-Induced Mania and Aggression in Children 385

Eli Lilly and the FDA Ignore Reports of Aggressive Behavior on Prozac 385

Eli Lilly and the FDA Ignore Reports of Suicidal Behavior on Prozac 386

Eli Lilly Hides Increased Suicidality on Prozac in Controlled Clinical Trials 386

Eli Lilly Employees Express Shame 388

Adverse Reactions to Prozac in Eli Lilly’s Earliest Research 389

Prozac-Induced Aggression in Eli Lilly’s Earliest Animal Studies 390

British and German Regulatory Authorities Inquire About Prozac-Induced Stimulation, Agitation, and Depression 391

Eli Lilly Hides Akathisia 392

Lilly Covers Up Prozac Withdrawal Reactions 393

Similar Drug Approval Problems With Zoloft and Paxil 394

Prozac Interaction With Monoamine Oxidase Inhibitors and Tryptophan 394

Prozac in Combination With Tricyclic Antidepressants 395

Eli Lilly Mired in Controversies With Life-Threatening Implications 395

Lilly Fights to Hide Data on Deadly Adverse Drug Effects 398

GlaxoSmithKline (GSK) and Paxil 399

Paxil Overstimulation 399

The Lacuzong Case 400

Paxil and GSK Criticized by Medical Journals and Foreign Drug Regulatory Agencies 402

The Attorney General of New York State Takes Action Against GSK and Paxil 403

Britain Takes Action 405

British Psychiatry Versus American Psychiatry 406

Better Than Nothing? 407

A Final Word on Spellbinding 408

第15章如何更安全地停止服用精神類藥物411

基本原則 412

特殊問題 415

避免危及生命的風險 417

取款期間的身體風險 417

與特定藥物相關的戒斷症狀 418

退出 SSRI 418

退出三環 419

從鋰和其他情緒穩定劑中撤出 419

退出抗精神病藥 420

退出興奮劑 420

從苯二氮卓類藥物中撤出 421

戒毒期間的心理治療422

面對藥物束縛的後果 423

慶祝新生活 423

治療師的治療臨在 424

第16章失敗的承諾、最後的手段和心理治療425

真的和他們說話？ 426

廣泛的文獻 427

精神科藥物作為最後的手段 428

外科醫生、計算機專家和精神科醫生 431

真正心理治療的道德基礎 432

我的精神病學和心理治療臨床實踐 436

437 苦難的作用

無藥物治療 438

20 治療深度不安的人的指南 441

結論 457

附錄：459 類精神病藥物

參考書目 463

索引 527

Chapter 15 How to More Safely Stop Taking Psychiatric Drugs 411

Basic Principles 412

Special Problems 415

Avoiding Life-Threatening Risks 417

Physical Risks During Withdrawal 417

Withdrawal Symptoms Associated With Specific Drugs 418

Withdrawal From SSRIs 418

Withdrawal From Tricyclics 419

Withdrawal From Lithium and Other Mood Stabilizers 419

Withdrawal From Neuroleptics 420

Withdrawal From Stimulants 420

Withdrawal From Benzodiazepines 421

Psychotherapy During Drug Withdrawal 422

Facing the Aftermath of Medication Spellbinding 423

Celebrating a New Life 423

The Therapist’s Healing Presence 424

Chapter 16 Failed Promises, Last Resorts, and Psychotherapy 425

Actually Talk to Them? 426

An Extensive Literature 427

Psychiatric Drugs As a Last Resort 428

The Surgeon, the Computer Specialist, and the Psychiatrist 431

The Moral Foundation of Genuine Psychotherapy 432

My Clinical Practice of Psychiatry and Psychotherapy 436

The Function of Suffering 437

Drug-Free Therapy 438

20 Guidelines for Treating Deeply Disturbed Persons 441

Conclusion 457

Appendix: Psychiatric Medications by Category 459

Bibliography 463

Index 527

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Preface

關於單詞的詞 在本書中，我使用了諸如注意力缺陷/多動障礙 (ADHD)、雙相情感障礙、重度抑鬱症和精神分裂症等診斷術語。 如果我每次使用這些術語時都表達我對這些術語的科學懷疑，那麼這本書就會因不斷的中斷而受損。 相反，我想從一開始就確定我使用這些診斷術語只是為了與我所引用的各種來源中的當前用法保持一致，例如臨床研究、研究報告和食品和藥物管理局 (FDA )-批准的藥物標籤。

A WORD ABOUT WORDS Throughout this book, I use diagnostic terms such as attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and schizophrenia. If I were to express my scientific skepticism toward these terms each time I used them, the book would be marred by constant interruptions. Instead, I want to establish from the beginning that I am using these diagnostic terms only for the purpose of consistency with current usage in the various sources on which I am drawing, such as clinical studies, research reports, and Food and Drug Administration (FDA)-approved drug labels.

正如本書將指出的那樣，這些診斷類別並不反映有效的疾病或與阿爾茨海默病、中風或糖尿病相當的疾病。 儘管有相反的說法，但這些精神疾病沒有經過證實的遺傳、化學或生物學基礎。 他們不能被診斷出有身體症狀或實驗室檢查。

As the book will indicate, these diagnostic categories do not reflect valid diseases or illnesses comparable to Alzheimer’s disease, stroke, or diabetes. Despite claims to the contrary, these psychiatric disorders have no proven genetic, chemical, or biological basis. They cannot be diagnosed with physical symptoms or laboratory studies.

當然，沒有人否認人們會變得高度非理性，與普通現實脫節，或者變得自殺或暴力。 但是，一種極端的情緒反應，無論多麼具有破壞性，本身並不需要根植於生物功能障礙的解釋。 沒有任何潛在的醫學疾病，人類具有極端心理反應的能力，尤其是在壓力下。

Of course, no one denies that people can become highly irrational, lose touch with ordinary reality, or become suicidal or violent; but an extreme emotional response, however destructive, in itself does not demand an explanation rooted in biological dysfunction. Without any underlying medical disorder, human beings have the capacity for extreme psychological reactions, especially under stress.

當然，真正的大腦疾病或失調，如內分泌失調或癡呆，會改變和破壞人類行為。 在這本書和藥物瘋狂（出版中）中，我描述了精神藥物如何導致導致混亂、謀殺和自殺的腦部疾病。 事實上，FDA 終於開始確認我很久以前就抗抑鬱藥引起的精神和行為異常所做的觀察。 然而，除了由精神科藥物引起的腦功能障礙和生化失衡外，經常尋求精神科醫生和 xxiii xxiv 幫助的人的大腦中沒有已知異常。

Of course, genuine diseases or disorders of the brain, such as endocrine disorders or dementia, can change and disrupt human behavior. In this book and in Medication Madness (in press), I describe how psychiatric drugs cause brain disorders that lead to mayhem, murder, and suicide. Indeed, the FDA at long last has begun to confirm observations that I made long ago concerning antidepressant-induced mental and behavioral abnormalities. However, except for the brain dysfunction and biochemical imbalances caused by psychiatric drugs, there are no known abnormalities in the brains of people who routinely seek help from psychiatrists and xxiii xxiv

前言
PREFACE (xxiii)

他們被診斷出患有多動症、精神分裂症和重度抑鬱症等疾病。

who become diagnosed with disorders like ADHD, schizophrenia, and major depressive disorder.

給患有多動症的兒童貼上標籤，或者給患有精神分裂症或重度抑鬱症的成年人貼上標籤，就是給他們貼上破壞性的、令人沮喪的標籤，並鼓勵或強迫他們接受藥物和電擊等生物精神干預。 在我自己的精神病學實踐中，我不會用傳統的診斷術語來思考或告訴患者他們患有所謂的精神障礙。 相反，我試圖了解每個人的生活故事——他或她的個人傳記——在其所有微妙的複雜性中。 通常，我讓親人和家人參與進來，以幫助他們相互了解。 在這種真正理解的基礎上，而不是千篇一律的診斷，我更有能力幫助人們過上更令人滿意、更成功的生活。

To label children with ADHD or to label adults with schizophrenia or major depressive disorder is to stigmatize them with damaging, discouraging labels and to encourage or coerce them to submit to biopsychiatric interventions such as drugs and electroshock. In my own psychiatric practice, I do not think in conventional diagnostic terms or tell patients that they have so-called mental disorders. Instead, I try to understand the life story of each individual—his or her personal biography—in all its subtle complexity. Often, I involve loved ones and family to help them understand each other. On this basis of genuine understanding, instead of cookie-cutter diagnoses, I am far more able to help individuals lead more satisfying, successful lives.

致謝 (xxv)

Acknowledgments

Springer Publishing Company 出版了我的第一本醫學書籍《電擊：它的腦功能障礙效應》，很久以前，也就是 1979 年。現在，差不多 30 年後，這本新版的精神病學腦功能障礙治療正值公眾認知 精神科治療的觀點更接近於我在早期 Springer 書中採取的許多看似有爭議的立場。 即使在醫療保健行業，人們也越來越認識到與精神科藥物和休克治療相關的風險比最初預期的要大，而且它們的有效性比預期的要有限。

Springer Publishing Company published my first medical book, Electroshock: Its Brain-Disabling Effects, a long time ago, in 1979. Now, almost 30 years later, this new edition of Brain-Disabling Treatments in Psychiatry comes at a time when the public’s perception of psychiatric treatments has come closer to many of the seemingly controversial positions taken in my earlier Springer books. Even within the health care professions, there is growing recognition that the risks associated with psychiatric drugs and shock treatments are greater than originally anticipated and that their effectiveness is more limited than hoped.

本書原版或其前身《精神病藥物：對大腦的危害》（1983 年）和《電擊》（1979 年）中的基本斷言都沒有被證明是錯誤的。 相反，大量新證據支持我在過去幾十年中一直在發展的主要主題。 在許多領域，食品和藥物管理局在第一版中證實了曾經似乎特別有爭議的斷言，例如，抗抑鬱藥對兒童無效，增加了自殺未遂率，而且還增加了年輕人的自殺率。 我在早期著作中得出的許多其他結論已被主流採納，包括最近證實電擊治療會導致永久性腦損傷和功能障礙。

None of the basic assertions in the original edition of this book or in its precursors, Psychiatric Drugs: Hazards to the Brain (1983) and Electroshock (1979), have been proven wrong. Instead, a mountain of new evidence supports the main themes that I have been developing over the last decades. In a number of areas, the Food and Drug Administration has confirmed assertions in the first edition that once seemed especially controversial, for example, that antidepressants are ineffective in children and increase the rate of suicide attempts and that they also increase suicidality in young adults. Many other conclusions made in my earlier books have been adopted by the mainstream, including recent confirmation that electroshock treatment causes permanent brain damage and dysfunction.

當 Springer Publishing Company 決定推出我的前兩本醫學書籍 Electroshock (1979) 和 Psychiatric Drugs (1983) 時，它需要勇氣。 該公司總裁厄休拉·斯普林格博士和當時的高級編輯卡羅爾·薩爾茨不得不擔心發表如此批評看似已確立的治療概念的觀點。 他們給我的機會有助於鼓勵我在該領域的一生工作。 從那時到現在，我幾乎所有的出版物都從前兩本書中汲取了能量和方向。

When Springer Publishing Company decided to bring out my first two medical books, Electroshock (1979) and Psychiatric Drugs (1983), it required courage. The president of the company, Dr. Ursula Springer, and the senior editor at the time, Carole Saltz, had to be concerned about publishing a viewpoint so critical of seemingly established concepts of treatment. The opportunity they gave me has helped to encourage a lifetime of work in the fi eld. From then until the present, nearly all of my publications have drawn energy and direction from these first two books.

我很感激施普林格博士和她的公司發現我的前兩本醫學書籍具有足夠的價值和重要性來承擔 xxv xxvi 的風險

I am grateful that Dr. Springer and her company found my first two medical books of sufficient merit and importance to take the risk of xxv xxvi

致謝

ACKNOWLEDGMENTS

publishing them. If they had not, my career might have taken a different and ultimately less useful direction.

Nearly three decades later, and after the retirement of Dr. Springer, Springer Publishing Company and Sheri W. Sussman, Senior Vice President, Editorial, have continued to support my work with a new paperback edition of The Heart of Being Helpful (1997b) and now with this new edition of Brain-Disabling Treatments in Psychiatry.

Springer Publishing Company also worked with me and my wife,

Ginger, in developing the peer-reviewed scientifi c journal Ethical Human Psychology and Psychiatry, sponsored by the International Center for the

Study of Psychiatry and Psychology (ICSPP; http://www.icspp.org). The

journal is now enjoying a decade of publishing under the leadership of younger professionals and provides a unique opportunity for scientists and clinicians to publish independent research in the light beyond the shadow of the psychopharmaceutical complex.

I also want to thank the many members of ICSPP who have been so supportive of my work and each other’s work in the reform movement.

As in many of my books, my research assistant Ian Goddard continued to provide much-needed help obtaining original articles, sometimes under considerable time pressure, often delivering them along with a big dose of his own original ideas and remarkable insights. Beyond that, he read the entire manuscript and made many useful editorial observations.

This new edition is a better book because of Ian.

And now, approaching 25 years together, my wife, Ginger, continues to provide the strength and often the inspiration behind so much of what I do. It is because of Ginger’s encouragement that the book now has two concluding chapters on treatment and my 20 guidelines for therapy with disturbed patients. She insisted that I needed to write them, and then she helped to edit them.

介紹

確認背後的科學

第一版

Introduction

Confirming the Science Behind

the First Edition

這本書是針對專業讀者的，但希望它寫得足夠清晰和解釋清楚，以供非專業人士閱讀。 當前版本已進行了非常徹底的修訂，但基本的科學主旨基本保持不變。 過去幾年已經證實了精神病治療的腦殘原則，作者的許多看似有爭議的結論也得到了更廣泛的接受。

This book is aimed at professional audiences, but it is hoped that it is written with sufficient clarity and explanation to be read by nonprofessionals. The current edition has been very thoroughly revised, but the basic scientific thrust remains essentially the same. The past several years have confirmed the brain-disabling principle of psychiatric treatment, and many of the author’s seemingly controversial conclusions have become more widely accepted.

科學的徹底更新（xxvii）

A THOROUGH UPDATE OF THE SCIENCE (xxvii)

在本書的這一版中，腦功能障礙治療的概念已經更新和擴展，增加了藥物施法的概念（中毒失知症）。 神經安定藥章節已更新，包括更多關於新型非典型藥物的材料以及所有抗精神病藥物的神經毒性和細胞毒性的新信息。 大量關於抗抑鬱藥和興奮劑的新信息導致了每種藥物的附加章節。

For this edition of the book, the concept of brain-disabling treatment has been updated and expanded with the additional concept of medication spellbinding (intoxication anosognosia). The neuroleptic chapters have been updated to include much more material on the newer, atypical drugs as well as new information on the neurotoxicity and cytotoxicity of all antipsychotic drugs. A massive amount of new information about antidepressant drugs and the stimulant drugs has resulted in an additional chapter on each drug.

The new edition concludes with two entirely new chapters on treatment—one on how to safely withdraw from psychiatric drugs, and the other about psychosocial and educational approaches to very disturbed people, including 20 guidelines for therapy. I am pleased to include how-to treatment information in the book for the first time.

對上一版的日益確認 (xxviii)

GROWING CONFIRMATION OF THE PREVIOUS EDITION

我對抗抑鬱藥引起一系列興奮或激活效應的觀察——包括激動、敵意、攻擊性和躁狂症，以及陷入抑鬱和自殺——在新的食品和藥物管理局（FDA )-強制改變抗抑鬱藥標籤。 精神藥物具有神經毒性的概念現在已成為科學研究中廣泛接受的原則，特別是關於抗精神病藥物和情緒穩定劑的研究已經開始，研究表明在所有類別的精神藥物中都有類似的神經毒性作用。 許多其他醫學專家現在加入了我對 FDA 未能履行職責的批評以及我對製藥公司對精神病學理論和實踐的腐敗影響的擔憂。 簡而言之，我不再是一個在荒野中哭泣的孤獨聲音。
My observations that antidepressant drugs cause a spectrum of stimulant or activation effects—including agitation, hostility, aggression, and mania as well as crashing into depression and suicidality—have been elevated to the status of official dogma in the new Food and Drug Administration (FDA)-mandated changes in antidepressant labels. The concept that psychiatric drugs are neurotoxic is now a widely accepted principle in scientific research, especially concerning the antipsychotic drugs and mood stabilizers, and research has mounted up that demonstrates similar neurotoxic effects in all categories of psychiatric drugs. Many other medical experts have now joined in my criticism of the FDA’s failure to do its duty and my concern about the corrupting influence of the drug companies on the theory and practice of psychiatry. Put simply, I am no longer quite such a lonely voice crying in the wilderness.

確認從 1983 年開始的長遠觀點 (xxviii)

CONFIRMING THE LONGER VIEW STARTING IN 1983 (xxviii)

這個新版本的譜系始於 1983 年的《精神病藥物：對大腦的危害》，這本書開創了新的領域，首次廣泛審查了神經安定藥誘發的癡呆這一主題。 它還堅定地認為，精神安定藥經常導致年輕人遲發性運動障礙 (TD)。 兒童的 TD 已成為公認的現實，因此該部分的尺寸已縮小。 遲發性精神病正在獲得越來越多的認可，如果緩慢的話。 遲發性癡呆仍然存在爭議——儘管不應該如此——而且越來越多的證據支持我之前對神經安定藥引起的認知缺陷的觀察。 此外，實驗室正在更公開地研究精神藥物的神經毒性。

The lineage of this new edition began in 1983 with Psychiatric Drugs: Hazards to the Brain, a book that broke new ground with the first extensive review of the subject of neuroleptic-induced dementia. It also took a fi rm stand on the view that neuroleptics frequently cause tardive dyskinesia (TD) in young people. TD in children has become an accepted reality, and so that section has been reduced in size. Tardive psychosis is gaining increasing, if slow, recognition. Tardive dementia remains controversial—although it should not be—and an increasing amount of evidence supports my earlier observations on the cognitive deficits caused by neuroleptics. In addition, the neurotoxicity of psychiatric drugs is being studied more openly in laboratories.

在 1970 年代，當我第一次開始對精神藥物、醫學模式和精神藥物綜合體進行詳細評論時，我在很多情況下都在開闢新天地，而且最初的支持者寥寥無幾。

In the 1970s, when I first began offering detailed critiques of psychiatric drugs, the medical model, and the psychopharmaceutical complex, I was, in many cases, breaking new ground, and initially, there were few supporters.

到 1997 年第一版《精神病學中的腦損傷治療》時，我已經可以引用許多從不同角度對生物模型和物理治療提出強烈批評的書籍（Armstrong，1993；Breeding，1996；Caplan， 1995；Cohen，1990；Colbert，1995；Fisher 等人，1989；Grobe，1995；Jacobs，1995；Kirk 等人，1992；Modrow，1992；Mosher 等人，1989；Romme 等人，1993； 夏基，1994）。

By the time of the first edition of Brain-Disabling Treatments in Psychiatry in 1997, I could already cite many books that voiced strong criticism of the biological model and physical treatments from a variety of perspectives (Armstrong, 1993; Breeding, 1996; Caplan, 1995; Cohen, 1990; Colbert, 1995; Fisher et al., 1989; Grobe, 1995; Jacobs, 1995; Kirk et al., 1992; Modrow, 1992; Mosher et al., 1989; Romme et al., 1993; Sharkey, 1994).

尤其是在過去幾年中，越來越多的作者，其中許多來自醫療機構內部，一直在強烈批評這個強大的利益集團，尤其是製藥業的主導影響（Abramson 等，2005； Angell, 2004, 2007; Glenmullen, 2000, 2005; Healy, 2004; Jackson, 2005; Kean, 2005, 2006; Medwaret al., 2004; Moncrieff, 2006a, 2006b; O’Meara, 2006; Rost, 2006)。

尤其是在過去的幾年裡，越來越多的作者，其中許多來自醫療機構內部，一直在提供強有力的

Especially in the last few years, an escalating number of authors, many from within the medical establishment, have been offering strong criticism of that conglomerate of powerful interest groups, and especially the dominating influence of the pharmaceutical industry (Abramson et al., 2005; Angell, 2004, 2007; Glenmullen, 2000, 2005; Healy, 2004; Jackson, 2005; Kean, 2005, 2006; Medwaret al., 2004; Moncrieff, 2006a, 2006b; O’Meara, 2006; Rost, 2006).

精神病學情況惡化 (xxix)

THE SITUATION IN PSYCHIATRY WORSENS

儘管我對生物精神病學和精神藥物綜合體的許多批評和批評得到了更廣泛的接受，但在許多方面，隨著製藥公司實力的增強，情況已經惡化。 在這個過程中，我對精神藥物複合體不斷增長的力量的預測已經成真。

Although many of my critiques and criticisms of biological psychiatry and the psychopharmaceutical complex have a broader acceptance, in many ways, the situation has deteriorated as the strength of the drug companies has grown. In the process, my predictions about the growing power of the psychopharmaceutical complex have come true.

在過去的二十年裡，人們對精神科藥物的依賴不斷增加，不僅在精神病學領域，而且在整個醫學、心理健康甚至教育領域。 在私人執業精神病學中，通常在第一次就診時給患者藥物，然後告知他們終生都需要藥物。 家庭醫生、內科醫生和其他醫生大量分發抗抑鬱藥和苯二氮卓類鎮靜劑。 非醫學專業人士，如心理學家和社會工作者，覺得有義務推薦他們的病人進行藥物評估。

The last two decades have seen escalating reliance on psychiatric drugs, not only within psychiatry but also throughout medicine, mental health, and even education. In private-practice psychiatry, it is common to give patients a medication on the fi rst visit and then instruct them that they will need drugs for their lifetimes. Family practitioners, internists, and other physicians liberally dispense antidepressants and benzodiazepine tranquilizers. Nonmedical professionals, such as psychologists and social workers, feel obliged to refer their patients for drug evaluations.

管理式護理積極推動藥物排除心理治療。 成人藥物越來越多地開給兒童。 醫院違背病人的意願強行給病人服用精神科藥物。

Managed care aggressively pushes drugs to the exclusion of psychotherapy. Adult medications are increasingly prescribed to children. Hospitals force psychiatric drugs on patients against their will.

精神病學內部有一個成功的運動，在許多州實施，這使得強迫診所門診病人接受長效藥物注射變得容易。 根據這些門診承諾法，如果患者拒絕來診所，精神衛生工作者可以上門強行進行注射。 與此同時，還有一場運動，對學童，甚至學齡前兒童進行所謂的精神疾病篩查。 這種潛在的災難性運動是由製藥公司的資金推動的，旨在增加其產品的市場。

There is a successful movement within psychiatry, implemented in many states, that makes it easy to force clinic outpatients to take long-acting injections of drugs. Under these outpatient commitment laws, if the person refuses to come to the clinic, mental health workers can come to the home to administer the injections by force. At the same time, there is a movement to screen schoolchildren, and even preschoolers, for so-called mental illness. This potentially disastrous movement is driven by drug company money and aims at increasing the market for their products.

外行也加入了對毒品的熱情。 由於媒體對藥物的支持以及對公眾的直接廣告和促銷，患者到達醫生辦公室時經常會想到一種精神科藥物的名稱。 老師經常推薦孩子進行藥物評估或治療。

Laypersons have joined in the enthusiasm for drugs. Because of media support for medication as well as direct advertising and promotion to the public, patients frequently arrive at the doctor’s office with the name of a psychiatric drug already in mind. Teachers often recommend children for drug evaluation or treatment.

這場藥物革命將精神科藥物視為有益而非有害，即使是一種完全的祝福。 就像胰島素或青黴素一樣，它們被大力推廣為特定疾病的特定治療方法。 通常，據說它們可以糾正大腦中的生化失衡。 這些信念創造了一種環境，在這種環境中，對藥物不良反應的強調受到冷遇，對精神科藥物的批評原則上是不常見的異端邪說。
This drug revolution views psychiatric medications as far more helpful than harmful, even as an unmitigated blessing. Much as insulin or penicillin, they are vigorously promoted as specific treatments for specific illnesses. Often, they are said to correct biochemical imbalances in the brain. These beliefs have created an environment in which emphasis on adverse drug effects is greeted without enthusiasm, and criticism of psychiatric medication in principle is uncommon heresy.

製藥公司大力宣傳這種未經證實的推測，即他們治療的問題是生物學上的，是由生化失衡造成的。 廣告標語被用來證明藥物處方的合理性。 例如，抗精神病藥物 Risperdal 的製造商 Janssen（2005 年）提供了一個“關於雙相情感障礙”的部分，該部分於 2006 年 2 月從其網站下載。它宣稱，精神疾病是一種醫學疾病，就像高血壓或 心髒病。

Drug companies heavily promote that unproven speculation that the problems they treat are biological in origin and result from biochemical imbalances. Advertising slogans are used to justify the prescription of medications. For example, Janssen (2005), the manufacturer of the antipsychotic drug Risperdal, offers a section “About Bipolar Disorder,” downloaded from its Web site in February 2006. It declares, Mental illness is a medical illness, just like high blood pressure or heart disease.

Janssen 網站繼續說：“人們還認為雙相情感障礙可能是由該疾病的遺傳易感性引起的，因為它傾向於在家庭中傳播。” 再次注意，沒有聲稱科學真實性。 但是，這些不科學的生化和遺傳推測的重複仍然使人們相信精神科藥物是針對遺傳、生化疾病的特定治療方法，就像治療高血壓的抗高血壓藥物或治療糖尿病的胰島素一樣。

The Janssen Web site goes on to say, “It is also thought that bipolar disorder may be caused by a genetic predisposition to the illness because it tends to run in families.” Notice again that no claim to scientific veracity is made. But the repetition of these unscientific biochemical and genetic speculations nonetheless conditions people to believe that psychiatric drugs are specific treatments for genetic, biochemical disorders, much like antihypertensive drugs for high blood pressure or insulin for diabetes.

這本書採取了與生物精神病學截然不同的觀點。 它提供了理論和證據，表明精神藥物通過引起腦功能障礙來實現其主要或基本作用，並且它們往往弊大於利。 我將證明精神藥物不是針對任何特定的所謂精神障礙的特定治療方法。 精神藥物不是糾正生化失衡，而是導致它們，有時是永久性的。

This book takes a decidedly different viewpoint from that of biological psychiatry. It provides theory and evidence that psychiatric drugs achieve their primary or essential effect by causing brain dysfunction and that they tend to do far more harm than good. I will show that psychiatric drugs are not specific treatments for any particular so-called mental disorder. Instead of correcting biochemical imbalances, psychiatric drugs cause them, sometimes permanently.

醫療保健提供者和公眾也被廣為宣傳的猜測所迷惑，即腦部掃描可以證明精神障礙的存在，甚至可以診斷它們。 實際上，沒有任何精神疾病可以通過腦部掃描 (Jackson, 2006a) 或任何其他醫學或生物學手段證實或診斷。

Health care providers and the general public have also been bamboozled by the much-advertised speculation that brain scans can demonstrate the existence of mental disorders, and even diagnose them. In reality, no psychiatric disorder is demonstrable or diagnosable by brain scan (Jackson, 2006a) or by any other medical or biological means.

這本第二版書討論瞭如何停止服用精神科藥物，並提供了 20 條治療指南。 在其他地方很容易獲得關於如何在不訴諸藥物或電擊的情況下幫助受干擾和乾擾的人的更多信息（Breggin，1991a，1992a，1997；Breggin 等，1994a，1996，2002）。 Reclaiming Our Children (2000b)、Talking Back to Ritalin (2001c)、The Antidepressant Fact Book (2001a) 和 The Ritalin Fact Book (2002b) 中的章節也涉及治療方法。 關於我幫助他人的方法的最佳總體總結可以在 The Heart of Being Helpful (1997b) 中找到。

This second-edition book discusses how to stop taking psychiatric drugs and presents 20 guidelines for therapy. Considerably more information on how to help disturbed and disturbing people without resort to drugs or electroshock is readily available elsewhere (Breggin, 1991a, 1992a, 1997; Breggin et al., 1994a, 1996, 2002). Chapters in Reclaiming Our Children (2000b), Talking Back to Ritalin (2001c), The Antidepressant Fact Book (2001a), and The Ritalin Fact Book (2002b) also deal with therapeutic approaches. The best overall summary of my approach to helping people can be found in The Heart of Being Helpful (1997b).

最後，藥物瘋狂：混亂、謀殺和自殺的真實故事（印刷中）可以被視為本書的伴侶，提供了這些藥物對個人生活造成破壞性影響的真實案例。

Finally, Medication Madness: True Stories of Mayhem, Murder and Suicide (in press) can be viewed as a companion to this book, providing real-life cases of the devastating impact of these drugs on individual lives.