Most anti-anxiety drugs, or anxiolytics, belong to a class of chemical compounds called benzodiazepines, a category which includes alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), olanzapine (Zyprexa), chlordiazepoxide (Librium), clonazepam (Klonopin, Clozaril, Leponex), and estazolam (Prosom). These drugs are variously marketed as anxiolytics, sedatives, muscle relaxants, hypnotics, or anticonvulsants, implying a specificity of action that does not in fact exist. All these drugs are general central nervous system depressants, essentially no different in their mode of action from opiates or barbiturates or, for that matter, gin.
These drugs may reduce anxiety in the short term, but in many cases the anxiety attacks can return, more distressing than ever--a phenomenon known as the "rebound effect," as George learned to his sorrow.
The case of Xanax is instructive in this regard. "Panic disorder" was officially recognized as a distinct diagnostic entity in 1980 in the third edition of the
Diagnostic and Statistical Manual of Mental Disorders, or
DSM-III, which is produced by the American Psychiatric Association and which serves as a kind of Sears catalog of mental illness psychiatrists use as a guide to prescribing their nostrums. Two years later, the maker of Xanax, the Upjohn Company, began drawing up plans for the Cross-National Collaborative Panic Study to assess the efficacy of Xanax in preventing panic attacks. (Upjohn has since been swallowed up by pharmaceutical giant Pfizer.)
Number of people disabled by anxiety disorder has soared
The patients enrolled in this study had to be suffering from at least one panic attack per week. Each patient received either Xanax or placebo for eight weeks, followed by a one-month period in which they were tapered off the drug, followed by two weeks of post-taper monitoring.
At four weeks, patients receiving Xanax experienced a 43% reduction in the frequency of panic attacks compared to those receiving the placebo. That sounds pretty good, but by the eighth week that difference had shrunk to insignificance. By the end of the post-taper period, patients taking Xanax showed an alarming 381% increase in panic attacks compared to those in the placebo group.
In plain English, most patients were better off if they had never taken the drug. Nevertheless, on the basis of the favorable results at four weeks, Xanax became the first drug specifically approved for treatment of panic disorder. The study authors recommend that patients with panic disorder be given Xanax for at least six months.
Xanax went on to become the best-selling anxiolytic in the world. Doctor Mark Hyatt, Chief of Psychiatry at Lexington's Veterans Affairs Medical Center, complained to the
Lexington Times-Herald "Doctors are handing it out like candy."
Meanwhile, the number of people disabled by anxiety disorder has soared. We're not talking about just the number of people labeled as having this condition (although that, too, has soared). The number of people disabled by this condition has skyrocketed, as author Robert Whitaker demonstrates in his blockbuster work of nonfiction
Anatomy of an Epidemic. Extrapolating from data from the peer-reviewed scientific literature, he estimates that the number of people disabled by anxiety disorders has risen by a staggering 6000 percent since these drugs were introduced.
Just as disturbing is the reported tendency of drugs of this class to cause atrophy of the brain. As far back as 1981, Doctor Malcom Lader reported brain shrinkage, similar to that seen in long-term alcoholics, in patients taking these drugs. An investigation by the
Independent found that the Medical Research Board (MRC) of the UK convened a meeting of experts, who issued a report recommending further studies on the matter. The report was accepted by the Neurosciences Board of the MRC in January of 1982, but nothing more ever was done, and the report was sealed.
Atrophy of the brain
"I should have been more proactive," Dr. Lader, by then Professor Emeritus of the Institute of Psychiatry, told the
Independent. "I assumed the prescribing would peter out, but GP's are still swinging them around like smarties."
Currently some 13.3 million Americans are taking these drugs. Recall that Dr. Weich and his colleagues found these drugs are correlated with an increase in the death rate of one-half of one percent per year. One-half of one percent of 13.3 million comes out to almost seventy thousand. In plain English, these drugs may be killing as many as seventy thousand Americans per year. That would mean more Americans are dying every year from these drugs than died in the Vietnam War, both Gulf wars and the War in Afghanistan combined. Why wasn't this front-page headline news?
And that's just counting the ones who are killed. It doesn't count the number maimed by falls or automobile accidents incurred under the influence of these drugs. And it doesn't count the myriad side effects including but not limited to sedation, fatigue, tremors, memory loss, ataxia, dyskinesia, diabetes, rebound anxiety, and brain shrinkage.
Why do these drugs continue to be handed out like candy?
Today anti-anxiety drugs are a 9 billion-dollar-a-year industry
Today anti-anxiety drugs are a 9 billion-dollar-a-year industry. Of the 27 authors of the latest edition of
Diagnostic and Statistical Manual of Mental Disorders, or
DSM-V, only eight reported no financial ties to the pharmaceutical industry. All of the other 19 members admitted to taking money from drug companies including Pfizer (Xanax), Wyeth (Ativan), Eli Lilly (Zyprexa), Hoffman LaRoche (Valium, Klonopin), Novartis (Clozaril, Leponex), and Teva Pharmaceuticals (makers of generic equivalents of Librium, Valium, Klonopin, and Prosom).
In 1999, Hoffman LaRoche paid a 500 million dollar fine for leading a conspiracy to raise and fix the prices of its products. Teva Pharmaceuticals currently is under investigation by the Securities and Exchange Commission for alleged violations of US anti-bribery laws. Within the last six years, Pfizer, Wyeth, Eli Lilly, and Novartis all have paid out hundreds of millions of dollars to settle claims of illegal marketing, including a whopping 2.3 billion dollars paid by Pfizer in what at the time was the largest health care fraud settlement in history. Keep in mind that the drug companies are, by and large, responsible for assessing the safety and effectiveness of their wares. Given this kind of track record, should we go on believing them when they insist their products are "safe and effective?"
Before we go any further down this road, perhaps it is time to think long and hard about where we are going. There never has been a time in history in which more people had a greater chance of living to a ripe old age, and yet as a society for some reason we find it necessary to consume such colossal amount of anti-anxiety drugs that here in the overdeveloped world, our rivers contains not just measurable amounts of benzodiazepines, but enough to alter the behavior of fish living in the water. Again, why wasn't this front-page headline news?
As for George, his dreams now are on hold. Three times he has tried to taper off the Klonopin, but to no avail. Each time the anxiety came roaring back worse than ever, along with nausea, chills, confusion, and uncontrollable shaking. Unable to work or care for himself, he has moved back home with his mother.
"People go on this stuff for anxiety," he says, "But they really shouldn't at all, because the anxiety you have trying to come off of it is ten times worse.
"I'd probably be working a job right now if I wasn't on stuff, you know, I'd be a human being with a normal life. It's just taken everything from me. My life has been torn to shreds."
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