17 Comments
User's avatar
Joe Canimal's avatar

They now have depot shots so that you only need to give treatment, say, once a month. It is nuts this is not mandated more frequently.

Expand full comment
MEL's avatar

It is nuts that people making comments like these are not mandated to receive depot shots before pushing them on others. Take your own medicine, etc.

Expand full comment
JaziTricks's avatar

tangentially, we should consider lock up to avoid damaging others in some cases.

ie violent psychotics refusing treatment, Isis graduates, Mafia bosses.

Expand full comment
MEL's avatar
Aug 20Edited

> More people should be on high quality anti-psychotics

Especially the author of an article calling anti-psychotics "good"; it would unironically cure them of this delusion.

> In the former Soviet Union, drugs were advised to be used as a form of punishment under the guise of "helping" in psychiatric institutions and most likely whenever it fit. Haloperidol, an antipsychotic medication, was a preferred agent.

- https://en.wikipedia.org/wiki/Pharmacological_torture

Expand full comment
JaneInToronto's avatar

Research how many mass shooters are on anti-depressants, esp. SSRIs, known to produce emotional numbness. The German pilot who flew SwissAir into a mountain was depressed, not just about his relationship break-up, but about his failing eyesight. They gave him more anti-depressants, known to have adverse effects on the eyes, so he got more depressed and more emotionally numb. The result was predictable. At the time, it was said that Transport Canada was still allowing pilots on these Rx pills to fly..... Such is the power of Pharma.

Expand full comment
Car Alarm's avatar

Interesting piece. However, I don’t think you can infer psychosis from his being prescribed quetiapine. It’s such an ineffective antipsychotic drug that it’s mainly used (in Scandinavia, where I practice & where we are very restrictive with benzos) as a sleep aid and for anxiety.

Expand full comment
Emil O. W. Kirkegaard's avatar

That's interesting. Judging from the videos, he doesn't look like a typical GAD person, he looks more like a schizophrenic.

Expand full comment
Car Alarm's avatar

Wasn’t thinking of GAD per se. Quetiapine just isn’t the first drug of choice for any diagnosis, you throw it at someone who has ill defined ‘poor mental health’. Usually when there is concomitant substance abuse which (unless someone is absolutely and lastingly barking mad) makes diagnostics pretty much impossible.

Expand full comment
Car Alarm's avatar

And why seroquel? Few side effects, in particular compared to olanzapine (metabolic effects) and bensos (addictive properties, rebound anxiety).

Expand full comment
Car Alarm's avatar

Also, I’m fairly certain substance abuse is an important confounding factor when it comes to violence committed by persons with psychosis?

Expand full comment
Emil O. W. Kirkegaard's avatar

It's not a confounding factor if it's part of the same package deal (P factor).

Expand full comment
MSimon's avatar

Addiction is not caused by drugs.

Dr. Lonny Shavelson found that 70% of female heroin addicts were sexually abused in childhood.

Addiction is a symptom of PTSD says Nobel Prize Winner in Medicine Eric Kandel in his book, "The Disordered Mind."

Expand full comment
TGGP's avatar

What's the percentage for male heroin addicts?

Expand full comment
Brad & Butter's avatar

Q: between Clozapine for anti-crime purposes, and its side effects e.g. obesity, could it be viewed as a form of pre-emptive death penalty, or at least a reduced QALY?

Expand full comment
JDaveF's avatar

You make the classic error people with no experience with the severely mentally ill make: you assume any extreme behavior you do not support must be due to "psychosis".

Here is a fact: psychosis is quite rare among mass shooters. No one really knows what sort of problems they have - for one thing, the majority die in their mass shooting episode, either at their own hands, or the hands of the police - but if anything, they likely have a personality disorder, not a psychotic disorder. Or maybe they are just evil - something people today shudder to accuse anyone, even the most heinous murderer of. Mustn't show yourself to be "judgemental" right? That's even worse than being transphobic!

Truly psychotic individuals, even those very paranoid, rarely commit major violent acts, especially carefully planned acts. Most mass killers have made extensive, careful plans, which they have researched over months before they acted. It's hard to plan things out when the voices in your head are screaming at you day and night. However, when under the spell of "command hallucinations" - voices commanding the patient to commit a certain act, psychotic individuals can be extremely dangerous.

Expand full comment
Emil O. W. Kirkegaard's avatar

No such error was made.

Expand full comment
MSimon's avatar

After years of study I am convinced there are very few inherently evil people. There are lots of abused children. Stalin. Hitler. Putin.

Expand full comment