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About this book

Over 60 million psychiatric drugs are prescribed in England every year. This lively and provocative overview provides the most complete examination to date of the lived experience of taking psychiatric drugs. The book examines the consequences of long-term psychiatric drug use from the perspectives of people who have taken them and tried coming off them. It draws out the tensions between patients and professionals about medication and offers examples of how to resolve these constructively.

Based on extensive UK research, this book includes exploration of:

? current practice in the use of psychiatric drugs
? the varied experiences of people who take them
? the debate over effectiveness
? what service users perceive as both good and bad practice by health professionals
? the different experiences of people from black and minority ethnic
communities.

Timely and topical as well as clear and accessible, this book is essential reading for students, educators, practitioners and service users in the fields of psychiatry, mental health, social work and counselling.

Table of Contents

Introduction

Abstract
This is a book about psychiatric drugs written from a fresh perspective; that of people who have taken them. My interest in the subject stems from my own experience of being on psychiatric drugs and many years of discussing them with friends and colleagues in the mental health system survivor or service users’ movement. Much of the content of this book relies on people’s willingness to talk openly about their experiences, and in my working life as a trainer, writer, researcher and consultant on issues of concern to service users, I developed the principle of not asking people to share information I wasn’t prepared to share myself, so I will begin this introduction with a brief account of my own psychiatric drugs story.
Jim Read

1. Overview and Key Issues

Abstract
Drugs are the predominant form of treatment in mental health in the UK and other Western industrialised countries. It is unusual for somebody to be diagnosed as mentally ill and not be prescribed psychiatric drugs. A survey by the Healthcare Commission (2008a, tables section C) found that 93 per cent of people in England using community mental health services had been on medication in the previous 12 months.
Jim Read

2. What People Taking Psychiatric Drugs Have to Say about Them

Abstract
These two quotations, taken from a survey by the Scottish Association for Mental Health (SAMH 2004, pp. 47–8), immediately demonstrate the contribution that service users can make to our understanding of psychiatric drugs. Both people were talking about the same drug, the antidepressant venlafaxine (Efexor). The literature about psychiatric drugs tends to focus on their global effects — whether overall a drug is better than a placebo, better than another drug, and so on — whereas surveys of service users’ experiences and views remind us of the wide variation in people’s individual responses to psychiatric drugs.
Jim Read

3. What is Known about Coming off Psychiatric Drugs

Abstract
We have already seen how staying on or coming off psychiatric drugs can become a battleground between doctors and patients. At their most extreme, disputes are resolved by the law. Medical staff are empowered to literally force medication on their patients. Even when this power is not used, knowledge of it lurks in the background as a threat hanging over the reluctant recipient, turning negotiation into an uneven contest.
Jim Read

4. Coping with Coming Off: Making the Decision

Abstract
The mental health charity, Mind, has taken an interest in people’s experiences of trying to come off psychiatric drugs since its involvement in the That’s Life! Survey on tranquillisers (Lacey & Woodward 1985). This survey exposed how commonly people had great difficulty in stopping taking tranquillisers. A report published in 2001, Mind’s Yellow Card for Reporting Drug Side Effects (Cobb, Darton & Juttla 2001), included a section which highlighted the range of experiences associated with withdrawal from all psychiatric drugs (p. 23): ‘Outcomes varied enormously from emphatically good outcomes — ‘back in the real world, not a zombie’ — to getting ill again or ‘back to square one’.
Jim Read

5. Coping with Coming Off: The Consequences

Abstract
We had asked people about their experience of psychiatric drugs and attitudes towards them, why they decided to try to come off them, and how they did or didn’t involve their doctors in their decisions. Our next questions were about what happened when they tried to come off. We started by asking how long they took, and the results are shown in Table 5.1.
Jim Read

6. Coping with Coming Off: Three Stories

Abstract
One theme that emerges from the CWCO research concerns people on neuroleptics and, to a lesser extent, antimanics, and the basis on which they make decisions to come off their drugs. In particular, how do they relate to doctors and other mental health workers about their decision making, and why?
Jim Read

7. Key Issues, Suggestions and Conclusion

Abstract
In this final chapter we revisit the five key issues for the third time, briefly summarising material from Chapters 1 and 2, and adding new thoughts arising from subsequent chapters. Five proposals are made for improving the use of psychiatric drugs and the main messages from this book are brought together in the conclusion.
Jim Read
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