So it looks like Eli Lilly’s new medication for schizophrenia, an injectable form of Zyprexa, will be approved by the U.S. Food and Drug Administration by the end of the year. Why do you need an injectable form of a medication when pills work just as well?
When people don’t want to take their medications.
Furious Seasons has the story, and comes down on the side of admitting that sometimes people do need to be forced into taking their medication:
I’ve recently had to rethink my stance on the use of injectables because of a murder that was committed five blocks from my apartment, allegedly by an ex-convict with a long track record of extreme violence who was blowing off his meds and whom, for some reason, did not get admitted to a psych unit. The short story is that there is a very small portion of people diagnosed with schizophrenia who should be forcibly medicated with injectables. It’s just about the only available option. I say that with much regret. I’ll get into my thoughts on this another day.
It’s not pretty and it goes against every civil libertarian bone in my body, but there are times where we have to look out for both the public good and a person’s own safety. Sometimes, that includes ensuring that people who suffer from schizophrenia take their medications (even when the voices tell them not to). So we agree with Philip.
Is Zyprexa injectable a good treatment for schizophrenia? Time will tell. We hope it is.
(5 votes, average: 5 out of 5)
Loading ...This entry was posted on Thursday, February 7th, 2008 at 4:59 pm and is filed under General, Policy and Advocacy, Disorders, Schizophrenia, Treatment. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
10 Responses to “Forcibly Injecting Medication into People with Schizophrenia” (Pingbacks/trackbacks not shown below)
Jaime at 7:19 am on
February 8th, 2008
I think that Zyprexa, in a form of an injection is a good idea; however, I do not see how one will be able to force someone to take the drug. Most insurance companies will not provide a home health nurse to go in every day to provide the medication. I do not feel that there will be any difference in who takes their medication compared to those who do not.
Sandra Kiume at 4:40 am on
February 10th, 2008
Zyprexa comes as a wafer, too, it would be great if nurses talked the person into calmly putting it in their mouth. However, it’s a feature of the illness in some people that they will not take it, insist they don’t need it, or that it’s poison. Ironically, as a depot injection it can reinforce paranoid thoughts.
A complex matter, in ethical abstract terms, but in RL clinical settings there are a lot of people and not enough resources. Random deaths are the cost of that neglect in a way.
Realistic are complex cases that don’t fit binary answers.
Kent at 3:58 pm on
February 10th, 2008
Despite all the news reports of the dangerous side effects of Zyprexa, including its tendency to cause diabetes, there are still people who insist that the only reason anyone would resist taking it is because “it’s a feature of the illness” that they think it could be dangerous. You could be slowly killing a person by forcing them to take Zyprexa, especially if for anything but a very short time.
If you do this to anyone who has no history of ever having committed a violent crime, for any reason other than to prevent someone who has committed such a crime from being likely to do so again in the future, then you have no business talking about ethics, because you have none.
I for one would not like to be forced to take a drug known to have serious side effects. I’m currently taking a pill that when I take too much of it makes me urinate uncontrollably however I am willing to endure this to reduce the effects of schizophrenia. The symptoms never are gone completely but buried deep enough to maintain somewhat of a normal life. I created a stress level list to help me cope with the anger part of my schizophrenia.
Brenda Ball at 1:28 pm on
February 13th, 2008
I hope that means i can get this med and give it to my boyfriend. He refuses to admit he has this problem, and how to get this person to a Dr in the first place so i can see that he can get this treatment would help. If anyone no’s how that i can please help. Write me so i may be able to get him treatment.
en at 9:49 pm on
February 19th, 2008
I’m all confused..I thought Zyprexa already came as an IM prep! Is this a depot preparation?
As far as the question of giving medications to somebody who does not wish to take them, it is definitely a grey zone. Does a psychotic patient have the capacity to make that decision? Even if they don’t, how do we know what they would have wanted had they had the capacity?
As far as the law goes, I do believe you can get a court order to give a patient injectable medications if they are a risk to themselves or others. The population depot preparation work best in is the patient who wants to take meds when stable but refuses to take them when psychotic. By giving them depot preparation when they are stable, we can prevent the risk of relapse when they go home. And there are no ethical grey areas.
Nancy at 10:02 am on
March 8th, 2008
Forcing an IM on someone is not pleaasant, the patient is out of control and it takes several people to hold them down to give the injection. Do I believe in forcing a medication by injection? You bet I do. The patient needs to be a danger to themselves and others to do this and they are. They are very sick. Its similiar to being in severe pain without any relief. Once the medication starts to work and the patient is not so psychotic they will start taking it on their own. Often not even remembering having the medication forced on them because they were so out of control. They are now on the road to stabilization, they just need a jump start to get the car started to get on that road.
Below, a courageous long-time mental health worker sounds the alarm
about the long-term use of neuroleptic psychiatric drugs which are
also known as “antipsychotics.”
The daily newspaper for Eugene, Oregon, USA published Chuck Areford’s
guest column which you can read BELOW. Please forward his emergency
warning about deaths and brain damage related to neuroleptics to all
appropriate places on and off Internet. Chuck is on the Advisory
Committee for MindFreedom Lane County. Opposition is expected. At
BOTTOM is how you can write a letter to editor and take other action.
~~~~~~~~~~~~
_The Register-Guard_, Eugene, Oregon, USA
16 March 2008 - Commentary - Guest Viewpoint
http://www.mindfreedom.org/kb/psychiatric-drugs/antipsychotics/
areford-neuroelptics
Antipsychotic drugs are doing harm
By Chuck Areford
[It is essential to note at the outset that suddenly stopping or
reducing psychiatric medications can be hazardous. Adjustments in
medication are best done under the supervision of a medical
professional.]
In the early 1990s, a new class of drugs promised to revolutionize
the treatment of schizophrenia and other mental disorders. Known as
atypical antipsychotics, drugs such as Clozaril, Zyprexa and
Risperdal largely replaced older medications such as Thorazine,
Haldol and Prolixin. Research and advertising sponsored by the
pharmaceutical industry led to the widespread belief that the newer
medications were indisputably safer, more effective and well worth
additional billions of dollars in taxpayer money. Pharmaceutical
profits soared.
Since then, the life expectancy of those treated in community mental
health centers has plunged to an appalling 25 years less than
average. Life expectancy may have fallen by as much as 15 years since
1986. Indications are that the death rate continues to accelerate in
what must be ranked as one of the worst public health disasters in
U.S. history.
The toxicity of antipsychotic medications, also known as
neuroleptics, is thoroughly documented. Atypical antipsychotics
initially seemed less hazardous because they produce fewer movement
disorders. We now know that the newer drugs lead to more
cardiovascular disease, which is by far the leading killer of those
in the public mental health system.
People who need mental health services already suffer from high rates
of cigarette smoking, lack of exercise, substance abuse, poor
nutrition, homelessness and poor access to health care. Adding
medications pours gasoline on a fire. This lethal combination is
almost certainly driving the spiraling death rate.
Advances in brain imaging techniques show that antipsychotic
medications cause brain damage. Animal and human studies link the
drugs to shrinkage of the cerebral cortex, home to the higher
functions. One study of monkeys given either older or newer
neuroleptic medication in doses equivalent to those given humans
showed an 11 percent to 15 percent shrinkage of the left parietal
lobe. Drugs that cause brain damage almost invariably reduce life
expectancy.
Marketing campaigns for atypical antipsychotic drugs target new
groups of patients, including the elderly and children. Public
television recently reported that as many as 1 million children have
been newly diagnosed with bipolar disorder, and thus may receive
neuroleptic medication. This does not include children treated with
antipsychotics for other disorders.
The damage to developing brains cannot be overemphasized. Years ago,
the Soviet Union was condemned for giving neuroleptic medication to
political dissidents. We now are giving a more lethal form of this
medication to our children. Where is the outcry?
Recent studies published in the New England Journal of Medicine and
elsewhere demonstrate that the newer drugs are no more effective than
the older ones in reducing psychotic symptoms. Patients stop taking
the new drugs at the same high rate as the old ones because they do
not like the way the drugs affect their lives.
While medications are effective in relieving symptoms in the short
run, research indicates that people suffering from psychosis recover
more quickly and completely without medication. Incredibly, one study
showed that those not taking medications had eight times the recovery
rate of those who remained medicated. Research in Finland shows that
immediate psychosocial interventions achieve far better results than
those in this country. It simply makes sense that people recover
better when not treated with medication that causes brain damage and
shortens their lives.
Yet professionals and the public widely believe that it is unethical
to treat serious mental disorders without antipsychotic medication.
The reasons for this are complex, but foremost is the enormous
profitability of the pharmaceutical industry. In the early 1990s, the
top 10 drug companies earned more profit than all the other Fortune
500 companies combined. The sheer volume of money corrupts medical
research, and misinformation is fed to professionals, clients and the
public.
The deplorable conditions at the Oregon State Hospital are,
unfortunately, just one more indication of the failure of psychiatry
as a whole. I know many of the psychiatric professionals in Lane
County, and they are intelligent and compassionate people who want
the best for their clients. There will always be a place for
medication in the treatment of emotional disorders, yet there must be
public acknowledgement that the long-term use of antipsychotic
medication, particularly the atypicals, is a costly mistake. Silence
truly equals death.
The Oregon Department of Addictions and Mental Health has the
responsibility to confront the terrible inadequacies of the current
system and to fund the development of alternatives. We owe this to
the taxpayers, to society and especially to those who suffer from
mental illness.
Chuck Areford of Eugene has worked in the public mental health system
for the past 25 years.
http://www.overweightchild.org at 1:53 am on
April 1st, 2008
“ On your terms” means customizing the available materials CPod has to offer to my needs, my attension span, my life style. You are absolutely right that this“ learner- centric” model is increasing in other industries. I have commented before regarding this issue, but as a practicing physician, I must continuously keep my medical knowledge up- to- date; it’ s a challenge to fit that knowledge acquisition into my hectic life. Services such as www. cmedownload. com was created with flexibility in mind (it’ s…
tpsychnurse at 11:58 am on
May 10th, 2008
Have to disagree w/Chuck from Oregon re:meds causing brain damage. Research has shown that each psychotic episode that goes untreated is neurotoxic. Resistance to taking meds is more likely the cause of damage. I do agree w/Chuck re:the metabolic consequences of treatment w/the atypical antipsychotics. The depot meds are certainly helpful for those who can’t remember or for those who suffer from impaired insight into the need for treatment secondary to the illness itself. Ideally, someone who has been stabilized can make an informed decision re: the long acting med and be able to balance risk and benefits..
Be a Part of the Conversation! Comment on this Entry Now:
I think that Zyprexa, in a form of an injection is a good idea; however, I do not see how one will be able to force someone to take the drug. Most insurance companies will not provide a home health nurse to go in every day to provide the medication. I do not feel that there will be any difference in who takes their medication compared to those who do not.
Zyprexa comes as a wafer, too, it would be great if nurses talked the person into calmly putting it in their mouth. However, it’s a feature of the illness in some people that they will not take it, insist they don’t need it, or that it’s poison. Ironically, as a depot injection it can reinforce paranoid thoughts.
A complex matter, in ethical abstract terms, but in RL clinical settings there are a lot of people and not enough resources. Random deaths are the cost of that neglect in a way.
Realistic are complex cases that don’t fit binary answers.
Despite all the news reports of the dangerous side effects of Zyprexa, including its tendency to cause diabetes, there are still people who insist that the only reason anyone would resist taking it is because “it’s a feature of the illness” that they think it could be dangerous. You could be slowly killing a person by forcing them to take Zyprexa, especially if for anything but a very short time.
If you do this to anyone who has no history of ever having committed a violent crime, for any reason other than to prevent someone who has committed such a crime from being likely to do so again in the future, then you have no business talking about ethics, because you have none.
I for one would not like to be forced to take a drug known to have serious side effects. I’m currently taking a pill that when I take too much of it makes me urinate uncontrollably however I am willing to endure this to reduce the effects of schizophrenia. The symptoms never are gone completely but buried deep enough to maintain somewhat of a normal life. I created a stress level list to help me cope with the anger part of my schizophrenia.
I hope that means i can get this med and give it to my boyfriend. He refuses to admit he has this problem, and how to get this person to a Dr in the first place so i can see that he can get this treatment would help. If anyone no’s how that i can please help. Write me so i may be able to get him treatment.
I’m all confused..I thought Zyprexa already came as an IM prep! Is this a depot preparation?
As far as the question of giving medications to somebody who does not wish to take them, it is definitely a grey zone. Does a psychotic patient have the capacity to make that decision? Even if they don’t, how do we know what they would have wanted had they had the capacity?
As far as the law goes, I do believe you can get a court order to give a patient injectable medications if they are a risk to themselves or others. The population depot preparation work best in is the patient who wants to take meds when stable but refuses to take them when psychotic. By giving them depot preparation when they are stable, we can prevent the risk of relapse when they go home. And there are no ethical grey areas.
Forcing an IM on someone is not pleaasant, the patient is out of control and it takes several people to hold them down to give the injection. Do I believe in forcing a medication by injection? You bet I do. The patient needs to be a danger to themselves and others to do this and they are. They are very sick. Its similiar to being in severe pain without any relief. Once the medication starts to work and the patient is not so psychotic they will start taking it on their own. Often not even remembering having the medication forced on them because they were so out of control. They are now on the road to stabilization, they just need a jump start to get the car started to get on that road.
Below, a courageous long-time mental health worker sounds the alarm
about the long-term use of neuroleptic psychiatric drugs which are
also known as “antipsychotics.”
The daily newspaper for Eugene, Oregon, USA published Chuck Areford’s
guest column which you can read BELOW. Please forward his emergency
warning about deaths and brain damage related to neuroleptics to all
appropriate places on and off Internet. Chuck is on the Advisory
Committee for MindFreedom Lane County. Opposition is expected. At
BOTTOM is how you can write a letter to editor and take other action.
~~~~~~~~~~~~
_The Register-Guard_, Eugene, Oregon, USA
16 March 2008 - Commentary - Guest Viewpoint
http://www.mindfreedom.org/kb/psychiatric-drugs/antipsychotics/
areford-neuroelptics
Antipsychotic drugs are doing harm
By Chuck Areford
[It is essential to note at the outset that suddenly stopping or
reducing psychiatric medications can be hazardous. Adjustments in
medication are best done under the supervision of a medical
professional.]
In the early 1990s, a new class of drugs promised to revolutionize
the treatment of schizophrenia and other mental disorders. Known as
atypical antipsychotics, drugs such as Clozaril, Zyprexa and
Risperdal largely replaced older medications such as Thorazine,
Haldol and Prolixin. Research and advertising sponsored by the
pharmaceutical industry led to the widespread belief that the newer
medications were indisputably safer, more effective and well worth
additional billions of dollars in taxpayer money. Pharmaceutical
profits soared.
Since then, the life expectancy of those treated in community mental
health centers has plunged to an appalling 25 years less than
average. Life expectancy may have fallen by as much as 15 years since
1986. Indications are that the death rate continues to accelerate in
what must be ranked as one of the worst public health disasters in
U.S. history.
The toxicity of antipsychotic medications, also known as
neuroleptics, is thoroughly documented. Atypical antipsychotics
initially seemed less hazardous because they produce fewer movement
disorders. We now know that the newer drugs lead to more
cardiovascular disease, which is by far the leading killer of those
in the public mental health system.
People who need mental health services already suffer from high rates
of cigarette smoking, lack of exercise, substance abuse, poor
nutrition, homelessness and poor access to health care. Adding
medications pours gasoline on a fire. This lethal combination is
almost certainly driving the spiraling death rate.
Advances in brain imaging techniques show that antipsychotic
medications cause brain damage. Animal and human studies link the
drugs to shrinkage of the cerebral cortex, home to the higher
functions. One study of monkeys given either older or newer
neuroleptic medication in doses equivalent to those given humans
showed an 11 percent to 15 percent shrinkage of the left parietal
lobe. Drugs that cause brain damage almost invariably reduce life
expectancy.
Marketing campaigns for atypical antipsychotic drugs target new
groups of patients, including the elderly and children. Public
television recently reported that as many as 1 million children have
been newly diagnosed with bipolar disorder, and thus may receive
neuroleptic medication. This does not include children treated with
antipsychotics for other disorders.
The damage to developing brains cannot be overemphasized. Years ago,
the Soviet Union was condemned for giving neuroleptic medication to
political dissidents. We now are giving a more lethal form of this
medication to our children. Where is the outcry?
Recent studies published in the New England Journal of Medicine and
elsewhere demonstrate that the newer drugs are no more effective than
the older ones in reducing psychotic symptoms. Patients stop taking
the new drugs at the same high rate as the old ones because they do
not like the way the drugs affect their lives.
While medications are effective in relieving symptoms in the short
run, research indicates that people suffering from psychosis recover
more quickly and completely without medication. Incredibly, one study
showed that those not taking medications had eight times the recovery
rate of those who remained medicated. Research in Finland shows that
immediate psychosocial interventions achieve far better results than
those in this country. It simply makes sense that people recover
better when not treated with medication that causes brain damage and
shortens their lives.
Yet professionals and the public widely believe that it is unethical
to treat serious mental disorders without antipsychotic medication.
The reasons for this are complex, but foremost is the enormous
profitability of the pharmaceutical industry. In the early 1990s, the
top 10 drug companies earned more profit than all the other Fortune
500 companies combined. The sheer volume of money corrupts medical
research, and misinformation is fed to professionals, clients and the
public.
The deplorable conditions at the Oregon State Hospital are,
unfortunately, just one more indication of the failure of psychiatry
as a whole. I know many of the psychiatric professionals in Lane
County, and they are intelligent and compassionate people who want
the best for their clients. There will always be a place for
medication in the treatment of emotional disorders, yet there must be
public acknowledgement that the long-term use of antipsychotic
medication, particularly the atypicals, is a costly mistake. Silence
truly equals death.
The Oregon Department of Addictions and Mental Health has the
responsibility to confront the terrible inadequacies of the current
system and to fund the development of alternatives. We owe this to
the taxpayers, to society and especially to those who suffer from
mental illness.
Chuck Areford of Eugene has worked in the public mental health system
for the past 25 years.
“ On your terms” means customizing the available materials CPod has to offer to my needs, my attension span, my life style. You are absolutely right that this“ learner- centric” model is increasing in other industries. I have commented before regarding this issue, but as a practicing physician, I must continuously keep my medical knowledge up- to- date; it’ s a challenge to fit that knowledge acquisition into my hectic life. Services such as www. cmedownload. com was created with flexibility in mind (it’ s…
Have to disagree w/Chuck from Oregon re:meds causing brain damage. Research has shown that each psychotic episode that goes untreated is neurotoxic. Resistance to taking meds is more likely the cause of damage. I do agree w/Chuck re:the metabolic consequences of treatment w/the atypical antipsychotics. The depot meds are certainly helpful for those who can’t remember or for those who suffer from impaired insight into the need for treatment secondary to the illness itself. Ideally, someone who has been stabilized can make an informed decision re: the long acting med and be able to balance risk and benefits..
