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17 deaths reported after schizophrenia drug injections

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The Japanese unit of major drugmaker Janssen Pharmaceuticals says 17 people have died after being injected with its drug to treat schizophrenia since it was launched in Japan last November.

The company, an affiliate of U.S.-based healthcare giant Johnson and Johnson, advised medical workers in Japan to use the Paliperidone Palmitate medication with great care even though it was not know whether it had caused the deaths.

The drug, brand-named Xeplion, is estimated to have been used by 10,700 people since it was released in Japan on Nov 19, according to a notice posted on the Japanese unit's website and seen Wednesday.

The causes of the 17 deaths included cardiac infarction, pulmonary embolism and suffocation due to inhalation of vomit.

In many cases the deaths occurred about 40 days after injections of the drug.

The notice advised doctors to "fully understand that the substance remains in the body for at least four months after being injected" and to stay alert for any side-effects.

It also asked them to refrain from using the medicine with other anti-psychotic drugs because the "effectiveness and safety" of such a combined application had not been established.

The use of Xeplion has been approved in 78 countries and areas of the world as of June 2013, the company has said.

© (c) 2014 AFP

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Jim PoushinskyApr. 12, 2014 - 10:52PM JST Yes Frungy, I've just celebrated my 68th birthday.

Congratulations!

And no, what I am talking about was not "accepted wisdom" in my day. I got my B.A. in Experimental Psychology in the early 1970s, followed by a post graduate certificate in Child Care, and then a Master's in Social Work. I began working as an orderly in mental hospitals with adults where drugs and electric shock were the only "treatment". Psychiatrists only saw patients for 5 minutes every second week to adjust medication levels. I was responsible for the welfare of these mental patients in their day to day lives 24-7, and heard their stories first hand as I helped them cope with their problems. Those problems were often made worse by the electric shock and drug therapies, which were little more than negative conditioning used to torture people into going back to being who their boss or social circle or society wanted them to be.

The dark ages of psychology.

Seems the only thing that has changed today is some new drugs have been introduced and more emphasis on behaviour modification.

I can assure you that, at least where I come from, a great deal has changed for the better. And don't be so dismissive of behaviour modification, while I agree that it is only part of the picture we really can't know what's going on inside another person's mind, however if I can stop someone from committing suicide or killing someone else then that's something I can get behind. There's nothing wrong with aiming for concrete results, there is something wrong if that's all you're aiming for and you stop there and don't consider if the person is any happier or if they're just "keeping a lid on it", because that only works for so long.

As for suicidal behaviour, seeing a "professional" is no guarantee that won't happen.

There are no guarantees anywhere else in life (even those ones you but on products in the store and then find out that there's a list of exceptions as long as your arm), so looking for a guarantee is a bit unreasonable.

Psychiatrists have one of the highest suicide rates of any profession!

And social workers aren't far behind them. Once you've seen two manic-depressives and a schizophrenic before lunch, then three depressives and a child abuse victim after lunch you'd have to be an uncaring robot not to affected, and even with regular therapy sessions and the best tools the burnout rate and suicide rate in the profession is high... but that's only to be expected. Still, when it takes nearly 8 years to qualify a psychiatrist and they burn out in, on average, 10 years it does create problems.

Yes, a compassionate society cares about the lives of its citizens. But ultimately each of us is free to decide to exit this life or not, for our own reasons. This is the issue that needs to be faced regarding so called compassionate assisted suicides for people with fatal debilitating disease, or for people being kept alive by machines.

Hey, I'm with you here. I'm in favor of people being given as much choice in their lives as possible, provided it doesn't limit or interfere with the choices of others. If someone is already going to die then I'm 100% behind the idea of them choosing when and how they die.

What makes us want to stay here are the people who love us and who we love unconditionally. Drugs and behaviour modification and "experts" charging money to tell us they know best, are no substitute for genuine human compassion and assistance. As John Lennon said "Love is all you need".

And with respect, I disagree. Sometimes people need professional help, like schizophrenics. No amount of love or compassion will make it possible for a schizophrenic to resume a normal life. I am 95% certain that any schizophrenic patient entrusted to my care will be stable in under 3 years, will be able to take a part-time job in 5 years, and will be able to pursue a career in a low-stress profession in about 10 years, and will be happier, feel more fulfilled and in control of their life, and will be able to pursue their hopes and dreams like any other person. That result relies heavily on pharmaceuticals and behaviour modification, but I feel no qualms about it because it means that at the end of the day that person is happier and living a more fulfilling life. That sure beats the pants off the old approach, which was to lock schizophrenics away for the rest of their lives. And it sure beats the pants off the approach you initially suggested, looking for childhood trauma that won't do a thing to help these people get their lives back on track. And that's what this discussion was about, whether the treatment method you advocated would actually do any good for these people. It won't and there's a ton of research to prove it.

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Yes Frungy, I've just celebrated my 68th birthday. And no, what I am talking about was not "accepted wisdom" in my day. I got my B.A. in Experimental Psychology in the early 1970s, followed by a post graduate certificate in Child Care, and then a Master's in Social Work. I began working as an orderly in mental hospitals with adults where drugs and electric shock were the only "treatment". Psychiatrists only saw patients for 5 minutes every second week to adjust medication levels. I was responsible for the welfare of these mental patients in their day to day lives 24-7, and heard their stories first hand as I helped them cope with their problems. Those problems were often made worse by the electric shock and drug therapies, which were little more than negative conditioning used to torture people into going back to being who their boss or social circle or society wanted them to be.

Seems the only thing that has changed today is some new drugs have been introduced and more emphasis on behaviour modification. As for suicidal behaviour, seeing a "professional" is no guarantee that won't happen. Psychiatrists have one of the highest suicide rates of any profession! Yes, a compassionate society cares about the lives of its citizens. But ultimately each of us is free to decide to exit this life or not, for our own reasons. This is the issue that needs to be faced regarding so called compassionate assisted suicides for people with fatal debilitating disease, or for people being kept alive by machines. What makes us want to stay here are the people who love us and who we love unconditionally. Drugs and behaviour modification and "experts" charging money to tell us they know best, are no substitute for genuine human compassion and assistance. As John Lennon said "Love is all you need".

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Jim PoushinskyApr. 11, 2014 - 10:24PM JST Good to see my comment sparked such lively debate! Just a few thoughts after reading these posts. I'm a retired mental health social worker, though I continue to do volunteer work in this field.

I'm guessing that "retired" means that you're in your 60's or older? In which case I apologise. When you were studying the theories you describe were the accepted wisdom. However that was back in the dark ages of psychology where it was more guesswork than science. With the rise of evidence-based treatment we've been collecting a lot more data on what works and what doesn't, and as a result have been able to discard theories that simply don't produce results or don't match the data.

Just show you care by listening to them and encouraging and supporting them to be safe and to work on healing themselves. Expressing unconditional love and compassion for those going through difficult times is fundamental to helping others and to living a good life.

Yes, no, maybe. I sat and looked at your comment for a long time. I can see that you're well-intentioned and trying to help, however what you're describing can also be incredibly dangerous since you've omitted the critical caveat, "and make sure that if you feel someone is a danger to themselves or others that they see a professional as soon as possible". In a recent case I dealt with the person had strong support from their social circle, and used to phone their friends at all hours and they'd talk the person down from suicide. This didn't happen once, it happened several times, so the friends were aware that the person was suicidal. But nobody made a move to contact a professional, they thought that their good wishes and support were enough... right up until the person couldn't contact someone at 3am in the morning and they made a suicide attempt. Fortunately it wasn't successful, but it easily might have been.

This person should have been referred to a qualified and certified professional age ago, but because of the type of thinking that you're describing they didn't. It is incredibly common, amazingly generous and deeply, deeply dangerous.

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Good to see my comment sparked such lively debate! Just a few thoughts after reading these posts. I'm a retired mental health social worker, though I continue to do volunteer work in this field.

First off, the only dividing line between those considered mentally ill and everyone else is whether or not you can cope with your problems. This line becomes blurred when you disagree with the people around you, and they decide you are mentally ill. It is also blurred when the people around you are violent and hurting you or others physically, emotionally, or sexually. Your only way of surviving this may be to develop what are regarded by people outside of your negative social environment as symptoms of mental illness.

Regarding the origins of such illness in overwhelming childhood trauma that results in sub-clinical PTSD of which later mental illnesses are symptoms, I have only helped children and adults whose condition was considered hopeless after years of "treatment" by the Establishment medical system. Not all had trauma from early childhood. In some cases the trauma was from birth, or happened in the womb, or in a past life, or some combination of all the above. It doesn't matter what my beliefs are, it is what makes sense to the person seeking to heal him or her self that counts. As long as they feel better and are able to cope with their life, that is success for them and for me. You don't have to be an "expert" to help someone with mental and emotional problems. Just show you care by listening to them and encouraging and supporting them to be safe and to work on healing themselves. Expressing unconditional love and compassion for those going through difficult times is fundamental to helping others and to living a good life.

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However I'm quite happy to spare a few moments to educate those who are so clearly desperately in need of instruction.

It must be so hard to come here day after day and deal with people you seem to believe are beneath your superior knowledge in everything...

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yoheikunApr. 11, 2014 - 12:54PM JST Frungy, since you express yourself to be such a knowledgable authority on the subject, I hope you are based in Japan, giving clients the proper treatment they deserve, and making a difference instead of spending your time online with this stranger arguing over what mental health approach is best or what is mistaken, etc.

Actually I teach Japanese medical students, which I think is the most efficient use of my time. However I'm quite happy to spare a few moments to educate those who are so clearly desperately in need of instruction.

That's what I would do if I were a mental health practitioner, but thankfully I'm not, and I work to improve Japan in other ways in my profession. Best of luck to you in yours.

And the best of luck to you too.

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You don't like the term 統合失調症 ?

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Frungy, since you express yourself to be such a knowledgable authority on the subject, I hope you are based in Japan, giving clients the proper treatment they deserve, and making a difference instead of spending your time online with this stranger arguing over what mental health approach is best or what is mistaken, etc. That's what I would do if I were a mental health practitioner, but thankfully I'm not, and I work to improve Japan in other ways in my profession. Best of luck to you in yours.

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Really enjoying the exchange between youheikun and grungy.

"with individuals who can be very challenging to deal with during the few years of the condition"

But, what did you mean by "few years"?

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What would the mortality rate be of an equal number of afflicted people who did not get the injections?

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yoheikunApr. 11, 2014 - 02:28AM JST Frungy-- your point is well noted but you're pointing out a central divide between clinical psychology and psychiatric medicine, and your judgment and condemnation or bias against psychotherapy is obvious.

You are mistaken. I am all in favour of psychotherapy, provided that the CORRECT psychotherapy is used. Did you miss the part where I recommended CBT, problem-solving therapy and family therapy? What I am against is the strong bias in Japan towards using psychoanalysis for every problem, even when it is completely and utterly inappropriate. It would be like using antibiotics for every disease, regardless of whether it was appropriate or not. It is bad clinical practice and it is bad for patients. That you see good clinical practice as bias just supports my earlier conclusion that you have no idea about the field.

I have no interest in arguing with you about who is right, as it really doesn't matter.

Good, because there's no argument here. I'm right, you're mistaken. The end.

Medication is a good thing and there are some amazing and very useful treatments, especially for schizophrenia and other conditions, and in conjunction with real and meaningful, empowering counseling. What is most unfortunate is that so many doctors worldwide dismiss talking and counseling altogether, as you have so swiftly and critically dismissed it in your comments about even the mere suggestion of such an approach.

You clearly didn't read my post, because otherwise you would have noticed that I suggested CBT, family therapy and problem-solving therapy in combination with medication. Obviously you belong to the camp that believes that psychotherapy begins and ends with psychoanalysis. Again, some of us have learnt a thing or two in the last 60 years. Newer psychotherapies like CBT are producing very good results for some conditions. Evidence-based practice shows that psychoanalysis is useful for some conditions, but it is NOT the only psychotheraputic approach. Unfortunately it seems to be the only psychotheraputic approach being used in Japan.

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Frungy-- your point is well noted but you're pointing out a central divide between clinical psychology and psychiatric medicine, and your judgment and condemnation or bias against psychotherapy is obvious. I have no interest in arguing with you about who is right, as it really doesn't matter. And I agree with you that the state of mental health care in Japan is abominable to some extent, but at least there is insurance to pay for treatment to some degree and at least there is improvement. On the other hand there is a shocking lack of therapy and counseling in Japan that really WOULD make a difference, whether or not experimental psychology or pharmaeceutical corporations or the medical establishment believe that psychotherapy matters. And I would argue that because the state of mental health care is so shoddy in Japan to begin with, it has been proven that there are plenty of misdiagnoses here as well, including for "schizophrenia," which, by the way, is a word that is just as problematic as its Japanese variants. Medication is a good thing and there are some amazing and very useful treatments, especially for schizophrenia and other conditions, and in conjunction with real and meaningful, empowering counseling. What is most unfortunate is that so many doctors worldwide dismiss talking and counseling altogether, as you have so swiftly and critically dismissed it in your comments about even the mere suggestion of such an approach.

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So around 99.8% of people survived - that is very high. However, wonder about the other symptoms other than death.

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yoheikunApr. 10, 2014 - 11:34PM JST Frungy, you're misreading me.

I really don't think that I am.

I am saying that the previous poster is talking in more existential terms. And while saying all mental illnesses come from PTSD, which is not true, of course, in terms of schizophrenia, yes, significant trauma can trigger schizophrenia.

Existentialism is fine if you're talking about debating whether you're a butterfly dreaming about being a man or a man dreaming about having a beer, but when it comes to a serious illness like schizophrenia then I find that sort of debate quite unhelpful.

And while significant trauma can be associated with the psychotic break from reality there are an equal number of cases where there is no trauma and the psychotic break happens regardless. Poushinsky suggestion that all schizophrenia is a result of early childhood trauma is frankly ridiculous, and there is no evidence to support this position. It is also worth noting that when it comes to the treatment of schizophrenia the psychoanalytic model is a dismal failure, offering a success rate only marginally higher than the natural rate of remission (which is very, very, very low).

I don't mind touching upon the approaches of RD Laing (The Divided Self, etc.) with a barge pole because I am not a psychiatrist nor must one be one to qualify to comment on schizophrenia on Japan Today, wouldn't you agree?

Except that you wrote: "intersubjective transpersonal model of psychiatry". I was pointing out that these are NOT models in psychiatry, but are rather models in psychology, specifically psychoanalytic psychology, and have been proven to be inapplicable to the condition of schizophrenia.

I have known plenty of schizophrenic people and I think it is sad that they get medicated like crazy here in Japan with very few ever having a chance to explore other ways of navigating their illness and feeling a sense of control in their lives.

I'd agree here. I'd much rather see a more Western model where depot doses are used to stabilise patients within a week or two, and then patients could be treated on an outpatient basis, allowing them to gradually assume more control over their lives as they felt able.

It sounds like you are coming at this from a strictly medical/psychiatric model and not one of psychoanalysis, especially not a more intersubjective approach as put forth by Atwood and Stolorow. And intersubjective in this sense very much is about helping the client to map their world without judgment by the analyst--it is about the individual, not the individual and society as you claim, but then I suppose you aren't interested in or aware of that material?

You are, once again, incorrect. I am, in fact, familiar with Atwood, Stolorow and Donna's model, and it is very much about the individual in society, as opposed to treating the individual as an isolated entity. Early Freudian psychodynamic models focused on the individual, and largely ignored the effects of society beyond immediate family. Atwood and Stolorow's model can be seen as a reaction to that isolationist view of the individual within the larger movement towards social psychology. It is not about analyst judgement, but rather is primarily about the individual's context.

Though dated and problematic to some extent, "fragmentation" was indeed the term used by psychologist RD Laing on relation to schizophrenia--not multiple personality disorder/DID.

Yes, back in the 1960's when the condition was very poorly understood and electro-shock therapy was still being used for everything from anorexia to tourettes. Some of us have moved on from there rather than wallowing in the mistakes of the past. Perhaps you'd care to join us?

This has been a common psychoanalytical approach that sees schizophrenia not only as a possible chemical imbalance but also as a condition in which, usually due to overwhelming childhood trauma, the subject is unable to master consistent and cohesive integrity of the self---not fragmentation into different selves or personas, as you seem to misconstrue from my comment above and repaint as the Hollywood "split personality" trope. Then again, "fragmentation" is a misleading term. That's why the official term for schizophrenia in Japanese was relatively recently changed from 精神分裂病 (seishin bunretsu-sho) to 統合失調症 (togoshicchosho) in Japanese, which literally means a deficiency in integrity of the whole personality. But many clinical psychologists like would still work with the schizophrenic client in terms of assisting him or her to negotiate and restore a consistent sense of self, a central narrative to pull the pieces together to make sense out of whatever traumas they may have experienced. Unfortunately there are few counselors who work under this paradigm in Japan, so all most patients get is drugs and few tools to help themselves.

... and again, the psychoanalytic approach, regardless of which particular branch you're using, simply doesn't work for schizophrenia. Evidence-based practice (an approach that psychoanalysts are still in denial about because it tends to show that their approach is not the universal cure that they think it to be) shows that the best approach for schizophrenic patients is a combination of drug therapy (focused on rapid stabilisation and depot doses as schizophrenic patients tend to go off their meds as soon as symptoms are reduced), combined with CBT (cognitive behavioural therapy), problem-solving therapy, and family therapy (to help the family cope with and provide support with individuals who can be very challenging to deal with during the few years of the condition).

Psychoanalytic models have proven to be utterly useless for the treatment of schizophrenia. I am not misreading you here. I am just pointing out that you're insisting on applying a model that has been proven to be utterly ineffective. If a doctor prescribed medication that was known to be ineffective it would be unethical medical practice. The same thinking applies to psychologists, but psychoanalyists are in deep denial that their precious theory can't cure everything. Ironic, isn't it? Oh, and the relabelling of the term in Japan just goes to show how far behind the times psychology in Japan really is. They're just coming around to exploring avenues that were debunked in Western psychology 50 years ago. The state of psychology in Japan is utterly abominable.

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Frungy, you're misreading me. I am saying that the previous poster is talking in more existential terms. And while saying all mental illnesses come from PTSD, which is not true, of course, in terms of schizophrenia, yes, significant trauma can trigger schizophrenia. I don't mind touching upon the approaches of RD Laing (The Divided Self, etc.) with a barge pole because I am not a psychiatrist nor must one be one to qualify to comment on schizophrenia on Japan Today, wouldn't you agree? I have known plenty of schizophrenic people and I think it is sad that they get medicated like crazy here in Japan with very few ever having a chance to explore other ways of navigating their illness and feeling a sense of control in their lives. It sounds like you are coming at this from a strictly medical/psychiatric model and not one of psychoanalysis, especially not a more intersubjective approach as put forth by Atwood and Stolorow. And intersubjective in this sense very much is about helping the client to map their world without judgment by the analyst--it is about the individual, not the individual and society as you claim, but then I suppose you aren't interested in or aware of that material?Though dated and problematic to some extent, "fragmentation" was indeed the term used by psychologist RD Laing on relation to schizophrenia--not multiple personality disorder/DID. This has been a common psychoanalytical approach that sees schizophrenia not only as a possible chemical imbalance but also as a condition in which, usually due to overwhelming childhood trauma, the subject is unable to master consistent and cohesive integrity of the self---not fragmentation into different selves or personas, as you seem to misconstrue from my comment above and repaint as the Hollywood "split personality" trope. Then again, "fragmentation" is a misleading term. That's why the official term for schizophrenia in Japanese was relatively recently changed from 精神分裂病 (seishin bunretsu-sho) to 統合失調症 (togoshicchosho) in Japanese, which literally means a deficiency in integrity of the whole personality. But many clinical psychologists like would still work with the schizophrenic client in terms of assisting him or her to negotiate and restore a consistent sense of self, a central narrative to pull the pieces together to make sense out of whatever traumas they may have experienced. Unfortunately there are few counselors who work under this paradigm in Japan, so all most patients get is drugs and few tools to help themselves.

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until you live with someone who is a schizophrenic you can't really offer much of anything but terminology... it is a cruel disease... for the other members of family but especially for the one suffering it... and the drugs DO help a great deal... but the side effects are nasty and part of the pathology of it is that they think there's nothing wrong with them...

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Isn't this country the most medicated when it comes to mental illness? Most medicated but yet, never discussed and largely ignored.

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yoheikunApr. 10, 2014 - 05:08PM JST Jim Poushinsky's points above are very valid and salient in an intersubjective transpersonal model of psychiatry and psychoanalysis, at least in relation to schizophrenia, which is literally a fragmentation of the self.

Jim Poushinsky doesn't know what he's talking about, and neither do you.

There is a transpersonal model of psychology, which is often referred to as "spiritual psychology". Likewise there is an intersubjective model of psychoanalysis, which focuses on humans within society and not as discrete entities. ... a psychiatrist wouldn't touch either of these models with a barge pole. Just stringing together random terms related to psychology might fool some people, but it doesn't fool me, and frankly it just reveals you to be utterly ignorant on the topic.

Schizophrenia is not a fragmentation of self. You're thinking of DID (disassociative identity disorder, previously known as multiple personality disorder). In bad Hollywood movies DID is sometimes referred to as schizophrenia, but only someone with zero knowledge of psychiatry or psychology would make the mistake of confusing DID with schizophrenia.
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"Schizophrenia can thus be healed when the internal voices in one's head are understood as dissociated personalities created during overwhelming childhood abuse that enabled the child to survive"

That is an incredibly bold statement that I'm sure would have few supporters. (not saying that makes it wrong).

But I'd be interested if you could show me where to read more on that. Are you saying everyone with schizophrenia had "overwhelming" abuse? And at what stage of childhood are you talking about? i.e. What happens to your theory when you meet someone with schizophrenia who says they had no trauma in their childhood?

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Jim Poushinsky's points above are very valid and salient in an intersubjective transpersonal model of psychiatry and psychoanalysis, at least in relation to schizophrenia, which is literally a fragmentation of the self. It's not only that this disorder is a result of severe trauma; it's moreover a problem of how we classify "disorder" in the first place. It's not sufficient to explain that this is a disease that is the same for everyone, with the same cause, or that the same treatment will work for everyone. Drugs can indeed help the brain and body regain a sense of balance so that cognitive and personality functions can heal in ways that allow the individual to function better in society. Counseling and effective identification of that original fragmentation can also be essential for many people. But most people need this support for life, and that is OK!!! We should not judge that or blame the individual who is suffering.

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I'm currently doing a research paper on mental illness in Japan and the more you read on the topic the more your realise that Japan has a big problem when it comes to treating anyone with a mental illness. If you want to know more about the problems Japan faces read the ethnography by Karen Nakamura " schizophrenia in Japan ".

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You'd have to be crazy to take this drug.

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Jim PoushinskyApr. 10, 2014 - 10:48AM JST

Your post is so full of errors that I don't know where to begin.

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Wow! They treated over 10,000 people in four months just with this one drug? How prolific is schizophrenia in Japan?

I guess two people in every one has it.

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Schizophrenia can thus be healed when the internal voices in one's head are understood as dissociated personalities created during overwhelming childhood abuse that enabled the child to survive

Jim Poushinsky

Schizophrenia is not always connected to childhood abuse. You are simplifying the problem Schizophrenia is often connected to the same circuitry that allows artists to create from pure imagination. Often times the brain's compartmentalization breaks down. Interestingly, take a look at links between a genuis and their children. Case in point: Albert Einstein's son had schizophrenia. James Joyce's daughter had schizophrenia and Bertrand Russell's son had schizophrenia, just to name a few.

It has more to do with how the right and left hemispheres communicate.

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Some 40 researchers in America into various forms of mental illness reached a consensus back in the early 1990s that PTSD with dissociative symptoms resulting from overwhelming trauma in early childhood was the underlying cause of most mental illness.They requested the DSM3 revision of the psychiatric manual describe the various diagnostic categories as separate symptoms of dissociated childhood trauma. Doing so would enable healing of all forms of mental illness originating from this common cause by helping the survivor identify and consciously process the troubling symptoms to complete their understanding of what happened, so it can become a completed memory and its effects fade with time. However this research consensus was ignored by the powers-that-be revising the DSM3, because the drug companies have a vested interest in maintaining the myth that mental illness is many separate diseases of unknown origin, whose symptoms can only be controlled through profit making pharmaceutical drugs that alter brain function and must be taken for life.

Schizophrenia can thus be healed when the internal voices in one's head are understood as dissociated personalities created during overwhelming childhood abuse that enabled the child to survive. Instead of trying to obliterate them with drugs, understanding their role in past survival allows their integration into the whole awareness of self in a safe way. Yes, drugs can be useful in this therapeutic process, including drugs such as LSD, mescaline, and marijuana that give the trauma survivor insight that is useful for understanding and integrating their dissociated traumatic experiences. People are not healed by others, we can only heal ourselves. What others can do is help by accompanying us and supporting us on our personal healing journeys.

Far from being a Romantic, R.D. Laing's research found schizophrenics in England's mental hospitals were the sanest people in the insane family groups they came from, and had only escaped by being labelled insane and removed to a hospital. This certainly supports early childhood trauma as being the cause of their schizophrenia!

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Bilderberg-There is trith to what you say about Japanese mental health care, but it should be tempered by a few things;

-Treatment in bith "western" countries and Japan varies a great deal. Here insurance does not cover ounseling, but many modern psychiatrists here do attempt to do what they can. There is a trend to more humaniztic care here, and because of family members who are involved in mental health care both for severe cases such as schizophrenia as well as dementia and depression, I personally know good psychiayrists who know the limitations of meds as well as engage in counseling. There was also a long tradition of involuntary commitment, which is ending, and many go out of their way to insure the human rights of their patients.

In the west too there has been a similar tradition of shame and even prison like commitment was common earlier, although humanistic counseling has a longer history. In the US, despite Obama's insurance scheme, many peop e continue to go uninsured since the profit motive has not been taken out of insurNce, and so if you are relatiely well off, you can get decent medical care, but not by any means all people.

Last, in many "western" countries, drugs are overprescribed by GPs and this is another issue...you need someone who can properly diagnose.

We also have the increasing use of diagnosis in all countries to treat people for diseases which mY not need treatment, not limited to Japan.

But we need to be careful of myths which outlast the expiration dates. Japanese paychiatric care has maxe strides since mNy of our perceptions were informed. Like Hansen's disease, where people were imprisoned not only in Japan, things change, Japan too.

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MarkGApr. 10, 2014 - 08:12AM JST Sad and unexpected it seems as in use for 10 months around the world and is it ONLY Japan with fatalities? 3 suspected causes of death seemingly unrelated to each other directly.

Not really. Just off the top of my head it could be:

A bad batch - Sadly this does happen and while safety protocols are rigorous it would fit the pattern since a single batch is normally sent to a single country. The error may be accidental or deliberate (e.g. sabotage).

Doctor error - The wrong dosage may have been prescribed, the doctor may not have checked sufficiently rigorously for drug interactions (and given that many psychiatric medications can stay in the system for years in fatty tissue this is a real issue - Japan uses different medications so not all drug interactions may have been mapped), or giving it to the wrong patients (xeplion is not safe for elderly patients) - this might be an accidental error or this guideline might simply have been omitted or mistranslated in the medication guidelines in Japan.

Genetic - There might be a higher prevalence of an unusual gene in the Japanese population. I can't find data on Xeplion's use in other Asian countries, so it may be that Japan was the first major Asian market for the drug and so this problem is just surfacing now, whereas in multi-racial countries like the U.S. and U.K. a slightly higher fatality rate amongst asians might not appear statistically significant in a mixed race sample.

BertieWoosterApr. 10, 2014 - 08:23AM JST Trying to "cure" a mental problem with an injection is rather like trying to fix a software problem on a computer with a monkey wrench. It can't be done.

Broadly speaking mental illness can be divided into three categories. There are traumatic illnesses (e.g. PTSD, abuse, etc.), lifestyle illnesses (e.g. anorexia, bulemia, etc.) and physical illnesses (e.g. brain tumors, brain lesions, hereditary or acquired chemical or electrical imbalances).

Psychiatric medication can mask or alleviate symptoms in all three categories by manually tweaking the brain chemistry and rate of electrical activity. However I agree that it cannot "cure" any mental illness. Psychology can help people work through and resolve traumatic and lifestyle illnesses, but can't do a thing for physical illnesses.

Therefore I agree that while medicating schizophrenics (who fit into the "physical" category since the illness is caused by a triggered chemical imbalance) doesn't "cure" anything, it is the best treatment regime currently available and gives patients the best quality of life possible.

-12 ( +3 / -15 )

Japanese mental health care, and the attitudes here surrounding mental health problems in general, are decades behind First World countries. I would be very wary about getting any "treatment" from a Japanese mental health doctor, let alone such a risky injection of a new drug....

4 ( +7 / -3 )

Schizophrenia is not in the same category as depression, anxiety, etc., conditions which even psychiatrists differ on how much they are actual diseases and how much the tail (drug companies) wag the dog (diagnostic guidance); in other words the availability of drug treatments means they get prescribed more and more, and people who perhaps would not in a previous era have been diagnosed with a "disorder" may now be. Even still, with the profit motive perhaps driving prescriptions up, many people do well on some meds, often combined with various counseling therapies.

Not so with schizophrea, which develops before the age of 30 in most, where the patient can suffer with delusions and paranoia. The person is almost literally in another world. Drugs keep the condition under control to a greatervor lesser extent in different patients. Not clear what the reason for the Japanese deaths is...a new drug, so there is always a lot to be learned. But you cannot tell a schizophrenic to go drug free, though RD Laing tried to romanticize the condition in the 60s.

8 ( +11 / -3 )

Trying to "cure" a mental problem with an injection is rather like trying to fix a software problem on a computer with a monkey wrench.

The injection is not a cure, as there simply are no cures for mental illness. But if you have ever met someone with mental problems who uses these medicines, and compared their condition from when they were taking their meds to when they weren't, the differences can be amazing.

9 ( +13 / -4 )

Trying to "cure" a mental problem with an injection is rather like trying to fix a software problem on a computer with a monkey wrench.

It can't be done.

-5 ( +8 / -12 )

Sad and unexpected it seems as in use for 10 months around the world and is it ONLY Japan with fatalities? 3 suspected causes of death seemingly unrelated to each other directly.

I am fortunate not to take any drugs for any reason and even when I was prescribed pain meeds I chose not to fill the prescription. I feel all drugs have a risk. Einstein's Realativity point of view I take.

0 ( +5 / -5 )

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