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Response to Charles Krauthammer's Op-Ed Another massacre, another charade suggesting that psychosis, not guns, is the real cause of mass shootings in America.


On the one hand, Mr. Krauthammer suggests that more aggressive psychiatric intervention might make a difference; and on the other he states that Roseburg shooter Christopher Harper-Mercer "had no psychiatric diagnosis beyond Asperger's."

First, apparently Mr. Krauthammer missed the memo that Asperger's is no longer a psychiatric diagnosis - it was voted out of the latest version of the American Psychiatric Association (APA) Diagnostic and Statistical Manual (DSM-5), published in May 2013.  Many people don't realize that so-called mental disorders are voted in or voted out of American psychiatry's "bible," not scientifically discovered or undiscovered.  Another prominent example of a so-called mental disorder going the way of the dodo by popular vote of American psychiatrists is homosexuality, first included in, then excluded from the DSM.  Referring to the DSM-5, Dr. Thomas Insel, Director of the National Institute of Mental Health (NIMH), declared,"The weakness is its lack of validity.  Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure... Patients with mental disorders deserve better... That is why NIMH will be re-orienting its research away from DSM categories." ( http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

American psychiatry's inability to determine with scientific clarity what does or does not constitute a mental disorder is compounded by the fact that the United States is one of only two countries in the world, New Zealand being the other, that allows direct-to-consumer advertising by pharmaceutical companies.  Big Pharma does such a good job of disease-mongering -- often inventing then selling a disorder and creating then funding corresponding "grassroots" advocacy groups (aka "astroturfing") in order to sell their drugs -- that it makes it difficult to take back a mental disorder once it has been invented and sold to the American public. 

The first and most obvious flaw with the wishful thinking that more aggressive psychiatric intervention might make a difference (read prevent) mass shootings in America is that American psychiatry cannot reliably define what a mental disorder is, let alone agree upon and recommend its efficacious treatment.

Second, Mr. Krauthammer can't possibly know for a fact that Mr. Harper-Mercer's only psychiatric diagnosis was Asperger's.  This is a classic example of jumping to conclusions, based on a report of out-of-context online posts by a relative.  It has also been reported that Mr. Harper-Mercer's online alias was "Lithium_love."  It should be noted that if in fact Mr. Harper-Mercer was taking lithium, that drug is indicated for Bipolar Disorder, not Asperger's (or Autism Spectrum Disorder/ASD).  So if Mr. Harper-Mercer was prescribed lithium, he was either diagnosed with Bipolar, or the drug was prescribed to him off-label.  To be sure, off-label prescribing, as well as polypharmacy (ie. prescribing multiple drugs), is rampant in American psychopharmacology, a symptom of the shoot first aim later, trial and error prescribing habits of an industry that has a tough time defining mental illness, much less deciding on how to effectively treat it.  The reality is we will probably never know the extent of Mr. Harper-Mercer's psychiatric diagnoses, or the name, number and doses of the psychotropic medications prescribed to treat them.

Third, Mr. Krauthammer invoked the Naval Shipyard shooter Aaron Alexis as an example of someone whom he suggests did not receive needed psychiatric help.  In fact, Mr. Alexis received psychiatric care from the Department of Veterans Affairs, in the form of a prescription for the antidepressant drug Trazodone ( https://www.washingtonpost.com/national/health-science/trazodone-antidepressant-used-by-aaron-alexis-described-as-very-safe/2013/09/18/4336c044-20ae-11e3-966c-9c4293c47ebe_story.html ).  Mr. Alexis went voluntarily to the VA for help with a psychiatric symptom, and pills are what he was given.  This is where we get to the root of the problem, as well as expose one of the biggest myths about mass shooters.

The fact of the matter is that most mass shooters in recent history were under psychiatric care and were prescribed psychotropic medications: e.g. Joseph Wesbecker (Prozac, lithium, trazodone, temazepam), Eric Harris (Luvox), Edward Lutes (Luvox), Jeffrey Weise (Prozac), Steven Kazmierczak (Prozac, Xanax, Ambien), Robert Stewart (Celexa, Xanax), Kipland Kinkel (Prozac, Ritalin), Aaron Alexis (Trazodone), James Holmes (Zoloft, Klonopin), Ivan Lopez-Lopez (Celexa, Wellbutrin, Ambien, Lunesta), Aaron Ybarra (Prozac, Risperdal), Bradley Stone (Risperdal, Trazodone), Elliot Rodger (Xanax), Myron May (Vyvanse, Wellbutrin, Seroquel), etc.

The suggestion that the aforementioned mass shooters were not receiving psychiatric care, and if only they had access to needed psychiatric care then perhaps the tragedies might have been averted, is misleading.  The problem is that in America -- where doctors are paid handsome consulting fees by pharmaceutical companies to pitch their drugs to other doctors, and where the pharmaceutical industry spends approximately $230M per year to influence Congress --  psychiatric care has become synonymous with psychotropic drugging. 

The earlier choice of the words "in recent history" was not accidental, because this tragic mass shooting phenomenon has only been recent in America's history, since the clock tower shooter Charles Whitman (Valium, Dexedrine) killed 16 people on the University of Texas campus.  In an upcoming documentary, Dr. Jean Stolzer points out that "guns have always been in this country since the first Europeans stepped on American shores." (see also https://leoniefennell.files.wordpress.com/2013/05/the-systemic-correlation-between-psychiatric-medications-and-unprovoked-mass-murder-in-america2.pdf )  Likewise, President Obama has pointed out: "The United States does not have a monopoly on crazy people.  It's not the only country that has psychosis.  And yet we kill each other in these mass shootings at rates that are exponentially higher than any place else.  Well, what's the difference?" [NOTE: Most people missed the fact that Mr. Obama's above response was to a question about mass shootings posed via Tumblr by Nick Dineen, residential assistant to UC Santa Barbara mass killing victim George Chen - whom the coroner later determined was killed with a knife, not a gun, like two other of Elliot Rodger's victims.  Mr. Obama's response and Mr. Dineen's question can be viewed here: https://www.youtube.com/watch?v=NDVFs2l6-fo and the coroner's findings that Mr. Chen, Weihan Wang, and Chen Hong each died of multiple stab wounds can be viewed here: http://www.sbsheriff.us/documents/ISLAVISTAINVESTIGATIVESUMMARY.pdf .  This demonstrates how jumping to conclusions based on initial media reports can be problematic.]

Indeed, what's the difference?  Neither guns or psychosis are new or unique to America.  So what has changed? 

What has changed in America and what is unique to our country is the alarming increase in the number of Americans taking psychotropic drugs, which carry FDA-mandated label warnings of serious psychiatric adverse events, including suicidal and homicidal ideation.

For example, a recent study commissioned by the Louisiana Senate ( http://dhh.louisiana.gov/assets/ADHD/ADHD_DHH_RspnseRsltn39.pdf ) found that 35.8 percent of ten-year-old white boys were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and prescribed predominantly stimulant medications, which an FDA Center for Drug Evaluation and Research (CDER) medical reviewer found cause hallucinations, mania, and psychosis at a rate of two to five per hundred person years ( see http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4210b_11_01_AdverseEvents.pdf and http://www.fda.gov/ohrms/dockets/ac/06/minutes/2006-4210m_Minutes%20PAC%20March%2022%202006.pdf ).  The FDA's medical reviewer also noted that the psychotic side effects of ADHD stimulants occur in regular doses, in children with no risk indicators or other psychiatric history besides ADHD, and at a rate that cannot be considered rare.

Whereas in some places in our country nearly two out of every five ten-year-old boys are being medicated with psychosis-inducing drugs for ADHD, the estimated rate of ADHD diagnosis in Europe is less than one percent ( https://www.psychologytoday.com/blog/suffer-the-children/201203/why-french-kids-dont-have-adhd ).  Over-diagnosis and over-medication of psychiatric disorders is a decidedly American problem.

Similarly, while Britain was banning antidepressants for kids due to an increased risk of suicidal thoughts and behavior associated with the drugs, the FDA threatened the same medical reviewer, Dr. Andrew Mosholder, with an internal investigation, and prevented him from presenting his findings that the drugs doubled suicidality in kids at a Pediatric Advisory Committee meeting ( http://www.gpo.gov/fdsys/pkg/CHRG-108hhrg96099/html/CHRG-108hhrg96099.htm ).

According to the DSM-5,"Between 7 percent and 25 percent of individuals presenting with a first episode of psychosis in different settings are reported to have substance/medication-induced psychotic disorder."

Big Pharma invented and has successfully marketed the unproven theory that mental illness is the result of a chemical imbalance in the brain.  Swallowing this marketing theory hook, line and sinker, Americans are also swallowing psychotropic pills -- and shoveling them into their children's mouths -- at rates dwarfing other nations. 

Ironically, there is evidence that psychotropic drugs derive their action precisely by creating a chemical imbalance in the brain, according to former NIMH Director Dr. Steven Hyman ( http://search.proquest.com/openview/5610c361a22516dda3dc72bb25f5371e/1?pq-origsite=gscholar ).  Psychiatric medications, he wrote, "create perturbations in neurotransmitter functions."  The brain must then compensate to adapt to "alterations in the environment."  Chronic administration of the drugs, he added, cause "substantial and long-lasting alterations in neural function." 

Referring to his own LSD trip, immediate past President of the APA, Dr. Jeffrey Lieberman, wrote: "My [LSD] trip did produce one lasting insight, though--one that I remain grateful for to this day...I marveled at the fact that [if] such an incredibly minute amount of a chemical...could so dramatically alter my cognition, the chemistry of the brain must be susceptible to pharmacologic manipulations in other ways, including ways that could be therapeutic."  ( http://www.huffingtonpost.com/dj-jaffe/book-review-shrinks-the-u_b_6924810.html )

We, as a nation, are reaping the fruits of this historically unprecedented, massive-scale experimentation on the chemistry of the human brain. 

When most mass shooters were taking psychotropic drugs, it's an insult to what's left of our collectively numbed intelligence to suggest that more psychotropic drugs are the answer to mass shootings.  If psychotropic drugs were the answer, then the astronomical increase in Americans' use of psychiatric drugs should have led to a dramatic decrease in the number of mass shootings, not an increase.  Experience shows that more mental health treatment with psychiatric drugs will lead to more mass murder, not less.

Take, for instance, the case of Bradley Stone.  Not unlike Charlie Gordon in Flowers for Algernon, Mr. Stone might once have been considered a darling example of the shining success of mental health diversion courts and Assisted Outpatient Treatment (AOT) of the kind advocated by Rep. Tim Murphy (R-PA) in his proposed Helping Families in Mental Health Crisis Act (HR 2646) - that is, until Mr. Stone shot and chopped up seven people, before poisoning himself with the Risperdal and Trazodone he was prescribed and then stabbing himself ( http://www.montcopa.org/ArchiveCenter/ViewFile/Item/2128 ). Or there's Spc Ivan Lopez-Lopez who in the months preceding the second deadly Ft. Hood shooting spree voluntarily met with a half dozen Army mental health providers at Ft. Bliss, Ft. Leonard Wood, and Ft. Hood on ten occasions, dutifully refilling prescriptions for psychotropic medications ( http://www.pharmabuse.com/blogs/98 ).

At the very least, we know psychotropic drugs do not prevent mass killings, since toxicology results for most of the aforementioned dead mass shooters revealed the prescribed drugs were still in their blood.  Moreover, the FDA has received 765 reports of homicide as a side effect of psychotropic drugs, many of which were multiple homicides.  Just as the now well-established link between antidepressants and suicidality, which prompted a black box warning, was once covered up, the extent of the temporal link between psychotropic drugs and violence toward others has been concealed from the American public.  Now, thanks to a recent Freedom of Information Act (FOIA) lawsuit filed against the FDA, we're obtaining the relevant adverse event report records, and they will be made public for the first time.

The FDA adverse event records support recent scientific studies finding a link between psychotropic medications and homicide ( see http://ki.se/en/news/study-analyses-link-between-psychotropic-drugs-and-homicide-risk and http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015337 ).    

U.S. taxpayers should not spend more money on mental health programs promising to prevent mass shooting tragedies, because such undoubtedly costly programs, by the very nature of their promise, would be fraudulent.  If anything, Congress should investigate whether psychotropic drugs, which have been demonstrated time and time again as being incapable of preventing homicide, may actually be living up to their scary label warnings.

The guns versus mental health debate is a red herring.  They are two sides of the same coin - emphasis on coin, as in money.  The gun lobby and the pharma lobby are a marriage made in heaven (or, more aptly, hell).  We're hearing from the gun lobby that more guns would help victims protect themselves from psychotic mass shooters.  We're hearing from the pharma lobby that forced mental health treatment with psychotropic drugs, which the mass shooters were already voluntarily taking, would prevent mass shootings.    

The only lobby seemingly letting a crisis go to waste is the entertainment lobby.  We haven't heard that more violent video games and movies would prevent mass shootings -- yet.