The New York Times has an article which skilfully captures one of the central dilemmas in mental health: deciding whether the benefits of psychiatric drugs outweigh their side-effects for any individual patient.
The story centres on the ongoing court case where the state of Alaska are suing drug company Eli Lilly over claims that the multinational failed to inform professionals and the public about the side-effects of the antipsychotic drug olanzapine (Zyprexa) despite knowing about them for some time.
Olanzapine is a useful and effective drug for managing psychosis and, for some people, the only effective treatment for severe mental illness.
But, like the other newer generation drugs in this class, causes weight gain and significantly increases the risk for heart disease and diabetes. Like all other antipsychotics, it can also leave you feeling groggy and reduce your ability to experience pleasure (owing to the fact it affects the dopamine ‘reward’ system).
While mental health professionals tend to focus on the benefits of the drug for the person’s mental state, patients tend to focus on its negative effects on their health and enjoyment.
This differing focus is partly because the mental health professionals, on the whole, are not the ones who have to take the drugs and experience their side-effects, but also because psychosis often means the person does not realise their thinking has become disturbed, meaning they don’t see the point of being prescribed medication in the first place.
This dilemma was rather poignantly mirrored in the Alaska court house. While the Alaska vs Eli Lilly case was going on in one courtroom, in the next was a case concerning whether an obviously disturbed man should be compelled to take olanzapine by his hospital.
The NYT piece covers the two cases, drawing parallels between the individual dilemma and the landmark legal action, and captures the dilemma very succinctly.