By Cortland Pfeffer (with Irwin Ozborne)
Guest writers for Wake Up World
“I just think it is time we try something new,” said the doctor to his patient, “It’s called Abilify.”
“But I’ve been doing well,” the patient pleaded, “I have had no problems for over six months and I am feeling fine.”
“Well, you are on an involuntary (civil) commitment and I would hate to have to extend that 18 months,” said the doctor, “You understand that the court will always do what the doctor recommends, and I think that you are in need of a switch to Abilify.”
This is a conversation that I overheard when I first started working at a county hospital. I was new and trying to learn from these wonderful doctors that I believed were there to help people. This facility saw the “sickest” patients in the county, and I thought this would give me an incredible opportunity to learn. As this was one of the first conversations I heard, I was certainly learning… and slowly discovering that the label of “sick” is being placed on the wrong individual in this context.
Eventually, I worked my way up to a role that included auditing the psychiatrist’s records along with the responsibility of meeting with pharmaceutical representatives who were pushing their free medication samples. The only means of distributing free promotional samples is by the reps being able to talk directly to the psychiatrist along with a signature, and I was like a modern-day gatekeeper. The different reps would visit and provide a pitch as to why they should be able to take the king (psychiatrist) on a date – and unfortunately describing it as a “date” was far more literal than figurative.
The sales reps entertain psychiatrists with dinners at the finest restaurants in town and grant them access to luxury suites at sporting events in an effort to push their medications. But, they had to get by the guard (me) first. So they started to befriend me and offer similar gifts. They pulled out all the tricks in the book to try to gain access to psychiatrists, just like the Greeks trying to enter the city of Troy. In their finest efforts, the most beautiful women you have ever seen would show up as “sales reps” but they were really no more than a Trojan Horse posing as another false gift to gain access inside the gates. It really is only about one step away from prostitution, and I wouldn’t be surprised if in some cases these reps do take that ‘extra step’.
I had been officially introduced to the dark side of psychiatry, a field I had always believed was a “helping” industry. After battling my own lifelong struggles, I got into the field to help others only to find myself on the truly “sick” side of psychiatry – the side that is fueled by corruption, greed, back-scratching and dysfunction.
And this was just the tip of the iceberg!
Crossing a Line
I met a patient that I will call “Ronelle.” She was in the state hospital and preparing to be discharged after six months. She was assigned to my caseload for when she returns. Ronelle sent me a six-page letter describing herself and her situation. However, the doctor took this from me and informed me of her “delusional thinking patterns” and then coached me as to how to handle her care. He was still her psychiatrist and was ensuring I was aware of the extremity of her “sickness.” I was naïve, and had no reason to question this prominent psychiatrist.
Prior to my first encounter with Ronelle, it was already engrained in my mind that she was sick and delusional. While reviewing her medications, I noticed she was taking four different antipsychotics – one of which was 30mg of Abilify. There it is again, Abilify, the latest atypical antipsychotic. “I really do not need to be on all these medications,” she told me, “I really am not that sick.” Another delusion, I thought. So I blew her off, just as everyone had always done. I didn’t realize I was another cog in the psychiatric industrial machine.
As months went by, our talks were always the same and I was getting tired of hearing how she did not need her medications.
One night, while out on a date at a fancy restaurant – courtesy of the gift cards from the sales representatives – we headed upstairs to check out the view of the city and I recognized the same psychiatrist providing an educational talk to nurses and mental health workers about Abilify. He was sharing all the wonders of this drug and how more people need to be pushed towards this magical medication. As he took his seat, he was embraced and kissed by the same young Abilfy sales rep. I had to take a second-look as I was taken aback by the blatant corruption that sat before the entire crowd. Next day back at the office, I asked other sales reps about this encounter. They laughed and said, “Didn’t you know that? They are married.”
Shocked, upset, and in disbelief, I came to discover this prominent psychiatrist was pushing a medication on his colleagues that his wife was selling! Is this really about helping people? Or is it about expanding their personal portfolio?
Disease Mongering: The Selling of Sickness
After discovering this new information, I had to find out more about Abilify. Every single doctor I spoke with provided the same answer, “No, it doesnt really work.” One doctor even referred to it as “Vitamin A.” Abilify was introduced as a new atypical antipsychotic medication to treat schizophrenia but never gained the market-share they were expecting. So, a few years later, it was approved to treat bipolar disorder. Later, the FDA approved its use in conjunction with other medications to treat severe depression – which is when it soared to become the top-selling drug in America.
So, following the failed experiment of treating schizophrenia, the pharmaceutical company simply changed the “purpose” of the drug to treat other indications – specifically depression and anxiety – which is what you will see it marketed for today. In fact, you will find it marketed for just about everything.
“In the 12 months ending August 2011, more than $453 million [US] was spent promoting antipsychotics through physician deals, direct-to-consumer advertising, and professional advertising. Abilify led with over $174 million, or 38% of the total market… Clearly, Abilify and Seroquel have performed well… in part because of the investments their marketers have made, both in promotion and acquiring expanded indications.” 
Yet, despite raking in more than seven billion dollars per year, both the USDI and FDA state the way Abilify works is “unknown.” This is a very common practice in the pharmaceutical industry. It works like this:
- Create a new disorder (identify a new market)
- Hire a firm to spread awareness (disease branding/marketing)
- Convince the normal person they have this disorder (creating a need)
- Use a new drug to treat that disorder (solution)
- The patent for the drug is good for 7 years; apply monopoly prices
- Once patent expires, repeat step one
- Repackage the “new” drug under a different name
- Repeat steps two through five
Patents for new drugs are applicable for 7 years. Once it runs out, it allows the generic brand companies to make the same drug at reduced prices. To avoid this, the large pharmaceutical companies simply adjust a molecule of the drug and repackage it, or alter the condition it is prescribed to treat, allowing for a new patent. This process has been repeated throughout the past few decades as the psychiatric industry has abandoned psychotherapy in favor of drug management.
Valium was the highest prescribed drug in the world in 1978 and earned the nickname “Momma’s little helper” as it was marketed to stressed out housewives; and also referred to as “Executive Excedrin” for the overworked businessman. This was the turning point of America becoming a choose-your-mood society. As far as the pharmaceutical industry is concerned, there is a pill for everything, and the goal is to find the right pill for each person.
The 1980s saw the next “breakthrough” — the drug Prozac was released to treat symptoms of depression. And of course, the diagnoses of depression skyrocketed as public campaigns (funded by pharmaceuticals) let us all know that we, or someone we know, may be struggling with depression. Then in 1999 came “news” of the latest epidemic – Social Anxiety Disorder (ie. shyness). A coalition was created to help those suffering from this “disorder” and those targeted were told that there was a drug to alleviate their symptoms – Paxil. What is generally unknown to the public however, is that these coalitions to ‘spread awareness’ are funded by pharmaceutical companies, and psychiatrists are paid to give speeches about the newly devised “illnesses” — which are always sold as a chemical imbalance — along with the accompanying medication.
Although widely accepted in the psychiatric industry, the “chemical imbalance” theory has never been proved in humans.  Furthermore, it has not been demonstrated why common depression drugs do not alleviate depression almost immediately, since they create a maximum increase in serotonin and dopamine within two days. Today, psychiatry is finally retreating from its long-held position of “chemical imbalance” in the face of intense criticism of this baseless theory. For instance, Dr. Fred Baughman, board certified neurologist/child neurologist and author of the book The ADHD Fraud — How Psychiatry Makes “Patients” of Normal Children, has testified widely, including hearings at the US Food and Drug Administration (March 2006) and the Congress of Mexico (March 2006), that there is no proof that any psychiatric disorders have been scientifically validated.
The psychiatric establishment, of course, is slow to acknowledge these facts. As noted by retired psychologist Philip Hickey Ph.D in an article for Mad In America;
This falsehood was promoted vigorously by psychiatrists and by pharma, and tragically has been accepted as fact by two generations in western countries and increasingly in other parts of the world. [source]
What research does suggest, however, is not that a chemical imbalance causes mental illnesses (as the industry would have us believe) but rather that depressive states may in fact cause chemical changes to biogenic amine (or neurotransmitters) in the brain.  Therefore, treating mental and emotional disturbances with pharmaceuticals is simply aiming to address symptoms and not causes — a common failing of the conventional medical establishment. Explains Ronald Pies, M.D., Professor of Psychiatry and Lecturer on Bioethics & Humanities at SUNY Upstate Medical University (NY) and Clinical Professor of Psychiatry at Tufts University School of Medicine (Boston):
Unfortunately, the biogenic amine hypothesis got twisted into the “chemical imbalance theory” by some pharmaceutical marketers, and even by some misinformed doctors. And, yes, this marketing was sometimes aided by doctors who—even if with good intentions–didn’t take the time to give their patients a more holistic understanding of psychiatric illness. To be sure, those of us in academia should have done more to correct these beliefs and practices. [source]
The Legal Drug Cartels
Paxil was FDA approved in 1992, and to get approval status, the FDA appointed a board of psychiatrists – all of whom had financial ties with the pharmaceutical companies. In 2001, the infamous Paxil 329 study attempted to “prove” the effectiveness of their antidepressant in adolescents – another then-untapped market. Martin Keller ran this study on behalf of Glaxio Smith Kline and tested 100 children on the drug. There were 22 co-authors of this study, all ‘important’ psychiatrists, which concluded the effectiveness and safety of Paxil. The FDA granted their blessing to the faulty study and within a year, more than 55 million people were taking Paxil.
However, what was omitted from this “study” was that seven of children on which Paxil was tested were hospitalized and another 11 experienced serious side effects. Keller admitted no fault and simply did not count those individuals in the results of the study, and labelled them as either “noncompliant” or noted that they had “dropped out.” In 2004 he settled out of court for $2.5 million dollars for his role in the fraudulent study, but in 2012 the US Department of Justice brought a civil case against Glaxio Smith Kline which resulted in the company being fined US$3 billion dollars!  In that same year, however, Paxil brought in US$11.6 billion in sales for Glaxo Smith Kline which, from a business perspective, still made the fraudulent Paxil study a valuable corporate exercise. You can read the guilty plea in the case US vs Glaxo Smith Kline here.
In the book, “Sociology of Health and Illness” by Peter Conrad he writes:
“Marketing diseases, and then selling drugs to treat those diseases, is now common in the “post-Prozac” era. Since the FDA approved the use of Paxil for SAD [Seasonal Affective Disorder] in 1999 and GAD [Generalized Anxiety Disorder] in 2001, GlaxoSmithKline has spent millions to raise the public visibility of SAD and GAD through sophisticated marketing campaigns. The advertisements mixed expert and patient voices, providing professional viability to the diagnoses and creating a perception that it could happen to anyone (Koerner 2002). The tag line was, “Imagine Being Allergic to People.” A later series of advertisements featured the ability of Paxil to help SAD sufferers brave dinner parties and public speaking occasions (Koerner 2002). Paxil Internet sites offer consumers self-tests to access the likelihood they have SAD and GAD (www.paxil.com). The campaign successfully defined these diagnostic categories as both common and abnormal, thus needing treatment.
Prevalence estimates vary widely, from 3 to 13 percent of the population, large enough to be a very profitable pharmaceutical market. The marketing campaign for Paxil has been extremely successful. Paxil is one of the three most widely recognized drugs, after Viagra and Claritin (Marino 2002), and is currently ranked the number six prescription drug, with 2001 U.S. sales approximately $2.1 billion and global sales of $2.7 billion. How much Paxil was prescribed for GAD or SAD is impossible to discern, but by now both Paxil and SAD are everyday terms. While there have been some concerns raised about Paxil recently (Marshall 2004), it is clear that GlaxoSmithKline’s campaign for Paxil increased the medicalization of anxiety, inferring that shyness and worrying may be medical problems, with Paxil as the proper treatment”. [page 484]
Then there was the Cymbalta clinical testing that resulted in five suicides, which somehow still managed to pass through the FDA approval process. 19 year old Traci Johnson had no history of depression, suicidal ideation, or any mental illness. Yet, after being involved in this clinical study she ended her life – one of five suicides resulting from the in clinical testing of Cymbalta. After her death, 20% of the volunteers withdrew from the study, and these ‘dropout’ numbers (again) were simply not accounted for in the final data analysis. In 2013, Cymbalta delivered more than $5.1 billion in sales.
This unsavoury marriage between pharmaceutical companies and psychiatry goes back over 100 years. While it was highly publicised that Sigmund Freud touted the use of cocaine – both recreationally and therapeutically – what is not widely known is that his well publicized passion for this “magical drug” was actually the result of hefty payments he received from the newly-formed pharmaceutical companies, Merck and Park Davies, for his professional endorsement for their drugs. 
Drug Pushers in White Coats
The story I related earlier about the psychiatrist with the penchant for Abilify, is one of possibly hundreds of thousand of other examples of this sort of prescribing within this industry. Drug companies are profiting by more than US$80 billion each year as a result of ‘mental disease mongering’, as well as ludicrous mark-up pricing. These medications are incredibly cheap to manufacture – i.e. the cost to produce 100 Xanax pills is about $0.025 (yes that is 2.5 cents) yet they sell for $136 at the pharmacy – a 500,000% profit margin. 
With these kind of profits, the pharmaceutical companies are able to pay enormous settlement fees which hardly crack their bank account. In 2007, Abilify paid a $515 million settlement for illegally marketing their drug in nursing homes, despite knowing that it commonly caused death for patients with dementia.
In April of 2015, Abilify’s patent expired for treating schizophrenia and bipolar disorder and generics can now be purchased at discounted prices. So, in turn, in May of 2015 its maker the Otsuka America Pharmaceutical, Inc. attempted to sue the FDA, claiming that the drug was now an orphan-drug in treating pediatric Tourette’s syndrome and thereby extending its exclusivity period.
So why do we keep prescribing people these medications?
Simply, it is because we have created a gravy train that is producing a lot of money for a lot of powerful people – drug companies, doctors, pharmacies, and investors. In creating a new disorder, it is marketed as a lifelong and incurable disease, creating a customer for life. The first problem for the drug companies in marketing their pharmaceutical “solutions” is if it kills a person; the second problem is if they actually cured someone – imagine the financial hit they would take. Their aim, therefore, is to create addictive drugs that don’t kill but also don’t cure.
Upon learning more about this dark side of psychiatry, I literally grew nauseous. I started to examine this psychiatrist’s charts to find that nearly every one of his patients was prescribed Abilify. In comparison, other providers prescribed Abilify only 4% of the time… compared to his rate of 75%. Then, of course, he is also married to the pharmacy representative for this company. For each prescription he writes, she gets paid a commission. She also gets paid for talking to doctors because of her free pass into the clinic. He also is funded by the same company to give speeches on this drug, and for signing off on peer-reviewed articles and studies on these drugs – again 100% funded by drug companies. They are making exuberant amounts of money by medicating people with a drug that in their own words “doesn’t really work.”
I was reeling over how it is possible that this level of corruption is happening right before our eyes. But the chief of psychiatry didn’t seem at all concerned — he was busy playing golf with the Risperdal sales representative! Upon hearing this, I was prompted to look into the Risperdal Consta injections that were administered at our facility, only to discover that more than half of our one-thousand patients were being given this drug — a procedure that runs a bill of more than $1,000 per injection. This has all been given the ‘green light’ by our “Chief of Psychiatry” — our facility’s ‘pillar of respectability’ who has been featured in studies in medical journals and other publications and studies for the past fifty years.
This kind of corruption is, unfortunately, not uncommon in the psychiatric/pharmaceutical industry. Peter C Gøtzsche, a physician, researcher and professor of Clinical Research Design and Analysis at the University of Copenhagen, has firsthand experience with the criminal workings of the pharmaceutical industry, which he exposed in his book “Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Healthcare.” Gøtzsche detailed the corruption behind exorbitant prices for branded drugs, and outlines that clinical drug trials are often fraudulent, with pharmaceutical companies selecting populations and comparison groups that will support the preferred outcome of the study, controlling and filtering data in-house, cherry picking the results to suit their marketing needs, and hiring professional writers to document their “findings”. He also claims it is not uncommon for academics who were not involved in studies to be paid to be listed as contributors, to give the study credibility despite its “shamelessly biased data.”
A number of other prominent scientists — including 2 former editors-in-chief of major scientific journals — have also publicly stated that up to half of published research is biased or simply untrue. Says Dr. Marcia Angell, physician and longtime editor-in-chief of the New England Medical Journal:
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine.”
Recently Martin Shkreli, CEO of Turing Pharmaceuticals made the headlines after he increased the price of the AIDS medication Daraprim from $13.50 to $750 — a 5000% increase. Yet, the drug companies are adding these huge mark-ups all the time. According to a recent article from LiveStrong.com:
“Insight Journal” reports that many of the active ingredients in prescription drugs are manufactured overseas, and that the pharmaceutical industry earns from 2,809 percent markup of the cost of active ingredient in Zestril, to as much as 570,000 percent markup in Xanax; the markup for Xanax is based on a consumer price of $137.79 for 100 tablets and $0.024 for the cost of the active ingredients.
Now, a startling new development comes from the manufacturers of Abilify, Otsuka America Pharmaceutical, Inc. The corporation intends to turn Abilify into a “digital drug”, and are seeking approval from the US Food and Drug Administration to insert a chip into each capsule that can measure whether a patient is taking their medications as prescribed. If approved, this move would give doctors and courts the power to monitor whether people prescribed these drugs are complying with the dictates of their financially-motivated prescriptions. 
While the moral and legal implications of this proposal are staggering, the ludicrous insensitivity of such a proposal was highlighted by Comedy Central’s Stephen Colbert who joked:
“Nothing is more reassuring to a schizophrenic than a corporation inserting sensors into your body and feeding information to all those people watching your every move.”
You can read about this development here.
So, who are the sick ones in this industry?
Eventually, I started listening more to what “Ronelle” had to say about her ‘drugging’ — I felt it only right to hear her out. With some collaborative efforts and a bit of manipulating, we were able to switch doctors. Her new doctor met with the legal drug cartel sales representatives but didn’t ‘buy into’ the shiny objects they tried to use to bribe him. “None of these meds really work,” he told one of the drug dealers, “Maybe 15% of the time at best, so we really shouldn’t use them unless it is absolutely necessary. They are only to be used as a last resort.”
Imagine that?! A doctor who still cared for patients, stands by his morals and ethics, and could not be bought-out. Of course, he often was shunned by his colleagues for his ethical tactics that made waves and exposed their corruption.
However, once he began working with Ronelle, he gradually got her off her medications to see how she would function without being doped up 24 hours a day. Eventually, she was reduced from 4 antipsychotics to a more suitable anxiety medication and an antidepressant. She was doing fine and never returned to the hospital again; she was happy, excited, and managed to lose a lot of the weight she had gained from the ‘doping’ her previous psychiatrist had forced on her to line his own pockets.
Unfortunately, the patient that I described in the beginning of this article was not so lucky. He did not get to switch doctors and was forced to continue taking Abilify since he was on civil commitment. He ended up fleeing for two years, taking a flight to Africa, and doing himself serious damage in the process. From what I have heard from others since, he eventually returned to the United States but his life has been destroyed.
Ironically, this doctor we have been discussing prescribed a cocktail of drugs that literally drove a troubled man to desperation, fleeing to Africa as a last ditch effort to escape his mental torture. Yet at the same time, the doctor responsible for this poor man’s state-enforced over-medication — the ‘professional’ who earned enormous sums of money pairing patients with his preferred drugs — used his ill gotten gains to funds his own vacation to Africa later that year, an expedition to escape the stress of “dealing with the mentally ill.”
In rounding out this article, it would be remiss of us to not point out the fact that more people die from overdose deaths from taking ‘properly prescribed’ prescription drugs each year than from illegal street drugs. Writes Scott Bonn, Ph.D., an Associate Professor of Sociology and Criminology at Drew University, in a 2014 article for Psychology Today :
Drug overdose death rates in the United States have more than tripled since 1990 and have never been higher. At least 100 people die from drug overdoses every day in the U.S. More than 36,000 people die from drug overdoses annually and most of these deaths are caused by prescription drugs…
In 2011, the Centers for Disease Control and Prevention reported that the rate of antidepressant use in the United States rose by 400 percent between 1988 and 2008…
The problem is getting worse and, frequently, medical doctors enable their drug addicted patients by frivolously filling prescriptions.
Reference (1) CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999-2008. MMWR 2011; 60: 1-6.
To find out more about psychotropic drugging and the ‘dirty dealings’ of the FDA, Psychiatry and Big Pharma, we urge you to take the time to watch the following documentary…
Making a Killing: The Untold Story of Psychotropic Drugging
“This video provides the facts about psychotropic drugs and the huge profits they create for the pharmaceutical industry. These drugs are not safe and have not been on the market long enough to provide sufficient long term studies regarding their effects. Over half of the people that commit suicide in the United States are prescribed to psychotropic drugs.”
Taking the Mask Off: Destroying the Stigmatic Barriers of Mental Health and Addiction Using a Spiritual Solution
“Taking the Mask Off” is the new book by Cortland Pfeffer and Irwin Ozborne. Cortland Pfeffer spent years as a patient in psychiatric hospitals, treatment centers, and jails before becoming a registered nurse and working in the same facilities. Based on his experience, this story is told from both sides of the desk. It offers a unique and valuable perspective into mental health and addiction, revealing the problems with the psychiatric industry while also providing the solution – one that brings together science, spirituality, philosophy, and personal experience.
-  US Spends Most on This Drug…and No One Knows How it Works
-  Leonhauser, Melissa (2012). IMS Health. Antipsychotics: Multiple Indications Help Drive Growth.
-  The Marketing of Madness: Are We All Insane? (Film)
-  Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. (Lacasse JR, Leo J.) PLoS Med. 2005; 2(12): e392. doi:10.1371/journal.pmed.0020392
-  Paxil, Lies, and the Lying Researchers Who Tell Them
-  Grohol, John (2008). PsychCentral. More on Infamous Paxil Study 329
-  GlaxoSmithKline to Plead Guilty and Pay $3 Billion to Resolve Fraud Allegations and Failure to Report Safety Data
-  Lender, Jeanne (2005). Slate.com. Drug Secrets: What the FDA isn’t Telling.
-  Sigmund Freud, Cocaine and the Birth of Big Pharma
-  Davis, Sharon; Palmer, Mary. US Department of Commerce. The True Costs of Your Prescriptions.
-  Duff, Wilson (2011). New York Times. Side Effects May Include Lawsuits.
-  New ‘Smart’ Drugs Tell Doctor You’re Not Taking Them
-  Prescription Drugs Are More Deadly Than Street Drugs
Previous articles by Cortland Pfeffer and Irwin Ozborne:
- Celebrating Genocide – Christopher Columbus’ Invasion of America
- The Craving Behind the Craving: Addiction as a Spiritual Disease
- Bipolar? Or Gifted? The Modern Day Epidemic of Medicated “Madness”
- Suicide: Falling Through the Cracks of Stigma
- The Fictions Surrounding ADHD and the “Chemical Imbalance” Theory of Mental Illness
- Schizophrenia – Psychosis or Something More Profound?
About the authors:
Cortland Pfeffer founded Taking The Mask Off in 2014 to help shine a light on the mental health industry (as well as other areas of our society that are shrouded in deceit and misinformation). Sharing insider perspectives and real life stories that have been gathered over 20 years in the field, Cortland (a pen-name) is a psychiatric Registered Nurse who was himself once a patient in psychiatric hospitals, jails, and treatment centers. He now wishes to share his experiences with others, and has recently made several public speaking appearances. Cortland can be contacted for speaking engagements through Facebook.com/takingthemaskoff.
This article was co-written by Cortland’s partner Irwin Ozborne (also a pen-name). An avid historian, Irwin Ozborne (a pen-name) is a survivor of childhood abuse and torture over a period of 13 years, and a recovered alcoholic. As a mental health practitioner, today Irwin practices holistic care and incorporates eastern philosophy into his work with clients. He is available for speaking engagements as well, and can be contacted via email: [email protected]