This week, we hear from Dr. Michael Hengartner. Michael is a Senior Researcher and Lecturer at the Zurich University of Applied Sciences in Switzerland. His areas of expertise include psychiatric epidemiology, public mental health, evidence-based medicine and conflicts of interest in psychological and biomedical research. He was an expert evaluator for the European Research Council and the World Health Organization and currently is a member of the Swiss School of Public Health, the German Society for Social Psychiatry, and the European Public Health Association. In this interview, we discuss Michael's recently released book entitled “Evidence-biased Antidepressant Prescription, Over-medicalisation, Flawed Research, and Conflicts of Interest.” The book addresses the overprescribing of antidepressants and it critically examines the current scientific evidence on the efficacy and safety of the drugs.

Michael Hengartner – Evidence-biased Antidepressant Prescription

Welcome to the Mad in America podcast, a weekly discussion that searches for the truth about psychiatric prescription drugs and mental health care worldwide.

Hosted by James Moore, this podcast is part of Mad in America’s mission to serve as a catalyst for rethinking psychiatric care. We believe that the current drug-based paradigm of care has failed our society and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change. 

On the podcast we have interviews with experts and those with lived experience of the psychiatric system. Thank you for joining us as we discuss the many issues around rethinking psychiatric care around the world.

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On the MIA podcast this week we turn our attention to conflicts of interest (COIs) and new research from the British Medical Journal (BMJ). Mad in America has  previously examined the problems with conflicts of interest in research but this time we extend that to look at the potential effect of COIs on diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). Joining me today are Lisa Cosgrove and Brian Piper, two of the authors of a paper which appeared in the BMJ. The paper is entitled “Undisclosed Financial Conflicts of Interest in the DSM-5 TR: Cross-Sectional Analysis,” and it was published in January 2024. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Undisclosed Financial Conflicts of Interest in the DSM-5: An interview with Lisa Cosgrove and Brian Piper

Swapnil Gupta is an Associate Professor and Medical Director of Ambulatory Psychiatry at Mount Sinai Morningside Hospital. She was trained as a psychiatrist in India and the United States, at SUNY Downstate Medical Center and Yale University, and PGI Chandigarh in India. She is known for her work on deprescribing from and discontinuation of psychiatric drugs. Dr. Gupta’s career began with research on the role of the endocannabinoid system in the pathophysiology of schizophrenia as an academic psychiatrist. Her subsequent scholarship has focused on applying deprescribing, the systematic reduction of unnecessary medications, to psychiatry by rooting it in the principles of recovery-oriented care. She has authored several peer-reviewed papers on deprescribing and co-authored a  book with Rebecca Miller and John Cahill. She is an active member of two organizations that aim to enhance stakeholder engagement in psychiatric research. She is also a part of the editorial board of the Community Mental Health Journal. Currently, she is working on creating educational resources to help people discontinue psychiatric medications and gathering information on the knowledge and opinions of psychiatrists regarding the discontinuation of such drugs. In this interview, we discuss deprescribing from psychiatric drugs, the difficult decisions faced by patients, the importance of psychosocial support during withdrawal, and how deprescribing is central to recovery-oriented practices such as shared decision and patient choice. We will also tackle the complex issue of whether the recurrence of symptoms once a drug is tapered is a mark of relapse or withdrawal caused by the psychiatric medication. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Deprescribing Psychiatric Drugs to Reduce Harms and Empower Patients - Swapnil Gupta

Justin Garson is a Professor of Philosophy at Hunter College and The Graduate Center, City University of New York, and a contributor for Psychology Today and Aeon. He writes on the philosophy of madness, the evolution of the mind and purpose in nature. His most recent book is Madness: A Philosophical Exploration, published by Oxford University Press in 2022. He is also the author of the forthcoming The Madness Pill: The Quest to Create Insanity and One Doctor’s Discovery that Transformed Psychiatry, which will be published by St. Martin’s Press. In this interview, Justin joins us to talk about the ways in which society has attempted to explain or categorize madness over the years. We also discuss the value of looking at madness, not as disease or defect, but as a designed feature. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Is Madness an Evolved Signal? – Justin Garson on Strategy Versus Dysfunction

Deborah Kasdan is author of  Roll Back The World: A Sister’s Memoir, in which she describes her extraordinary late sister Rachel–poet, musician, free spirit–and her decades-long journey through psychiatric treatment until, finally, she found a place of peace and community.  Kasdan is a longtime business and technology writer who pivoted to memoir writing on a quest to tell her sister’s story, joining the Westport Writers’ Workshop. Her book, published in October by She Writes Press, is a moving and nuanced portrait filled with love and grief, candor, and complexity.  *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

'It Was a Joint Effort'- Deborah Kasdan on Bringing Her Late Sister's Story to Life

Hello and welcome to the Mad in America: Rethinking Mental Health podcast. If you are new here, hello. My name is James and I will be your host as we ask critical questions about the state of psychiatry and psychology in the 21st Century. In this podcast, we examine mental health with a critical eye by speaking with psychologists, psychiatrists, researchers, journalists and people with lived experience. When you hear such conversations, you realise that much of what is believed to be settled in mental health is actually up for debate. Is mental health a matter of faulty biology or is there more to it? Are the treatments used in psychiatry helpful or harmful in the long term? Are psychiatric diagnoses reliable? With the help of our guests, we examine these questions and so much more. I think you will find the podcast insightful, informative, and, most of all, thought-provoking. It’s available on all major podcast platforms like Spotify, Apple or Google podcasts and YouTube. Just search for Mad in America: Rethinking Mental Health. Please join us for these important conversations. *** Mad in America is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Michael Hengartner – Evidence-biased Antidepressant Prescription

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