Iatrogenic Mental Disorders

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Understanding Iatrogenic Mental Disorders Better

No one talks about iatrogenic disorders nearly enough. Iatrogenic disorders (literally, disorders caused by the physician or treatment) including mental disorders, have not been very well understood. However, in medical literature, it is well known that drugs can cause mental distress, injury, and illnesses.¹ Nonetheless, we hear more often about a drug that “triggered some underlying mental illness.” Or, a patient begins a prescription of Klonopin and contracts panic disorder literally overnight. The prescribing physician may not recognize the person’s condition as an iatrogenic or drug-induced disorder. The doctor, in the rush to find relief for the patient, may declare that the patient has developed panic disorder. And, prescribe more drugs.

Another example is a patient who may opt to take a sleeping pill seeking relief from insomnia. The drug may produce side effects like emotional blunting, depression, and perhaps even suicidality. Promoters of prescription drugs often put a fuzzy filter on the subject of medicine and side effects. Consequently, the practitioner may not recognize these new symptoms as drug side effects, and may even diagnose that a new mental illness has emerged. Through this short-sighted lens, the doctor could even decide that the drug merely “revealed” the underlying condition.²

There is a great burden of information gathering that is placed on prescribing physicians. Simply reading the pamphlets provided by drug sales reps is not going to provide a thorough understanding of all that can be known about drug-based treatments. While the burden of understanding is great, relying solely on advertising-based information commonly places a skewed filter over the judgment of many physicians who otherwise would know better. Medical school curricula on pharmacology also do not relieve this problem adequately. By the time a doctor graduates, probably 1000s of new drugs have come to market, none of which were covered in their studies. And though it may be time-consuming, the prescriber is best-advised to do their own research for as complete an understanding as possible.^5,6,12

Iatrogenic Psychiatric Disorders Include:

• Suicidality
• Anxiety, depression, panic attacks, mood disorders
• Insomnia, disturbed sleep
• Lethargy
• Serotonin syndrome
• Agitation
• Confusion
• Hypochondriasis
• Sexual dysfunction
• Invalidism
• Psychosis, hallucinations, mania
• Emotional blunting
• Anhedonia
• Drug dependence

Avoiding Over-Medication

Overmedication is a growing problem in all age groups, not the least of which is the elderly. The more drugs that are prescribed the greater the iatrogenic risk becomes for adverse drug reactions, interactions, and hospitalizations. As a person ages, doctors and practitioners tend to chalk up additional diagnoses of disorders including mental illnesses, and can overlook entirely the identification of cumulative adverse drug reactions, (ADRs). Consequently, these ADRs are typically accompanied by further medications. The doctor may now be treating the patient as if suffering from multiple disorders, rather than recognizing they are suffering from over-medication. This has become, unfortunately, a prevailing medical model for treatment. Such practices can take a great toll on a person’s overall health and ability to recover, not to mention the disruption of the person’s family life and career. This appears to be a worldwide phenomenon. A study out of Austria found that of a cohort of 169 patients, on average, the patients were on between 6 and 12 medications and that at least one non-evidence-based prescription was found in 93% of the participant’s daily regimen.

A similar but much larger study out of the US showed that 23% of the group of 16,000+ patients were each prescribed a set of 8 potentially inappropriate medications. A large review of prescribing practices that spanned both the US and Europe also found that the practice of inappropriately prescribing medications to elderly care home clients was “highly prevalent,” ranging from 12% to 40% of these populations. Overmedication commonly leads to cognitive impairments, falls, and other drug-related adverse events (ADEs).

The CDC reports that 89% of adults in the US take at least one medication and that 29% take at least 5 medications. The CDC reports also that excess medical treatment for adverse drug events costs about $3.5 billion each year, and that these numbers are growing.

After millions of dollars spent on research, the US Dept of Health’s published guidelines about how to avoid ADEs from overmedication remain sparse. At Alternative to Meds Center, we offer alternatives to medication and safe ways to get off medications that have been inappropriately prescribed. We know these are superior solutions to this problem ^3,7-9

Knowledge About Drug Side Effects Is Necessary

Drugs such as methylphenidate (Ritalin©, Adderall©, et al) as well as some antidepressants are known to contribute to and cause cardiovascular adverse events. One did not have an irregular heartbeat (arrhythmia) before the prescription.³ Such a drug-induced illness would be correctly described as iatrogenic. Studies that link certain drugs to specific known adverse reactions demonstrate this cause and effect with certainty. Doctors don’t always warn their patients about the possibility (but should.) Physicians are often caught in the pressure of trying to help a patient quickly by prescribing drugs for mental disorders such as anxiety, depression, or other symptoms. Drugging to numb the symptoms is not true healing. With diligence and an increased understanding of safely and effectively treating the many sources of mental symptoms without drugs, iatrogenic ADEs and ADRs can be successfully avoided.^4,10,11

Overall, our alternative strategies to medication and safe, gentle tapering programs have consistently transitioned our clients to drug-free or greatly reduced drug reliance, and brought much relief. Iatrogenic mental disorders played a not insignificant part in conditions that debilitated many of our clients for years before finding us and enrolling in a personally tailored treatment program.

for Iatrogenic Mental Disorders Help

1. Peer RF, Shabir N. Iatrogenesis: A review on nature, extent, and distribution of healthcare hazards. J Family Med Prim Care. 2018 Mar-Apr;7(2):309-314. doi: 10.4103/jfmpc.jfmpc_329_17. PMID: 30090769; PMCID: PMC6060929. [cited 2022 Sept 6]

2. Fava G, Rafanelli C Iatrogenic Factors in Psychopathology. Journal of Psychotherapy and Psychosomatics [INTERNET] 2011 [cited 2022 Sept 6]

3. Whitlock FA. Adverse psychiatric reactions to modern medication. Aust N Z J Psychiatry. 1981 Jun;15(2):87-103. doi: 10.3109/00048678109159417. PMID: 6116487. [cited 2022 Sept 6]

4. IATROGENIC DISEASE. JAMA. 1954;154(16):1352–1353. doi:10.1001/jama.1954.02940500032014 [cited 2022 Sept 6]

5. Rodziewicz TL, Houseman B, Hipskind JE. Medical Error Reduction and Prevention. [Updated 2022 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499956/ [cited 2022 Sept 6]

6. Rodríguez-Carranza R, Vidrio H, Campos-Sepúlveda E. La enseñanza de la farmacología en las escuelas de medicina. Situación actual y perspectivas [The teaching of pharmacology in medical schools: current status and future perspectives]. Gac Med Mex. 2008 Nov-Dec;144(6):463-72. Spanish. PMID: 19112717. [cited 2022 Sept 6]

7. Planton J, Edlund BJ. Strategies for reducing polypharmacy in older adults. J Gerontol Nurs. 2010 Jan;36(1):8-12. doi: 10.3928/00989134-20091204-03. Epub 2010 Jan 12. PMID: 20047247. [cited 2022 Sept 6]

8. Buck MD, Atreja A, Brunker CP, Jain A, Suh TT, Palmer RM, Dorr DA, Harris CM, Wilcox AB. Potentially inappropriate medication prescribing in outpatient practices: prevalence and patient characteristics based on electronic health records. Am J Geriatr Pharmacother. 2009 Apr;7(2):84-92. doi: 10.1016/j.amjopharm.2009.03.001. PMID: 19447361. [cited 2022 Sept 6]

9. US Dept of Health, National Action Plan for Adverse Drug Event Prevention [published online c.2012] [cited 2022 Sept 6]

10. Reddy DS. Current pharmacotherapy of attention deficit hyperactivity disorder. Drugs Today (Barc). 2013 Oct;49(10):647-65. doi: 10.1358/dot.2013.49.10.2008996. PMID: 24191257. [cited 2022 Sept 6]

11. Biffi A, Rea F, Scotti L, Lucenteforte E, Vannacci A, Lombardi N, Chinellato A, Onder G, Vitale C, Cascini S, Ingrasciotta Y, Roberto G, Mugelli A, Corrao G; Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE). Antidepressants and the Risk of Cardiovascular Events in Elderly Affected by Cardiovascular Disease: A Real-Life Investigation From Italy. J Clin Psychopharmacol. 2020 Mar/Apr;40(2):112-121. doi: 10.1097/JCP.0000000000001189. PMID: 32134848. [cited 2022 Sept 6]

12. Siomopoulos V. Psychiatric iatrogenic disorders. Am Fam Physician. 1986 Oct;34(4):111-6. PMID: 3766357. [cited 2022 Sept 6]

13. Ferguson JM. SSRI Antidepressant Medications: Adverse Effects and Tolerability. Prim Care Companion J Clin Psychiatry. 2001 Feb;3(1):22-27. doi: 10.4088/pcc.v03n0105. PMID: 15014625; PMCID: PMC181155. [cited 2022 Sept 6]

14. McCabe C, Mishor Z, Cowen PJ, Harmer CJ. Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment. Biol Psychiatry. 2010 Mar 1;67(5):439-45. doi: 10.1016/j.biopsych.2009.11.001. Epub 2009 Dec 24. PMID: 20034615; PMCID: PMC2828549. [cited 2022 Sept 6]

Originally Published Mar 10, 2020 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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Diane Ridaeus

Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.