Peter R. Breggin, MD, has been called "The Conscience of Psychiatry" for his many decades of successful efforts to reform the mental health field. His scientific and educational work has provided the foundation for modern criticism of psychiatric drugs and ECT, and leads the way in promoting more caring and effective therapies. He has authored dozens of scientific articles and more than twenty books including the bestseller Talking Back to Prozac (1994, with Ginger Breggin), Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime (2008), and Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families (2013). In 2010 he testified before Congress about psychiatric-drug induced violence and suicide in the military.

     Dr. Breggin acts as a medical expert in criminal, malpractice and product liability suits, often involving adverse drug effects such as suicide, violence, brain injury, death, and tardive dyskinesia. A review of Dr. Breggin's forensic work can be found at Legal Cases. He began testifying in the early 1970s and has been qualified in court 85 times or more since 1987.

      Dr. Breggin is a Harvard-trained psychiatrist and former full-time consultant at NIMH. Dr. Breggin's private practice is in Ithaca, New York where he treats adults, couples, and families with children. He has a subspecialty in clinical psychopharmacology, including adverse drug effects and psychiatric drug withdrawal.

More information on Dr. Breggin.


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    See Dr. Breggin's new
    ECT Resources Center
    with more than 125 annotated scientific articles, glossary of searchable terms and a brochure for patients and families.


     
    Court Order Halts Some Research in Psychiatry | Print |  E-mail

    The New York Times December 27, 1996, page A1

     

    Court Order Halts Some Research in Psychiatry

    By PHILIP J. HILTS

     

    NEW YORK -- In a decision that has forced the cancellation of at least 10 research projects, a New York state appeals court has found the state's rules governing psychiatric experiments on children and the mentally ill to be unconstitutional.

     

    The court found that the rules did not adequately protect people who, because of age or illness, cannot give informed consent to taking part in drug tests or other experiments.

     

    The decision focused particularly on experiments that might pose a health risk without providing any direct benefit to the patient. For example, one study that has been halted involved spinal taps on suicidal adolescents to monitor the levels of chemicals in their nervous systems.

     

    The unanimous decision was issued Dec. 5 in Manhattan by the First Department of the Appellate Division of state Supreme Court. It upheld a 1995 ruling by Justice Edward Greenfield.

     

    Authorities said it would affect 10 to 15 of the 400 state and privately financed psychiatric research projects in the state. The ruling did not affect federally financed research, which is governed by stricter federal rules, but the court agreed to reconsider that question at the request of the plaintiffs.

     

    While the decision does not set a precedent outside New York, experts said it could have wide effect because other states have similar rules, and some are in the process of rewriting them.

     

    "This could be a landmark case," said Jonathan Mareno, an ethicist at the State University of New York's Downstate Medical Center in Brooklyn, "and it will raise a lot of eyebrows in other states. It is the first big case in which mental-health officers are taken to task for rushing ahead with experiments at the expense of patients' rights."

     

    Researchers, however, defended the rules, saying that the only way to test drugs intended for treatment of severe mental illness or Alzheimer's disease is on patients with those disorders, many of whom lack the capacity to consent.

     

    They expressed fear that more stringent rules on obtaining consent from parents or guardians could seriously hamper research efforts.

     

    Dr. John Oldham, director of the New York State Psychiatric Institute, said that if the court's view of consent was allowed to stand, many vital experiments "simply won't be able to be done" because the time and trouble it would take to get consent, possibly through a court hearing, would be too great.

    Under the rules that were struck down, researchers could use mental patients in such experiments with the approval of what the court described as "surrogates" like friends or family members. The rules did not require that the surrogate be the legal guardian of the patient.

     

    Similar rules applied to children. The rules permitted researchers to use children in experiments that posed a possible health risk but no direct benefit, with consent from a family member. The rules did not require that the family member be a parent or guardian.

     

    In both situations, the court found the rules violated the due process provisions of the state and federal constitutions.

     

    The court forbade all such experiments on children. In an opinion written by Justice David Ross, it declared: "We are not dealing here with parental choice among reasonable alternatives but with a decision to subject the child to nontherapeutic treatments and procedures that may cause harmful permanent or fatal side effects.

     

    It follows therefore that a parent or guardian, let alone another adult who may be a member of a child's family, may not consent to have a child submit to painful and/or potentially life-threatening research procedures that hold no prospect of benefit for the child."

     

    Different states and the federal government have different rules about experiments on children and incapable adults.

     

    Lynda Schuler, a lawyer for the Bazelon Center for Mental Health Law in Washington, said that many states -- including California, Connecticut, Massachusetts and Illinois -- flatly prohibit research with risks but no benefits when the patient cannot give consent.

     

    Federal rules are also stricter than the New York rules. For example, under the federal rules, only a court-appointed surrogate can give consent, not any relative or friend.

     

    Moreover, for experiments on children with substantial risk and no direct benefit to the child, the federal rules require parental consent, consent of the secretary of health and human services, approval by an expert panel, and public notice and comment. The New York rules require only the consent of a relative.

    Officials at the New York State Office of Mental Health, which wrote the rules, declined comment and said they had not decided whether to appeal. Officials at the Department of Health, which oversees the Office of Mental Health, also refused to comment.

     

    The case began five years ago, when the state set out to update rules governing psychiatric experiments conducted with private or state money, to make it easier for medical researchers to recruit patients, while strengthening safeguards to protect patients, officials said.

     

    Both sides said that many provisions of the new rules were improvements on the sketchy, loose rules they replaced.

     

    But patient advocates found fault with the rules governing people who cannot give consent, and they filed suit on behalf of six mental patients who had been committed and treated by court order without their consent and who the advocates said feared that they would also become subjects of experiments without their consent.

     

    The case was brought by Cliff Zucker of Disability Advocates in Albany and Ruth Lowenkron of New York Lawyers for the Public Interest in New York City.

     

    Patient advocates say that experiments should be carried out only on those who can give or withhold consent, not children and incapable adults. In the worst cases, they say, patients who can't give consent are put into experiments that have considerable risks and no likely benefits to them.

     

    Oldham said several experiments at the New York State Psychiatric Institute had been halted because of the ruling, including the study -- involving spinal taps -- of mentally ill adolescents and suicide. The experiment, he said, had been under way for more than a year and had enrolled hundreds of adolescents, with their parents' permission.

     

    "That experiment has been greatly compromised," he said. "We may not be able to do it any other way."

    In neuroscience and brain studies, Oldham said, "We have a special situation because some of the diseases we are talking about do impair reasoning and cognitive capacity in severe cases. But we need to work with patients with severe illness."

     

    He said one example of the progress made with this type of experimentation was the new schizophrenia drug Clozapine. "This is the only new medicine to come along in recent memory that is effective in schizophrenia," he said. "My opinion is that the Clozapine experiments just wouldn't have been done, and the drug wouldn't have come to market in the U.S." under the court's ruling.

     

    Patients' advocates disagreed. Zucker said that at early stages of a drug experiment, it was true that incapable adults probably could not be used, because it would be unclear what benefit, if any, the drug offers. But in later phases when benefits are known, it is possible to get surrogates' consent.

     

    Also, he said, in many illnesses like schizophrenia, patients often cycle between lucid and delusional states. Consent may be obtained when the patients are capable of giving it, he said.

     

    Oldham said he hoped that new rules could be worked out, even if researchers had to get court permission for some experiments. "It is just crucially important that this work go on," he said.

     

    In addition to New York State Psychiatric Institute, which is affiliated with Columbia University, institutions where experiments have been halted include the Pilgrim Psychiatric Center in Brentwood and the Nathan S. Kline Institute at Rockland Psychiatric Center in Orangeburg.

     

    The case is part of a trend across the United States to re-examine the relations between experimenters and their subjects. Texas and Maryland are currently considering new rules, said Dr. Adil Shamoo of the University of Maryland, an expert in ethics and psychiatric experiments. In both states the proposals would prohibit risky, nonbeneficial experiments on those who cannot consent.

     

    The New York court decision, Shamoo said, "is quite strong and will help bring these issues to the front burner across the country, both in the states and in the federal government. The court said that some of the common practices were not only against the state law and state Constitution, but violated the federal Constitution. So it is a national matter."

     

    The case began five years ago, when the state set out to update rules governing psychiatric experiments conducted with private or state money, to make it easier for medical researchers to recruit patients, while strengthening safeguards to protect patients, officials said.

     

    Both sides said that many provisions of the new rules were improvements on the sketchy, loose rules they replaced.

     

    But patient advocates found fault with the rules governing people who cannot give consent, and they filed suit on behalf of six mental patients who had been committed and treated by court order without their consent and who the advocates said feared that they would also become subjects of experiments without their consent.

     

    The case was brought by Cliff Zucker of Disability Advocates in Albany and Ruth Lowenkron of New York Lawyers for the Public Interest in New York City.

     

    Patient advocates say that experiments should be carried out only on those who can give or withhold consent, not children and incapable adults. In the worst cases, they say, patients who can't give consent are put into experiments that have considerable risks and no likely benefits to them.

     

    Oldham said several experiments at the New York State Psychiatric Institute had been halted because of the ruling, including the study -- involving spinal taps -- of mentally ill adolescents and suicide. The experiment, he said, had been under way for more than a year and had enrolled hundreds of adolescents, with their parents' permission.

     

    "That experiment has been greatly compromised," he said. "We may not be able to do it any other way."

    In neuroscience and brain studies, Oldham said, "We have a special situation because some of the diseases we are talking about do impair reasoning and cognitive capacity in severe cases. But we need to work with patients with severe illness."

     

    He said one example of the progress made with this type of experimentation was the new schizophrenia drug Clozapine. "This is the only new medicine to come along in recent memory that is effective in schizophrenia," he said. "My opinion is that the Clozapine experiments just wouldn't have been done, and the drug wouldn't have come to market in the U.S." under the court's ruling.

     

    Patients' advocates disagreed. Zucker said that at early stages of a drug experiment, it was true that incapable adults probably could not be used, because it would be unclear what benefit, if any, the drug offers. But in later phases when benefits are known, it is possible to get surrogates' consent.

     

    Also, he said, in many illnesses like schizophrenia, patients often cycle between lucid and delusional states. Consent may be obtained when the patients are capable of giving it, he said.

     

    Oldham said he hoped that new rules could be worked out, even if researchers had to get court permission for some experiments. "It is just crucially important that this work go on," he said.

     

    In addition to New York State Psychiatric Institute, which is affiliated with Columbia University, institutions where experiments have been halted include the Pilgrim Psychiatric Center in Brentwood and the Nathan S. Kline Institute at Rockland Psychiatric Center in Orangeburg.

     

    The case is part of a trend across the United States to re-examine the relations between experimenters and their subjects. Texas and Maryland are currently considering new rules, said Dr. Adil Shamoo of the University of Maryland, an expert in ethics and psychiatric experiments. In both states the proposals would prohibit risky, nonbeneficial experiments on those who cannot consent.

     

    The New York court decision, Shamoo said, "is quite strong and will help bring these issues to the front burner across the country, both in the states and in the federal government. The court said that some of the common practices were not only against the state law and state Constitution, but violated the federal Constitution. So it is a national matter."

     

    Copyright 1996 The New York Times Company

     

    Special Topics

    Legal Cases

       

    Dr. Peter Breggin often acts as a medical expert in criminal, malpractice, product liability and class action suits, and since the 1970s has testified in approximately 100 trials. Most of his cases settle before trial. However, a list of more than 80 trials in which he has testified 1986 are found in the final section of his Resume.

    Dr. Breggin’s testimony has involved antidepressants, benzodiazepine tranquilizers, sleeping aids, antipsychotic drugs, stimulants for children diagnosed ADHD, drugs in nursing homes and the elderly, electroshock (ECT), psychosurgery, and involuntary treatment. Cases often include drug-induced tardive dyskinesia, suicide, violence, diabetes, and death.

    Here is a small sample of positive and sometimes precedent-setting legal outcomes with Dr. Breggin as the psychiatric expert:


    Here are some of the details of several lawsuits:

    Read more...
     

    Therapy

     
    Blunting ourselves with drugs is not the answer to overwhelming emotions. Intense emotions should be welcomed. Emotions are the vital signs of life. We need and should want them to be strong. We also need our brains and minds to be functioning at their best, free of toxic drugs. That allows us to use our intelligence and understanding to the fullest. Thinking clearly is one of the hallmarks of taking charge of oneself instead of caving in to helplessness. 
     
    Read more...
     

    Children


    Throughout his career, Dr. Breggin has been especially concerned about the psychiatric abuse of children and the failure to provide more effective solutions through improved parenting, educational reform and community resources. As the drug companies and organized psychiatry have sought larger markets for pharmaceutical products, children have come under extensive from the psychopharmaceutical complex. The first great assault took place in the form of diagnosing children with ADHD and then medicating them with stimulant drugs. Soon millions of children were defined as mentally dysfunctional or defective and were submitted to brain-damaging psychoactive medications.

     


    Read more...
     

    ECT

     

    See Dr. Breggin's new
    ECT Resources Center
    with more than 125 annotated scientific articles, glossary of searchable terms and a brochure for patients and families.

     

    ECT (electroconvulsive treatment) damages the brain and mind. In many cases, it results in huge permanent gaps in memory for important life events, educational background, and professional skills. The individual may even lose his or her identity. Even when much less harm is done, individuals continue to suffer from ongoing cognitive difficulties with learning and remembering new things, and with unwanted changes in their personalities. Dr. Breggin has now created a free ECT Resources Center that includes (1) a brochure for patients, families, and advocates, (2) introductory scientific articles that cover the field of ECT-induced harm to the brain and mind, and (3) more than 125 articles about ECT with search terms such as "brain damage," "memory loss," "women," and "abuse." The ECT Resources Center will help introduce newcomers to the field and provide research materials for advanced researchers as well.

     

    The most detailed recent publication about the harm associated with ECT is found in a chapter in Dr. Breggin’s book, Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock and the Psychopharmaceutical Complex, Second Edition (2008).

     

    Dr. Breggin was the medical expert in the first and only electroshock malpractice suit won by the injured patient. He was also the expert in a recent malpractice suit against an ECT doctor that resulted in a settlement of more than $1 million.

     
    The acronym ECT stands for "ElectroConvulsive Therapy" (also called EST, for ElectroShock Therapy)  a psychiatric treatment in which electricity is applied to the head and passed through the brain to produce a grand mal or major convulsion. The seizure brought about by the electric stimulus closely resembles, but is more rigorous or strenuous than that found in idiopathic epilepsy or in epilepsy following a wide variety of insults to the brain.
     
    Patients given ECT are administered an electric current of sufficient intensity and duration to produce an acute organic brain syndrome, characterized by the classic symptoms of disorientation to time, place, and person; mental deterioration in all intellectual spheres such as abstract reasoning, judgment, and insight; emotional lability with extremes of apathy or euphoria; and overall childlike helplessness.

    Read more...
     

    Psychosurgery

     
    Psychosurgery is the destruction of normal brain tissue for the purpose of treating psychiatric disorders or for the control of emotions and behavior.  It does not include operations, such as those for Parkinson's disease or epilepsy, where an identifiable physical abnormality in the brain is causing a known physical disorder.  
     
    Lobotomy and other psychosurgeries merit special attention because, as the prototype of brain-damaging therapeutics, they can shed light on the clinical effects of other brain-disabling treatments such as electroconvulsive therapy (ECT) and major tranquilizers. Despite the paucity of active practitioners and advocates of psychosurgery, many psychiatric authorities have condoned this treatment precisely because the principles that find their extreme expression in lobotomy and other forms of psychosurgery also find more subtle expression in all the major somatic treatments in psychiatry.
     
    Read more...
     

    Racism & Social Control


    The widespread diagnosing of children is a subtle form of social control that suppresses children rather than providing them with what they need to fulfill their basic needs in the home, school and family.  For more information about social control and youngsters see the Children's section under Special Topics and Children's section under Scientific Papers, and well as several of Dr. Breggin's books, especially Brain-Disabling Treatments in Psychiatry (1998).  Dr. Breggin's blogs often address current children's issues.

     
    In Toxic Psychiatry (1991) Dr. Breggin addresses the psychiatric oppression of women.

    See Dr. Breggin's astonishing speech on Totalitarian Psychiatry & the Nazi Holocaust.

    Both Peter Breggin and Ginger Breggin have worked extensively to stop racist psychiatric programs of social control, especially those aimed at subuding inner city children. These successful reform projects are described in detail in their book, The War Against Children of Color (1998).   The following article is based on the book and presents a summary of their efforts. 

     
    Read more...
     

     

    WARNING!

    Most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems. In short, it is not only dangerous to start taking psychiatric drugs, it can also be dangerous to stop them. Withdrawal from psychiatric drugs should be done carefully under experienced clinical supervision. Methods for safely withdrawing from psychiatric drugs are discussed in Dr. Breggin's new book, Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients, and Their Families.