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Psychiatrists can prescribe drugs because they are medical doctors. It is highly unlikely that the American Medical Association would be willing to give a piece of that highly lucrative practice away to psychologists. Instead of expanding the number of people who can hand out powerful psychotropic drugs (anti-psychotics like phenothiazines), we would do well to examine the current practice of prescribing drugs to mentally ill patients.

My own experience with psychiatrists and drug prescriptions is that they tend to give them out like candy and they make a lot of money on their drug business. When I worked with mentally ill adults in a residential facility, I asked a psychiatrist if the mental patients became acclimated to their drugs. He assured me that the same dose would always have the same effect and increasing doses were not necessary unless the patient became more seriously ill.

I hope that he was lying to me because if he wasn't, then he was remarkably stupid and/or uninformed. I saw patients with their first psychotic break being given a certain dose of an antipsychotic drug. Once they settled down and became manageable and lucid, their dosage was never reduced! The next time they had a break, which was almost inevitable, the psychiatrist simply upped their dosage. Every time they had a break, the dosage would go up.

When one of our residents took off from the house looking for coffee and cigarettes, she was rounded up by the nearby hospital and taken to the psych ward, where she was well known. This woman had her break when she was 16 and was 32 at the time this happened.

The hospital was required to hold her overnight for observation. The psych nurse on duty called me and asked me what drug the patient was taking and what dosage. I told her it was Mellaril, a common antipsychotic. She asked me how many pills the patient was taking. (These were 100 mg pills.) I told her she was taking 13. There was silence at the end of the phone and then the nurse said, "That's impossible. That's a lethal dose."

The recommended dose for a disturbed schizophrenic is 150-400 mg/day. The maximum dose is 800 mg. This woman was taking 1,300 mg daily. The careless prescribing of these powerful anti-psychotics is nothing short of criminal. Before we start letting psychologists hand out drugs, we'd better clean house in the psychiatric profession and make it illegal for any psychiatrist to profit from any drug prescribed, the same with any medical doctor. As long as doctors are married to the pharmaceutical industry, people are going to be over-medicated.

Learn more about this author, Bob Trowbridge.
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