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A new large-scale study scrutinizing psychiatric prescribing finds clinicians continue to give high-risk drugs to Medicare dementia patients—most of the time with no documented justification at all.

WARNING: Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. —Food and Drug Administration

For decades, clinical guidelines have warned against prescribing brain-altering drugs like antidepressants and antipsychotics to dementia patients. Yet the practice persists.

And a new study published in the Journal of the American Medical Association (JAMA) reports that clinicians prescribe these drugs to roughly 25 percent of Medicare beneficiaries diagnosed with dementia.

That means one in four elderly Medicare beneficiaries with diagnosed dementia take pills known to carry serious risks, which can leave older adults drowsy and confused, unsteady on their feet and more prone to falls.

In the worst case, antipsychotics can even cause death, according to FDA warnings.

Clinicians were about twice as likely to prescribe psychotropics when there was no documented reason whatsoever than when there was one.

The study found doctors prescribed these drugs to over two-thirds of patients without any documented justification—no condition, symptom or circumstance that would justify prescribing the drugs—despite their known dangers. In other words, clinicians were about twice as likely to prescribe psychotropics when there was no documented reason whatsoever than when there was one.

“You would think it would be the opposite,” said Harvard Medical School’s Anupam Jena, a professor of health care policy.

No kidding.

The study’s senior author, Dr. John N. Mafi, was even more direct. Authorizing dangerous drugs without even so much as a purported justification to such a wide population of often helpless individuals can constitute, as he puts it, “inappropriate and harmful prescribing.”

These are “not trivial drugs,” he added. Some “actually have an FDA black box warning because they almost double the risk of death in patients with dementia.”

As people age, their ability to metabolize drugs changes, and they become more “susceptible to the toxicities of drugs,” Mafi explained. Older adults also tend to take multiple medications, increasing the risk of dangerous interactions.

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Researchers tracked more than 1,000 Australian infants and found children whose mothers used antidepressants in the last three months of pregnancy had up to nine times higher odds of developing autism.

At two months old, he didn’t babble or laugh or respond to any affection.

At 6 years old, he stared through you while you were talking, or fixed his eyes on some distant point above and beyond as if he were watching a plane passing by.

At 8 years old, he often flapped his hands or rocked back and forth for no apparent reason, ignoring attempts to intervene.

This is autism—a condition affecting brain development that can influence communication, social interaction and behavior.

It can also break a parent’s heart.

The message is clear: If you want a healthy baby, don’t take antidepressants during pregnancy.

And now, an Australian study reveals that a mother’s choices during pregnancy can dramatically increase the odds that her child will become autistic. Mothers who used SSRI or SNRI antidepressants during the last three months of pregnancy gave birth to children with nine times higher odds of autism compared to those who did not use the drugs.

So, if that’s what happens if you consume these drugs in the last three months of pregnancy, is it safe to take them during the first six months?

Only if you consider a 6.43 times higher risk of autism for your baby “acceptable.”

Researchers arrived at their conclusions after analyzing data from the Barwon Infant Study, an ongoing long-term research project that follows more than 1,000 children born in the Barwon region of the Australian state of Victoria between 2010 and 2013, tracking their health outcomes over time.

The data leaves little room for doubt. Higher antidepressant use during pregnancy is consistently linked to dramatically higher rates of autism.

And the message is clear: If you want a healthy baby, don’t take antidepressants during pregnancy.

The researchers, however, are cautious. They identify a series of other potential factors that could also influence their findings—including nutrition, air pollution and vinyl flooring.

But the numbers tell a different story.

A US Department of Health and Human Services press release last spring declares, “Autism Epidemic Runs Rampant.”

The article continues: “One in 31 American children born in 2014 [is] disabled by autism. That’s up significantly from two years earlier and nearly five times higher than when the CDC first started running autism surveys in children born in 1992. Prevalence for boys is an astounding 1 in 20, and in California, it’s 1 in 12.5.”

The obvious conclusion is that if autism has nearly quintupled since, then whatever was an active factor in creating autism must also have nearly quintupled over the same period.

Did the vinyl flooring industry boom nearly five times over since that year?

No, but something else did.

That “something else” entered the psychiatric armory in the late 1980s and exploded in popularity almost overnight: “modern” SSRI antidepressants.

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Long‑term use of common psychiatric drugs like Xanax and Valium can trigger a newly recognized condition that leaves users with years of fatigue, anxiety and cognitive damage.

Xanax, Valium, Librium, Ativan, Klonopin, Restoril.

On the street, they’re called “benzos”—psychiatric drugs that promise to reduce anxiety by slowing brain activity.

Considered “minor” tranquilizers (unlike antipsychotics, which are “major”), they are so culturally ubiquitous that in the Burt Reynolds film Starting Over, a character asks, “Does anyone have a Valium?” and every woman pulls out a pill bottle to offer one.

But benzos are no laughing matter. Only recently have researchers begun to document the extent of the prolonged and often devastating symptoms some users experience after stopping benzos.

“It takes everything in me to appear normal.… It was a nightmare. My brain has not been the same.”

A team at the University of Nebraska Medical Center recently reported a new disturbing condition resulting from long-term use.

They described a 57-year-old man with a 40-year benzo habit—originally begun to manage alcohol addiction, depression and anxiety. When he finally quit, he suffered debilitating fatigue, brain fog, uncontrollable anxiety, overwhelming emotional distress and panic far beyond the typical two-week withdrawal window.

His condition set off alarm bells for researchers, who recognized they were seeing benzodiazepine addiction as well as persistent damage to the nervous system, which they refer to as Benzodiazepine-Induced Neurologic Dysfunction (BIND).

BIND is real, underdiagnosed and dangerous. “While acute benzodiazepine withdrawal is well characterized, typically emerging within days and resolving in under two weeks, some patients experience prolonged symptoms such as fatigue, impaired concentration and anxiety that persist well past this time frame,” researchers wrote.

For patients trying to leave benzos behind, the road is long and grueling, The New York Times reported: “Many then get cut off from their medication or taper too quickly, and face dangerous and potentially life-threatening withdrawal symptoms that can linger long after the drugs are discontinued.”

The American Society of Addiction Medicine recommends lengthy tapering procedures, sometimes lasting more than a year, with monitoring even after the drug is fully stopped. Yet weaning millions of Americans off benzos is daunting: The FDA reports over 92 million prescriptions filled in 2019 alone.

Going cold turkey is often neither effective nor safe.

The human toll is severe. Tasha Hedges quit Xanax after 20 years and suffered hot flashes, cold sweats, restless legs, shaking and teeth grinding. Years later, she said: “It takes everything in me to appear normal.… It was a nightmare. My brain has not been the same.”

A University of Colorado Anschutz Medical Campus survey of 1,207 benzo users—63.2 percent still taking, 24.4 percent tapering, 11.3 percent fully off—found shocking results: 54.4 percent reported suicidal thoughts or attempts. Symptoms often lasted over a year, including low energy, memory loss, anxiety, insomnia, sensitivity to light and sound, digestive issues, muscle weakness and body pain. Over 40 percent reported 17 or more ongoing symptoms at least a year after quitting.

Dr. Christy Huff, one of the researchers and a former benzo user herself, explained: “Patients have been reporting long-term effects from benzodiazepines for over 60 years.… Even though I took my medication as prescribed, I still experience symptoms on a daily basis at four years off benzodiazepines.”

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Factors like sex, race or foster care status didn’t explain the fivefold jump in psychotropic stacking. The results expose a system primed to drug children rather than help them.

aston was introduced to drugs at the age of 3. Barely potty-trained, he was nevertheless diagnosed with ADHD and put on guanfacine, a blood pressure medication often prescribed for children who can’t sit still.

The physician assistant who wrote the prescription failed to mention that the FDA had never approved guanfacine—whose side effects include blurred vision, confusion, dizziness, severe weakness and depression—for toddlers like Easton.

The drug made Easton “like a zombie,” according to his aunt and adoptive mother, Kymberly Stacks. Yet each time she raised her concerns with the physician assistant, the answer was to increase the dose.

Up and up the doses went, until Stacks switched to a psychiatrist who promptly put him on the antipsychotic Abilify.

Then the stimulant Evekeo.

Followed by Concerta, ProCentra and Ritalin.

None “cured” him.

“We have made a mess and it’s dangerous.”

Now age 6 and a veteran of six psychiatric drugs, he’s presently on his seventh, Quelbree, another ADHD drug.

Its side effects include insomnia, blood-pressure problems, depression and suicide.

How will Easton’s story end? More drugs until the symptoms suppressing his symptoms are more palatable to society at large, or until he’s too drugged out to function at all?

“I constantly think he was put on medication way too young, but no doctor ever said anything,” said Stacks.

The doctors may not be talking, but the Medicaid stats speak loud and clear: Of roughly 166,000 children ages 3 to 14 who started ADHD drugs in 2019, over 39,000—more than 23 percent—were taking two or more psychiatric drugs at the same time by 2023. More than 4,400 of these children were on four psychotropics simultaneously. Children who were started on ADHD drugs at younger ages were considerably more likely to be prescribed additional psychiatric drugs over the ensuing four years.

“There are concerns about safety, because there can be additive adverse effects of different types of medications,” said Dr. Javeed Sukhera, of the Institute of Living at Hartford Hospital in Connecticut.

“We have made a mess and it’s dangerous,” said Jennifer Havens of the NYU Grossman School of Medicine. “If a kid is on five, six, seven medications, that’s just wrong.”

Yet it continues.

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A landmark reform shuts down deceptive drug ads that fueled overprescribing, misinformation and billions in profits for Big Pharma.

ruthful and non-misleading Direct-to-Customer (DTC) advertising is protected under the First Amendment and has documented evidence of advancing patient awareness and engagement,” said Alex Schriver, senior vice president at Pharmaceutical Research and Manufacturers of America (PhRMA).

Because he said it in a statement, we have no way of knowing if his fingers were crossed or if he was stifling a smirk.

Schriver made the statement in response to a historic raft of reforms coming down from the FDA and Department of Health & Human Services (HHS) requiring pharmaceutical companies to include full safety warnings in DTC ads—with an emphasis on the word “full.” The reforms close a 1997 “adequate provision” loophole that allowed companies to minimize risk disclosures, referring the viewer interested in learning all the risks to a tiny print website address or phone number, while lulling them with images of delighted people doing joyous things.

DTC ads work just fine the way they are now—for drug companies.

PhRMA is a trade and lobby group that has worked tirelessly for the good of Big Pharma since 1958—lobbying against lower drug prices, price limits and price negotiations, and levying lawsuits while donating vast sums of dark money to groups that oppose reform. It wants no changes in the status quo, which is why it insists that DTC ads are “truthful and non-misleading.”

The evidence, of course, tells a different story.

Doctors themselves admit that when patients request drugs they’ve seen advertised, the doctor often feels pressured to prescribe—even when it isn’t medically appropriate. In fact, studies show physicians are 17 times more likely to write a prescription if a patient specifically asks for the drug, sometimes just to protect their own satisfaction scores. The results are predictable: unnecessary prescriptions for powerful, dangerous psychotropics like Adderall, along with an overall surge in inappropriate drug use.

A 2021 review likewise confirmed what doctors and patients already knew: DTC ads result in more prescription requests, more prescriptions written and more inappropriate prescribing. Even a brief exposure to a statin commercial made low-risk patients 16–20 percent more likely to be diagnosed with high cholesterol, and 16–22 percent more likely to walk away with a prescription.

And the ads themselves? A 2024 review found that nearly two-thirds were of poor scientific quality. Almost half were outright misleading, and more than a third were judged potentially harmful. Content analyses show why: Only about a quarter even bother to explain the disease or its mechanisms. A tiny fraction mention risk factors. But almost all—94 percent—lean on emotional manipulation (that syrupy music with the happy slow-motion people).

Worst of all, the ads drive patients toward pills at the expense of effective—and far safer—lifestyle changes.

So, yes, DTC ads work just fine the way they are now—for drug companies. They work so well, in fact, that prescription drug use among Americans increased from 39 percent (1988–1994) to 49.9 percent (2017–2020) in the last 30 years.

That means if you’re a six-year-old boy today, you can expect to spend 47.1 percent of the rest of your life on prescription drugs, while if you’re a baby girl, you can expect to spend 58.2 percent of your life popping pills.

Small wonder, then, that “drug makers spent a whopping $5.15 billion on national TV ads in 2024,” CNN reported. “They continued to open their wallets in 2025, spending just shy of $3 billion on national TV ads during the first half of the year, a 12.2 percent year-on-year increase.”

It’s to the point now where Big Pharma is currently fourth in terms of total TV ad spending by industry, accounting for 11.1 percent of the market. If you’re binge-watching “The Great British Baking Show” or Netflix’s “Wednesday”  right now, chances are you’ll see a drug commercial or six within the next hour or two.

Those of you who are old enough: Remember all those TV ads for prescription drugs before 1997?

You would be excused if you can’t. That’s because there were virtually none. In those days, pharmaceutical ads had to give full disclosure and report all risks. Some of those lists of side effects and dangers run to pages of small print. It would just take too long to read them out loud (the commercials would be the length of the TV shows they sponsored).

Thousands of sponsors will receive warning letters, while dozens of companies will be hit with actions for false and misleading promotion.

That all changed in 1997, with the FDA’s introduction of the “adequate provision” loophole. “Adequate provision” is an important-sounding term that describes permitting pharmaceutical advertisements to hide safety information by placing it in another format or location. As long as they recite a vague “major-risk statement” and then point viewers to a website, toll-free number or print insert for more complete information on how their drug can make you sicker, more miserable or suicidal, we’re cool.

The result: a 24/7 tsunami of pharmaceutical lies inundating America’s airwaves and assaulting our senses.

As HHS indicated in announcing the reform: “This loophole—which denies patients vital safety information required for them to make an informed decision—has had a clear negative impact on public health.”

The reform, HHS goes on to say, “simply returns to the status quo policy pre-1997. It requires the presentation of factual and uncontroversial statements which are already legally required to be communicated in drug advertising; goes directly to the core government interests of protecting the public from deception and protecting public health—as supported by voluminous evidence of public harm under the current system; and does not unduly burden advertisers, by preserving their right to engage in commercial speech under the standards that existed prior to 1997.”

But this time, with teeth.

The FDA is putting the drug industry on notice: Remove deceptive ads or face enforcement. Thousands of sponsors will receive warning letters, while dozens of companies will be hit with actions for false and misleading promotion. “No longer asleep at the wheel,” the FDA will wield its authority aggressively to crack down on misbranding.

This is welcome news. The FDA? Doing its job?? Hooray! And they’ve already begun. On the day of the announcement, the FDA issued approximately 100 cease-and-desist letters and thousands of warning letters directly to pharmaceutical companies.

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