“Rights-based mental-health systems are achievable in practice. The remaining challenge is not proof of concept; it is whether funding priorities and regulatory frameworks will support approaches that place human recovery above psychiatric-pharmaceutical expansion and profits.” – Jan Eastgate, President CCHR International

CCHR calls for urgent reform as millions face long-term drug harm despite evidence that safer, community-based models work.

By Jan Eastgate
President CCHR International
February 27, 2026

Seventy-two years after the first antipsychotic, Thorazine, was approved, psychiatry is only now seriously discussing the need to deprescribe these drugs. For millions already exposed, that realization comes far too late. Despite decades of mounting evidence of severe and sometimes irreversible harm, new drugs in the same class continue to receive federal approval. This represents a systemic failure that demands urgent reform.

Of the 76.9 million Americans taking psychiatric drugs in 2020, more than 11 million, including over 829,000 children and teens, were prescribed antipsychotics. These drugs are associated with profound risks: diabetes, heart risks, sexual and hormonal problems, suicidal feelings and behavior, neuroleptic malignant syndrome (rare but serious neurological disorder, which may also occur as a withdrawal symptom, and can be fatal) and emotional effects such as agitation, aggression, excitability, depression, out of touch with reality; socially withdrawn and detached from those around you.[1]  

Among the most devastating adverse effects are tardive psychosis (the emergence of new psychotic symptoms) and tardive dyskinesia, an often irreversible, potentially permanent drug-induced movement disorder characterized by involuntary, repetitive movements such as grimacing, lip-smacking, and tongue protrusion.[2]

Antipsychotics have also been linked to episodes of aggression and violence. A December 2023 article in MedShun, titled “The Link Between Antipsychotics and Aggressive Behavior: Understanding the Potential Causes of Violence,” reported that “there have been instances where their use has been associated with increased aggression and violent behavior.” The article emphasized that understanding why antipsychotics can, in some cases, precipitate violence is essential to ensuring patient safety and developing treatment strategies that minimize these risks. Documented high-risk adverse effects include agitation, hostility, impulsivity, and akathisia, a state of intense inner restlessness associated with behavioral dysregulation.[3]

A review published in Drug Safety found treatment failure or relapse rates ranging from 38% to 93%, depending on the study. Researchers concluded that the extent of multi-system injury caused by antipsychotics warrants scientific and regulatory reappraisal.[4] 

Yet approvals continue.

As of 2016, the Food and Drug Administration (FDA) had approved 12 atypical antipsychotics.[5] Between 2017 and 2025, three additional antipsychotic drugs were approved—Caplyta (2019), Lybalvi (2021) and Cobenfy (2024).[6] In February 2026, yet another antipsychotic, milsaperidone, an active metabolite of iloperidone, the antipsychotic Fanapt, received approval for “schizophrenia” and “bipolar I disorder.” Like others in its class, it carries boxed warnings regarding increased mortality in elderly patients with dementia-related psychosis, along with risks of metabolic disruption, blood disorders, seizures, cardiac irregularities, and permanent neurological damage.[7]

CCHR questions why drugs known to cause such irreversible injury continue to expand in use, including through involuntary administration in psychiatric facilities.

Deprescribing: A Late Recognition

There is now a growing professional discussion about deprescribing antipsychotics.

In the May 2025 edition of Current Opinion in Psychiatry, Drs. Mark Horowitz and Joanna Moncrieff reviewed evidence supporting gradual tapering of long-term antipsychotic use. Rapid withdrawal can trigger anxiety, agitation, and psychotic-like symptoms, which are frequently misinterpreted as relapse rather than withdrawal. Importantly, research shows that although relapse rates may initially be higher in dose-reduction groups, long-term outcomes equalize, and social functioning often improves among those who successfully reduce or discontinue medication. Gradual tapering allows neurological adaptation. Rapid discontinuation can create “withdrawal-associated relapse.”

The authors stated, “It is well established that gradual tapering of psychiatric drugs, like benzodiazepines, produces a better outcome than more rapid tapering, and this principle is increasingly accepted for other classes of psychiatric drugs as well.”[8]

CCHR argues that acknowledging the need to taper after decades of mass prescribing underscores a deeper regulatory failure: long-term safety was never adequately addressed before widespread adoption.

Irreversible Harm: Tardive Dyskinesia

Tardive dyskinesia (TD)—tardive, meaning “late” and dyskinesia meaning “abnormal movement” —is a persistent, and often permanent, movement disorder caused by antipsychotics. TD is characterized by involuntary, repetitive movements of the face, tongue, lips, trunk, and extremities. In many cases, the condition does not resolve even after the drug is discontinued. Estimates suggest it affects 20 to 50% of long-term antipsychotic users.[9] While not all of the 11 million Americans being prescribed antipsychotics are chronically exposed, applying that risk range to long-term users suggests that a substantial number—potentially hundreds of thousands to over a million—may be living with a persistent drug-induced neurological movement disorder.

Psychiatry has even classified TD as a “medication-induced movement disorder” within its Diagnostic and Statistical Manual of Mental Disorders (DSM).However, they have effectivelytransformed drug-induced injury into a billable diagnosis.[10]

When TD develops, additional psychotropic drugs are often prescribed to suppress the iatrogenic symptoms. These carry their own adverse effects — fatigue, blurred vision, impaired coordination, cardiac irregularities, drooling, tremors, and restlessness —sometimes mimicking or compounding the conditions they are intended to treat.[11]

This cycle raises a fundamental medical and ethical question: why are drugs known to cause permanent neurological injury so widely prescribed, including forcibly?

Accountability and the Regulatory Divide

When individuals deliberately administer dangerous drugs to harm and even kill someone, the criminal justice system responds. There have been life sentences for administering fentanyl with lethal intent. A nurse was prosecuted for intentionally injecting fatal doses of insulin into patients. An individual was convicted of attempted murder for poisoning victims with sedative-laced food.

Those cases involve criminal intent.

But the distinction is instructive. The legal system treats deliberate lethal drugging as a grave crime precisely because the consequences are catastrophic and foreseeable.

By contrast, when drugs known to cause permanent neurological injury are administered under regulatory approval, including forcibly, the resulting harm is categorized as a side effect rather than an injury requiring systemic reassessment.

The issue, then, is regulatory accountability.

When documented, non-coercive models show equal or superior long-term outcomes with significantly less drug exposure, failure to prioritize those models raises serious public-policy concerns.

The Soteria Model: A Proven Alternative Deliberately Marginalized

Soteria Houses were pioneered by Dr. Loren Mosher, former Chief of the Center for Studies of Schizophrenia at the National Institute of Mental Health (NIMH), who conceived and established the project between 1971 and 1983 under the title Community Alternatives for the Treatment of Schizophrenia.[12] It was a federally funded, real-world experiment that directly challenged hospital-based, drug-centered psychiatry.

Young adults experiencing a first or second episode of psychosis were assigned either to conventional hospital treatment or to live in a Soteria house. These were small, home-like residences staffed largely by carefully selected laypersons rather than psychiatric professionals. The model emphasized human connection, shared daily living, meaningful activity, and the preservation of autonomy. Antipsychotics were deliberately avoided as the initial intervention. Only if a person did not stabilize would a low dose be introduced, with the individual’s participation in the decision.[13] Many residents remained medication-free or used substantially less medication than hospital-treated patients, and follow-up data indicate that a significant number were not maintained on antipsychotics long term, suggesting that some who received low-dose medication during acute stabilization were later able to discontinue it.

After two years, 42% of Soteria participants had never been exposed to antipsychotics during the follow-up period. Of the 58% who did receive the drugs, only 19% were continuously maintained, meaning 39% received antipsychotics but were not maintained on them long-term. Two-year follow-up evaluations showed that Soteria participants achieved higher occupational functioning, greater independent living, and fewer hospital readmissions than those receiving standard hospital-based drug treatment.[14]

These findings directly challenged the dominant psychiatric model by demonstrating that recovery from psychosis did not require immediate or lifelong pharmacological management.

These outcomes posed a direct challenge to the dominant psychiatric-medical model. They demonstrated that recovery from psychosis did not require immediate or lifelong pharmacological management.

A 2013 meta-analysis examining schizophrenia recovery rates found that long-term recovery has gradually declined since the 1970s, with outcomes in the era of atypical antipsychotics lower than those reported even before the widespread use of these drugs.[15] In that context, the Soteria results carry particular significance.

Dr. Gary G. Kohls later wrote that the Soteria Project “was sabotaged by Dr. Mosher’s own National Institute of Mental Health. The obviously unwelcome positive findings that were coming out of the Soteria Project were accurately seen by the establishment types in the NIMH, Big Pharma, and Big Psychiatry as an economic threat to their industries, and they acted to subvert the project.”[16]

Despite an internal NIMH review acknowledging success, funding was discontinued. Dr. Mosher later resigned from the American Psychiatric Association, stating: “Psychiatry has been almost completely bought out by the drug companies.” In a 2003 interview, he further stated, “We’re so busy with drugs that you can’t find a nickel being spent on [non-drug] research.”[17]

Yet the model did not disappear. Soteria houses have operated in Hungary, Israel, the Netherlands, Sweden, Germany, Japan, France, Switzerland, and Vermont in the United States.[18]  

In February 2026, Pathways Vermont announced a new permanent home for its Soteria House program, the only one of its kind in the United States. Operating since 2015, it has provided a voluntary, home-based alternative to hospitalization.[19]

A 2022 study on the Soteria model in Israel reviewing 486 residents found that between 63 and 92% avoided hospitalization, and only 19% returned after an initial stay, which was substantially lower than typical psychiatric readmission rates. Israel’s Ministry of Health formally recognized the model and supported its expansion as of 2023, eighteen Soteria houses were operating there.[20]

Soteria houses in Switzerland have been similarly described as non-hospital, family-like environments where medication use is low or absent and personal autonomy is central.[21]

Soteria demonstrates that serious mental distress can be addressed in ways that reduce drug exposure, preserve dignity, and produce durable functional recovery.

Dr. Giorgio Antonucci: Restoring Life Where Psychiatry Had Written It Off

Beginning in 1968, Italian physician Dr. Giorgio Antonucci implemented a simple but radical principle: “Never use restraints.” Working in institutions where patients had been restrained for years, subjected to electroshock, and heavily sedated, Antonucci removed restraints and reduced drugging.[22]

In 1969, Antonucci joined the psychiatric hospital in Gorizia under the direction of reformer Franco Basaglia, who, like CCHR’s founder, Professor Thomas Szasz and Antonucci, called for dismantling institutions built on involuntary detention and forced treatment.[23]

In 1973, Antonucci was given a ward of 44 women labeled “incurable” and violent.

He untied them one by one.

“When I untied these people, they couldn’t stand up,” he recalled. “I had to begin by accompanying them… to let them get their muscular function back.”

“It was like resuscitating them from death.”[24]

Detailed in his book The Lessons of My Life: Medicine, Psychiatry and Institutions, patients regained mobility, speech, and autonomy. Some later traveled to the European Parliament to testify about needed rights.

“Forced treatments are violations of their rights and harmful to them,” Antonucci maintained. “For me, to free people from internment in an insane asylum has mostly meant to see people that seemed finished, both mentally and physically, return to life fully and to regain all those abilities that they had before they met psychiatrists.”

Antonucci’s experience stands as documented evidence that even in the most extreme institutional environments, human recovery is possible when restraint, forced treatment, and chemical suppression are replaced with dignity, freedom, and support.[25]

This is needed today.

Today, in Trieste, Italy, community mental-health centers replaced large asylums. Coercion is resisted, small emergency units replace locked wards, and care emphasizes social integration rather than chemical containment.

Former Duke University psychiatry chair Dr. Allen Frances described Trieste as a place of choice for individuals with serious mental health challenges — contrasting it sharply with the U.S. system, which he defined as “the worst place in the world to have a mental illness.”[26]

These service models demonstrate that non-coercive, rights-based mental-health systems are achievable in practice. The remaining challenge is not proof of concept; it is whether funding priorities and regulatory frameworks will support approaches that place human recovery above psychiatric-pharmaceutical expansion and profits.

The current federal initiative to reopen or expand state psychiatric institutions would move the United States in the opposite direction. Large-scale institutional settings historically rely on involuntary commitment and routine antipsychotic drugging. Expanding that infrastructure would almost certainly increase forced treatment and long-term exposure to damaging antipsychotics.

Such a policy risks repeating the very institutional model that countries like Italy have moved beyond, substituting chemical control for voluntary, non-invasive community care.

[1] https://www.mind.org.uk/information-support/drugs-and-treatments/antipsychotics/side-effects/#NeurolepticMalignantSyndromeNMS

[2]   https://www.cchrint.org/2025/09/19/why-psychiatric-detainment-and-drugging-cannot-deliver-public-safety/; “Antipsychotics,” MIND UK, https://www.mind.org.uk/information-support/drugs-and-treatments/antipsychotics/side-effects/; Karen Frei, “Tardive dyskinesia: Who gets it and why,” Parkinsonism & Related Disorders, Vol. 59, Feb. 2019, https://www.sciencedirect.com/science/article/abs/pii/S1353802018305157; https://my.clevelandclinic.org/health/diseases/6125-tardive-dyskinesia

[3] https://www.cchrint.org/2025/08/01/involuntary-psychiatric-commitment-homeless-dangerous-costly-failure/; Alex Alikiotis “The Link Between Antipsychotics And Aggressive Behavior: Understanding The Potential Causes Of Violence,” MedShun, 24 Dec. 2023, https://medshun.com/article/why-do-antipsychotics-cause-violence

[4] https://www.cchrint.org/2025/09/19/why-psychiatric-detainment-and-drugging-cannot-deliver-public-safety/; Thomas J. Moore, Curt. D. Furberg, “The Harms of Antipsychotic Drugs: Evidence from Key Studies,” Drug Safety, Jan. 2017, https://pubmed.ncbi.nlm.nih.gov/27864791/

[5]  Krutika P. Chokhawala; Lee Stevens, “Antipsychotic Medications,” StatPearls, 26 Feb. 2023, https://www.ncbi.nlm.nih.gov/books/NBK519503/

[6] Shannon Giliberto et al., “A Comprehensive Review of Novel FDA-Approved Psychiatric Medications (2018-2022),” Cureus, 20 Mar. 2024, https://pmc.ncbi.nlm.nih.gov/articles/PMC11028406/

[7] Kristen Monaco, “New Pill Approved for Schizophrenia, Bipolar Disorder,” MedPage Today, 23 Feb. 2026, https://www.medpagetoday.com/psychiatry/bipolardisorder/120004

[8] Mark A Horowitz, Joanna Moncrieff, “Gradually tapering off antipsychotics: lessons for practice from case studies and neurobiological principles,” Curr Opin Psychiatry, 9 May 2024, https://pmc.ncbi.nlm.nih.gov/articles/PMC11139239/

[9] https://www.cchrint.org/2025/12/01/millions-children-caught-in-escalating-psychiatric-polypharmacy/; Sarayu Vasan; Ranjit K. Padhy, “Tardive Dyskinesia,” StatPearls, 24 Apr. 2023, https://www.ncbi.nlm.nih.gov/books/NBK448207/; https://www.cchrint.org/2026/02/16/decades-of-warnings-persistent-inaction/; Elyse M. Cornett, PhD, “Medication-Induced Tardive Dyskinesia: A Review and Update,” The Ochsner Journal, Summer 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472076/

[10] https://www.cchrint.org/2025/12/19/psychiatric-drug-damage-ignored-for-decades/; Elyse M. Cornett, PhD, “Medication-Induced Tardive Dyskinesia: A Review and Update,” The Ochsner Journal, Summer 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472076/

[11] https://www.cchrint.org/2025/08/01/involuntary-psychiatric-commitment-homeless-dangerous-costly-failure/; https://www.rxlist.com/ingrezza-side-effects-drug-center.htm#professional; https://www.drugs.com/sfx/ingrezza-side-effects.html

[12] https://duluthreader.com/articles/2017/01/20/107817-the-tragic-story-of-dr-loren-moshers-soteria; https://pmc.ncbi.nlm.nih.gov/articles/PMC514223/

[13] “Soteria Israel: A Vision from the Past is a Blueprint for the Future,” Mad in America, 10 Feb. 2018, https://www.madinamerica.com/2018/02/soteria-israel-a-vision-from-the-past-is-a-blueprint-for-the-future/

[14] John R. Bola, Ph.D. and Loren Mosher, M.D., “Treatment of Acute Psychosis Without Neuroleptics: Two-Year Outcomes From the Soteria Project,” The Journal of Nervous and Mental Disease, Vol. 191, No. 4, 2003

[15] Erika Jääskeläinen, et al., “A Systematic Review and Meta-Analysis of Recovery in Schizophrenia,” Schizophrenia Bulletin, Vol. 39, No. 6, pp. 1296–1306, 20 Nov. 2013, https://pmc.ncbi.nlm.nih.gov/articles/PMC3796077/pdf/sbs130.pdf

[16] Dr. Gary G. Kohls, M.D., “The Tragic Story of Dr. Loren Mosher’s Soteria Project and the Plot to Kill It,” Duluth Reader, 19 Jan. 2017, https://duluthreader.com/articles/2017/01/20/107817-the-tragic-story-of-dr-loren-moshers-soteria

[17] https://mindfreedom.org/campaign/still-crazy-after-all-these-years/

[18] Micah Ingle, PhD, “How Does the Soteria House Heal? The alternative treatment model of Soteria helps individuals suffering from schizophrenia without relying on medication or coercion,” Mad in America, 11 Sept. 2019, https://www.madinamerica.com/2019/09/soteria-house-heal/; “Managing schizophrenia without medication? A look into the Soteria model,” AMI-Quebec, https://amiquebec.org/soteria/; https://pmc.ncbi.nlm.nih.gov/articles/PMC1414694/

[19] “Pathways Vermont opens new permanent home,” WCAX 3 News, 2 Feb. 2026, https://www.wcax.com/2026/02/02/pathways-vermont-opens-new-permanent-home/; https://www.pathwaysvermont.org/programs/soteria-house/

[20] John Read, Ph.D., “An Alternative to Psychiatric Hospitals,” Psychology Today, 22 June 2022, https://www.psychologytoday.com/us/blog/psychiatry-through-the-looking-glass/202206/alternative-psychiatric-hospitals;  Avraham Friedlander, et al., “The

Soteria model: implementing an alternative to acute psychiatric hospitalization in Israel,” Psychosis, 1 Apr. 2022, 14:2, 99-108, https://www.tandfonline.com/doi/full/10.1080/17522439.2022.2057578; Gidi Rosenfeld, “A New Vision for Mental Health Care at Soteria Jerusalem,” Mad in America, 16 Sept. 2023, https://www.madinamerica.com/2023/09/a-new-vision-for-mental-health-care-at-soteria-jerusalem

[21] https://www.cchrint.org/2021/06/06/cchr-supports-who-recommendations-for-psychiatric-living-wills-to-prevent-abuse/’ “Guidance on community mental health services: Promoting person-centred and rights-based approaches,” World Health Organization, 10 June 2021, p. 50, https://www.who.int/publications/i/item/9789240025707

[22] https://www.cchrint.org/2017/12/05/the-legacy-of-giorgio-antonucci-abolishing-coercive-psychiatry-to-achieve-humane-mental-health-care/

[23] https://www.cchrint.org/2017/12/05/the-legacy-of-giorgio-antonucci-abolishing-coercive-psychiatry-to-achieve-humane-mental-health-care/

[24] https://www.cchrint.org/2017/12/05/the-legacy-of-giorgio-antonucci-abolishing-coercive-psychiatry-to-achieve-humane-mental-health-care/

[25] https://www.cchrint.org/2017/12/05/the-legacy-of-giorgio-antonucci-abolishing-coercive-psychiatry-to-achieve-humane-mental-health-care/

[26] Ron Walters, “The Old Asylum Is Gone: Today A Mental Health System Serves All,” Health Affairs, Vol 39, No. 2, Feb. 2020, https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01671