Cheap side effects: the Soviet era drugs forced on children at Russian psychiatric hospitals

Patients at Russian psychoneurological boarding schools and hospitals are still prescribed strong psychotropic drugs with severe side effects, often for "disciplinary" purposes. Sofia Savina looked into the scale of the government’s procurement of "medicines," which dissidents in the USSR were tortured with. 
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"You do not want to live anymore. Everything becomes gray, there is an irresistible longing. After the first day of taking aminazin you can not concentrate, read, perceive information, you hear the words, but you can not answer," said Maria Alekhina, a participant in the Russian punk band Pussy Riot, about one of the most popular drugs in Russian psychiatry.

Before she was a punk rocker, Alekhina volunteered and ran creative classes for the patients of Children's Psychiatric Hospital No. 6 in Moscow. According to her, there were no mentally ill people in this hospital, only unruly children from orphanages or those who had tried to commit suicide, at least for two or three months.
"An auntie of about 70 years old worked there and she prescribed strong antidepressants and aminazin for children, in the form of pills or injections. After the aminazin, the children laid on their beds, move slowly and only holding on to the wall, it was difficult for them to move their legs. After receiving the antidepressants, they sit, look at one point and smile. And if you ask them what they think, they answer, ‘I do not want to smile, I'm scared,’" recalled Alekhina.

Maria Alekhina mentioned the use of aminazin in children's psychiatric hospitals,  in her "last word" while in court on August 8, 2012. Five years later the hospital has changed its name, but not the methods of treatment. Today, the Scientific and Practical Center for the Psychological Health of Children and Adolescents in May 2017 once again purchased drugs, among which was the same "vegetable" medicine.
"The whole body seems to twist - the way you squeeze laundry after wash. Muscles cramp and you can’t do anything," said a patient describing the effects of haloperidol,  another neuroleptic drug popular in Russian psychiatry. A drug that "restrains" the nervous system.

Haloperidol and aminazin were used in Soviet times to suppress dissidents. "During the Soviet era, not only in prisons, but also in mental hospitals, there were three types of torture. A twisting contraction, when the person's head was wrapped up in wet sheets, they then dried up, and the head was squeezed in pain, aminazin and haloperidol," said Maria Alekhina.

These two drugs are most often mentioned in stories about the "unwanted" patients of psychoneurological boarding schools. Aminazin was prescribed to the deceased son of a Siberian Orthodox activist Yuri Zadoy, who, due to disagreements with his son, placed him in a psychiatric hospital.

Another example is the case of Chelyabinsk activist Alexei Moroshkin, who was arrested in 2015 for spreading separatism propaganda on social networks. The court placed him in a psychiatric clinic where the activist received high doses of neuroleptics, which led to depression.

If not properly used, these drugs are extremely dangerous for one’s health. A patient's symptoms do not disappear, but only intensify. Haloperidol exacerbates psychosis and hallucinations, leading to uncontrolled movements of the hands and feet. Aminazin causes depression and an unceasing tremor. The side effects of taking haloperidol and aminazin can linger for years.


A year ago, the Ministry of Labor and Social Protection announced the beginning of the reform of psychoneurological boarding schools. "It's difficult to cope with thousands of unemployed people concentrated in one place, so the practice of using soothing, psychotropic drugs is widespread," said one of the authors of the reform, Elena Klochko, co-chairman of the Coordination Council for Disabled People and Other Persons with Disabilities in the Public Ward.

The reform has not yet helped the psychoneurological boarding schools to stop the use of obsolete medicines. "Russian psychiatry is very late in the generations of drugs. Patients are often prescribed obsolete medicine, with strong side effects," the International Human Rights Group Agora notes in its report on practices of punitive psychiatry in modern Russia.

Aminazin and haloperidol belong to the first generation of neuroleptics - they were discovered in the 1950s. Since then, other, modern tools have been developed. But Russian psychoneurological boarding schools prefer to buy obsolete drugs. One of the reasons is their cheap price. A package of haloperidol costs 100 rubles and aminazin costs 200 rubles.

"Changing bed-pans is cheaper than curing. The inventor of the lobotomy received the Nobel Prize because this led to a phenomenal saving in the cost of monitoring patients, " says Azgar Ishkildin, director of the Civil Commission for Human Rights, which monitors human rights violations in the field of psychiatry.

In those rare cases when the psychoneurological boarding school refuses cheap neuroleptics, the system loses money. This happened at the Zvenigorod psychoneurological boarding school in the Moscow region, when, in 2016, a group of public observers came to the boarding school.

"The renunciation of cheap and obsolete aminazin and the transition to more modern drugs, with fewer side effects, led to a rise in the cost of treatment," they noted in their report. If in 2015 the cost of treatment per person per day was 19 rubles, a year later it grew to 25 rubles. At the same time, according to the norms, there is even less for a person, only 14 rubles.

Despite the fact that the group of inspectors noted positive changes in Zvenigorod psychoneurological boarding school in 2016, the institution continues to purchase potent antipsychotics still. Haloperidol was bought for the boarding school in March, April and August, 2017, documents show that are posted on the official state procurement website.


Other Russian psychoneurological boarding schools continue to give their patients first generation neuroleptics, according to an analysis of public procurement. According to Russiangate calculations, at least 203 out of 500 Russian adult psychoneurological boarding schools have bought haloperidol over the past five years and 160 have purchased aminazin.
One of the modern neuroleptics, aripiprazole, has only ever been ordered twice in the whole country over the past five years, according to the public procurement website.

These figures are not exhaustive. These figures were calculated for only those contracts in which haloperidol or aminazine was indicated as the subject of procurement. Often, general words are given in contracts, for example, "psychotropic drugs" and detailed technical specifications are not published.

However, even this selection shows that such preparations are being purchased more and more each year. In 2011, 93 contracts were concluded for "haloperidol" as the subject of purchase, while in 2016, 191 contracts, more than twice as much.

The largest amount of money spent on haloperidol  in one year was  by Nelidovo psychoneurological boarding school in the Tver region. In 2015, it concluded four contracts worth 752,000 rubles. The most expensive contract was for the supply of the drug was concluded by the same institution. For 466,000 rubles, the boarding school purchased 1,500 packages of haloperidol.

Aminazin prices are more expensive, with Novotroitsky psychoneurological boarding school in Orenburg region in 2016 spending on this drug 2.4 million rubles, buying 11,000 packages.

In 2016, psychoneurological boarding school No. 9 in St. Petersburg spent 2 million rubles for aminazin while Denezhkovsky psychoneurological boarding school in the Moscow region purchased 1.6 million rubles worth of the drug in 2016.

Even though there is not enough  money for modern drugs in the budget of psychoneurological boarding schools, there is always room for second-hand goods. Petersburg psychoneurological boarding school No. 3 purchased a tractor for 2.9 million rubles, as well as 1.5 million rubles on household appliances such as microphones, spotlights and a mixing console.

Psycho-neurological boarding school No. 9 in St. Petersburg spent 29 million rubles on "landscaping and planting of greenery." Masalsky psychoneurological boarding school in Altai Krai modestly ordered 200 thousand rubles worth of work for the improvement of the sauna.
Last year, Moscow psychoneurological boarding school No. 30 came under a public inspection and participants reported about the involuntary use of psychotropic drugs.

“N. complained of very poor meals and said that if someone starts complaining, they ‘close’ him. He himself now is not being closed, because he tries to remain silent. N. also says that in the psychoneurological boarding school they do not ask consent for treatment: ‘And when you find yourself in a hospital, you still need to sign ‘I agree,’ this way you will leave this place faster,’" the authors of the report wrote.

In 2017, Moscow psychoneurological boarding school № 30  spent 10,2 million rubles for security services.