Sep 10

Psychiatry and Big Pharma: James Davies, Author of “Cracked”

Cracked: Why Psychiatry is Doing More Harm Than Good is by British therapist and researcher James Davies. In it he takes on psychiatry and Big Pharma.

According to the author’s literary agency, Davies set out to answer three puzzlers:

  1. Why has psychiatry become the fastest growing medical specialism in history when it still has the poorest curative success?
  2. Why are psychiatric drugs now more widely prescribed than almost any other medical drugs in history, despite their dubious efficacy?
  3. And why does psychiatry, without solid scientific justification, keep expanding the number of mental disorders it believes to exist–from 106 in 1952, to 374 today?

Cracked‘s publisher states that these questions “can be explained by one startling fact: in recent decades psychiatry has become so motivated by power that it has put the pursuit of pharmaceutical riches above its patients’ well being.”

From the author’s website, some of the ways Big Pharma has affected psychiatric care:

The charge sheet is damning: negative drug trials routinely buried; antidepressants that work no better than placebos; research regularly manipulated to produce positive results; doctors, seduced by huge pharmaceutical rewards, creating more disorders and prescribing more pills; and ethical, scientific and treatment flaws unscrupulously concealed by mass-marketing.

A relevant excerpt from the Publishers Weekly review of Cracked:

On the pharmaceutical front, Davies takes aim at Big Pharma’s tendency to ‘cherry pick’ positive clinical trial data to suit its needs. The results are drugs whose curative efficacy is questionable and which sometimes come with serious side effects (such as the ’emotional blunting’ that occurs in about half of all Prozac users). Further undermining the integrity of the psychiatric profession is the fact that many doctors, having received grants and/or speaking and consulting fees from Big Pharma companies, are essentially prescribing from within the deep pockets of their benefactors. The consequences for patients and the profession are obvious.

Others within the ranks of psychiatry who’ve been protesting the connection between their field and the pharmaceutical industry includes such notables as Irving Kirsch and David Healy. But it’s not only disgruntled psychiatrists who aren’t enthralled with the drug-related hijinks—others are catching on too.

The 2007 book Shyness: How Normal Behavior Became a Sickness, by Christopher Lane, revealed how a pharmaceutical company can use pathologizing towards unscrupulous ends. Lane concludes, “Before you sell a drug, you have to sell the disease. And never was this truer than for social anxiety disorder.” Paxil anyone?

Also on the topic of Paxil, Alison Bass wrote Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial, which Arnold S. Relman, M.D., from Harvard Medical School called “a richly detailed account of the disgraceful self-serving ties between drug companies and the psychiatric profession.”

A 2010 article by Tyler Woods, Ph.D., reports that 68% of members of The American Psychiatric Association’s task force writing the next (2013) edition of the DSM admit to “economic ties with drug companies.” How do you think this might affect their opinions regarding whether something belongs in the DSM as a mental disorder?

As therapists and clients become increasingly aware of the implications of pathologizing as well as the actions of Big Pharma, perhaps we can be more careful ourselves about not “buying into” the costly and misguided labeling of our problems.

Aug 31

“Coming of Age on Zoloft”: Our Youth On Antidepressants

Coming of Age on Zoloft (2012) by writer/journalist Katherine Sharpe takes the issue of “the medication generation” into more specific territory, “the antidepressant generation.” She includes her own story of using Zoloft for 10 years, starting in college. From the book description:

She explores questions of identity that arise for people who start medication before they have an adult sense of self. She asks why some individuals find a diagnosis of depression reassuring, while others are threatened by it. She presents, in young people’s own words, their intimate and complicated relationships with their medication. And she weighs the cultural implications of America’s biomedical approach to moods.

Among other concerns, Sharpe is afraid that mental health professionals may in effect pathologize and/or squelch the normal emotions of children and adolescents when prescribing antidepressants too readily for psychic pain. What she says about her own experience (wsj.com): “For me, antidepressants had promoted a kind of emotional illiteracy. They had prevented me from noticing the reasons that I felt bad when I did and from appreciating the effects of my own choices.”

The most challenging topic to write about in Coming of Age On Zoloft was her choice to discontinue the antidepressant, which she’s been off now for about six years.

Selected Reviews of Coming of Age on Zoloft

Dr. David Healy, author of Let Them Eat Prozac: “Beautifully written…This is a book for anyone taking or thinking about taking antidepressants, anyone who prescribes them, anyone who wonders about their suitability–or anyone who wants a mirror held up to our time.”

Kirkus Reviews: “Balanced and informative—an education for any parent considering psychiatric medication for a troubled adolescent.”

Publishers Weekly: “This is a fine book that nicely weaves together personal, sociological, and philosophical perspectives for a thoughtful view of how antidepressants are shaping many people’s lives.”