Thursday, November 22, 2007

Big Pharma: The anti-depressant edition

[David] Healy doesn't deny that SSRIs can be effective against mood disorders, and he has prescribed them to his own patients. As a psychopharmacologist, however, he saw from the outset that the drug firms were pushing a simplistic "biobabble" myth whereby depression supposedly results straightforwardly from a shortfall of the neurotransmitter serotonin in the brain. No such causation has been established, and the proposal is no more reasonable than claiming that headaches arise from aspirin deprivation.... But by insistently urging this idea upon physicians and the public, Big Pharma widened its net for recruiting patients, who could be counted upon to reason as follows: "I feel bad; I must lack serotonin in my brain; these serotonin-boosting pills will surely do the trick." ... Thus millions of people who might have needed only counseling were exposed to incompletely explained risks.

There's more in this book review by Frederick C. Crews. The stuff about the effect of anti-depressant medication in normal (or, mildly depressed) people is truly scary:

Those risks, Healy perceived, included horrific withdrawal symptoms, such as dizziness, anxiety, nightmares, nausea, and constant agitation, that were frightening some users out of ever terminating their regimen—an especially bitter outcome in view of the manufacturers' promise of enhancing self-sufficiency and peace of mind. The key proclaimed advantage of the new serotonin drugs over the early tranquilizers, freedom from dependency, was simply false. ...

As for the frequently rocky initial weeks of treatment, a troubling record not just of "suicidality" but of actual suicides and homicides was accumulating in the early 1990s. The drug firms, Healy saw, were distancing themselves from such tragedies by blaming depression itself for major side effects. ...

The most gripping portions of Let Them Eat Prozac narrate courtroom battles in which Big Pharma's lawyers, parrying negligence suits by the bereaved, took this line of doubletalk to its limit by explaining SSRI-induced stabbings, shootings, and self-hangings by formerly peaceable individuals as manifestations of not-yet-subdued depression. As an expert witness for plaintiffs against SSRI makers in cases involving violent behavior, Healy emphasized that depressives don't commit mayhem.