October 17, 2009

The Creation of Psychopharmacology

The Creation of Psychopharmacology by David Healy. Harvard University Press, 2002.

David Healy, a British psychiatrist, is probably most famous, or infamous, for being asked to resign from a prestigious academic chair of psychiatry at Toronto University after just being appointed, because a pharmaceutical company, which was funding the position to the tune of several hundred thousand dollars, learned of this doctorís position on psychiatric drugs and the pharmaceutical industry and wanted him out.

His major work to date is The Creation of Psychopharmacology, a 469 page heavy weight, which initially is not easy reading, even for a doctor, but rewards the reader with an erudite, well thought out, broad conclusion about the drug companiesí influence on the way we think of ourselves and how we deal with our problems. While his focus is on the revolutionary impact the drug, chlorpromazine or Thorazine, had on both patient care and psychiatric thinking, his discussion about other drugs reveals how marketing and sales, more than any other factors, dictate which drugs are researched and how the conditions they are meant to treat are promoted within the population. The best example is Prozac, or fluoxetine, which was initially developed by Eli Lilly to address anxiety. But because of a spate of lawsuits in the 1980s over the addictive aspects of anti-anxiety agents like Valium, Lilly decided to test Prozac for the treatment of depression.

Prozac works as well to ameliorate depression as it did for anxiety so Lilly marketed Prozac as an anti-depressant. Depression was not commonly diagnosed in America during the 1980s but with the introduction of Prozac, the diagnosis of depression soared -- a sort of cart following the horse ñ a pattern regularly seen in psychiatry. There are those who might challenge some of Healy's assertions (he strongly believes that Prozac is addicting) but overall this is a well researched important book. In any case, any one interested in learning about the economic factors involved in psychiatric diagnosis and treatment would be advised to read The Creation of Psychopharmacology.

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