Review of TLNC in the Toronto Star

Lawrence Diller, in his reflective and candid book, The Last Normal Child, points out that the practice of getting children stoned to make them conform to our demands for achievement is so common now that North Americans consume 80 per cent of the 3,000 tons of "legal speed" produced each year, with most of it going to children. (Heard of Ritalin?)

Diller has witnessed a dramatic change in the kinds of children who are brought to him for behavioural problems by their parents. He aims a great deal of his ire at Big Pharma itself, for pathologizing childhood before offering its E-Z solution. He cites TV ads in which parents, asked if their kids are having trouble with homework, are soothingly offered Ritalin as a solution.

"Ours is the only country in the world," Diller writes of the U.S., although Canada is increasingly complicit, "where the 'symptoms' of forgetfulness, dreaminess, and intelligence -- in short, the characteristics of the absent-minded professor or child -- would be considered signs of a mental disorder to be treated with a psychiatric drug."

Yet the remarkable upsurge in the number of prescriptions for children has continued for a decade, Diller notes, after drug companies won permission to market directly to consumers in 1997.

The use of anti-psychotics for kids, for instance, has increased fivefold since 1993, even though they are traditionally prescribed only to adult schizophrenics and psychotics, and have alarming side effects. ADD drugs get doled out like candy; countless grade-schoolers take antidepressants.

All to make parents feel better, Diller says: "This phenomenon is really driven by the fear and anxiety of parents about their children's performance and self-esteem."

In his wide-ranging essays on the ethics of drug prescription, the dubiousness of ADD diagnoses and the importance of letting children develop uniquely, at their own pace, Diller left me with this essential, stick-it-on-your-fridge point: having medicalized their children, and standardized their activities and achievements, what parents have left completely undernourished are their children's characters, and their souls.

Reviews on depression, therapy, and psychiatric drugs

I have not passed on several books Iive read over the past months that I believe would be of interest to those concerned about children, culture and psychiatric drugs. Here are some of them with brief reviews.

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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.