Wednesday, December 15, 2004
In case you haven't noticed, anti-depressants have been making the news recently and much of that news has been negative. Now, JAMA has a book review on "Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression" by David Healy. The reviewer Dr. Varley does not wildly enthusiastic about the book to say the least, although he does state,
"This book could raise awareness of legitimate, serious questions about how effective antidepressant medications are for the treatment of depression. This awareness is especially relevant given issues about the efficacy and safety of antidepressant medication in children and adolescents. There has been vigorous academic debate, regulatory action, and media attention in Great Britain and in the United States. However, the book might also discourage the public from seeking treatment for mental disorders, and even alienate the public from mental health professionals. Data already suggest that the majority of children, adolescents, and adults with major depression are not receiving psychiatric treatment that might benefit them. Although an informed consumer can potentially make better use of mental health services, being the recipient of assertions without substantial foundation could potentially obstruct access to helpful care."
However, Dr. Varley has some further concerns with the book and wants physicians and others to be aware of its publication for a number of reasons. He states,
"Physicians should be aware of Let Them Eat Prozac. Elements of international "conspiracy" (p 79), implied malfeasance by high-ranking individuals, and consequences in the billions of dollars are provocative themes. The public might embrace this book. It is important to be aware of what is asserted and the foundations upon which those assertions are based in order to provide best care to patients. Healy’s intimate involvement for many years in academic psychiatry, regulatory agencies, and the pharmaceutical industry provides a unique opportunity to examine a highly pertinent topic. Other strategies could have been put forward to address important concerns. Rather than implying misconduct, not only by the pharmaceutical industries but by respected international experts in psychiatry and regulatory agency, the author could have chosen a less inflammatory approach by pointing out relevant questions and solutions regarding what is a controversial theme. In that sense, this book is a disappointment."
Thanks to Jim Tomaszewski for this update.