Reviews for Before Prozac: The Troubled History of Mood Disorders in Psychiatry

The average rating for Before Prozac: The Troubled History of Mood Disorders in Psychiatry based on 2 reviews is 3.5 stars.

Review # 1 was written on 2017-05-25 00:00:00 Robert Obrien Medical historian Edward Shorter notes that drugs are labeled for marketing and to satisfy government regulation, not for medical usefulness. In Before Prozac he argues that this is why no progress has been made in psychiatric treatment since the 1950s. Shorter believes old drugs'amphetamines and barbiturates, tranquilizers such as Librium and Valium, antidepressants such as Marsilid, and antipsychotics such as Thorazine'were far more effective than anything available today. So what happened? Why did all those great drugs disappear? Some went off patent and became unprofitable, but according to Shorter, many were regulated out of existence by a power-crazed Food and Drug Administration (FDA), leaving, in his view, only useless antidepressants such as Prozac. The whole idea of mood disorders is suspect, he believes. They are defined by the drugs designed to treat them. Thus, when drugs disappear, the disorders they treat also disappear (e.g., "nerves," "melancholy"'nobody has those anymore). When new drugs are produced (such as Prozac), new disorders are invented to fit the new medications (e.g., "major depression"). The main villain in his story is the FDA. One might think its purpose is to prevent drug companies from marketing miracle cure-alls, like the patent medicines of the 19th century. But Shorter claims their motivation is really bureaucratic self-aggrandizement'FDA officials drunk with power are set on humbling the mighty pharmaceutical industry by disallowing their most profitable drugs. Why? Because they can. Control of the label means control of the drug, and to satisfy these regulators, the field of psychiatric drugs became increasingly defined by the "antidepressant" because that's what the FDA believed in. But Shorter believes that the only effective treatment for depression is ECT (electro-convulsive shock therapy). "Electroconvulsive ('shock') therapy, originated in 1938, remains the most effective treatment of serious, melancholic depression" (p. 48). This book was partially funded by Max Fink, a prominent psychiatric researcher and author, well-known advocate for ECT and the founder of the Journal of ECT, in which Shorter occasionally publishes. Naturally then, the author has a dim view of SSRI antidepressants like Prozac and the FDA which'in his view'forced the pharmaceutical industry to produce them to the virtual exclusion of all else. His thesis seems to be that while melancholic depression is a particular biological disorder best treated by ECT, everyone has been deluded by the DSM, the FDA, and big pharma into thinking that depression is a diffuse category of mood disorders for which SSRIs are the best treatment, even though they are based on a false theory and are no more effective than placebos. In my reading, Shorter fails to make a convincing case that he is right and everybody else is wrong. That said, this history of psychopharmacology in the United States since 1938 is engagingly written and informative. Because Before Prozac is not an impartial history, I recommend it only to well-informed mental health professionals and for students only in the context of a broader discussion.

Review # 2 was written on 2014-09-11 00:00:00 Stanley Abadie this book is awesome. i finished it in one sitting- i could not put it down. it's at once funny, optimistic, disturbing, and the rage of the author is infectious as well as cathartic. i want to read everything else by edward shorter. he is the martin luther of pharmacotherapy and it is wonderful.