Saturday, July 08, 2006

Talking Back to Prozac, and fired for dong so!

A piece from 2002, in which psychiatrist David Healy apparently lost his job because of becoming a very outspoken critic of Prozac, after having been was among the first to prescribe Prozac. Here are some excerpts:

In a flood of academic publications and talks, the British psychiatrist David Healy has issued harsh criticisms of both the pharmaceutical industry in general and the nearly $20 billion-dollar-a-year antidepressant industry in particular. Healy's central charge: The manufacturers of Prozac, Paxil, Zoloft and the other drugs belonging to the family of antidepressants known as SSRIs (selective serotonin-reuptake inhibitors) have deliberately misled the public about both the safety and effectiveness of their popular products.

As he writes in his controversial new book, "Let Them Eat Prozac," forthcoming this spring from New York University Press, "Far from being the most researched drugs in history, these drugs have only been tested to the minimum extent needed to get on the market and to develop that market." And to develop that market, Healy charges, drug companies have helped exaggerate the extent of serious depression. What's more, he says, for a small but significant minority of patients, Eli Lilly's Prozac and its siblings may actually increase rather than reduce the risk of suicide.

The Times Literary Supplement has called Healy "the leading international authority on the history of psychopharmacology." In this age of specialization, Healy, 49, is as comfortable discussing Aristotelian physics as the physiology of brain chemistry. Though he has been involved in clinical trials and conducted a wealth of studies on the effects of psychiatric drugs, his scholarship -- consisting of about a dozen of books and over 100 journal articles -- goes beyond the number-crunching of empirical research to explore the intersections of psychiatry, the philosophy of science, and cultural criticism.

Until recently, Healy's outspokenness had little effect except to wreak havoc on his own career. The SSRI manufacturers that used to shower him with consulting fees have dropped him like a hot potato. "Several drug reps have informed me they are no longer permitted to include me in their in-house educational programs geared to primary-care physicians," said Healy in a recent telephone interview. In addition, three years ago, following a controversial speech, the University of Toronto gave Healy his walking papers just as he was about to assume a prestigious professorship, citing his "incompatible" approach. [...]

One of Healy's main arguments is that the drug industry has played a much greater role in shaping our understanding of psychiatric illness than has previously been acknowledged. Ever since 1962, when FDA regulations underwent changes designed to improve drug safety, companies have been forced to develop products targeted to specific diseases rather than general conditions such as "neurosis" or "stress." As a result, the companies have gone into the business of marketing not just pills, but the diseases that they are supposed to cure. In other words, Healy argues, first come the pills and then the disease. [...]

Today it is commonly said that as many as 20 percent of Americans suffer from depression at some point in their lives. But Healy rejects the conventional wisdom that this startling increase over the last 50 years is due largely to improved diagnosis and reduced social stigma. "The Prozac story," writes Healy in his latest book, is one of a "wholesale creation of depression on so extraordinary and unwarranted a scale as to raise grave questions about whether pharmaceutical and other health care companies are more wedded to making profits from health than contributing to it."

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