The 'Anti-Depressant' Controversy again

Today I turn to a different sort of drug – this time a fully legal and respectable sort. I will no doubt re-engage soon with Mr Wilkinson on cannabis, but think this is more pressing and also that what follows is rather exciting, if , like me, you are excited to see dissent from conventional wisdom championed by a clear, scientifically trained mind, in limpid prose.

A friend has alerted me to two powerful  and refreshing articles in the New York Review of Books on the huge and urgent topic of antidepressant drugs, about which regular readers know I am greatly concerned.  Both can be found on the web. Both are by Marcia Angell.

The first  (to be found here) is entitled 'the Epidemic of Mental Illness: Why'. The second (to be found here) is called 'The Illusions of Psychiatry'. Or you can buy the magazine, which should be encouraged for publishing articles of this calibre.

Marcia Angell is  a qualified doctor and was the first woman to edit the highly reputable new England Journal of Medicine. She now lectures at Harvard Medical School. I don't think she or her argument can be lightly dismissed.

Her articles are reviews of four books ('The Emperor's New Drugs: Exploding the  Antidepressant Myth' by Irving Kirsch;  'Anatomy of an Epidemic: magic Bullets, Psychiatric Drugs, and the astonishing rise of Mental Illness in America' by Robert Whitaker ; 'Unhinged: the Trouble with Psychiatry – a Doctor's Revelations about a Profession in Crisis' by Daniel Carlat; and the American Psychiatric Association's 'Diagnostic and Statistical Manual of Mental Disorders', Fourth Edition, Text Revision (DSM-IV-TR)'.

I have not yet read any of these books myself, though I hope to do so . I think we can trust Dr Angell to have given a fair account of them.

Using them as her foundation, she charts the revolution in Psychiatric treatment, which has shifted almost entirely from Freudian therapy to the prescription of drugs in a very short time. She notes the huge increase in categories of mental illness, and the matching increases in the numbers diagnosed with them.

She asks :'What is going on here? Is the prevalence of mental illness really that high and still climbing? Particularly if these disorders are biologically determined and not a result of environmental influences, is it plausible to suppose that such an increase is real? Or are we learning to recognise and diagnose mental disorders that were always there?

'On the other hand, are web simply expanding the criteria for mental illness so that nearly everyone has one? And what about the drugs that are the mainstay of treatment? Do they work? If they do, shouldn't we expect the prevalence of mental illness to be declining, not rising?'

Now, I agree with all these questions, and if I asked them I would be angrily pelted with slime by supporters of the 'antidepressant' culture. But this isn't me. And it's based on several reputable books by qualified experts.

I can't urge you strongly enough to read the whole thing for yourself, both parts.

But I will leave you with one profound thought arising from these cogent and tightly-packed reviews to which I think we need an urgent answer. She notes that the great discovery of science in this area was that 'psychoactive drugs affect neurotransmitter levels in the brain, as evidenced mainly by the levels of their breakdown products in the spinal fluid.'

Then ' the theory arose that the cause of mental illness is an abnormality in the brain's concentration  of these chemicals that is specifically countered by the appropriate drug'.  She gives examples.

She adds (devastatingly in my view)  'Thus, instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug'.

I will repeat that because it is so important : 'An abnormality was postulated to fit a drug.'

That, she says, was a great leap in logic. It was 'entirely possible that drugs that affected neurotransmitter levels could relieve symptoms even if neurotransmitters had nothing to do with the illness in the first place'.

On the logic used to justify these drugs, 'one could argue that fevers are caused by too little aspirin'.

Now, what follows is my view, not Dr Angell's . If these drugs  (which undoubtedly do act powerfully on the brains of those who take them) are being prescribed on this guesswork basis, isn't is possible that they may in fact affect the brains of otherwise healthy people in unpredictable and unintended ways?

And is it possible that they are now such a large industry that doubts of this kind are unwelcome?

I do urge those interested to drink deeply at this particular spring. When you have done so, I would like to renew the argument (which is also relevant to the mass prescription of drugs to children alleged to suffer from 'ADHD') .