Matter Over Mind: Psychiatrists and their Pills

Reprinted from Barron’s, July 2010. Page 33.

Matter Over Mind: Psychiatrists and their Pills

Anatomy of an Epidemic
By Robert Whitaker
Crown, 416 pages, $26

Reviewed by David L. Nathan, MD

FOR OVER 50 YEARS, A RAPID rise in psychiatric prescriptions has been accompanied by the development of whole new classes of medications, and uses for them. This book attacks the notion that those new drugs and new practices are safe and effective, asserting that long-term outcomes are invariably negative. While acknowledging that a few individuals appear to improve on psychiatric medications, Robert Whitaker cites studies and quotes authorities to demonstrate that antidepressants, antipsychotics, mood stabilizers, stimulants and sedatives do more harm than good.
He claims that people are sicker and disability claims have skyrocketed as a result of the psychopharmacology revolution, and that drug companies and psychiatrists have deliberately conspired to manipulate the media and public opinion into accepting the drugging of America.
I must have missed that meeting. But Whitaker’s conspiracy does not stop there. He claims that “Eli Lilly and the psychiatric establishment” are responsible for the media’s purported campaign against opposition groups like the Church of Scientology, a religion whose cosmology portrays psychiatrists as an ancient evil race.
This isn’t to suggest that none of the author’s critiques have merit. As a practicing psychiatrist, I don’t dispute that psychotropics are overprescribed by doctors. Big Pharma’s marketing practices do improperly shape physicians’ prescribing habits and do play down the dearth of long-term data on impact and safety. Even so, it’s a reach to conclude drugs are responsible for rising psychiatric-disability numbers. The author seems more intent on condemning psychiatry than improving it, and this book contains more rant than reason.
A major contradiction (and cruel twist for the antipsychiatry forces) comes in the book’s final and shortest section, entitled “Solutions.” After hundreds of pages that attempt to show how psychiatric medications are essentially useless and inherently dangerous, the author states that psychotropics “may alleviate symptoms over the short term, and there are some people who may stabilize well over the long term on them, and so clearly there is a place for the drugs in psychiatry’s tool box.”
But such a reasonable viewpoint comes too late to save this book.

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