Page 65 - Fall2012

All Thumbs Book Reviews

and/or “low name-your-chemical” as the root from measures such as vigorous exercise, herbs
causes of depression for some time. that do not have the harmful side effects of an-
Dr. Kirsch not only questions this theory, tidepressants, the quintessential placebo called
but offers evidence of the faulty “depression “psychotherapy,” and even through disclosed
as chemical imbalance” theory—a theory that placebos—and all with far fewer side effects
focuses blame on a handful of named neu- compared to antidepressants.
rotransmitters, thereby creating a strong case Citing an example of the complexity of
(and thereby fertile marketing environment) for the interrelationship between mind and body,
“correcting” such “imbalances” via targeted the author reminds us of E.M. Forster’s novel
drugs. Much like cholesterol-reducing drugs, A Room with a View, and in its context tells us
depression drugs are big business—a business of an interesting experiment. Roger Urich, a
that can “scale” only if large swaths of the popu- researcher at the University of Delaware, tested
lation can be deemed first to be depressed and the hypothesis that rooms with pleasing views
second, curable through concerted, long-term had a positive therapeutic effect on gall blad-
use of antidepressants. Longer-term use here der surgery patients. Patients were divided into
equals a lucrative, annuity-type revenue stream two groups: one group with a window view
for pharmaceutical firms. overlooking a park-like setting and a second
Via freedom-of-information requests to the group of patients with a window view onto a
FDA, Dr. Kirsch unearthed and analyzed raw brick wall. He discovered that the former group
data on all clinical trials pertaining to major required less medication, were in better spirits,
antidepressants that were recently marketed. He recovered faster and were discharged earlier than
discovered that in fact drug companies employed patients in the second group. Thus in Dr. Kirsch’s
various nefarious schemes to dress up results opinion, the ability of emotions to affect health,
that ranged from mixed to completely negative. for better and worse, is real, and the quality of
They withheld negative studies from publication any therapeutic relationship enhances physical
and published positive studies multiple times, improvement.

thereby making it appear as though positive stud- Cultural historian and profession, Dr. Morris
ies and outcomes in the drug trials outnumbered Berman, who also reviewed this book, compares
negative studies when in fact they did not. In sev- the psychiatric drugs of our time to the wide-
eral instances, clinical trials undertaken outside spread and ultimately deadly use of leaden forks
the United States mysteriously showed positive by early Romans: “The (same) leaden forks that
results, whereas the same trial carried out within wiped out a thriving earlier civilization” can do
the U.S. did not show these results. Yet the FDA the same to us.
was persuaded to accept the foreign studies as For the millions of Americans who are on
valid while the U.S. study was ignored. In other long-term antidepressant prescriptions the future
words, drug companies routinely cherry-picked on these drugs does not bode well. However it Much like
results from the multi-site studies. There is good bodes very well for the financial bottom lines of cholesterol-
reason to believe that trials in foreign countries the drug companies. For anyone who might seek
where the FDA does not have jurisdiction can be counsel for depression, I would recommend The reducing
far more readily manipulated. Drug companies Emperor’s New Drugs as required reading, and drugs, anti-
also published data that were different from what I would also recommend that everyone heed the depressant
they submitted to the FDA; that is, they lied. warning that prescription antidepressants repre-
Dr. Kirsch asserts that equal or better ef- sent a poor health bargain. drugs are big
ficacy in combatting depression can be obtained Review by Sushama Gokhale business.
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