Boy oh boy does this book have an axe to grind. Basically, it makes the argument that because we don’t really understand exactly how psychopharmacological drugs work, they must not have any value. It raises the important question, “Am I depressed because my brain chemistry is out of whack or is my brain chemistry out of whack because I’m depressed?”
I read this book because it was referenced in “My age of anxiety” and thought it would be an interesting read. To be sure, there are parts of it that are very interesting. It is fascinating reading how scientists tried all manner of tests to try to determine why these drugs were effective in the first place. We all accept that SSRI work because they adjust your serotonin receptors. We believe this because in studies they would treat samples of brain cells that would turn purple when anything bound to the serotonin receptors in the brain, and when you add an SSRI the treated brains turned purple. Post hoc, ergo propter hoc.
The book makes a big deal out of the fact that there are thirty to a hundred different types of known receptors in the brain and we don’t know how they really, truly work, therefor we don’t know if it’s serotonin that is the key to us being happy or unhappy, or if it’s one of the other receptors piggy-backing along.
Maybe, but the author also seems to skip past the fact that these drugs had a profound affect on patients that didn’t anticipate the drug being used for mood at all – the first tranquilizer was originally developed as an allergy medicine.
There are also a number of horror stories of the early days of testing. Such as in 1955 when the governor ordered Reserpine (A drug from the dried root that is used as a tranquilizer in India) given to all 94,000 mental patients just to see what would happen. It’s terrifying to consider such a shotgun, brute force approach today, but there was a period of wild west and try-anything-to-get-results era of drugs and medicine.
This is also where the book starts to fall off the rails. The author traces how so much of the motivation for drug companies is to maximize profits, at times behaving in a largely unethical way. The last third of the book devolves into what feels like listening to a conspiracy theorist radio host ranting on his show. I don’t disagree that at times the behavior of corporations in a capitalistic society can be disturbing and immoral and we don’t always know how exactly something works. But that doesn’t negate the ability of the drugs to be useful. The historical pieces of the book were quite interesting and enjoyable; I just found found it to be overshadowed by the virtolic, and in my opinion unsubstantiated, anger of the author. It’s much like listening the moon landing conspiracy theorists or anti-vaccers; if you look hard enough at any subject, and scream loud enough, some of the facts feel very strange and disconcerting. That doesn’t make the conspiracy correct.