I purchased this book hoping to learn more about antidepressants. I would note first that around 3/4 of the content in this book is external: block quotes, large multi-page diagrams downloaded from the Internet, links to external resources, and lengthy patient testimonials dominate the text. The entire second half of the book — over one hundred and fifty pages — consists almost entirely of essays mailed in by patients. As someone who has not used SSRIs and was purely interested in the underlying science of these ubiquitous “miracle” drugs, I was hoping the author would take more time
to contextualize and reflect on the information she had so assiduously compiled. Still, she writes thoughtfully and with great empathy about a topic that is missing entirely from modern medical discourse, and I think this is commendable.
Overall, I learned a great deal from reading this book. I learned that antidepressants — drugs which purport to correct chemical imbalances in the brain — actually induce them, resulting in protracted withdrawals. I learned that the vast majority — over 85% — over depressive episodes are self-limiting and resolve on their own within one year. The author suggests that many individuals — especially the young and elderly — are victims of overprescription and “manufactured consent”, and that in many cases talk therapy and lifestyle changes should be the first line of defense. I also learned about the misleading terminology the pharmaceutical industry promotes to shift blame onto patients, including “discontinuation syndrome” and the alarming catch-all diagnosis of “somatic symptom disorder”. The number of generics which are formulated differently from the brand name product, and the number of brand name products which are prescribed off-label, is concerning. Our understanding of the mechanisms, side effects, and long term safety profiles of these psychoactive drugs is extremely poor, and borderline unacceptable.
In spite of its flaws, I can’t give this book anything less than four stars for tackling a highly politicized, poorly understood, and deeply divisive topic with grace, empathy, and humility. Even if, like me, you do not use SSRIs or suffer from mental health issues, this book is well worth a read. Tens of millions of Americans are dependent on medicine which alters their very brains, and no one is sure how exactly they work.