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Doody's Review ServiceReviewer: Steven T. Herron, MD (University of Arizona Health Sciences Center)
Description: Written as an expose of "modern" psychiatry, psychopharmacology, the pharmaceutical industry, and governmental intervention, this book explores various influences on the production of medications used to treat patients with mood disorders in the United States.
Purpose: The author attempts to examine the shortcomings of a promising beginning to the understanding of mood disorders and traces the problems forward to enable readers to comprehend how the field arrived at its current state.
Audience: Though targeted at a larger audience, much of this book is challenging for those unfamiliar with the field of psychiatry, the specifics of psychiatric research and statistical analysis, psychiatric diagnosis as assigned by the DSM-IV-TR, or psychiatric treatment.
Features: The author identifies three major sections in this work: the first being the introduction of medications used to treat psychiatric illness in the early 1950s; the second focusing on the FDA's power in steering the use of certain medications; and the third explaining the current state of affairs in psychopharmacology, including a chapter about how to begin to regain lost ground. There is one table, but no other illustrations, and the book ends with a glossary and annotated notes separated by chapter.
Assessment: It goes without saying there are numerous problems with the manner in which pharmaceuticals for mental illness are discovered, manufactured, and distributed in the United States and throughout the world. Much of the difference between what is permitted in the United States and in other industrialized countries is a result of what is approved for treatment by the FDA. And while it is important to expose the process and educate others about its shortcomings, it seems unrealistic to describe the procedure of drug approval as a huge conspiracy meant to pad the pockets of the pharmaceutical companies while simultaneously taking advantage of a naive and desperate public, all at the hands of hapless clinicians who are, by the author's description, nothing but dupes and mindless automatons who are either incapable, or unwilling, to think for themselves. In order to examine the global aspect of this problem, it seems likely there are other factors at play this author seems to have neglected, such as a legal system in the United States, which is unlike others in the world in that a huge liability is placed on the clinicians providing care, creating a very risk-averse physician population, as well as a general public that is led to believe pharmaceuticals will cure all ills with no reasonable expectation of legitimate side effects or other adverse events. Though some of the author's ideas are interesting and provocative, ultimately they are not based on hard evidence.