Book Review: The Limits of Drug-Based Psychiatry

BY JOSHUA C. KENDALL: For Complete Post, Click Here…

“The Mind and the Moon,” by Daniel Bergner, is a deeply reported critique of the medication revolution in psychiatry.

ABOUT 40 YEARS AGO, Daniel Bergner’s younger brother, Bob, then 21 and a college dropout, had a psychotic break. He became delusional; he was convinced that he might be the messiah and that he could cure their grandfather’s Alzheimer’s disease. Worn down by insomnia, Bob was also neglecting his personal hygiene. Out of desperation, the brothers’ parents arranged to have Bob committed to a locked psychiatric unit, where he was soon pumped up on a heavy dose of Haldol, an antipsychotic medication.

Shortly after Bob was hospitalized, their father handed Daniel a popular book by the late Ronald Fieve — first published in 1975— on mood disorders. According to this prominent psychopharmacologist, psychiatry was undergoing “a third revolution,” which was leading to new and highly effective drug cures for major mental disorders, including schizophrenia, bipolar disorder, and major depression. This book, notes Daniel Bergner in “The Mind and the Moon: My Brother’s Story, The Science of Our Brains, and the Search for Our Psyches,” gave his parents hope that his brother’s condition could be treated. “It was as if they had ingested the book’s sentences and elevated its paragraphs to articles of faith,” he writes. “They were immediate converts.”

As he reports in this deep dive into the history of psychiatric treatments over the last century — which features interviews with leading neuroscientists and psychiatrists, as well as profiles of people like Bob who have waged long battles with psychiatric problems — the biological revolution in psychiatry has not come close to living up to its grandiose promises.

Medication can indeed reduce emotional suffering. Bergner cites research suggesting that about half of people who take selective serotonin reuptake inhibitors, or SSRIs — a category of popular antidepressants that includes the mega-selling Prozac — do experience some symptom relief “if comparison with placebos is disregarded.” But while the number of Americans taking psychiatric drugs has been steadily increasing over the past 20 years (more than 40 million adults and as many as 40 percent of college students, according to recent estimates), drug treatment, he stresses, often does not work at all and sometimes is harmful due to noxious side effects. For example, SSRIs, can cause both sexual dysfunction and withdrawal symptoms, both of which, Bergner notes, their manufacturers have minimized. And antipsychotics can cause weight gain and increase the risk of diabetes; according to internal records of pharmaceutical company Eli Lilly, 16 percent of patients taking its blockbuster drug Zyprexa gained more than 66 pounds.

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