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Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America Hardcover – April 13, 2010

4.6 out of 5 stars 372 customer reviews

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Editorial Reviews

From Booklist

*Starred Review* When Whitaker (Mad in America, 2002) learned that between 1987 and 2007 the number of Americans disabled due to mental illness more than doubled despite a whopping $40 billion annual psychotropic drug tab, it gave him pause. Given their widespread use—greater than even that of cholesterol-lowering drugs—he had believed that psychopharmaceuticals were magic bullets, knocking mental illness out of the game, returning formerly disabled people to the ranks of productive citizens. But the deeper he probed into clinical studies in prestigious scientific journals, some dating back more than 50 years, the more he noticed a shocking anomaly. Psychiatric drugs have repeatedly been shown to worsen mental illness, to say nothing of the risks of liver damage, weight gain, elevated cholesterol and blood sugar, and reduced cognitive function they entail. The reality, he says, is that, because no one knows what causes mental illness, there’s no cure or palliation to be found in these pills. What with the conclusions Whitaker draws from his assembled literature and the accusations he levels at those who consciously deceive consumers eager for magical cures, his book will either blow the lid off a multibillion-dollar industry or cause him to be labeled a crackpot and, perhaps, medicated into obscurity. At the very least, it should prod those who take the drugs to question those who prescribe them. --Donna Chavez


“The timing of Robert Whitaker’s “Anatomy of an Epidemic,” a comprehensive and highly readable history of psychiatry in the United States, couldn’t be better.”—Salon.com

“Anatomy of an Epidemic offers some answers, charting controversial ground with mystery-novel pacing.”—TIME.com

“Lucid, pointed and important, Anatomy of an Epidemic should be required reading for anyone considering extended use of psychiatric medicine. Whitaker is at the height of his powers.”—Greg Critser, author of Generation Rx

“Why are so many more people disabled by mental illness than ever before?  Why are those so diagnosed dying 10-25 years earlier than others?  In Anatomy of an Epidemic investigative reporter Robert Whitaker cuts through flawed science, greed and outright lies to reveal that the drugs hailed as the cure for mental disorders instead worsen them over the long term.  But Whitaker’s investigation also offers hope for the future: solid science backs nature’s way of healing our mental ills through time and human relationships.  Whitaker tenderly interviews children and adults who bear witness to the ravages of mental illness, and testify to their newly found “aliveness” when freed from the prison of mind-numbing drugs.”—Daniel Dorman, M.D., Clinical Assistant Professor of Psychiatry, UCLA School of Medicine and author of Dante’s Cure: A Journey Out of Madness
“This is the most alarming book I’ve read in years.  The approach is neither polemical nor ideologically slanted. Relying on medical evidence and historical documentation, Whitaker builds his case like a prosecuting attorney.”—Carl Elliott, M.D., Ph.D., Professor, Center for Bioethics, University of Minnesota and author of Better than Well: American Medicine Meets the American Dream
Anatomy of an Epidemic investigates a profoundly troubling question: do psychiatric medications increase the likelihood that people taking them, far from being helped, are more likely to become chronically ill? In making a compelling case that our current psychotropic drugs are causing as much—if not more—harm than good, Robert Whitaker reviews the scientific literature thoroughly, demonstrating how much of the evidence is on his side. There is nothing unorthodox here—this case is solid and evidence-backed. If psychiatry wants to retain its credibility with the public, it will now have to engage with the scientific argument at the core of this cogently and elegantly written book.”—David Healy, M.D., Professor of Psychiatry, Cardiff University and author of The Antidepressant Era and Let Them Eat Prozac
“Anatomy of an Epidemic is a splendidly informed, wonderfully readable corrective to the conventional wisdom about the biological bases—and biological cures—for mental illness. This is itself a wise and necessary book—essential reading for all those who have experienced, or care for those who have experienced, mental illness—which means all of us! Robert Whitaker is a reliable, sensible, and persuasive, guide to the paradoxes and complexities of what we know about mental illness, and what we might be able to do to lessen the suffering it brings.”—Jay Neugeboren, author of Imagining Robert and Transforming Madness

“Every so often a book comes along that exposes a vast deceit. Robert Whitaker has written that sort of book. Drawing on a prodigious quantity of psychiatric literature as well as heart-rending stories of individual patients, he exposes a deeply disturbing fraud perpetrated by the drug industry and much of modern psychiatry—at horrendous human and financial cost to patients, their families, and society as a whole. Scrupulously reported and written in compelling but unemotional style, this book shreds the myth woven around today’s psychiatric drugs.” —Nils Bruzelius, former science editor for the Boston Globe and the Washington Post
“A devastating critique. . . . One day, we will look back at the way we think about and treat mental illness and wonder if we were all mad. Anatomy of an Epidemic should be required reading for both patients and physicians.” Shannon Brownlee, senior research fellow, New America Foundation and author of Overtreated


Product Details

  • Hardcover: 416 pages
  • Publisher: Crown; 1 edition (April 13, 2010)
  • Language: English
  • ISBN-10: 0307452417
  • ISBN-13: 978-0307452412
  • Product Dimensions: 6.5 x 1.5 x 9.5 inches
  • Shipping Weight: 1.4 pounds
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (372 customer reviews)
  • Amazon Best Sellers Rank: #112,043 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Louise Gordon on April 17, 2010
Format: Kindle Edition
Robert Whitaker's Anatomy of an Epidemic reveals the damage that can and very often does result from long-term use of psychotropic drugs, and, along with it, the alarming rise in chronic mental illness in this country since such drugs as Thorazine were introduced in the 1950s. Because this drug could cause tardive dyskinesia and other permanent nervous system damage, the pharmaceutical industry got to work on new generations of drugs that are being used now.

The rise in drug use corresponds with psychiatry staking a renewed claim to therapeutic expertise and market share, which had begun to erode due to competition from counselors, social workers and others (see the Selling of DSM by Kirk and Kutchins -- [...]-- and Making Us Crazy by the same authors). The prescription pad, and the power of academic psychiatry in collaboration with Big Pharma, allowed psychiatry to open up a very large market, one that today seems to encompass the entire population.

Whitaker documents the alarming rise of disability and increasing number of people on SSI and SSDI due to mental illness over the last 50 years, including the increase since the 1980s, when serotonin reuptake inhibitors such as Prozac were introduced, and again, with the introduction of what are called atypical antipsychotics (e.g., Risperdal, Zyprexa), and reliance on drugs in the benzodiazepine family (Valium). But perhaps the most tragic of all cases with drugs used to treat what were once considered within the range of "normal" behavior (e.g., shyness) is the prescribing of amphetamine-like agents such as Ritalin or Adderall for so-called attention deficit disorder (ADHD) in children, and, even worse, powerful psychotropic drug cocktails to treat a newly introduced category of illness, childhood-onset bipolar disorder.
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Format: Hardcover
As others have stated, this book is impeccably researched and the author presents his argument in a very thoughtful, careful way, with a lot of compassion for the individuals whose stories he tells to illustrate his point.

However, as I reach the end of the book, I find myself wondering whether it is fair to implicate only Big Pharma and the proponents of biological psychiatry in this scandal. I find myself wondering about the roles of shareholder value in the decision making process in the pharmaceutical industry, and of teachers and parents who would rather think that their children's behavior is due to "chemical imbalance" than to psychosocial issues like peer pressure, unavailable parents, overwhelmed teachers, and the like.

While the lopsided presentation of psychotropic drugs by the media certainly is part of the picture (and the problem), the truth is, I think, that we as a society would much prefer the idea of mental illness as a biological problem. It relieves us from personal responsibility, for our financial investments, our children, our students. To me, the most striking part of the book is the description of the callous use of psychotropic drugs to control children and pathologize perfectly normal childhood behaviors, based on the short-term efficacy of the drugs and with no regard for the long-term consequences. I'm a little disappointed that Whitaker doesn't even comment on the wider ethical implications of the problem he is addressing!
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Whitaker and many of Amazon's reviewers have a lot to say about psychiatric drugs, most of them virulently negative. As someone who actually is mentally ill and takes some of these drugs, I see things very differently and I want to share my story and my point of view.

I have schizoaffective disorder (a combination of schizophrenia and bipolar disorder). I developed this disease in my early 20s. I was beset by mania, depression, and psychosis. The mania and depression were bad but easier to manage than my psychosis. I heard loud, terrifying voices which threatened to kill me and worse. They sounded just as real as any voice I had ever heard in my life. They tortured me morning, noon, and night without interruption. I was completely disabled by them.

I was a bright young woman with a good education but I could barely leave my house, let alone work. I could not even have a meaningful conversation with anyone because the voices were too loud. My parents became my caretakers and my friends disappeared completely. Despite my family's support, I felt utterly alone in the world.

This went on for years as I tried different antipsychotics. They worked to a degree but the voices simply would not go away. I certainly did not get better or "heal" on my own--despite my family's love and support. No words can describe how hellish and worthless my life felt. I thought about killing myself but my parents helped me hold on to what seemed like a very slim hope that the voices would be stilled one day.

Geodon, the last antipsychotic I had settled on, began to give me symptoms of dyskinesia and my doctor made me stop taking it right away. The symptoms went away and I began to take a new drug: Seroquel.
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The point of psychiatric drugs is to improve the lives of people living with mental illness. Therefore people who take psychiatric drugs should do markedly better than their peers who do not take medication, right? Wrong. Long term studies show over and over again that people do worse on medication than off. In fact, medication may be responsible for a great increase in psychiatric disability since the introduction of medication.

If you find this fact shocking or preposterous this book is for you. If you suspected this all along, this book is for you, too. It is calm and scientific. Whitaker works from the psychiatric literature to do a review of evidence from within the field. He explains how the illusion that the drugs work and are needed is maintained: in short trials (usually six weeks) the drugs do provide some improvement in symptoms. In trials of abrupt withdrawal of drugs, patients do worse due to withdrawal effects, since their brains have adjusted to some interruption in neurotransmitter function and need time to adjust back. In clinical work doctors can see this: the drugs do some good at first, and when a patient stops taking them they usually do worse. While poor long term outcomes are deplorable, they are seen as first and foremost caused by the illness itself. Whitaker's thesis is that this is not the case: the increasingly poor long term outcomes are iatrogenic, caused by medication.

If that is the case, this is a huge scandal, so huge it is hard to get a grasp on it. And after reading this book, I am convinced that it is the case. I hope that many will read this book and take its message seriously, and I hope that it provokes productive dialogue. This would not be the first time that medicine got something this wrong.
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