Customer Reviews

Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression (Medicine, Culture, and History)

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Having been a pharmacist for 24 yrs I can say with depressing certainty that MDs have absolutely minimal understanding of the drugs they prescribe. They receive only the barest instruction in pharmacology in med school, and the majority of their ongoing drug education seems to come from pharmaceutical reps. This book just further validates observations I have already made about the side effects of Prozac and its cousins. The detail involved in the handling of the subject matter may be too technical for the casual reader but would be fascinating to healthcare professionals and attorneys. It underscores the penalties to be paid by honest researchers and healthcare professionals in this market-driven economy by those who dare to challenge the data put out by companies with huge profits to make and to protect--and who also have the financial resources to ruin anyone who tells the truth about their products. It reinforces what should be a guiding principal in most areas of life: before believing what you are told, ask who profits by your gullibility and need. And do not be too quick to distrust your own instincts and observations.

Dr. Healy is a proponent of drug use for patients with depression or other disorders. When a drug calms a person down or energizes her - in a good way - he says "that's a good drug for that person". He has been a leading figure in psychopharmacology for many years, in part because of sponsorship by drug companies. He has a great deal of experience prescribing Prozac, Zoloft, and other antidepressants for a variety of conditions.

Healy is also a dedicated, conscientious doctor. So when he first read reports of persons who behaved unaccountably when on Prozac or another Selective Serotonin Reuptake Inhibitor (SSRI), he naturally wanted to know why. It wasn't long before he had embarked on a research trek that led him to the inescapable conclusion that Prozac increases a patient's risk for suicide and violence. He tells the story of his journey almost like he is writing a suspense novel, and its grip is hard to shake.

Healy noticed that the "suicidal ideation" related to the use of Prozac was different from the non-drug induced suicide. Normal suicidal behavior takes into account the effect of this action on others, while drug-induced suicide and violent actions show a complete disregard for anyone else. Normal suicidal behavior is repeated - that is, an actual suicide typically follows at least one attempt. The cases that Healy followed, by contrast, were of normal people who had usually never attempted suicide before. Their behavior shortly before the attempted or actual suicide was described as strange and unlike them, almost as if they were possessed.

Although the book delves deeply into the pharmaceutical industry's practices, the efforts made by these companies to prevent negative information about their drugs from reaching doctors or the public, I was particularly struck by the effect these special patients had on Healy himself. He doesn't seem to be able to shake the vision of what they became and how their behavior, influenced by drugs, affected their friends and families, how the drugs ruined so many lives in such a horrifying way. I think it was this sense that drove Healy to write this book. No stranger to attacks and veiled threats by his peers, Healy has to know that his work will not be received with unadulterated admiration. But it is a work he had to write and that we all should read.

Since I am acquainted with the issues of antidepressants as someone with dysthymia, I decided it might be interesting to read the "other" side of the story. To that end, I just finished Let Them Eat Prozac - The Unhealthy Relationship Between The Pharmaceutical Industry And Depression by David Healy. Interesting stuff here...

Healy is listed as a former secretary of the British Association for Psychopharmacology and has written a number of articles and books on the subject. He's also been on the prescribing end of antidepressants, so I don't see (at least on the surface) any particular conflict of interest that might color his statements and conclusions. The book is part a personal story of his experience with the drug Prozac and its parent company Lilly, as well as an expose of how pharmaceutical companies are able to distort facts and studies to present misleading results on drug testing. The main thrust of this book is how Prozac and SSRI drugs in general show a strong increase in the rate of suicidal tendencies in users during the first few weeks of use. But looking at the information from the drug companies, you'd never know it. Based on creative manipulation of statistics, the suicide rates were presented as far less than they really were. And even now that Prozac has gone off patent and is now available in its generic form of fluoxetine, he still claims that little is known about the long-term effects of the drug, and who might be held responsible if issues arise down the road.

Coming into this book, I was ready to write him off as a conspiracy nut with an axe to grind. I was given fluoxetine nearly two years ago to help me deal with chronic low-level depression, and it's been a lifesaver. I've experienced very few side effects (very minor), and it has given me a new lease on life. But after reading the book, I realize that I am pretty lucky, in that the story could have been much worse. It's nearly impossible (from what I can tell) to predict how a specific person will react on an SSRI drug. My position has been that the doctor should be watching them extremely closely over the first two to four weeks. I'd now change that to the first two to four *days*. An adverse reaction to the drug could be deadly, and for more than just the person taking the drug.

Overall, very interesting material. I would hope that reading something like this wouldn't dissuade a person from seeking treatment and trying SSRI drugs, as they can and do work well for many people. But it's valuable to understand that they don't work for everyone, and it's possible that they could make the condition even worse. Just proceed with caution...

This important book undermines its effectiveness by jumbling together several distinct story lines:
1. The influence of pharmaceutical money on science and the practice of medicine.
2. The value of antidepressants versus their troubling side effects, most notably suicidality.
3. The legal battles over (a) the "Prozac defense" and (b) product liability of Lilly for adverse drug reactions.
4. Dr. Healy's personal travails as a result of his concerns about the safety of SSRI's.

Jumbling these related-but-different issues together results in a murky book, in which none of the four stories emerges clearly.

In general, Dr. Healy's views on these issues seem to be
1. Pharmaceutical money has badly corrupted both science and clinical practice.
2. Antidepressants and other psychotropics are important tools, but because the science and clinical practice have been skewed by pharmaceutical companies, they are over-prescribed, mis-prescribed, and generally used injudiciously.
3. The only reason his side has lost the legal battles that it has lost is the corrupt influence of pharma, and
4. He got screwed by the Evil powers.

I found the cases he made for points 1 and 2 (if I teased them out of the murk correctly) fairly persuasive, the case for point 3 provocative but not entirely compelling, and the case for point 4 hard to judge.

If you have a fair amount of patience and a serious interest in the different story lines Dr. Healy addresses, and if you know enough about the methodological issues involved in different ways of doing research to evaluate his criticisms of the preferred methodologies of pharmaceutical-funded research, the book is certainly worth reading. Otherwise, I suspect you will find the book more confusing and (probably) misleading than enlightening.

Healy is the world's foremost authority on psychopharmacology. The first part of this book (Introduction) is 39 pages and gives a most useful overview of depression's "history," the history of tranquilizers, the discovery of serotonin and chemical imbalances (which he calls a silly myth), SSRIs, etc. The book is also excellent on the marketing of antidepressants. This is where you might get upset as it becomes clear the marketing strategy involves very purposeful distortions of the truth and outright lies. His information about "ghostwriting" (when the drug company actually writes the journal article, not the drug researcher whose name appears on the article) is astonishing. I had read my medical journals for many years without ever even being aware this ever occurred. Healy describes his own experiences where the drug companies have tried to pay him for allowing his name to go on their "research" studies. He believes this is a much greater problem with antidepressants than with other classes of drugs. If all the book were as strong as the Introduction or the ghostwriting and marketing material I would give it five stars. However, he gives a lot of detail about his own experiences which is "why is this in the book?" kind of material. A more general book that is the best thing I have read yet on the antidepressant/antipsychotic topic is America Fooled. It is easy to understand but referenced as well as Healy's books (and I didn't think anyone could match Healy). We are fortunate to have Healy write this and his other books as he speaks from personal experiences and is a giant in the field.

A book to read if somebody in your family is considering taking SSRI. Not so much to go agaisnt medical advice but to recognize subsequent side effect that would alert the family member to an untoward reaction from taking the medication. A good book to read also for physicians who are prescribing or seeing patients who take SSRIs. This book goes into many details , from case studies to marketing and legal issues concerning the pharmaceutical companies 's handling of SSRIs. It is a compelling case for a cover up for serious side effects. Even if it only looks at one side of the story, it is a pretty large burden of proof. Not an easy read.

Dr. David Healy's Let Them Eat Prozac is packed with painstakingly referenced information. The book is deceptively panoramic in scope, ranging from ghost written article/adverts in medical journals masquerading as science, to how the line between the psychiatric community and the pharmaceutical industry has become increasingly blurred. Healy diligently documents how society has been inundated with information regarding the newest and `most proficient' pharmaceuticals, and how it has been increasingly difficult of late to separate legitimate scientific observations from the highly evolved marketing the industry has used to engage the public.

Dr. Healy tackles many key issues and demonstrates admirably how one should handle some of the more sensitive of these without sounding sensationalistic. There is much in this book that would otherwise not be public knowledge, and as Healy explains how the billions of dollars that these companies spend on public relations are used, one comes to appreciate/abhor the tact with which the pharmaceutical industry has promoted their products. However, David Healy is a man who refuses to play their game:

"A string of colleagues from Japan through Europe to the US called me or emailed me to tell me that they had been told to have no contact with me - that I was trouble, and about to be in trouble." (pg 248)

The quote refers to the difficulties Dr. Healy faced in bringing the life-threatening side effects of these drugs (namely akathisia and psychoses) to the attention of the public and the psychiatric community. These difficulties would reach their apex when his job contract with the University of Toronto was rescinded after he presented his concerns that some of these more dangerous side effects were being overlooked, concerns that would later prove true and result in a black box suicide warning being placed on all SSRIs and SNRIs.

Easily the best and most important non-fiction book I have ever read. I'll end with a couple quotes to give you a better idea of the content:

Memo from chief executive in the German branch of Lilly: "Hans [Weber] had medical problems with these directions and I have great concerns about it. I do not think I could explain to the BGA, to a judge, to a reporter or even to my family why we do this especially on the sensitive issue of suicide and suicidal ideation." (Healy 248) Followed by another memo: "I personally wonder whether we are really helping the credibility of an excellent ADE system by calling overdose what a physician reports as suicide attempt and by calling depression what a physician is reporting as suicide ideation."

Based on this it is safe to say that by the turn of the century, around 50% of the "scientific" literature in pharmacotherapeutics was ghost-written, originated within companies, or was published in non-peer-reviewed supplements to journals. (Healy 187)

Good review of the negative aspects of SSRIs (and there are many). Would have given it five stars, but he leaves out the very important fact that SSRIs can sometimes cause permanent sexual dysfunction after the drugs are stopped. This has long been overlooked by the medical community and should be included here. Do a goolge search for details.

Healy does a marvelous job of unveiling the hidden workings of the pharmaceutical industry and the corruption of psychiatry and academia as they have acquiesced to the power of the giant. It is a detailed and methodical book. It is also very well written and as suspenseful as a detective novel.

Though the focus of the book is SSRI's, specifically akathisia and suicidality, Healy touches on many fascinating subjects in which the pharmaceuticals have played a dominant role, such as the change in the physician patient relationship that has taken place over the past thirty or so years.

When I read this book several years ago, I was stunned by some of the revelations here. I had no idea till then that roughly 50 percent of the articles in psychiatric publications are ghost written by medical writing companies, which are essentially outsourced PR companies for Pharma. Not only is every moment of TV filled with ads promoting various 'diseases' and their 'cures', thus shaping the belief system of an entire culture; not only is every aspect of psychiatric treatment and education funded and controlled almost solely by drug companies; but the supposed 'academic' publications, those cornerstones of honesty and unbiased knowledge, are written to a large extent by the very same drug companies.

In this heavy fog of propaganda, it is difficult to see. Here are some questions for you to ponder:

Has prozac been proven to be effective as an antidepressant? It has? Are you sure?
Has the prevalence of depression decreased since these "effective treatments" have been discovered? It should have, shouldn't it?
Why is depression increasingly viewed as a life long condition requiring life long treatment with medication, when we now have 'effective treatment' for it?

Recently several other books in a similar vein have been published, and have been well received. The American Psychiatric Association has passed new rules to try and limit Pharma's influence. Whether psychiatry will free itself from this unholy alliance remains to be seen. David Healy's book was, I believe, a groundbreaker, and as such deserves special mention and a special recommendation to be read by those who missed it at the time of its publication.

This world took a bad turn when Big Pharma decided to produce drugs for healthy people. Suddenly, all kinds of new complaints were invented, together with miraculous pills that were supposed to treat them. Not to cure them, but to treat them... for life... That's why those drugs are called "lifestyle drugs".

The list is long, and gets longer every day. Now we have pills to treat cholesterol, the biggest business of pharmaceutical industries. But we have also pills to treat impotence, hyperactivity, and recently even "mild" depression can be "treated".

Dr. David Healy says Big Pharma is better in marketing new drugs than in discovering useful formulas. The FDA approved Prozac when Eli Lilly finally succeeded to present two (!) studies that showed "some" improvement in "mildly depressive" patients. Healy comments on this : "... it has not been uncommon for new drugs to be presented to the FDA that are superior to placebo in perhaps only two out of six trials. Instead of saying that, on balance, the new drug is simply not more effective than a placebo or is of such minimal effectiveness that it is hardly worth permitting on the market, the FDA approach is to say that any trials comparing a new drug to an older antidepressant in which the older drug appeared no different to a placebo were failed trials. That is, the trial rather than the new drug failed."

To make things worse for us, the general public, it results that the FDA hires its "experts" directly from Big Pharma to "help" evaluate new drugs. Dr. Healy says "it has become almost standard practice for advisers to the FDA to have a direct financial interest in the drug or topic they are asked to evaluate. The process of waiving conflicts of interest has become a mere formality. The FDA response to questions on this point is that the best experts for the FDA are often the best experts to consult with industry".

This book offers some important facts :
1. Prozac doesn't cure clinical depression.
2. Prozac doesn't cure mild depressions either, when compared to placebo.
3. Prozac increases the risk of suicide of mildly depressed people tenfold, when compared to a control group taking no medication at all.
4. Prozac also stimulates aggressive behaviour. One of the children participating in the Columbine High School slaughter was under the influence of such a "medicine" (Luvox).
5.The FDA shouldn't be trusted.

It is true that this world is sometimes a depressive place, but that has a lot to do with the way the big corporations are destroying our beautiful planet and poisoning our food chain. Therefore, we should certainly not rely on their drugs. We should act, together, as concerned citizens. We still outnumber the few CEO's messing up our planet.