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"Unhinged is a searingly honest and articulate account of modern psychiatry's failure to think outside the box of psychopharmacology in treating patients." (Alison Bass, author of Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial,winner of the NASW Science in Society Award for 2009)
“A psychiatrist looks deeply into the mirror and takes stock of his profession and what it has become. Whether you are a patient, student, trainee, clinician, or “KOL” (key opinion leader”), this frank and insightful book will definitely make you think.” (Erick Turner, M.D., Department of Psychiatry and Center for Ethics in Health Care, Oregon Health & Science University)
"Unhinged provides crucial insights for anyone who cares about the future of Psychiatry. Must reading for psychiatrists and patients alike." (Keith Ablow, MD, author of Living the Truth)
"Terrific book, terrific insights! Daniel Carlat is the kind of psychiatrist we wish we all had." (Manny Alvarez, MD, Senior Managing Health Editor at Fox News Channel)
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This is essentially a whistle blower reporting on the corruption of psychiatry by Big Pharma. Dr. Carlat went to UCSF med school in 1985 as psychiatry was rapidly transiting to psychopharmacology. He is practicing at Massachussetts General Hospital (MGH) where many of the key drug trials had taken place and where faculty members had received millions from Big Pharma to conduct such trials. He also used to accept Big Pharma's money ($30,000 in total, a very small amount relative to others) to lecture to pitch its drugs until his conscience regained the better of him. Thus, he had a front seat and was an active participant in psychiatry's' corruption. His confession is very insightful.
Carlat feels that psychiatry is in a state of crisis, as it has lost much credibility with the public. He mentions a recent Gallup poll that uncovered that only 38% of Americans trust psychiatrists, on par with chiropractors (36%) and even bankers (37%) and way below regular physicians (69%). There are several themes to Carlat's analysis of psychiatry devolution.
First, psychiatrists have given up on understanding their patients. They don't do psychotherapy anymore. They essentially just prescribe drugs (mainly anti-depressants). They now call themselves psychopharmacologists instead of psychotherapists. For psychotherapy, you have to go to a psychologist (who got a graduate degree in psychology, but did not go to med school, and is not allowed to prescribe drugs).
Second, psychiatrists overdiagnose their patients. Way too many children are overdiagnosed with ADHD and even bipolar disorder (the latter being often meaningless for young children). From 1994 to 2003, children and adolescent treated for bipolar disorder rose by 8,000%! The majority of cases are misdiagnosed.Read more ›
Dan Carlat's Unhinged: The Trouble with Psychiatry is a brutally honest account of the gaps in understanding psychiatric illnesses, the relative lack of knowledge about the actions and effects of psychiatric medications, and the importance of psychotherapy. This book should be required reading for all psychiatry residents and psychiatry faculty and on the bookshelves of both early and late career psychiatrists. It is also a must read for clinical psychologists training to prescribe. Prescribing and Medical Psychologists do not want to make the same mistakes that lead psychiatry to where it is today.
The spotty record of the efficacy for psychotropics comes as no surprise, I have seen this on a daily basis for 20 years. But, the degree of deceit and fraudulent behavior by pharmaceuticals was astounding (why I should be so astounded is beyond me). This is a well written book, readable, sensible and helpful. His recommended solution to the problems with psychiatry are totally sensible, although its not likely at this time I would want to go back for the training needed.
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Unhinged is the politically correct criticism of psychiatry that is safe enough to get Carlat interviews on mass media including NPR but which says nothing that will truly upset establishment psychiatry. Everything Carlat says here has been reported for a decade in the corporate media. Yes, psychiatrists are bribed by drug companies to push drugs - old news! Yes, most psychiatrists are nothing but drug pushers who farm out psychotherapy - old news! Yes, as Carlat quite timidly implies, psychiatry has little hard science to back up its biochemical claims - again old news.
Want to read the kind of critique of psychiatry that is BIG NEWS? Read investigative reporter Robert Whitaker's Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown Publishers, April 2010). It is the most important book on psychiatric treatment in a generation. Whitaker, as a reporter for the Boston Globe, won a George Polk Award for medical writing and was a finalist for a Pulitzer Prize. Whitaker is in the tradition of Michael Pollan, Eric Schlosser, and other investigative reporters who get taken seriously. A decade from now, nobody will remember Unhinged, but Whitaker's Anatomy of an Epidemic may do what Rachel Carson's Silent Spring was able to do - wake up an entire nation to the dangers of the arrogance of another chemical industry.
Something is rotten in the state of psychiatry today, and Daniel Carlat shows you, with brutal honesty, what the problem is. He shows the influence of the drug companies over doctors--even over himself at one point, which I give him credit for admitting. Several big names in psychiatry--including Daniel Amen--are shown to be quacks. Studies funded by drug companies turn out to be--shockingly!--biased and unreliable. Yes, as many reviewers have pointed out, drug company influence over doctors is hardly breaking news, but sometimes an important message needs to be repeated over and over again. At the end of this book, you'll like Dr.Carlat, but you may be weary of that Paxil pill your doctor just prescribed. If you're a mental health professional or patient, you need to read this delightful book.
Breath taking ! Shocking. Put as many adjectives you want still it wont be enough to describe the merits of this book. The unholy nexus between the doctor and the pharmceutical industry has been brilliantly portrayed. Unless the author has some personal grouse - I trust the author to be unbiased - this book brings to the fore some disturbing facts. He shows how the doctors are persuaded - rather one may even say bribed - by the salesmen of the big corporations to peddle their ware and how the doctors succumb to such soft tactics. The genuine issues of the profession - of psychology - are brought forth like the overwhelming number of patients that the shrink has to attend to and the impossiblity to give required therapeutic attention to the patients. But in my opinion, that is no excuse. A senate hearing should be held just on the basis of the reports in this book. The story telling is quite vivid. That too straight from the horse's mouth. The nefarious connection between the medical profession and the pharmaceutical industry.. The falsehood behind the statistical studies and the subsequent results published as if having the expert's approval . The innocent victims who think the ads to be gospel truths . Oh the shame of it ! We are reminded of the old saying " Statistics can prove anything ". Bravo ! It takes a lot of guts to come out into the open through his book with facts like this - even though the author himself belongs to the same profession. The lifeless souls that come out of such drug treatment bereft of their personality - the products of mind altering drugs. In the corporate world the evil nexus that existed between the auditors and the clients was substantially eliminated by laws like Sarbanes Oxley etc. But what about this ? Is there any way to tackle this problem at all ?Read more ›