My rating: 3 of 5 stars
I would like to open with saying that I used to do psychiatric research. I’ve stuck fluoxetine (aka Prozac) into a fairly large number of mice. It has been a few years and I was coming at it more from a neurobiological standpoint, but I do know how to scrutinize a study (no kidding, I had an entire course that focused on picking them apart.) Unlike many journalists trying to report on science, Bass is able to convey the complexities and fallibility of large human studies, and since she’s the mental health reporter for the Boston Globe, this makes sense. Even if what she mentions is anecdotal, it’s clearly stated and includes explanations for the layperson (I can’t comment on how successful these explanations are, but they seemed pretty straightforward to me).
One thing I’m going to say about this book, if you aren’t already bothered by the complex relationship between federal science/research funding, big pharma, and the supposedly objective voices in the field—the researchers—this is a must-read. Bass was involved with reporting the scandals at the time they were happening, and that’s a huge plus as far as her ability to look back at things and comment on their impact is. Every single chapter is supported with interviews as well as papers. There is no question about the quality of Bass’s research.
The big area this book fails in—the reason it’s a three-star read and not a full five—is the personal bits feel randomly inserted and tend to go into too much detail. I get that the narrative is more compelling if the pacing is slowed down, but learning about Rose Firestein’s relationship with her niece doesn’t add a thing to the section on building the case against GlaxoSmithKline or, well, any other part of it. It is a short book and I guess this makes the sympathetic characters even more sympathetic, but by and large I didn’t care.
Alright, I don’t enjoy 99% of memoir fiction anyway, and there were moments of relevance, such as the role Donna Howard’s own bipolar diagnosis played in her reaction to NAMI promoting Martin Keller’s rather dubious studies. Still, it’s hard not to want this to simply be a short, concise narrative of big pharma, ideally with some 2013 updates.
On that last note, though, the problem is that not nearly enough has been done to punish the flat-out lying that the industry with the assistance of well-known, respected people like Martin Keller have propagated (Google the latter and you’ll see he’s still got a nice page at Brown that makes no mention of the controversies, even though you can also find a BBC article on Study 329 that mentions its issues). So it’s hard to add more of the ‘what happened next’ because, even now, that essentially needs to be a call to action.
Maybe the book could have delved more into the thematic complication of wanting to be a good psychiatrist who ethically prescribes medications while not scaring away patients who could really benefit from these substances, but it is focused around the New York Attorney General’s prosecution (with a diverse amount of background information, including Martin Teicher’s case studies on increased suicide rates in patients on SSRIs a whopping fourteen years before anything got resolved). The AG’s office—Rose Firestein—very deliberately pursued this as a case of fraud since they’re not medically qualified to assess the efficacy of the drug itself. Neat and clever, but it does make it harder to incorporate the medical side of the narrative.
So all this said, READ THE BOOK.
Seriously, Americans trust drug ads and demand prescriptions far, far more than in countries on a nationalized system. If we’re going to be informed consumers, we need to pick up as many pieces as possible without actually studying the field or paying a big pile of money for articles on PubMed.