Mad in America

Today I attended a Master's tea with Robert Whitaker who just wrote Mad in America about how the industry producing psychiatric drugs has run amok. I left the tea feeling pretty low about the world. Here are some points he made: - Repeated studies by the World Health Organization show that schizophrenics in developing countries do much better than in developed nations. - The psychiatric drug industry has grown from $800 million in 1987 to $23 billion today. The influence of this money runs everywhere. Careers among academics get destroyed if they do not promote the drug industry party line. Many academic centers are supported with industry money, and because of this tests are not done scientifically. He told the story of one academic who opposed the drug industry, and was told his university salary of $90,000 was going to be cut by a third. Coincidentally, a drug company offered him a job at the same time for $300,000 which he accepted. - One test of St. John's Wort, Zolaf, and a placebo showed that the two drugs were ineffective. The academics spinning the test results reported it as, "St. John's Wort doesn't work," without a single mention that Zolaf also didn't work. - Government studies always have lower success rates than industry funded studies. - Master Keil, a professor of psychology, agreed with everything Whitaker said and added his own anecdotes of academic corruption he had witnessed. - The FDA is just as bad, because many FDA officials get hired right into the industry at high salaries after their term ends. -Psychiatrists have incentive to prescribe the drugs because prescribing drugs is what distinguishes psychiatrists from psychologists and justifies their high salaries. - Whitaker also talked about how our notions of normalcy and mental illness have become so out of whack. Never in history have so many people been diagnosed as mentally ill. While he believes that there is a place for drugs, he said that humans are meant to be emotional creatures. We are supposed to feel anxiety frequently and to feel depression. I have always been wary of liberal arguments about the evilness of pharmaceutical companies. I believe that companies have a right to charge for drugs if it was expensive to develop the drugs. But dishonesty and these massive conflicts and interests and outright fraud are absolutely terrible. We seriously need to structure the drug approval process in a way that lessens conflicts of interests and separates the financial incentives from the science of what works.