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Before Prozac - The Troubled History of Mood Disorders in Psychiatry (Hardcover)
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Before Prozac - The Troubled History of Mood Disorders in Psychiatry (Hardcover)
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Psychiatry today is a barren tundra, writes medical historian
Edward Shorter, where drugs that don't work are used to treat
diseases that don't exist. In this provocative volume, Shorter
illuminates this dismal landscape, in a revealing account of why
psychiatry is "losing ground" in the struggle to treat
depression.
Naturally, the book looks at such culprits as the pharmaceutical
industry, which is not inclined to market drugs once the patent
expires, leading to the endless introduction of new--but not
necessarily better--drugs. But the heart of the book focuses on an
unexpected villain: the FDA, the very agency charged with ensuring
drug safety and effectiveness. Shorter describes how the FDA
permits companies to test new products only against placebo. If you
can beat sugar pills, you get your drug licensed, whether or not it
is actually better than (or even as good as) current medications,
thus sweeping from the shelves drugs that may be superior but have
lost patent protection. The book also examines the FDA's early
power struggles against the drug industry, an influence-grab that
had little to do with science, and which left barbiturates,
opiates, and amphetamines all underprescribed, despite the fact
that under careful supervision they are better at treating
depression, with fewer side effects, than the newer drugs in the
Prozac family. Shorter also castigates academia, showing how two
forms of depression, melancholia and nonmelancholia--"as different
from each other as chalk and cheese"--became squeezed into one
dubious classification, major depression, which was essentially a
political artifact born of academic infighting.
An astonishing and troubling look at modern psychiatry, Losing
Ground is a book that is sure to spark controversy for years to
come.
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