Depression is an epidemic, and the best weapons against it are prescription drugs called selective serotonin re-uptake inhibitors (SSRIs). We all have a substance called serotonin in our brains and low levels of it are the cause of depression. SSRIs work by bringing them back to normal. The pills have unpleasant side-effects for some people, but this is outweighed by the relief they offer from wretchedness. This has been the prevailing view in medicine for nearly two decades, during which time the prescribing of antidepressants in the US has tripled, with more than 100m prescriptions written last year.
But change is afoot. The depression model centred on low serotonin has been seriously undermined by hard facts dug out of medical research by public health activists—chiefly in Britain (possibly because it is the natural home of glum stoicism). Those facts are set out in a new book: Medicines out of Control? Antidepressants and the Conspiracy of Goodwill. It is a carefully substantiated and elegantly written indictment of the drug companies that make SSRIs, explaining why their claims for the benefits of the drugs are unfounded, and who has hidden this information from us and how. It is a classic exposé and an essential corrective to the 1990s bestsellers on antidepressants—Listening to Prozac, Prozac Nation, and The Noonday Demon—all of which examined the pros and cons of the new generation of antidepressant drugs and concluded strongly in their favour.
The book’s chief author is Charles Medawar, director of Social Audit—a British spin-off of Ralph Nader’s Public Citizen network—and a blistering critic of modern medicine from deep within the fold of Britain’s scientific and medical elite (his book’s subtitle is borrowed from the writings of his father, Peter Medawar, who won the Nobel prize for medicine in 1960). The drug companies want their drugs to work well, just as much as doctors and patients do, but all three groups, along with government regulators, conspire to promote a “grand delusion” that hugely overestimates the effectiveness of pills.
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