Synopses & Reviews
When we stop at the pharmacy to pick up our Prozac, are we simply buying a drug? Or are we buying into a disease as well? The first complete account of the phenomenon of antidepressants, thisauthoritative, highly readable book relates how depression, a disease only recently deemed too rare to merit study, has become one of the most common disorders of our day--and a booming business to boot.
The Antidepressant Erachronicles the history of psychopharmacology from its inception with the discovery of chlorpromazine in 1951 to current battles over whetherthese powerful chemical compounds should replace psychotherapy. An expert in both the history and the science of neurochemistry and psychopharmacology, David Healy offers a close-up perspective on early research and clinical trials, thestumbling and successes that have made Prozac and Zoloft household names. The complex story he tells, against a backdrop of changing ideas about medicine, details the origins of the pharmaceutical industry, the pressures for regulationof drug companies, and the emergence of the idea of a depressive disease. This historical and neurochemical analysis leads to a clear look at what antidepressants reveal about both the workings of the brain and the sociology of drugmarketing.
Most arresting is Healy's insight into the marketing of antidepressants and the medicalization of the neuroses. Demonstrating that pharmaceutical companies are as much in the business ofselling psychiatric diagnoses as of selling psychotropic drugs, he raises disturbing questions about how much of medical science is governed by financial interest.
Review
The story Healy brilliantly recounts is one of increasing regulation of psychopharmaceuticals by governments...Healy's proposal will strike some as unscientific and others as humane, for he calls for thederegulation of psychoactive drugs, thereby putting control of mental illness back in the people's hands and forcing physicians to refocus their efforts on cultivating an empathic clinical encounter. In doing so, as Healy rightlyclaims, patients are better served and mental illness is better understood.
Review
"David Healey's book focuses on the discovery and development of antidepressants and provides a fascinating insight into the history of this field. He skillfully interweaves the account of the roles played by the key scientists and clinicians with the powerful influence of pharmaceutical companies...The antidepressant era represents one of the seminal events in the social and cultural history of the latter half of the twentieth century. This book is written in an individual and engaging style and the author reveals a deep knowledge of his subject; he has his own firm views but does not force them upon the reader. I found it a compelling read and hope that it will reach a wide audience."
--Leslie Iversen, Nature"As a history, it is brilliant and brilliantly written, tracing the introduction of antidepressants, which, along with the first antibiotics and antihypertensives, created a therapeutic revolution just after World War II. These developments brought health to the center of global politics and created the possibility of a common language that crossed ethnic, race, and class barriers. The paths traced begin in antiquity. Healy discusses concepts of disease and illness beginning with Hippocrates; the isolation of the tubercle bacillus by Robert Koch; the beginning of the pharmaceutical companies; (In 1804, there were 90 patent medicines listed. By 1857, the list had grown to 1,500); the discovery of the power of marketing with aspirin; the 1951 bill which gave the FDA power to decide which medicines should be made available by prescription; and the 1962 Kefauver-Harris amendment which charged the FDA with establishing the efficacy of over-the-counter as well as prescription drugs. The role of NIMH in testing the new psychotropic drugs, the discovery and testing of the antidepressants and the science developed to facilitate testing are well described. Since many of the scientists who participated in the antidepressant revolution were still around for interviewing, the material is vivid and personal."
--Myrna M. Weissman, Ph.D., New England Journal of Medicine"In the past five years [David Healy] has emerged as the leading international authority on the history of psychopharmacology...Healy's modest endnotes reveal that he has participated in numerous key events, and that he knows personally many of the main actors in the story...The body of Healy's book is a clear, detailed and highly informative reconstruction of the major lines of clinical and laboratory research that have produced modern psychiatric pharmacotherapy...Healy is well-informed...Without slighting the science, he manages to describe [major developments] in an admirably readable narrative...The best remedies of all, however, may be a historically informed medical profession and a biomedically enlightened public. David Healy's impressive and fascinating book is a means to these ends."
--Mark S. Micale, Times Literary Supplement"David Healy is one of the most remarkable figures in contemporary psychiatry. He combines the skills of an historian with a training in laboratory psychopharmacology, a research interest in psychopathology, and an encyclopedic knowledge of the psychotherapies. Throughout the past decade he has published books and papers on subjects as diverse as phenomenology, nosology, hysteria, and psychopharmacology...Healy's trilogy [The Psychopharmacologists,The Psychopharmacologists II, and The Antidepressant Era] is a major achievement: its importance goes beyond psychiatry and psychopharmacology to embrace the whole of medicine. These books represent a quantum leap in understanding the processes that shape therapeutic innovation in clinical practice. Work of this revolutionary scope comes along infrequently--perhaps once in a decade."
--Bruce G. Charlton, Journal of the Royal Society of Medicine"Dr. Healy has found his vocation as the unofficial oral historian of psychopharmacology. He has [previously] published two books of interviews with psychopharmacologists. Here he sets out not to present interviews, but to describe and set in context the development of the antidepressants...He gets into his stride with an enlightening account of the origins of the modern pharmaceutical industry. He describes in detail the early and initially quite uncertain work with the first modern antidepressants...dwelling on the people involved and putting in the picture many more of them than usual, drawing from his fund of interviews. This makes lively reading...Dr. Healy tells a good story and the book is well written...I have lived [this] history...[and] Dr. Healy has got the history right...I can recommend this book, both to the nostalgic older reader and to the younger one who wants to understand how we got to where we are today."
--E. S. Paykel, British Journal of Psychiatry"The story of the antidepressants and their times is now familiar. In the normal run of things, it would not warrant a new book but David Healy has an important trick up his sleeve. He has emerged as a latter-day Boswell to a succession of scientific Dr. Johnsons. Assiduously and meticulously, he had taped an impressive series of interviews with leading psychopharmacologists. Having previously published two volumes of these unique data, Healy now presents a synthesis of the newly gained information with the results of his considerable historical scholarship. Healy is a natural raconter and this book is a cornucopia, bursting with amusing anecdote. It would not do, however, to give the impression that he is just a stand-up comic. He can sift, rank, and evaluate like any statistician. He is both scathing and understanding about (indeed he is slightly obsessed by) the role of the drug companies in what can only be termed 'the making and marketing of depression.'"
--Merton Sandler, Science"David Healy is one of the most remarkable figures in contemporary psychiatry. He combines the skills of an historian with a training in laboratory psychopharmacology, a research interest in psychopathology, and an encyclopedic knowledge of the psychotherapies...[His] books represent a quantum leap in understanding the processes that shape therapeutic innovation in clinical practice. Work of this revolutionary scope comes along infrequently, perhaps once a decade. For medicine, things may never be the same again.
--Bruce G. Charlton, Journal of the Royal Society of Medicine [UK]"This is a fascinating account that embraces the history of psychiatry, modern medicine, pharmacology, and drug development; it includes clinicians, scientists, industrial manufacturers, regulatory authorities and patients; and discusses the impact of randomized control trials and of prescription-only status. In his introduction David Healy promises a study of ambiguities and ideologies, of tensions and drama, and he delivers what he promises."
--E. M. Tansey, History of Psychiatry [UK]"A fascinating overview of the history of depression and its pharmacological treatment...Healy has written a deeply absorbing book. He demonstrates a thorough mastery of his subject, a fresh and original interpretation of events, and an engaging wit...A wide range of readers would find this book informative and stimulating. It goes to the heart of many recent clashes between biological and psychodynamic frames of reference, with regard to depression and other psychiatric disorders."
--Richard M. Waugaman, Psychoanalytic Books"[A] subtle and illuminating history of the discovery of anti-depressant drugs...Studies of obscure subject matter can sometimes tell us a great deal about the wider world. Dr. Healy's book most definitely does this, and so it amply repays the trouble of reading it...All in all, this book is a subtle but deadly assault on the 'magic bullet' approach to psychiatric and psychological problems...His book should be given to every literate person who believes that he harbours a biochemical imbalance in his brain which causes him to behave badly."
--Sunday Telegraph [UK]"Healy chronicles the development of antidepressants from their serendipitous discovery in the 1950s to current debates about Prozac. His is a marvellously detailed story, set in the context of shifting ideas about medicine, the growth of the pharmaceutical industry, and wars of ideas between psychoanalysts and biologically oriented psychiatrists. This utterly compelling read subliminally suggests that psychiatric medicine has been largely governed, not by science, but by social and political forces. Despite great advances in neuroscience over the past decade, it seems that there have been virtually no new beneficial ideas in psychopharmacology. That itself is a bitter pill to swallow."
--The Independent [UK]"This is a superb book by a gifted, erudite, and energetic medical-psychiatric historian with a special interest in the history of psychopharmacology...[It is] is an insightful, fascinating, enlightening, and accurate account of the multitude of factors--human, scientific, social, and economic--that have interacted to mold contemporary diagnostic criteria and the scientific and regulatory requirements for establishing the clinical indications for these drugs...This book is an inexpensive treasury of valuable information for psychiatrists, basic scientists, academicians, employees of the pharmaceutical industry, and government regulatory agencies and research centers. Dr. Healy has shared with readers not only historical facts but also his personal views of contemporary psychopharmacology. His views are thought-provoking and worthy of serious consideration. This distillate of hundreds of hours of reading, tape interviews, and analyzing is like listening to a great symphony that has to be listened to repeatedlyto become aware of the composer's talents and message. The Antidepressant Era needs several readings, each of which, for me, was more enjoyable and rewarding."
--Frank J. Ayd, Jr., Journal of Nervous and Mental Disease"In this exhilarating intellectual ride, Healy offers brilliant insights and forgotten facts...Healy's fascinating dialectic is about using drugs to treat depression and related disorders, but even more, it is a history of how humans perceive diseases, the development of the pharmaceutical industry, the drug discovery process, the power of the FDA, how the randomized controlled trial became the sine qua non of scientific inquiry, and why that is a problem...A must for all academic libraries."
--B. C. Stuart, Choice"The Antidepressant Era...[is] fascinating reading and...a major contribution to the psychopharmacology literature. The book is extremely well written, filled with information not readily available elsewhere, and a point of view that needs to be discussed more fully than it has up to now."
--Elliot S. Valenstein, University of Michigan, author of Great and Desperate Cures and Blaming the Brain"The story Healy brilliantly recounts is one of increasing regulation of psychopharmaceuticals by governments...Healy's proposal will strike some as unscientific and others as humane, for he calls for the deregulation of psychoactive drugs, thereby putting control of mental illness back in the people's hands and forcing physicians to refocus their efforts on cultivating an empathic clinical encounter. In doing so, as Healy rightly claims, patients are better served and mental illness is better understood."
--Robert A. Crouch, Religious Studies ReviewReview
As a history, it is brilliant and brilliantly written, tracing the introduction of antidepressants, which, along with the first antibiotics and antihypertensives, created a therapeutic revolution just after WorldWar II. These developments brought health to the center of global politics and created the possibility of a common language that crossed ethnic, race, and class barriers. The paths traced begin in antiquity. Healy discusses concepts ofdisease and illness beginning with Hippocrates; the isolation of the tubercle bacillusby Robert Koch; the beginning of the pharmaceutical companies; (In 1804, there were 90 patent medicines listed. By1857, the list had grown to 1,500); the discovery of the power of marketing with aspirin; the 1951 bill which gave the FDA power to decide which medicines should be made available by prescription; and the 1962 Kefauver-Harris amendmentwhich charged the FDA with establishing the efficacy of over-the-counter as well as prescription drugs. The role of NIMH in testing the new psychotropic drugs, the discovery and testing of the antidepressants and the science developedto facilitate testing are well described. Since many of the scientists who participated in the antidepressant revolution were still around for interviewing, the material is vivid and personal.
Review
In the past five years [David Healy] has emerged as the leading international authority on the history of psychopharmacology...Healy's modest endnotes reveal that he has participated in numerous key events, and thathe knows personally many of the main actors in the story...The body of Healy's book is a clear, detailed and highly informative reconstruction of the major lines of clinical and laboratory research that have produced modern psychiatricpharmacotherapy...Healy is well-informed...Without slighting the science, he manages to describe [major developments] in an admirably readable narrative...The best remedies of all, however, may be a historically informed medicalprofession and a biomedically enlightened public. David Healy's impressive and fascinating book is a means to these ends.
Review
Well-written and thoroughly researched, the book provides an excellent overview of the history of psychotropic medicine from Hippocrates to the age of Prozac, using depression as a paradigm of the ways in which thepopularity of such drugs may have been influenced more by pharmaceutical marketing than by medical necessity.
Description
Includes bibliographical references (p. [269]-305) and index.
About the Author
David Healyis Reader in Psychological Medicine at the <>University of Wales College of Medicine.
Table of Contents
Acknowledgments
Introduction
Of Illness, Disease, and Remedies
The Discovery ofAntidepressants
Other Things Being Equal
The Trials of Therapeutic Empiricism
A Pleasing Look of Truth
The Luke Effect
From Oedipus to Osheroff
Postscript
Appendix: Current Major PhysicalTreatments for Depression
Notes
Index