Prescription for Sorrow: Antidepressants, Suicide, and Violence, Patrick D. Hahn, Samizdat Health Writer’s Co-operative, 2020.
There are quite a few books published about the lack of benefit and harm caused by so-called “anti-depressants.” The fact that so many people have felt compelled to write such books is interesting in itself. Prescription for Sorrow, by Patrick Hahn, is simply the best one I have read. It is the most engaging and readable. This is aided by victim vignettes of real people killed by these drugs to make the data real. It is quite a story, as Hahn writes in his preface:
This is an account of staggering corporate mendacity and greed, and of news media which all too often behave like lapdogs rather than watchdogs. But it is also a tale of courageous doctors, reporters, litigators, and ordinary men and women whose lives were turned upside-down by these drugs—all of whom were relentless in their drive to uncover the truth.
Hahn starts at the beginning. Emil Fischer of the University of Strasbourg synthesized iproniazid in 1875, which was used later by the Nazis for V-2 rocket fuel during World War II. There was a lot of it left over after the war so the search was on to find a use. It was discovered to be effective against the tuberculosis bacillus, but found unsuitable because fifty to seventy percent of patients suffered serious side effects. This later proved no impediment to its use as an antidepressant, though (the sarcasm is mine). He goes through the follow-on MAO inhibitors and the tricyclics, neither of which gained a lot of traction because their dangerousness was recognized.
The tricyclics represented a two-edged sword, because the difference between a therapeutic dose and a lethal dose is a narrow one.
Next up: “The Prozac Era,” with Eli Lilly’s successful marketing blitz making Prozac (chemical name fluoxetine) not only a household name, but “a cultural icon as no other drug before or since.” Books and magazine articles extolled Prozac as having almost magical qualities. There was even a musical and video game using its name. Prozac and other “me too” drugs are classified as Selective Serotonin Reuptake Inhibitors (SSRIs).
Prozac was approved by the Food and Drug Administration (FDA) in 1987, and by 1990 there were already a large number of reports of suicides by people taking Prozac. Hahn relays people’s descriptions of their suicidal thinking and actions while on these drugs. The FDA convened a panel of “experts” to consider the evidence, 5 of 9 of whom received waivers because they would normally have been disqualified due to their ties to drug companies. Despite compelling evidence that Prozac caused suicides, the panel and then the FDA did not issue a warning. Instead it ordered Eli Lilly to conduct a study to definitively determine whether it caused suicidality, which Lilly failed to do. Later analysis by Dr. David Healy found that antidepressants doubled the rate of suicidal actions and increased suicides by seven times.
Hahn next addresses the question of whether these drugs “work,” and concludes, as others have, that they don’t. For example, Hahn reports on a 2017 study:
The study authors found that, nine years into the study, patients who were treated with medication fared worse than undrugged patients, and that this difference remained even after controlling for initial severity of depression, along with all the other potential confounders they could think of.
Prescription for Sorrow also goes through the controversies over whether the antidepressants are addictive (they are), did the FDA Black Box Warning increase suicides (no), and cause rampage killings (yes), all in Hahn’s very readable and engaging style. The one thing I was surprised was not covered in any depth is the sexual dysfunction antidepressants cause, oftentimes long-lasting or even permanent. Talk about a prescription for sorrow.
Much of the information in Prescription for Sorrow has been written about elsewhere and anti-psychiatry groupies will know much of it. However, I know of no other book as engaging, and it provides an alternate explanation I haven’t seen anywhere else of the Conrad Roy suicide for which Michelle Carter was convicted of involuntary manslaughter, purportedly because she caused him to kill himself. Instead, Hahn makes a compelling case that Roy’s suicide would not have happened absent the antidepressants both were on. Michelle’s defense, testified to by Dr. Peter Breggin, was that she was “involuntarily intoxicated” by the drugs taken as prescribed. As an aside, I think this is a terrible name for the defense because it is not particularly descriptive and not at all sympathetic. I think “iatrogenic insanity” is both. “Iatrogenic” means caused by the treatment.
Prescription for Sorrow is the 4th book published by new publisher, Samizdat Health Writer’s Co-operative. Since then, it has published Shipwreck of the Singular by Dr. David Healy, which I am in the middle of and finding fascinating. Full disclosure: On May 1st Samizdat is going to publish the hardcover edition of my book, The Zyprexa Papers.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.