The antidepressant era revisited: Towards differentiation and patient-empowerment in diagnosis and treatment

Research output: Chapter in Book/Report/Conference proceedingChapterAcademicpeer-review

Abstract

In 1997, during the heyday of what has been labelled the “business of selling mental disease and psychotropic drugs”, David Healy published his book, “The
Antidepressant Era”. In the postscript, Healy argued that the majority of people who meet diagnostic criteria for depression or anxiety and seek treatment because of how miserable they feel have a condition or conditions that in principle cannot scientifically be shown to specifically benefit from available treatments, regardless of the nature of the treatment. Whether or not you agree with this statement, at least Healy has a point when saying that available psychotropic drugs do not have comparable specificity as antibiotics and other drug treatments do, such as insulin for diabetes or Viagra for erectile dysfunction. In this chapter, I will show that the addictive promise of the psychoactive magic bullet with a controllable and specific effect on the chemistry of the brain has not and will not materialize due to the complex and contextualized nature of mental disorders. Even molecular biologists have had to admit that they cannot find a single genetic cause for depression, anxiety
or schizophrenia. The one-gene-one-disease (‘O-GOD’) champions of the 1990s met their Waterloo in mental illness and have turned to epigenetics to develop new forms of neurogenetic and neurofarmacological modelling.
Despite the ever-growing demand for psychotropic drugs, patients have been
the first to point to the remarkably non-specific, sometimes harmful and addictive nature of drug treatments by pioneering a new form of patient power through trial at the bar against drug icons like Halcion, Prozac and Paxil. However annoying, the reason for trial at the bar are the side effects which represent the price that many chronic sufferers living a pharmaceutical life have been willing to pay since the introduction of the first mood molecules in a frantic search for relief of their mental illness. At the same time, consumer demand for alternative psychotherapy packages has grown just as fast. Mental illness was, is and will remain a mind-blowing social and economic health problem that supersedes the demand and costs of all other major diseases like cancer, heart disease or diabetes. The historical lessons are challenging yet engaging. They teach us, as I will argue, that coping with mental illness requires a differentiated and personalized therapy package approach that includes pharmacotherapy, psychotherapy and self-help programmes.
Original languageEnglish
Title of host publicationThe Routledge History of Madness and Mental Health
EditorsGreg Eghigian
PublisherRoutledge
Pages379-390
Number of pages11
ISBN (Electronic)978-1-315-20221-1
ISBN (Print)978-1-138-78160-3
Publication statusPublished - 1 Jun 2017

Publication series

NameThe Routledge Histories
PublisherRoutledge

Keywords

  • History of Psychiatry

Fingerprint

Dive into the research topics of 'The antidepressant era revisited: Towards differentiation and patient-empowerment in diagnosis and treatment'. Together they form a unique fingerprint.

Cite this