Let Them Eat Prozac, by Dr. David Healy
2003 James Lorimer & Company Ltd., Toronto
    462 pages    ISBN 1-55028-783-4

Review By Robert Sealey

Dr. David Healy is an unusual psychiatrist. Not only does he diagnose and treat patients when he works as a doctor, but he also researches, lectures and teaches at universities. He writes papers for medical journals, speaks at conferences, consults with drug companies, authors books about the history of psychiatric drugs and testifies in court. Such a busy chap, he works so hard. An expert and an insider. Healy’s Prozac book tells stories about SSRI medications (selective serotonin reuptake inhibitors).

We hope that Healy will explain how these pills inhibit the reuptake of serotonin and how that approach to mental healthcare can help sick people recover from depression and anxiety. As it turns out, serotonin has many jobs in the human body. By signaling throughout our brains, bodies and blood, serotonin affects our thinking and feeling, digestion and circulation. We might expect to read that SSRIs restore normal levels of serotonin. As it further turns out, scientists and physicians still don’t know whether SSRI medications slow and steady our serotonin signals or stimulate our energies. Or whether the pills balance our brain chemistries or merely dull our pains and dumb our brains while leaving our medical and mental problems undiagnosed and untreated. Astonishing that the experts don’t really know what goes on with these pills. What sort of health professionals would practice medicine by prescribing such mysterious pills to trusting patients? Let Them Eat Prozac introduces us to clinicians and their patients.

Family doctors and psychiatrists like Dr. Healy prescribe SSRIs for mood, thought, attention, personality and eating disorders, not to mention distresses and strains. The target brain conditions include depression, anxiety, bipolar disorder, schizophrenia, ADHD, autism, anorexia and bulemia. Sick patients hope that SSRI pills will work. We trust our physicians to understand our brains and know which pills will help us recover, not make us worse and certainly not cause problematic side effects, toxicities or drug-induced neurological disorders. We trust that our prescription medications are manufactured by ethical drug companies after proper approvals by regulatory authorities. We assume that careful scientific testing proved our pills safe and effective. Long before we get sick enough to need SSRIs, as vulnerable patients, we trust that psychiatrists, physicians, researchers, manufacturers and governments have cooperated on ethical research, done clinical trials and taken reasonable care to protect our interests. What if we trust too quickly? Who monitors the quality of our healthcare? Who will tell us what to expect after we take our SSRIs?

Like any competent professor, Dr. David Healy encourages us to think before we trust. He shares his scientific, research, medical and clinical knowledge in Let Them Eat Prozac and his previous books, The Antidepressant Era and The Creation of Psychopharmacology. He teaches us about mental medications and warns us that we are doomed to repeat problems from the past if we don’t learn our drug history lessons. Have we forgotten bromides? Barbiturates? Thalidomide? Benzodiazepines?

Page by page, Healy gently doses us with “the sad truth” about SSRIs. He outlines the research and the development, the benefits and the risks. He tells us what the insiders know. He shares the facts that big drug companies disclosed in court. He advises us to study our pills before we take them. For reasons such as biochemical individuality and differing diagnoses, we each need the right pills when we get sick. After we take SSRIs, we can note our progress and tell our doctors about any difficulties. Within days, some of us will improve while others will notice side effects; sadly, a few of us will get worse.

When I was sick during the depression phase of my bipolar II mood disorder, I visited several physicians. I was too sick to do more than scan their diplomas, trust their smiles and take their pills. I believed that they would help me recover. I wish I had read Healy’s book before SSRIs caused akathesia, gave me daily migraines, escalated suicidal thoughts, turned off my sexual functioning and triggered hypomania. Benzodiazepines and lithium added other problems. I struggled to cope, frustrated that I got worse for eight months while taking the pills that a published mood disorder expert psychiatrist quickly prescribed for me when I consulted him at the outpatient mood disorder clinic of a large Toronto teaching hospital. During every visit, he said, “you will get well.” I trusted him. My medical file proves that the brainy doctor never took my patient or family medical or mental histories, never did any diagnostic tests or mental status exams, never diagnosed my condition properly, never warned me about the side effects or the risks of SSRIs, lithium and benzo medications, never got my informed consent, never took my lithium blood levels and never checked my kidney functions. Too sick to research the practice guidelines of psychiatry when I was suffering with symptoms and side attacks, I felt worse than bad – a failed patient. I was wrong to trust an expert who apparently forgot his education and ignored his professional training but smiled and watched me deteriorate, month after month. When I trusted that medical specialist with my life, he took short cuts. I expected standard of care procedures, an accurate diagnosis and effective treatments; I got nihilism – nothing but smiles and wilful incompetence. Resilient and persistent, I survived negligence. Barely.

Better late than never, Dr. David Healy teaches us how pharmaceutical companies researched, developed and patented SSRI medications, marketed them to physicians and earned huge profits by targeting mental consumers. We meet the people behind the scenes and we learn about their discoveries, their progress and their problems: scientists, researchers, clinicians, doctors, psychiatrists, editors, regulators, marketers, shareholders and, oh yes, we even meet sick patients and clever lawyers. When certain people tried to combine their roles, for instance, as researchers, clinicians, educators and shareholders, we learn about their conflicts of interest. Long hidden from the public, now we can consider their actions and question their ethics. Honest enough to write that the insiders knew about the problems with SSRIs since the 70’s, Healy still believes that SSRIs can help people cope with depression and anxiety. But, he warns us, not every patient responds favorably. Even though Healy’s book covers more than thirty years of SSRI history, we don’t learn how the s-pills work. Apparently the experts still don’t know. Maybe that information will come in Healy’s next drug history book; maybe in a few years we will know the whole truth.

When our moods turn black and blue, we want to recover from our episodes of depression and anxiety and we want to keep well. We don’t expect our meds to make us worse. Let Them Eat Prozac encourages us to learn the facts before we take our pills. If you don’t understand the power of your SSRIs, you owe it to yourself and your family to read Dr. Healy’s book. Become an educated patient. Then, ask your doctor: Will these pills select my serotonin and heal my tired nerves? How exactly will they help me recover and keep me well? Listen carefully. Discuss your side effects. Ask for restorative care. Keep reading – bibliotherapy may save your life.

by R Sealey, BSc, CA
author of the Sear Series of layman’s guides:
Finding Care for Depression, Mental Episodes & Brain Disorders
90 Day Plan for Finding Quality Care
Depression Survivor's Kit
Finding Care for Depression has a chapter by Dr. Abram Hoffer called How Orthomolecular Medicine Can Help. Dr. Abram Hoffer is a PhD biochemist, a physician and a psychiatrist, the senior editor of the Journal of Orthomolecular Medicine (www.orthomed.org)  and the author of:
Orthomolecular Treatment for Schizophrenia
Vitamin B-3 and Schizophrenia: Discovery, Recovery, Controversy
How To Live With Schizophrenia
Dr. Hoffer’s ABC of Natural Nutrition for Children
Hoffer’s Laws of Natural Nutrition
Putting it All Together: The New Orthomolecular Nutrition
Vitamin C and Cancer
Smart Nutrients
Orthomolecular Medicine for Physicians
The Hallucinogens

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