Medicines out of control?
Antidepressants and the Conspiracy of Goodwill
Charles Medawar & Anita Hardon
reviewed by Mira de Vries
Guess who made the statement below?
And yet so little of this is
considered that one frequently hears the long continued use of some
sedative lauded with naïve exultation, and without a word being
said, or apparently without a thought being given, as to whether
patients recovered better, or recovered at all, by taking it …
A single dose, or an occasional dose from time to
time, at the commencement or in the course of a mental disorder, as a
palliative, may certainly be useful, but its habitual use is pernicious
… When that which may be used fitly as a temporary help – whether it be
stimulant or narcotic – is resorted to as an abiding stay, the result
cannot fail to be disastrous.
It was pioneer psychiatrist Henry Maudsley, writing in 1895,
that's right, 110 years ago
. He was referring to chloral, one
of a steady stream of drugs touted as the
solution to emotional
problems. It was preceded by alcohol, opium, morphine, cocaine, and
heroine, and followed by the bromides, barbiturates, benzodiazepines
(such as Valium), amphetamines, and various types of “antidepressants,”
most recently, the SSRIs. Every one of these drugs was in its day
prescribed by physicians (yes, even alcohol). Every one was considered
effective and safe. Every one was widely used, including by children.
Every one was claimed to be non-addictive. In fact, every one of these
drugs except alcohol and the bromides were used to treat addiction to
the previous drug of fashion once that drug’s harmfulness could no
longer be denied.
A. R. Cushny wrote in his 1928 textbook: “Numerous drugs have been
proposed for the cure of morphinomania [morphine addiction] but none of
them seems to have the slightest effect.” This statement, when extended
to addictions to all sorts of drugs and their proposed cures, is still
as true today.
In 1957 R. A. Hunter wrote an equally enduring truth: “…not only do the
patient’s symptoms for which barbiturates were in the first place
prescribed, return in full force when a dose wears off, which might but
for drug-taking have subsided without treatment – but they are
reinforced by the symptoms of barbiturate abstinence ... From then, the
drug is no longer taken for the original symptoms, but simply to ward
off increasingly distressing abstinence symptoms. The cause of this
exacerbation may not be recognized by doctor or patient – both may
think his original illness has got worse. This may lead to yet further
increase in barbiturate dosage with the result that not only do
abstinence symptoms become severer, but the symptoms of barbiturate
intoxication are added as well… Thus a mild psychiatric disturbance, in
all likelihood amenable to one or two sympathetic interviews, becomes
converted into a serious and perhaps protracted illness.” A half
century later there are hundreds of psychiatric drugs on the market,
but not one to which Hunter’s statement would not
By quoting these statements, Medawar & Hardon have amply
that the inefficacy and harmfulness of the SSRIs was more than
predictable. However, the main issue that they address in their book
is not the folly of psychiatric drugging nor the phoniness of most drug
claims, but the façade of drug regulation. This applies to all
modern medicines, although it is most blatantly demonstrated by the
catchy title hints that there is no control.
watchdog agencies in reality cater to industry interests, not, as we
like to imagine, the individual consumer’s. Actually, “patients” are
the one party that these agencies have consistently ignored.
Medawar & Hardon have done an excellent job of presenting their
case. But what about a solution? Immensely to their credit, they
exercise restraint in
not proposing unrealistic schemes.
In fact, they propose none at all. They only fleetingly
mention the need for
“honest science and decent democratic values” without a suggestion how
such might be achieved or judged.
This is what MeTZelf proposes: Let’s do away with (bogus) government
regulation and prescription laws.
“What?” many an astonished reader will respond. "But we need
protection. Think of thalidomide.” Indeed, think of thalidomide. This
is what Medawar & Hardon say about it:
The thalidomide crisis will always be unique
because of the innocence of the victims and the sudden, shocking
evidence of harm. But thalidomide happened because there was no
independent control for drug safety – whereas the SSRI crisis had grown
under the aegis of an elaborate and expensive global
drug control. (their emphasis)
The logic of this statement is flawed. If the SSRI crisis grew under
drug control, how can the authors conclude that lack of drug control
caused the thalidomide crisis? This might be explainable if the SSRI
crisis were more contained than the thalidomide crisis, but they
concede it is not. In numbers, the SSRIs have far outstripped
thalidomide. The mischief these two drugs have
caused is incomparable because of the uniqueness of thalidomide's harm,
as the authors rightly state, yet the harm from SSRIs is also
shocking, albeit less graphically sensational. Government drug
control has obviously only set the scene for more crises, not in the
least place by lulling the public into forsaking the vigilance that the
thalidomide crisis might have taught us.
Furthermore, whereas in many European countries thalidomide was sold
counter, SSRIs have always been available everywhere by
prescription only. Far from fostering wise use, prescription laws, like
watchdog agencies, discourage vigilance.
In addition, they stimulate consumption. Manufacturers of all sorts of
goods invest in
persuading consumers to use their products, but no persuasion is as
compelling as a doctor’s prescription.
The only fair appraisal can be that watchdog
agencies as well as prescription laws, like most of the drugs they
regulate, do more harm than good.
Although the authors do not reach this conclusion, Medicines out of
powerful argument for the abolition of government interference in the