96 internautes sur 100 ont trouvé ce commentaire utile
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Having been a pharmacist for 24 yrs I can say with depressing certainty that MDs have absolutely minimal understanding of the drugs they prescribe. They receive only the barest instruction in pharmacology in med school, and the majority of their ongoing drug education seems to come from pharmaceutical reps. This book just further validates observations I have already made about the side effects of Prozac and its cousins. The detail involved in the handling of the subject matter may be too technical for the casual reader but would be fascinating to healthcare professionals and attorneys. It underscores the penalties to be paid by honest researchers and healthcare professionals in this market-driven economy by those who dare to challenge the data put out by companies with huge profits to make and to protect--and who also have the financial resources to ruin anyone who tells the truth about their products. It reinforces what should be a guiding principal in most areas of life: before believing what you are told, ask who profits by your gullibility and need. And do not be too quick to distrust your own instincts and observations.
53 internautes sur 58 ont trouvé ce commentaire utile
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Dr. Healy is a proponent of drug use for patients with depression or other disorders. When a drug calms a person down or energizes her - in a good way - he says "that's a good drug for that person". He has been a leading figure in psychopharmacology for many years, in part because of sponsorship by drug companies. He has a great deal of experience prescribing Prozac, Zoloft, and other antidepressants for a variety of conditions.
Healy is also a dedicated, conscientious doctor. So when he first read reports of persons who behaved unaccountably when on Prozac or another Selective Serotonin Reuptake Inhibitor (SSRI), he naturally wanted to know why. It wasn't long before he had embarked on a research trek that led him to the inescapable conclusion that Prozac increases a patient's risk for suicide and violence. He tells the story of his journey almost like he is writing a suspense novel, and its grip is hard to shake.
Healy noticed that the "suicidal ideation" related to the use of Prozac was different from the non-drug induced suicide. Normal suicidal behavior takes into account the effect of this action on others, while drug-induced suicide and violent actions show a complete disregard for anyone else. Normal suicidal behavior is repeated - that is, an actual suicide typically follows at least one attempt. The cases that Healy followed, by contrast, were of normal people who had usually never attempted suicide before. Their behavior shortly before the attempted or actual suicide was described as strange and unlike them, almost as if they were possessed.
Although the book delves deeply into the pharmaceutical industry's practices, the efforts made by these companies to prevent negative information about their drugs from reaching doctors or the public, I was particularly struck by the effect these special patients had on Healy himself. He doesn't seem to be able to shake the vision of what they became and how their behavior, influenced by drugs, affected their friends and families, how the drugs ruined so many lives in such a horrifying way. I think it was this sense that drove Healy to write this book. No stranger to attacks and veiled threats by his peers, Healy has to know that his work will not be received with unadulterated admiration. But it is a work he had to write and that we all should read.
38 internautes sur 41 ont trouvé ce commentaire utile
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Since I am acquainted with the issues of antidepressants as someone with dysthymia, I decided it might be interesting to read the "other" side of the story. To that end, I just finished Let Them Eat Prozac - The Unhealthy Relationship Between The Pharmaceutical Industry And Depression by David Healy. Interesting stuff here...
Healy is listed as a former secretary of the British Association for Psychopharmacology and has written a number of articles and books on the subject. He's also been on the prescribing end of antidepressants, so I don't see (at least on the surface) any particular conflict of interest that might color his statements and conclusions. The book is part a personal story of his experience with the drug Prozac and its parent company Lilly, as well as an expose of how pharmaceutical companies are able to distort facts and studies to present misleading results on drug testing. The main thrust of this book is how Prozac and SSRI drugs in general show a strong increase in the rate of suicidal tendencies in users during the first few weeks of use. But looking at the information from the drug companies, you'd never know it. Based on creative manipulation of statistics, the suicide rates were presented as far less than they really were. And even now that Prozac has gone off patent and is now available in its generic form of fluoxetine, he still claims that little is known about the long-term effects of the drug, and who might be held responsible if issues arise down the road.
Coming into this book, I was ready to write him off as a conspiracy nut with an axe to grind. I was given fluoxetine nearly two years ago to help me deal with chronic low-level depression, and it's been a lifesaver. I've experienced very few side effects (very minor), and it has given me a new lease on life. But after reading the book, I realize that I am pretty lucky, in that the story could have been much worse. It's nearly impossible (from what I can tell) to predict how a specific person will react on an SSRI drug. My position has been that the doctor should be watching them extremely closely over the first two to four weeks. I'd now change that to the first two to four *days*. An adverse reaction to the drug could be deadly, and for more than just the person taking the drug.
Overall, very interesting material. I would hope that reading something like this wouldn't dissuade a person from seeking treatment and trying SSRI drugs, as they can and do work well for many people. But it's valuable to understand that they don't work for everyone, and it's possible that they could make the condition even worse. Just proceed with caution...
24 internautes sur 28 ont trouvé ce commentaire utile
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This important book undermines its effectiveness by jumbling together several distinct story lines:
1. The influence of pharmaceutical money on science and the practice of medicine.
2. The value of antidepressants versus their troubling side effects, most notably suicidality.
3. The legal battles over (a) the "Prozac defense" and (b) product liability of Lilly for adverse drug reactions.
4. Dr. Healy's personal travails as a result of his concerns about the safety of SSRI's.
Jumbling these related-but-different issues together results in a murky book, in which none of the four stories emerges clearly.
In general, Dr. Healy's views on these issues seem to be
1. Pharmaceutical money has badly corrupted both science and clinical practice.
2. Antidepressants and other psychotropics are important tools, but because the science and clinical practice have been skewed by pharmaceutical companies, they are over-prescribed, mis-prescribed, and generally used injudiciously.
3. The only reason his side has lost the legal battles that it has lost is the corrupt influence of pharma, and
4. He got screwed by the Evil powers.
I found the cases he made for points 1 and 2 (if I teased them out of the murk correctly) fairly persuasive, the case for point 3 provocative but not entirely compelling, and the case for point 4 hard to judge.
If you have a fair amount of patience and a serious interest in the different story lines Dr. Healy addresses, and if you know enough about the methodological issues involved in different ways of doing research to evaluate his criticisms of the preferred methodologies of pharmaceutical-funded research, the book is certainly worth reading. Otherwise, I suspect you will find the book more confusing and (probably) misleading than enlightening.
10 internautes sur 10 ont trouvé ce commentaire utile
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Healy is the world's foremost authority on psychopharmacology. The first part of this book (Introduction) is 39 pages and gives a most useful overview of depression's "history," the history of tranquilizers, the discovery of serotonin and chemical imbalances (which he calls a silly myth), SSRIs, etc. The book is also excellent on the marketing of antidepressants. This is where you might get upset as it becomes clear the marketing strategy involves very purposeful distortions of the truth and outright lies. His information about "ghostwriting" (when the drug company actually writes the journal article, not the drug researcher whose name appears on the article) is astonishing. I had read my medical journals for many years without ever even being aware this ever occurred. Healy describes his own experiences where the drug companies have tried to pay him for allowing his name to go on their "research" studies. He believes this is a much greater problem with antidepressants than with other classes of drugs. If all the book were as strong as the Introduction or the ghostwriting and marketing material I would give it five stars. However, he gives a lot of detail about his own experiences which is "why is this in the book?" kind of material. A more general book that is the best thing I have read yet on the antidepressant/antipsychotic topic is America Fooled. It is easy to understand but referenced as well as Healy's books (and I didn't think anyone could match Healy). We are fortunate to have Healy write this and his other books as he speaks from personal experiences and is a giant in the field.