While I am fan of certain aspects of orthodox medicine, I think overall it’s less effective and more hazardous than we generally imagine. As I wrote recently here, there is some thought that less medicine can result in improved outcomes. There is certainly some evidence that less can be more, where conventional medical care is concerned.
One medical speciality that this may be often true of is psychiatry. This brand of medicine used to be a primarily ‘talking’ therapy. But an ever-expanding medicine chest available to psychiatrists, particularly anti-depressants, have meant that psychiatry has become based on pharmaceutical approaches. One of the problems here is that many of the drugs used in psychiatry are not particularly effective. And these drugs are not without risk: not only are side-effects common, they also can lead to dependence which can be tricky to break (see here for more on this).
On top of this, we’ve had increasing recognition of the fact that the psychiatric profession tends to enjoy a close and quite cosy relationship with the pharmaceutical industry which jeopardises proper clinical care. See here for a 2005 article in the journal Psychiatric Bulletin which highlights the major issues here.
There been growing recognition in recent years of payments made by drug companies to doctors to promote their wares. In the US, congressman Chuck Grassley has been waging an almost one-man war on the tight bonds between the pharmaceutical industry, researchers and clinicians. Grassley’s attempts to get a bit more openness and transparency have highlighted the fact that those in the psychiatric profession appear to be some of the worst ‘offender’ where financial conflicts of interest are concerned.
Well, it seems that psychiatry is in for even more scrutiny now on the publication of a book entitled: Unhinged – The Trouble with Psychiatry – a Doctor’s Revelations about a Profession in Crisis. It’s by a US psychiatrist Dr Daniel Carlat.
I’ve not read the book, but as it title suggests, it purports to detail what is so wrong with modern-day psychiatry. You can read an overview of the book here. You can read here Dr Carlat’s highlighting of the fact that, in his opinion, psychiatry has become a profession of blind pill-pushing. He also makes special mention of the fact that psychiatrists have allowed themseives to be “bought off by the pharmaceutical industry”. Dr Carlat specifically refers to the fact that he used to speak for the drug company Wyeth Pharmceuticals, until he realised he was “being paid to deceive other doctors”. Dr Carlat wrote a piece in the New York Times in 2007 which recounted his experience as a hired hand for Wyeth which you can read here.
Because I haven’t read the book, it’s impossible for me to comment in a detailed fashion about it. However, just reading the overview of this book and Dr Carlat’s New York Times piece convinces me that this book will serve as a timely reminder about some major issues within the psychiatric profession, which apply to much of mainstream medicine too.