Lennard Davis on SSRIs

Over at his blog column at Psychology Today, distinguished disability theorist Lennard Davis has just posted “Five Reasons Not to Take SSRIs”. Selective Serotonin Reuptake Inhibitors, the best-known of which is Prozac, have been massively prescribed for the past 15-20 years by doctors and psychiatrists, especially for depression. Davis begins:

For the past five years, and in my recent book OBSESSION: A HISTORY, I have been questioning the effectiveness of Prozac-like drugs known as SSRIs. I’ve pointed out that when the drugs first came out in the early 1990’s there was a wildly enthusiastic uptake in the prescribing of such drugs. Doctors were jubilantly claiming that the drugs were 80-90 per cent effective in treating depression and related conditions like OCD. In the last few years those success rates have been going down, with the NY Times pointing out that the initial numbers had been inflated by drug companies supressing the studies that were less encouraging. But few if any doctors or patients were willing to hear anything disparaging said about these “wonder” drugs.

Now the tune has changed. …

To read the full post, click here.

One thought on “Lennard Davis on SSRIs

  1. I’m pretty underwhelmed by this. Reasons:

    1. Davis misrepresents, or at the very least over-hypes, the JAMA-published study which he touts as showing that SSRIs are no better than placebos. The study was a meta-analysis – a synthesis of existing studies – which covered only 718 people, and tested exactly two of the more than 30 SSRIs currently in use. The authors concluded in their abstract for JAMA that “medication vs placebo differences varied substantially as a function of baseline severity” – in other words, the more depressed you are, the more likely it is that drugs will help you. This is a far cry from claiming, as Davis does, that “one of the key class of drugs that for 20 years has been considered effective now fails”. SSRIs were definitely oversold, especially in the 1990s, but they remain useful and effective treatments for many people with severe or chronic depression.

    2. Davis seems to be operating from an implicit and unexamined anti-psychotropic standpoint. Mood-altering drugs like SSRIs are bad, he argues, because they are a harbinger of a world in which drugs control minds. However, most people spend a good chunk of their time trying to change their own neurochemistry and alter their moods, using caffeine, sugar, alcohol, exercise, prayer, sleep, meditation or art, to name only a few of the possibilities. What line do SSRIs cross? In other words, why is it okay for me to use caffeine from Starbucks to alter my mood, but not to use paroxetine hydrochloride from Eli Lilly? I’m not arguing that a line does not exist, only that Davis doesn’t articulate why he finds this particular technology for mood alterations so objectionable.

    3. The serotonin hypothesis has been sliding towards irrelevance for several years. It’s hardly news that there’s no “normal” level of serotonin circulating in the brain. As I understand it, most neurological research now locates the organic causes of depression in the morphology and electric activity of the brain, especially in the midbrain structures like the hypothalamus and amygdala. SSRIs work for depression like aspirin works for headaches – the aspirin makes you feel better, but headaches aren’t caused by low levels of aspirin in the body.

    4. Davis missed one of the most compelling reasons to avoid SSRIs if possible: the companies that make them, the big pharmas, are appallingly bad corporate citizens. I think his speculations about mind control are way off target – if you want reasons not to trust Eli Lilly and Glaxo-Smith-Kline, just look at the damage caused by their insistence on patent protection, especially for drugs going to treat common diseases in the global south.

    I like Davis’ other work, but this piece is just too sloppy.

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