Prozac's Worst Enemy

A psychiatrist argues in books and on TV that drugs don't help the mentally ill. His critics say he's crazy

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At issue is the very nature of mental illness. For the past few decades, the majority of researchers have worked to show that psychiatric disorders are triggered by chemical imbalances in the brain that can be rectified with medication. Breggin, by contrast, clings to an old-fashioned view: the emotional problems that land a person on a psychiatrist's couch result from traumas caused by outside forces, like sexual abuse during childhood. Drugs can't erase these traumas, he asserts, and aren't even appropriate for such severe conditions as schizophrenia and manic depression. "These are not illnesses," he says. "They are ways people become when they are hurt or frightened. The fact that something is extreme doesn't make it an illness."

This bizarre notion takes no account of mountains of evidence to the contrary. But, like a slick lawyer, Breggin has answers for every argument. Researchers have, for example, observed distinctive physical features in the brains of people with schizophrenia. A study of identical twins found that one portion of the brain was 15% smaller in the person with schizophrenia than in the normal sibling. Breggin says the difference could be the result of brain damage caused by the drugs given to control the disease. Of course, it is difficult to test his hypothesis because that would require studying people with schizophrenia who are deliberately left untreated -- a practice that most psychiatrists would deem unethical.

Breggin is also a master of capitalizing on embarrassing lapses in psychiatric research. Several times, scientific teams have trumpeted the news that they have isolated a genetic marker for manic depression. In all cases, the results could not be replicated by others, and the conclusions were withdrawn -- something Breggin delights in pointing out at every opportunity. Nor is he impressed by genealogical studies that trace schizophrenia through several generations. "Things run in families," he counters. "Speaking English runs 100% in American families. It's not surprising that being emotionally upset would run in families."

What galls psychiatrists most are Breggin's attacks on the usefulness of antipsychosis drugs. He doesn't content himself with describing possible side effects, such as uncontrollable jerky movements and facial ticks, but claims the drugs rarely have any benefit. He likens lithium, which is used to treat manic depression, to lead and compares Prozac to amphetamines.

Breggin's preachments would be laughable, say critics, if they weren't so dangerous. Though he warns his readers against stopping their psychiatric drugs too abruptly or without medical supervision, at least one schizophrenic man threw away his medications after listening to Breggin on TV. The patient became suicidal and was hospitalized for two weeks. "Breggin reinforces the myth that mental illness is not real, that you wouldn't be ill if you'd pull yourself up by the bootstraps," says Susan Dime-Meenan, president of the National Depressive and Manic-Depressive Association. "His views stop people from getting treatment. They could cost a life."

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