Pharmacy and the mind: Profit and peril

Reviews the book Psychiatry Under the Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform by Robert Whitaker and Lisa Cosgrove (see record 2015-23752-000). This book is a stimulating, critical review of American psychiatry in the last half-century, when psychotherapy gave way to medication as treatment of choice and pharmacology came to dominate the treatment of psychiatric conditions. Pharmaceutical promotion in the United States supports prolific use of new, expensive medications under patent that are often no better, and sometimes worse, than older medications. (Post-patent generic versions come after 12 years; they are often equivalent and almost always much less expensive.) The authors document how the American Psychiatric Association has benefitted from association with major corporations, creating a conflict of interest regarding evaluation of safety and effectiveness of prescription drugs. Key American Psychiatric Association officers have profited from association with pharmaceutical companies. The text describes the rise of psychotropic medicine to the point where millions of patients, including children, take these drugs for long periods. The authors propose identifying and amending policies favoring financial gain over effectiveness and safety. Major issues include the selective publication of research findings—good news about patented medicines is published, critical findings are not. Such factors compromise what is best for patients and the profession of psychiatry. Since only four percent of physicians are psychiatrists, all branches of medicine must consider recommendations for reform. (PsycINFO Database Record (c) 2016 APA, all rights reserved)