tag:blogger.com,1999:blog-7655407863660711763.post4949834556176400972..comments2023-04-13T15:43:17.917-04:00Comments on Billy Rubin's Blog: Is Robert Whitaker's book Anatomy of an Epidemic acceptable heresy, or dangerous nonsense?Billy Rubinhttp://www.blogger.com/profile/04850166742797443954noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-7655407863660711763.post-63525328982503036032014-06-11T21:22:12.176-04:002014-06-11T21:22:12.176-04:00My personal experience after some twenty years of ...My personal experience after some twenty years of treatment with SSRI's is that Whitaker is not entirely correct. I experience a nearly complete absence of rage in my life. Stuff can still piss me off and I have been harmed by the acts of others but I no longer bury myself in ill will towards people I have reason to dislike.<br /><br />I strongly believe that most 'active shooters' we hear about so often would still be alive and annoying ... but so would their victims, if this sort of treatment were more widely available. Whitaker may have a case that some people might not benefit from their prescribed mefications but a great number of people like myself would be thoroughly miserable if untreated.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7655407863660711763.post-25479337722924294392012-07-12T21:21:17.164-04:002012-07-12T21:21:17.164-04:00Thanks for your thoughts, Laura, and apologies for...Thanks for your thoughts, Laura, and apologies for the delay in posting your comment. <br /><br />As a clinician and (still so far) a scientist, I am a little gun-shy about using sweeping statements like "Whitaker's right and none of his opponents' critiques are legitimate", so I'd frame things a little differently. <br /><br />I think his arguments are certainly provocative and that there are a lot of hard questions that psychiatry and psychiatrists should be asking about their profession. I also think that many of the critiques of Whitaker are not well thought out.<br /><br />That said, not all of Whitaker's arguments are spot-on; for instance, Dan Carlat's review of <i>Anatomy</i> notes--I think correctly--that one of Whitaker's key arguments (that the expansion of psychiatric illness in this country coincides with the expansion of psychiatric meds, and that the latter has caused the former) is weak. But like Carlat, I think that Whitaker is asking some very important questions about the uncritical acceptance of a biopharmacological model of neuropsychiatry that may be a lot of smoke and mirrors. <br /><br />My field is infectious disease, where most, though not all, diseases can be studied more easily because they have clear outcomes. We learned about the magic of penicillin and sulfa because people who previously died managed to survive nasty infections. It's a lot harder to measure subjective feelings over the course of depression, and harder to know how long to treat depression, and in which people depression treatment is most effective. So Whitaker asks crucial questions. Based on what I have seen, there's a moderate chunk of docs out there that chuck out prescriptions for SSRIs without much thought for how long they want to treat their patients, and by what measures should they adjust--or stop--their treatment.<br /><br />Best, BillyBilly Rubinhttps://www.blogger.com/profile/04850166742797443954noreply@blogger.comtag:blogger.com,1999:blog-7655407863660711763.post-2706714912236299392012-07-09T09:07:10.852-04:002012-07-09T09:07:10.852-04:00I've just read Whitaker's remarkable and i...I've just read Whitaker's remarkable and impressive book. Then, I decided to spend an hour or so researching what critiques or opposition he has out there among psychiatric circles. <br /><br />There is none. None that is legitimate and based on any credible counter-evidence, that is. There are lots of psychiatrists floundering around talking vaguely about how meds "help people," but there is absolutely no solid evidence to rebut what Whitaker is saying. That's because he's right.Laura L. Wilsonhttp://ellewilson.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-7655407863660711763.post-82537105221429987622011-01-30T17:11:39.328-05:002011-01-30T17:11:39.328-05:00Thanks for your comments, Anon. One thing that I t...Thanks for your comments, Anon. One thing that I think is pretty clear after reading about Mr. Whitaker is that he's got a serious amount of street cred...or whatever the equivalent of "street cred" is among the world of journalists.<br /><br />Barry Marshall is but one example in a line of researchers whose theories were highly unorthodox at the outset and have since become the standard; anyone familiar with Judah Folkman's history will know how his thoughts on angiogenesis (how new blood vessels form as a key component of cancer tumor growth) were regarded as something approaching outright lunacy when he first proposed it in the early 1970s, but is now accepted. I could go on in this vein for some time. Most scientists are aware that this is the case and is one reason why we're cautious as hell when we think we've discovered something important (and is also why I, for one, am immediately skeptical when a scientist "goes public" with some discovery before submitting to the usual process of weeding the idea out, cf. Cold Fusion in the late 1980s).<br /><br />Comparing Whitaker to researchers like Marshall isn't quite fair to either party, since Whitaker isn't proposing a new mechanism about how biology works (as Marshall did), and Marshall wasn't calling for an intellectual overhaul of his profession (as Whitaker argues needs to happen in clinical psychiatry). It's a matter of perspective: Marshall may have had a radical idea but he was still very much part of the everyday scientific system; Whitaker is an outsider questioning the entire foundations of a subspecialty of medicine. <br /><br />As it turns out, this has happened before in psychiatry, and quite recently, i.e. standards of Shrink practice in the 1950's would be considered barbarous today. In my field of Infectious Disease, though, I can go all the way back to the 1920's and earlier and see that my professional forbears shared pretty much the same assumptions I do, and their methods can only be questioned on the level of technology and whether the results were adequate. That's just not so in psychiatry just yet, and while my sense is that we've made huge advances in the last 20-30 years at understanding and treating psychiatric conditions, I also think it wouldn't be totally surprising to learn over the next 20 years that future physicians will regard the kind of meds that I prescribed as a student and resident little better than the lancets used by bloodletters in the 18th century. Which is, boiled down, why I am going to be reading his book.Billy Rubinhttps://www.blogger.com/profile/04850166742797443954noreply@blogger.comtag:blogger.com,1999:blog-7655407863660711763.post-1882119923395237192011-01-30T16:04:37.164-05:002011-01-30T16:04:37.164-05:00As one who was lucky to see Mr. Whitaker personall...As one who was lucky to see Mr. Whitaker personally speak and who has read his book, I can't recommend it highly enough. I am sure alot of people will be greatly interested in your thoughts after you read it.<br /><br />That is a very interesting comparison to Dr. Barry Marshall. By the way, he treated one of my relatives who unfortunately had problems with the meds he prescribed which was definitely not his fault.<br /><br />Actually, it sounds like according to this site, he endured alot of hardship before his theories were accepted:<br /><br />http://www.metamath.com/math124/statis/Marhelio.htm<br /><br />Sadly, even if someone with greater credentials than Mr. Whitaker came up with studies like Barry Marshall did regarding the issues raised in Anatomy of an Epidemic, I doubt they would be accepted.<br /><br />Psychiatry is simply too entrenched in the meds come heck or high water philosophy in my opinion.Anonymousnoreply@blogger.com