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In Brain Chemistry We Trust – The Gospel According to Pharma

The rise of the biopsychiatric model of mental illness

If anyone has doubts about America’s faith in a Higher Power, all you need to do is to take a look at how we have come to worship the biomedical model of mental illness. This biomedical model is so entrenched in our culture that it has become gospel. Please note, however, that RxBalance is not saying that antidepressants don’t work or that brain chemistry and genetics do not contribute to mood disorders. Quite the contrary – psych meds have a role in treatment . We also respect the pharmaceutical industry’s role in helping to destigmatize mental health disorders like schizophrenia, depression and bipolar disorder.

With that said, drug companies have a vested interest in the biomedical model of mental illness, one that promotes a neurobiological basis to most emotional disorders. Since the 1980s, when the biomedical model became popular, drug companies have spent billions of dollars to educate all of us – consumer and providers alike – about how impaired brain chemistry is the cause of  mental health conditions such as depression, bipolar disorder and ADHD . In 2008 alone, we paid back industry’s efforts by ingesting $5 billion dollars worth of antidepressants and an additional $19 billion of antipsychotic medications such as Abilify, Risperdal and Zyprexa [Source: IMS National Sales Perspectives™]. In our culture, the dark side of the human psyche has become material, not for novelists, but for the machinations of the pharmaceutical industry.

Eli Lilly and the Growth of Serotonin Theory of Depression

Most Americans have a childlike faith in the serotonin theory of depression, a theory that states that depression is a biochemical imbalance in the brain. Antidepressants like Prozac, Paxil and Lexapro are a part of our national consciousness. It is important, however, to realize that the serotonin theory of depression arose from the labs of researchers working in the pharmaceutical industry, not from the labs of academic researchers.

As many of you know, drug companies fund most clinical trials, both in the United States and overseas. The clinical investigators who lead these trials, as well as the site monitors who track the study results, are often consultants to and/or employees of drug companies. Furthermore, the clinical data they generate is aggregated, analyzed, and prepared for publication by statisticians, medical writers and publication planners who are paid by drug companies. Today, these conflicts of interest are well known. However, when the biomedical model of mental illness first became popular, these conflicts were cloaked in secrecy.

Fluoxetine, which launched in the United States in 1988 under the brand name Prozac, was the first of a new class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Ray Fuller, a biochemist at Lilly who was co-discoverer of fluoxetine and Charles Beasley, a medical officer at Lily, authored many journal articles about the role of serotonin and selective serotonin reuptake (SSRIs) in the 1980s and early 1990s. One seminal article published by Dr. Fuller in J Clin Psychiatry in 1991, which highlighted the role of SSRI’s in treating depression, can be read here. What is less well known is that this particular issue of J Clin Psychiatry was a journal supplement paid for by none other than Eli Lily. Furthermore, other articles about fluoxetine published at the time indicating that SSRIs offered a superior safety profile compared to tricyclic antidepressants, the gold standard before the advent of SSRIs, were also published by Lily researchers.

Do we want to rely on medical research interpreted and written up by drug company personnel? For example, Lily researchers knew in the early 1990s about fluoxetine’s potential to induce suicidality, however kept it under wraps, convincing the FDA first to ignore the data through promises of conducting additional studies and than reneging on that promise when the brouhaha died down [See Antidepressant-Induced Suicide and Tort Reform, Joseph Glenmullen, MD, Congressional Hearing, Energy and Commerce Committee, February 10, 2005.]

Most folks assume that health care treatment decisions are based on unbiased expert opinion and unbiased evidence. Truth be told, this is far from what occurs, especially when looking at clinical studies on mental health drugs. If you follow the money, you will find that many of our most powerful beliefs about healthcare, like our faith in the serotonin theory of depression, have roots in an unholy alliance between industry, scientific publishers and physician researchers.

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