Thanks to Tsara Shelton for help with transcript editing.
Rob: Welcome to the Rob Kall Radio Show, WNJC 1360 AM Washington Township. This is another one of those shows that'll probably be aired both on the Rob Kall Bottom UP Radio Show and on the Rob Kall Future Health Radio Show because it's got angles that make it appropriate for both.
My guest tonight is Robert Whitaker. He's the author of a new book, Anatomy of an Epidemic, and also the author of Mad in America. He's a writer who has covered articles on the mentally ill and pharmaceutical industry, he's garnered national awards including a George Polk award for medical writing and a National Association of Science Writer Award for best magazine article. He's written for the Boston Globe, and he was named a finalists for the Pulitzer Prize in 1998. Welcome to the show Robert.
RW: Thanks you for having Rob. It's a pleasure to be here.
Rob: I'll tell you...I learned about this book from an interview with another one of my guests, Ray Tattenbaum, and I have to tell you I delved into this and within moments I was transfixed by it because this is a book that should get you a Pulitzer...I have to say it -- this is just an incredible, uncovering of information that's been readily available that you've tied together that's just mind blowing and...well let's start. I'd like start off taking care of you -- so what's your website?
RW: My website is...I have two websites. You can go to madinamerica.com, M-A-D-I-N-A-M-E-R-I-C-A.com or you can go to robertwhitaker.org, and I think the important things about the website, in addition you can contact me through there, but I have a lot of documents up there as well so if you want to see some of the source documents -- say, for Anatomy of an Epidemic -- you can go to madinamerica.com and that way you can...if your curiosity is as such, you can read the original source documentation for a lot of what I write about in the book.
Rob: Okay now, I'm going to give my overall impression of what this book does. This book basically tells us that the research in looking at the efficacy of the use of psychiatric drugs since their inception in 1955 with the beginning of the use of Thorazine, has pretty much showed that not only do they not in the long run not work, but they hurt people. And the model that was developed to sell this approach, biological psychiatry, has been damaging to probably millions of Americans and it has also created a way to sell drugs and to pathologize and label children in ways that didn't exist before; and this model seems to suggest that psychiatry is better and smarter now so that they can identify and come up with new diagnoses. But in a sense that's really got to be considered with the other consideration -- that psychiatry has done a devil's bargain with pharmaceutical companies, partnering them in an incredibly incestuous way.
RW: Yeah, you've raised a lot of themes there and they're all pretty accurate. I mean, we could start with the first theme, and the first theme that you mentioned was, you know, what is the efficacy of these medications? What does the science show? And what you...and when you start to get into that first question, what you do find is you find when they do short term trials of psychiatric drugs whether they be antipsychotics or antianxiety agents or antidepressants, there may be...
Rob: Or stimulants for children, right?
RW: Or stimulants for children, that's right....there may be some benefit on a target symptom over the short term, say 6 weeks...so you'll see the reduction a little bit better than a placebo on -- let's say the target symptom of psychosis...whatever that may be -- and even on the short term, often the efficacy is much smaller than you might expect. So, for example, with the antidepressants, even over the short term there's just...there's a very small benefit over a placebo, even in the 6 week studies. And in fact, just one small aside, when they test presence against an active placebo (an active placebo is some chemical agent that'll cause some small side effect like dry mouth so you think you're getting a magic pill)...when they do antidepressants against active placebos, there's basically no difference even over the short term.
But what I'm really interested in in this book is looking at what are the long term effects, and in the aggregate. In other words, does this paradigm of care...do these medications...do they shift the long term outcome for schizophrenia for the better? The long term of depression for the better, etcetera? And what you find when you start digging into the research literature, well you find many, many, many surprises. But the one constant you find is that, in fact, this paradigm of care is worsening long term disorders -- I mean, people become much more chronically symptomatic than they used to be, it lowers recovery rates, it lowers, sort of, employment rates for people who end up with, say, a bipolar diagnosis or a schizophrenia diagnosis, and you see other problems...yeah go ahead Rob.
Rob: Well, actually you're...when you say it lowers....it massively lowers them or it massively increases symptoms, and it also kills people. One thing I like about your book is you do a chapter that kind of goes through the history of the use of...the treatment of...the diagnosis, the treatment, the development of the drugs, the authorizations and approvals of them by the FDA, the marketing of them by both the American Psychiatric Association and the pharmaceutical companies; and then you'll have a chapter on how people suffered -- the victims of the use of these prescription medications...and people die -- people develop all kinds of diseases, chronic debilitating deadly diseases, because of these things, right?
RW: Yeah, I know that's...certainly when you long term, yeah, you see a lot of physical disability begin to arise, you think....say, with the atypical antipsychotics you see...let's just stop and start with the antipsychotics which you're talking about. You'll see all sorts of physical problems associated with it. You do see early death, no question...sometimes you'll see even rapid death, but more commonly you'll just see people becoming so physically unwell that you'll see...they're dying now 25 years earlier than normal. You do see when you really start digging into this...