Before Prozac

Before Prozac1

Edward Shorter, American-born, who earned his PhD at Harvard is a renowned scholar and author. His plethora of books include the classic work A History of Women’s Bodies (Basic), A History of Psychiatry from the Era of the Asylum to the Age of Prozac (Wiley) a new works, The Historical Dictionary of Psychiatry (Oxford University Press), Written In The Flesh: The History of Desire (University of Toronto Press), and Shock Therapy with David Healy (Rutgers University Press).  He is a professor of history at the University of Toronto.

“A witty foray into the worlds of psychiatry and pharmacology.”
Library Journal

Oxford University Press 2009

Before Prozac

The Troubled History of Mood Disorders in Psychiatry

An unsettling look at modern psychiatry, revealing how greed, lax regulation, and academic infighting have set the field back fifty years.

 Psychiatry today is a barren tundra, writes medical historian Edward Shorter, where drugs that don’t work are used to treat diseases that don’t exist. Based in part on unprecedented access to federal archives and on extensive interviewing, Shorter illuminates this dismal landscape in a revealing and provocative account of why psychiatry is losing ground in the struggle to treat depression.

The book looks at such culprits as the pharmaceutical industry, which is not inclined to market drugs once the patent expires, leading to the endless introduction of new – but not necessarily better – drugs. 

 But at the center of the story is an unexpected villain: the FDA, the very agency charged with ensuring drug safety and effectiveness. Shorter describes how the FDA permits companies to test new products only against placebo.  Beating sugar pills can ensure a license – whether or not a drug is actually better than (or even as good as) current medications. Drugs that may be superior but have lost patent protection are thus swept from the shelves.

 The book also examines the FDA’s early power struggles against the drug industry, an influence-grab with little concern about science, and which left many effective drug classes under-prescribed, despite the fact that under careful supervision they are better at treating depression, with fewer side effects that the newer drugs in the Prozac family.

 Shorter also castigates academia, showing how two forms of depression, melancholia and nonmelancholia – “as different from each other as chalk and cheese” – became squeezed into one dubious classification, major depression, which was essentially a political artifact born of academic infighting.

 An astonishing and troubling look at modern psychiatry, Before Prozac is a book that is sure to spark controversy for years to come.