The antidepressant era revisited

Towards differentiation and patient-empowerment in diagnosis and treatment

Authored by: Toine Pieters

The Routledge History of Madness and Mental Health

Print publication date:  April  2017
Online publication date:  April  2017

Print ISBN: 9781138781603
eBook ISBN: 9781315202211
Adobe ISBN: 9781351784399


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In 1997, during the heyday of what has been labelled the ‘business of selling mental disease and psychotropic drugs’, David Healy published his book, The Antidepressant Era. In the postscript, Healy argued that the majority of people who meet diagnostic criteria for depression or anxiety seek treatment for a condition, which in principle cannot scientifically be shown to specifically benefit from available treatments. 1 Whether or not you agree with this statement, at least Healy has a point when saying that available psychotropic drugs do not have comparable specificity as antibiotics and other drug treatments do, such as insulin for diabetes or Viagra for erectile dysfunction. In this chapter, I will show that the addictive promise of the psychoactive magic bullet with a controllable and specific effect on the chemistry of the brain has not and will not materialize due to the complex and contextualized nature of mental disorders. Even molecular biologists have had to admit that they cannot find a single genetic cause for depression, anxiety or schizophrenia. The one-gene-one-disease (‘O-GOD’) champions of the 1990s met their Waterloo in mental illness and have turned to epigenetics to develop new forms of neurogenetic and neuropharmacological modelling. 2

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