Elliot S. Valenstein

Valenstein combines an expertise in psychology and neuroscience with meticulous fact-finding to bring a controversial but very level-headed critique of current neuropsychological theories and the current neuropsychopharmacological industry. In short, he questions whether scientists and doctors really have any solid explanations for the underlying causes or even biological markers of schizophrenia, depression, anxiety, etc. and whether the drugs billed for these disorders work anywhere near as well as we are told to believe.

The first couple of chapters describe a detailed history of the discovery of psychotherapeutic drugs. The details, while dense, are necessary to give the reader a sense of the process of discovery... and a better understanding of what we actually know (little) and what surprisingly basic things about these disorders and drugs we don't.

Valenstein then moves into a section which stands on its own: his chapter outlining the do's and don'ts of data interpretation is worth the price of the book. He lays out the differences between cause and effect, levels of explanation, definitions of "illness", and all the rest of the fundamental ideas and distinctions that one really should know to make any sort of informed conclusion about research related to the brain and behavior. Photocopying and distributing this section has crossed my mind.

The rest of the book comprises a critique of the pharmaceutical industry. Valenstein lays out an abundance of evidence demonstrating the industry's ability to and habit of manipulating doctors, theories, and the consumers with a veil of expert knowledge. Valenstein claims that the industry's insistence on these disorders being simple "chemical imbalances" is not driven by any strong evidence in the scientific literature, but simple by the bottom line: it is more profitable to be able to provide specific treatments and to show evidence of pharmacological progress in treating these disorders than it is to spend time and money attempting to understand these conditions which more likely arise from a complex interaction of environment, genetics, and neurobiology: a daunting combination not simply solved by pills.

Most appreciated in the book is Valenstein's willingness to present the facts and leave the reader, whether a scientist or consumer, to make their own conclusions about where to go from here. He certainly has a point to make, but it's more along the lines of airing everyone's dirty laundry, not in staging a climactic call for all individuals to cease drug treatments or for the industry to be be shut down (he readily admits that some individuals do benefit from such treatments).

Overall, a most informative and thought-provoking read.… (mer)