Blame the Brain - The truth about Drugs and Mental Health

This book is not written from a Christian perspective, in fact I doubt that that author is a believer (he never mentions one way or the other), yet I gave it my personal choice award because it is such a good book at showing the false claims of the drug companies and how people are fooled into believing that they have a chemical imbalance which can be treated by drugs. The author believes in psychotherapy, which I also disagree with, but he gets it right on the drug issue. It is a well organized book and well documented.

Below are a few quotes from the book. I have not listed his supporting documents, I just want you to see what kind of information the book contains. If you are or if you have a loved one who is taking these psychotrophic drugs you should read this book.

It may surprise you to learn that there is no convincing evidence that most mental patients have any chemical imbalance. Yet many physicians tell their patients that they are suffering from a chemical imbalance, despite the reality that there are no test available for assessing the chemical status of a living person's brain. (page 4)

The explanations of how psychotherapeutic drugs help to alleviate mental disorders rarely go beyond stating what chemical changes the drugs induce. The psychiatric literature rarely addresses how or why an excess or deficiency in serotonin or dopamine activity explains any particular mental disorder. There are few serious attempts to bridge the huge gap between neurochemistry and the psychological phenomena that must ultimately be explained. Unquestionably, our knowledge of how drugs interact with brain chemistry has increased enormously, but are we really any closer to understanding how psychiatric drugs alleviate mental disorders or what causes these disorders? I will argue that we have made little real progress in answering these questions, yet the chemical theories of mental disorders are widely promoted as though they are firmly established scientific facts. (page 96)

There are many other problems for any theory of depression that is based on assuming that a deficiency in the activity of serotonin or norepinephrine is the major cause of this disorder. The theory cannot explain why there are drugs that alleviate depression despite the fact that they have little or no effect on either norepinephrine or serotonin. (page 99)

Although it is often stated with great confidence that depressed people have a serotonin or norepinephrine deficiency, the actual evidence contradicts these claims. It is not possible to measure norepinephrine and serotonin in the brains of patients. (page 100)

Psychiatrists prescribe Prozac and other selective serotonin reuptake inhibitors not only for depression, but also for obsessive-compulsive disorders, panic disorders, various food-related problems (including anorexia and bulimia), premenstrual dysphoric syndrome (PMS), attention-deficit/hyperactivity disorder (ADHD), borderline personality disorder, drug and alcohol addiction, migraine headaches, social phobia, arthritis, autism, and behavioral and emotional problems in children, among many other conditions. It is a paradox that a drug that is praised for the specificity of its pharmacological action should be prescribed as a treatment for such a variety of conditions. It certainly makes it difficult to justify the belief that the newer, more selective acting drugs are correcting the unique biochemical abnormality that has caused each of the different mental disorders. It is sometimes claimed that there is a common etiology underlying all the different conditions that respond to the same drug. However, those who make this claim are not able to specify this underlying condition and to document its presence in an objective, noncircular manner, the claim has a hollow ring and it seems more defensive than convincing. (pages 105-106)

Contrary to what is often claimed, no biochemical, anatomical or functional signs have been found that reliably distinguish the brains of mental patients. While several investigators have reported that there is something different about the brains of schizophrenics, for example, other investigators have not been able to verify these findings. Even in the studies reporting positive results, many schizophrenics do no have the reputed brain "abnormality," while some of the people in the normal "control" group do, even though they have no history of psychiatric disorder. (page 125)

Studies of the drugs used to treat attention deficit/hyperactivity disorder (ADHD) illustrates how misleading it can be to draw conclusions about the cause of a disorder from a treatment just because it may be effective in ameliorating symptoms. Children diagnosed with ADHD are generally hyperactive, highly distractible, inattentive, and often disruptive in a classroom and elsewhere. The diagnosis of ADHD in many instances can be difficult, as children may manifest one or all of this behavior for many reasons and to varying degrees. According to Howard Morris of the National Attention Deficit Disorder Association, many physicians use the drug Ritalin as a diagnostic tool, assuming the attitude that if Ritalin works, "then you've got it and if it doesn't, then you don't."

Children with ADHD are assumed to have a biochemical abnormality because Ritalin, an amphetamine like drug that is a psychomotor stimulant, produces a "paradoxical" slowing of activity and increases attention span in these children. A study by Judith Rapoport and her colleagues at the National Institute of Mental Health, however, demonstrated that the response of ADHD children to amphetamine is not paradoxical at all. These investigators administered Ritalin to children of professionals in the biomedical and mental health community and found that the drug also decreased activity and increased attention span in these normal children. Rapoport concluded that there may be some minimal brain damage (MBD) in a subset of children with ADHD, but the assumption that they have a biochemical abnormality has no foundation in hard evidence. (page 133)

There are a number of examples of the dangers of ex juvantibus (LATIN: from that which produces health) reasoning in psychiatry. For example, because depression may be alleviated by drugs that elevate the activity of serotonin or norepinephrine or both it has been assumed that depression us caused by low levels of activity in those neurotransmitter systems. So committed is much of psychiatry to this ex juvantibus reasoning that when a drug that has little effect on either of these neurotransmitters proves to be an effective antidepressant, it is called an "atypical antidepressant." Rather than leading to questioning the biogenic amine theory of depression, such results are classified as atypical. Similarly, in patients appear to be depressed in many ways, but do not experience insomnia or a decreased interest in food and sex and may actually eat, sleep, and engage in sex excessively, they are often diagnosed as having an "atypical depression." It is a paradox, however that the patients with "atypical" depression, who may eat and sleep excessively, show no less improvement with antidepressant drugs that elevate serotonin and norepinephrine than do the patients with "typical" depression. The term "atypical" in both instances implies that the drugs or the patients are exceptions to the basic theory, which is rarely questioned. It is the same type of reasoning implied by the phrase that "they are exceptions that prove the rule," which, in reality, is never the case. (page 134)

In pursuing the biochemical approach to mental disorders an enormous amount has been learned about neurochemistry and drug action, but it is questionable how much has been learned about mental illness. We do not really know if a biochemical imbalance is the cause of any mental disorder, and we do not know how even the hypothesized biochemical imbalances could produce the emotional, cognitive, and behavioral symptoms that characterize any mental disorder. There remains a huge gap between the levels of these phenomena that has not been bridged. (page 138)

Pharmaceutical companies often suggest a specificity that is not supported by the evidence. As a marketing strategy, drugs that are identical or very similar chemically are given different names, and the marketing is aimed at different patient populations. Wellbutrin and Zyban, for example, are identical drugs, but the former is marketed as an antidepressant, while the latter is advertised as an aid to quitting smoking. Similar benzodiazepine drugs are used therapeutically for anxiety, for muscle spasms, and as an anticonvulsant. The specificity is in the packaging, not in the pharmacology. (page 145)

Back to Book Reviews