This quotation by a patient opens the tenth chapter of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astounding Rise of Mental Illness in America. This is the seventh part of a blog about the book.
The author offers an interesting exercise in logic: What if there was a virus that makes people sleep 12-14 hours a day, move slowly, and appear emotionally disengaged? What if this virus made blood sugar levels and cholesterol levels soar? What if patients with the virus were developing diabetes… especially children and young adults? And some were even dying from pancreatitis? And then government studies were discovering that the virus was having these effects because it was blocking an astounding multitude of critical neurotransmitter sites in the brain: dopaminergic, sertononinergic, muscarinic, adrenergic, and histaminergic? And imagine that this virus was shrinking the cerebral cortex causing cognitive impairment… Scary virus, no? And then the author delivers the punchline: He has just described the effects of Eli Lilly’s best-selling antipsychotic drug Zyprexa. And, yes, millions (including children) are taking it. And, yes, BILLIONS have been paid out and continue to be paid out in settlements by Lilly …
But Zyprexa continues to be sold. Why? Hold that question…
What’s going on? Whitaker unravels the mystery by connecting the dots between physicians (and the desperate desire on the part of psychiatrists to become “real” doctors with their own magic bullet drugs), and pharmaceutical companies, and medical schools, and the National Institute for Mental Health. Nobody is specifically evil. Nobody is intending to unleash an iatrogenic epidemic of damaged brains on the American public. Folks are just doing business: Doctors are telling patients what they want to hear (“We can fix you with a pill.”). Pharmaceutical companies are cultivating profitable and positive relationships with doctors, who are, after all, the real “point-of-sale” folks.
Medical colleges are eager to accept donations to fund research and research facilities. It’s understandable that these funds would be coming from the pharmaceutical companie, who have such a stake in research. And, the National Institute of Mental Health is, of course, staffed by the folks who have come out of these medical schools with the powerful connections that would get them into the loop of a government agency, and the agency, of course, is responsive to the cutting edge of research and the needs of the population… which are demonstrably for more pyschotropic drugs… And, my god, look at the burgeoning mental health problems this country has! Good thing doctors, drug companies, med schools, and the government are all on the same page about working together on this thing…
What’s going on? Let’s follow some of the money…
Eli Lilly’s value increased nearly tenfold between 1987 and 2000. The head of the psychiatric department at Emory received $960,000 from one drug company just to promote Paxil and Wellbutrin. In 2006, drug companies gave physicians in Minnesota $2.1 million dollars. The totally accidental and random discovery of drugs that affect the brain and the very focused and intentional marketing of them has ushered in what amounts to a psychotropic Gold Rush.
And who pays the bill? In 2008, the US spent $170 billion on mental health services, which was twice as much as in 2001. By 2015, the cost is estimated to be almost twice as high. About 60% of this is paid by the US government via Medicare and Medicaid. We’re all paying the bill.
But money is not the primary cost. The highest price is the cost to our mental health. Whitaker makes an argument that is difficult to refute that the current mental health epidemic in this country is an iatrogenic one.
The eighth and final blog on this issue will be focused on solutions. Stay tuned!