Books

The Emperor's New Drugs: Exploding the Antidepressant Myth


The Emperor's New Drugs: Exploding the Antidepressant Myth

Publisher: Basic Books
Length: 240
Author: Irving Kirsch, Ph.D.
Price: $23.95
Format: Hardcover
US Publication Date: 2010-02
Amazon

What if antidepressants were not just too easily available and overly prescribed by doctors -- as has been argued in many venues for years now, though to no discernible effect -- but didn't even work? That's the takeaway premise of psychology professor Irving Kirsch, Ph.D., in his new book, The Emperor's New Drugs: Exploding the Antidepressant Myth.

By examining a broad spectrum of research, using both the published drug studies and the deep well of unpublished research which many drug companies would prefer stay hidden, Kirsch presents the all-too-plausible theory that there is essentially no positive effect from taking antidepressants. In fact, comparing test results between patients taking antidepressants and those taking active placebos (a drug that isn't an antidepressant but has other, noticeable side effects, so that the patient can tell something is working on them), Kirsch found no statistically significant difference. Actually, he found that it didn't seem to matter what drug patients were taking, as long as they knew they had ingested some kind of active drug, they improved by about the same degree. So much for the last few decades' great advances in pharmacology, it would seem.

If what Kirsch is saying is true, then not only are untold millions being wasted on essentially worthless drugs, but an entire school of psychological thought is utterly wrong. Kirsch spends an entire chapter of his tightly argued book tearing down the oft-recited belief that depression is frequently or always caused by a chemical imbalance in the brain. After relating several studies which purport to show that drugs which increase, decrease, or have no effect on the serotonin levels in patients brains (something long described as crucial to pharmacological therapy) all have about the same effect, Kirsch concludes very simply that "the data just do not fit the theory".

Problematically, this doesn't seem to be news to anybody outside the industry. Kirsch writes of how drug-industry researchers have long referred to the often negligible difference in results between antidepressants as the "dirty little secret". He even presents evidence that the Food and Drug Administration cautioned drug companies in 2004 to not publicize their findings that antidepressants were no better than placebos for depressed children. Their reasoning was that doing so would discourage doctors from prescribing those drugs. For those readers now wondering why the FDA would want doctors to push ineffective medications, there doesn't seem to be a logical answer.

Proving or disproving Kirsch's hypothesis (based as it is on massive amounts of crunching data not available to the average person) will be beyond the abilities of most lay readers, which is his book's greatest downside, apart from the cardboard-stiff prose. (Kirsch is a great synthesizer of data, but no artist when it comes to relating his findings to a general audience.) But given how resolutely the treatment of mental disease has shifted from therapy- to drug-based regimens, just about any good-faith effort to turn the focus of treatment back on actual human interaction seems well worth it.

The year in song reflected the state of the world around us. Here are the 70 songs that spoke to us this year.

70. The Horrors - "Machine"

On their fifth album V, the Horrors expand on the bright, psychedelic territory they explored with Luminous, anchoring the ten new tracks with retro synths and guitar fuzz freakouts. "Machine" is the delicious outlier and the most vitriolic cut on the record, with Faris Badwan belting out accusations to the song's subject, who may even be us. The concept of alienation is nothing new, but here the Brits incorporate a beautiful metaphor of an insect trapped in amber as an illustration of the human caught within modernity. Whether our trappings are technological, psychological, or something else entirely makes the statement all the more chilling. - Tristan Kneschke

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Electronic music is one of the broadest-reaching genres by design, and 2017 highlights that as well as any other year on record. These are the 20 best albums.


20. Vitalic - Voyager (Citizen)

Pascal Arbez-Nicolas (a.k.a. Vitalic) made waves in the French Touch electro-house scene with his 2005 debut, OK Cowboy, which had a hard-hitting maximalist sound, but several albums later, Voyager finds him launching into realms beyond at his own speed. The quirky, wallflower vocals and guitar snippets employed throughout Voyager drop a funk that brings to mind WhoMadeWho or Matthew Dear if they had disco-pop injected between their toes. "Levitation" is as pure a slice of dance floor motivation as theoretically possible, a sci-fi gunfight with a cracking house beat sure to please his oldest fans, yet the album-as-form is equally effective in its more contemplative moments, like when Miss Kitten's vocals bring an ethereal dispassion to "Hans Is Driving" to balance out its somber vocoder or the heartfelt cover of "Don't Leave Me Now" by Supertramp. Voyager may infect you with a futuristic form of Saturday Night Fever, but afterwards, it gives you a hearty dose of aural acetaminophen to break it. - Alan Ranta


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Film

Hitchcock, 'Psycho', and '78/52: Hitchcock's Shower Scene'

Alfred Hitchock and Janet Leigh on the set of Psycho (courtesy of Dogwoof)

"... [Psycho] broke every taboo you could possibly think of, it reinvented the language of film and revolutionised what you could do with a story on a very precise level. It also fundamentally and profoundly changed the ritual of movie going," says 78/52 director, Alexandre O. Philippe.

The title of Alexandre O. Philippe's 78/52: Hitchcock's Shower Scene (2017) denotes the 78 set-ups and the 52 cuts across a full week of shooting for Psycho's (1960) famous shower scene. Known for The People vs. George Lucas (2010), The Life and Times of Paul the Psychic Octopus (2012) and Doc of the Dead (2014), Philippe's exploration of a singular moment is a conversational one, featuring interviews with Walter Murch, Peter Bogdanovich, Guillermo del Toro, Jamie Lee Curtis, Osgood Perkins, Danny Elfman, Eli Roth, Elijah Wood, Bret Easton Ellis, Karyn Kusama, Neil Marshall, Richard Stanley and Marli Renfro, body double for Janet Leigh.

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Mary Poppins, Mrs. Gamp, Egyptian deities, a Japanese umbrella spirit, and a supporting cast of hundreds of brollies fill Marion Rankine's lively history.

"What can go up a chimney down but can't go down a chimney up?" Marion Rankine begins her wide-ranging survey of the umbrella and its significance with this riddle. It nicely establishes her theme: just as umbrellas undergo, in the everyday use of them, a transformation, so too looking at this familiar, even forgettable object from multiple perspectives transforms our view of it.

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7

Those who regard the reclusive Argerich as one of the world's two or three greatest living pianists—classical or otherwise—would not have left the concert hall disillusioned.

In a staid city like Washington, D.C., too many concert programs still stick to the basics. An endless litany of Rachmaninoff and Tchaikovsky concerti clog the schedules and parades of overeager virtuosi seem unwilling to vary their repertoire for blasé D.C. concertgoers. But occasionally you encounter a concert that refreshes your perspective of the familiar. The works presented at The Kennedy Center on 25 October 2017 might be stalwarts of 20th century repertoire, but guest conductor Antonio Pappano, leading the Orchestra dell'Accademia Nazionale di Santa Cecilia, reminded us how galvanizing the canonical can still be. Though grandiose executions of Respighi's The Fountains of Rome and The Pines of Rome were the main event, the sold-out crowd gathered to see Martha Argerich perform one of her showpieces, Prokofiev's Third Piano Concerto. Those who regard the reclusive Argerich as one of the world's two or three greatest living pianists—classical or otherwise—would not have left the concert hall disillusioned.

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