A landscape of overmedication
May/June 2008
by Charles Barber

Charles Barber, a lecturer in psychiatry at the School of Medicine, is the author of Songs from the Black Chair: A Memoir of Mental Interiors, and Comfortably Numb: How Psychiatry is Medicating a Nation.

In my two decades of work counseling the mentally ill homeless, I have witnessed the lifesaving impact of psychiatric drugs for people who really need them, people with true medical illnesses like schizophrenia, bipolar disorder, and major depression. Many of the severely ill clients that I worked with would not have survived without such medications, from antidepressants like Prozac to antipsychotics such as Zyprexa.

But in our characteristic American impatience and zeal, these drugs, particularly initially, were hyped beyond the limits of their ability to help many people. Their efficacy with very specific populations and legitimate psychiatric disorders has been over-generalized to treat, in many cases, the life problems and life stressors of the masses. Indeed, antidepressants are now the most prescribed category of drugs in this country.

Technically, three events conspired to create the current landscape of overmedication. The most significant development was the mid-1990s change in regulation that allowed the television advertising of prescription drugs. Before that, TV ads for drugs were illegal, and they remain so everywhere in the world other than the United States and New Zealand. The ads, which quickly became omnipresent in prime time, made the 20 or so "blockbuster" drugs household names, and arguably, household commodities. That Claritin and Zoloft and Nexium were advertised next to Coca-Cola and toothpaste gave the impression that they were household products. Research has shown that doctors, under pressure from consumers influenced by the latest ad ("Ask your doctor about [fill in the blank]"), will write prescriptions at times even if they feel ambivalent about the appropriateness of the treatment.

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