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<text id=94TT1357>
<title>
Oct. 10, 1994: Medicine:Prozac's Worst Enemy
</title>
<history>
TIME--The Weekly Newsmagazine--1994
Oct. 10, 1994 Black Renaissance
</history>
<article>
<source>Time Magazine</source>
<hdr>
MEDICINE, Page 64
Prozac's Worst Enemy
</hdr>
<body>
<p> A psychiatrist argues in books and on TV that drugs don't help
the mentally ill. His critics say he's crazy
</p>
<p>By Christine Gorman--Reported by Alice Park/New York and Dick Thompson/Washington
</p>
<p> By some yardsticks, Dr. Peter Breggin seems to be a successful--perhaps even influential--psychiatrist. He has earned impressive
academic credentials, published a string of books and shown
up on Today and The Oprah Winfrey Show. Many patients rave about
the doctor. "He's a wonderful person," says one satisfied customer.
"He cares so much about his clients. He gave me the will to
get better."
</p>
<p> So why are so many other people saying such nasty things about
him? The head of the National Alliance for the Mentally Ill
calls Breggin "ignorant" and claims he's motivated by a lust
for fame and wealth. The former director of the National Institute
of Mental Health brands Breggin an "outlaw." The president of
the American Psychiatric Association says the doctor is the
modern equivalent of a "flat earther."
</p>
<p> What causes these critics to lose their professional cool at
the mere mention of Breggin is his relentless crusade against
the conventional wisdom of psychiatry--and his increasingly
high profile. What causes Breggin to rail against his profession
is its eagerness to embrace technology, from the early zeal
for lobotomies and electroshock to the modern reliance on such
psychoactive drugs as Thorazine and lithium. In looking for
the quick fix, Breggin argues, too many psychiatrists have forgotten
the importance of love, hope and empathy in maintaining sanity.
The power to heal the mind lies in people, he says, not pills.
</p>
<p> For many years no one paid much attention to Breggin, 58, but
that was before the dawn of the Prozac Age. The immense popularity
of the drug, which is most often prescribed for depression but
is gaining a reputation as an all-purpose personality enhancer,
has given Breggin his best ammunition yet. In his new book Talking
Back to Prozac (co-written with his wife Ginger Ross Breggin),
he says the drug is merely a stimulant that does not get to
the root of depression and is probably dangerous when used over
long periods. He has dumped on Prozac in TV and radio debates
with Dr. Peter Kramer, whose best seller Listening to Prozac
describes the drug's powers in generally favorable terms. In
the process, Breggin has infuriated Prozac's manufacturer, Eli
Lilly, prompting the firm to deluge journalists with material
intended to discredit the maverick psychiatrist.
</p>
<p> Breggin didn't start out to be a renegade. As his book jackets
proudly point out, his background is pure establishment: Harvard
College, Case Western Reserve Medical School, a teaching fellowship
at Harvard Medical School. But early in his career, he became
deeply disturbed by the treatment of psychiatric patients, particularly
the many long-term residents of mental hospitals who spend their
lives in a drugged-out state. In 1971 Breggin declared his rebellion,
launching the Center for the Study of Psychiatry in Bethesda,
Maryland, as a way to push for reform.
</p>
<p> At issue is the very nature of mental illness. For the past
few decades, the majority of researchers have worked to show
that psychiatric disorders are triggered by chemical imbalances
in the brain that can be rectified with medication. Breggin,
by contrast, clings to an old-fashioned view: the emotional
problems that land a person on a psychiatrist's couch result
from traumas caused by outside forces, like sexual abuse during
childhood. Drugs can't erase these traumas, he asserts, and
aren't even appropriate for such severe conditions as schizophrenia
and manic depression. "These are not illnesses," he says. "They
are ways people become when they are hurt or frightened. The
fact that something is extreme doesn't make it an illness."
</p>
<p> This bizarre notion takes no account of mountains of evidence
to the contrary. But, like a slick lawyer, Breggin has answers
for every argument. Researchers have, for example, observed
distinctive physical features in the brains of people with schizophrenia.
A study of identical twins found that one portion of the brain
was 15% smaller in the person with schizophrenia than in the
normal sibling. Breggin says the difference could be the result
of brain damage caused by the drugs given to control the disease.
Of course, it is difficult to test his hypothesis because that
would require studying people with schizophrenia who are deliberately
left untreated--a practice that most psychiatrists would deem
unethical.
</p>
<p> Breggin is also a master of capitalizing on embarrassing lapses
in psychiatric research. Several times, scientific teams have
trumpeted the news that they have isolated a genetic marker
for manic depression. In all cases, the results could not be
replicated by others, and the conclusions were withdrawn--something Breggin delights in pointing out at every opportunity.
Nor is he impressed by genealogical studies that trace schizophrenia
through several generations. "Things run in families," he counters.
"Speaking English runs 100% in American families. It's not surprising
that being emotionally upset would run in families."
</p>
<p> What galls psychiatrists most are Breggin's attacks on the usefulness
of antipsychosis drugs. He doesn't content himself with describing
possible side effects, such as uncontrollable jerky movements
and facial ticks, but claims the drugs rarely have any benefit.
He likens lithium, which is used to treat manic depression,
to lead and compares Prozac to amphetamines.
</p>
<p> Breggin's preachments would be laughable, say critics, if they
weren't so dangerous. Though he warns his readers against stopping
their psychiatric drugs too abruptly or without medical supervision,
at least one schizophrenic man threw away his medications after
listening to Breggin on TV. The patient became suicidal and
was hospitalized for two weeks. "Breggin reinforces the myth
that mental illness is not real, that you wouldn't be ill if
you'd pull yourself up by the bootstraps," says Susan Dime-Meenan,
president of the National Depressive and Manic-Depressive Association.
"His views stop people from getting treatment. They could cost
a life."
</p>
<p> The psychiatrist's credibility is not helped by the air of flakiness
that surrounds his life and work. Lilly regularly links him
to the Church of Scientology, which has long been a rabid opponent
of psychiatry. Breggin admits that he was once an ally of the
group and that his wife was a member. But he insists they both
renounced Scientology more than two decades ago. Lilly, meanwhile,
has combed through his old books and articles in search of anything
embarrassing--just like the conservatives who used Lani Guinier's
writings to scuttle her nomination to serve in the Justice Department.
In Breggin's case, his opponents found a doozy: the doctor once
wrote approvingly of sexual relations between children. "I don't
agree with that anymore," Breggin says now, accusing Lilly of
character assassination. "That's from a period in the '60s,
and I've certainly left that far behind."
</p>
<p> Unfortunately, what gets lost in the cross fire is any serious
consideration of Breggin's ideas. Amid extremely dubious assertions
like the notion that drugs don't help schizophrenics, Breggin
makes some points that many psychiatrists would agree with.
Among them: too many doctors prescribe drugs for minor depression
or anxiety without talking to patients long enough to understand
their problems. Too many patients look for pills to smooth out
the inevitable ups and downs of everyday life. And powerful
psychoactive drugs can indeed be dangerous if used cavalierly.
</p>
<p> It would be better if Breggin, the loudest voice making those
points, were less shrill and more reasonable. But then, the
calmer voices never seem to make it onto Oprah.
</p>
</body>
</article>
</text>