Ordinarily Well: The Case for Antidepressants

Kramer (Listening to Prozac), a psychiatrist and professor at Brown Medical School, makes an energetic and personal case for the role of antidepressants in easing crippling depression. Starting with the history of psychotherapy, when “infinite patience was the norm” in treatment for depression, Kramer delves into the breakthrough use of imipramine for treatment in the mid-1950s that helped “redefine the disorder” and “invigorate” psychopharmacology. But Kramer’s more captivating story is about the resistance to antidepressants that emerged in the 1970s and was further stoked by Irving Kirsch’s 1998 essay, “Listening to Prozac but Hearing Placebo,” which took direct aim at Kramer’s work. Kramer also takes on the imperfect system of rating a drug’s efficacy, the placebo effect controversy (a “minor element,” he asserts), “cosmetic psychopharmacology,” and the use of antidepressants even after a bout of the illness is resolved. Kramer’s work is data-dense—this is ”the most technical of [his] books,” he concedes. And while there’s a plaintive quality to his arguments, there is also real hope: “Practicing doctors witness antidepressants’ efficacy daily, and the formal evidence supporting those observations is ample.” Kramer shows that the tools may be imperfect, but people battling severe depression are “ lucky to have them.” Agency: Wylie Agency. (June)