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by Alison Bass
Algonquin, 2008
Review by James K. Luiselli, Ed.D., ABPP, BCBA on May 12th 2009

Side Effects

In 1995, investigative reporter, Alison Bass, received an anonymous tip concerning misappropriation of funds from the Massachusetts Department of Mental Health. She subsequently spoke with an employee from a university affiliated psychiatry department who was convinced that researchers were collecting funds under false pretenses. Bass followed up with a series of newspaper articles which uncovered unsavory practices by the pharmaceutical industry, psychiatry professionals, and United States Food and Drug Administration (FDA). Side Effects is her stranger-than-fiction account of the people and circumstances surrounding these events.

The basis of this expose was the rampant prescription of antidepressant medication, specifically serotonin selective reuptake inhibitors (SSRI), among children and adolescents during the 1990s. By 2004, worldwide sales of antidepressants approached $20 billion and one such medication, Paxil, led the way, producing massive profits for its manufacturer, GlaxoSmithKline. Other drug companies jumped aboard the antidepressant bandwagon, their marketing plans driven by purportedly positive research findings endorsed by the psychiatric community. But there were problems. For one, several eminent psychiatrists had reported data suggesting that Paxil caused suicidal thoughts and behavior in some children. One person featured in the book, Dr. Martin Teicher, played a prominent role in speaking out about antidepressant side effects, only to be ignored and ostracized by his colleagues. And then the New York State attorney general’s office launched a successful lawsuit against GlaxoSmithKline on the grounds that the company falsified its drug research in favor of Paxil, withheld negative findings, and covered up uncomplimentary case data. In this part of the story, Bass introduces us to a gritty state prosecutor, Rose Firestein, who worked tirelessly on the case that eventually settled against GlaxoSmithKline. The impact of that litigation reformed how drug companies must report the results of clinical trials and present negative findings.

Side Effects is a tour de force that rivals any suspense novel! A meticulous reporter and skilled writer, Alison Bass builds her story from face-to-face interviews with key players and detailed reviews of testimonial transcripts, industry communications, news articles, medical publications, and previously unreleased material. In the best muckraking tradition she reveals how some executives in the giant pharmaceutical industry and their associations with a few corrupt medical professionals can dupe the public in ways that produce tragic outcomes. Unfortunately, there remain concerns about financial ties between drug companies and medical researchers, as well as the regulatory integrity of the FDA. But as illustrated in this marvelous book, we can be comforted knowing that meaningful reform and vindication are possible thanks to the dedicated efforts of people who understand right from wrong and are willing to sacrifice personal wellbeing for a greater common good.

© 2009 James K. Luiselli

James K. Luiselli, Ed.D., ABPP, BCBA is a psychologist affiliated with May Institute and a private-practice clinician. Among his publications are 6 books and over 200 journal articles. He reviews books for The New England Psychologist.