Talk:Anatomy of an Epidemic

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Unbalanced viewpoint[edit]

This article mostly retells the content of Whitaker's book (complete with ISBN and link to his website), which seems to say that antipsychotics and/or antidepressives cause mental disorder. Seeing that this is a medical/pharmacology topic, the text should respect WP:MOSMED. It worries me a bit that there is not a single source from a peer reviewed journal (or any scientific journal at all). And it would be nice if the article weren't throwing a number of rather different types of drug in the same pot, even if the book does. (Does it?) --ἀνυπόδητος (talk) 17:33, 13 October 2010 (UTC)

The article says that Whitaker is pro-drug. So I'm not sure how much more clear I can be regarding WP:MOSMED. If you have a suggestion I'd be very interested in adding it. Also you're right there are no studies here. This is a summary of a summary of them. I will gladly add some if you think they are necessary. Thanks very much for your comments. -SusanLesch (talk) 17:40, 13 October 2010 (UTC)
I am not sure what Whitaker's being pro-drug has to do with MOSMED. Unfortunately I have not read the book, but a number of statements are quoted from the book which need balancing. (Is this his personal opinion? Does he cite any scientific sources that support him?) I am mainly talking about:
  • "It should be understood that they’re not fixing any chemical imbalances.", "Unfortunately, the reasons the pharmaceutical companies gave for the drugs working have not proved to be true." The matter is more complicated than that, but biochemical imbalances do seem to play a role.
  • "the drugs that patients receive can perturb their normal brain function." Definitely needs a scientific source. Does Whitaker cite one?
  • "He finds the idea that the 'invention of Thorazine' emptied asylums to be a myth." Really interesting if it's true, but again, needs an independent source.
Thanks --ἀνυπόδητος (talk) 17:52, 13 October 2010 (UTC)
I came here from a note at WP:WikiProject Pharmacology. I'd suggest deleting the section listing the table of contents of the book. I don't think it's really a problem to present the views in the book in this way, so long as the page indicates that the views are those expressed in the book, rather than the "views" of Wikipedia. The page mentions a negative review; it might be a good idea to expand on that, and generally to expand on reactions, positive and negative, to the book. As the page stands now, I have some concerns about whether it passes Wikipedia:Notability (books). The very fact that the current version of the page seems to indicate that the book has not received many reviews raises questions in that regard. --Tryptofish (talk) 17:53, 13 October 2010 (UTC)
Yes, clearly labelling the statements as Whitaker's views would be fine. Would you give it a try, Susan? --ἀνυπόδητος (talk) 18:06, 13 October 2010 (UTC)
Anypodetos, the article is a book review, and every point is already sourced to the author. Yes there are studies to back up the three things you found interesting. I don't think though that a book review is the place to discuss them. I would instead have to refer you to other Wikipedia articles which may (or may not) have included those studies. For example, antipsychotics, psychiatry etc. I will try to add them to those article when I have time, but it is not easy to do. Do you have any other specific interests that I can try to add to? -SusanLesch (talk) 18:12, 13 October 2010 (UTC)
Maybe I'm reading too much into your choice of words, but the article should not be, literally, a book review. --Tryptofish (talk) 18:15, 13 October 2010 (UTC)
Susan, scientific sources for the items I listed above would of course be a bonus, but Tryptofish's solution of marking the statements as Whitaker's is definitely less work. I don't care so much about what I am interested in, but what might look like sourced statements of Wikipedia (and that always means third-party sources) but is actually a summary of the book's content. Shall I try to phrase the article more clearly with respect to that difference, or do you want to do it? --ἀνυπόδητος (talk) 18:33, 13 October 2010 (UTC)
Tryptofish, yes sorry it was a poor choice of words on my part. At your request to expand on the reviews of this book, I added four positive reviews to the article. Does this meet with your approval? -SusanLesch (talk) 18:46, 13 October 2010 (UTC)

"It worries me a bit that there is not a single source from a peer reviewed journal (or any scientific journal at all)."

The sources are noted in the footnotes of Whitaker's books and most of them are from mainstream psychiatric and scientific journals. I see there being a problem with this article in that it is citing the book and not the sources that the book cites. Somebody ought to fix that. (talk) 02:23, 25 October 2010 (UTC)

"Somebody ought to fix that". Well I'm here and ready to do whatever needs doing. It would sure help if you flagged whatever it is you'd like cited, -SusanLesch (talk) 02:01, 2 November 2010 (UTC)
Mostly in answer to Anypodetos.
Whitaker is a medical journalist and generally his book is very well sourced. In fact, his arguments are largely constructed out of a reading of the psychiatric literature (except for his initial question)
* Deinstitutionalisation: Some historians like Edward Shorter still argue that decarceration was due to the discovery of chlorpromazine but the broad consensus is that it was the result of changes in service provision rather than any treatment modality. In many countries deinstitutionalisation precedes modern drug therapies (which is not to argue that chlorpromazine does not have an effect on psychotic symptoms). I can get plenty of references for this if you like.
* Drugs and perturbation of brain function. He quotes from Steve Hyman, director of NIMH from 1996-2001, called, 'Initiation and adaption: a paradigm for understanding psychotropic drug action' in American Journal of Psychiatry, vol. 153 (1996): 151-161 - in regard to psychotropic drugs he wrote that brain function after a few weeks of such medication is 'qualitatively as well as quantitatively different from the normal state'. And Barry Jacobs, 'Serotonin and behaviour' in Journal of Clinical Psychiatry, vol. 52, suppl. (1991): 151-62. Regarding SSRIs, he states:

These drugs 'alter the level of synaptic transmission beyond the physiologic range achieved under [normal] environmental/biological conditions. Thus, any behavioural or physiologic change produced under these conditions might more appropriately be considered pathologic, rather than reflective of the normal biological role of 5-HT [serotonin].

* Chemical imbalance (monoamine hypothesis): Old thesis, sometimes described as a useful metaphor for public/patient discourse, although there's been a little revival of late in research. There's a whole range of research on this - but basically, there's no correlation between serotonin levels and depression. J. Lacasse, 'Serotonin and depression: a disconnect between the advertisements and the scientific literature' PLoS Medicine, vol. 2 (2005): 1211-16: "there's no clear and convincing evidence that monamine deficiency accounts for depression; that is there is no 'real' monamine deficit". Steve Hyman, Molecular Neuropharmacology (2002): "There is no compelling evidence that a lesion in the dopamine system is a primary cause of schizophrenia". FiachraByrne 03:57, 3 April 2011 (UTC)

Reply to Tryptofish[edit]

This conversation above is tripping on itself. I have expanded the number of book reviews (from one negative to five total, one negative and four positive). Do you have other requests? This article does not say "Wikipedia says..." anything controversial. Instead it says "Whitaker says...". For cripes sake, Wikipedia has other articles about books (I've written a couple of them myself). -SusanLesch (talk) 18:52, 13 October 2010 (UTC)

Susan, I'm sure it's fine, and thanks for expanding on the reviews. Really, the page isn't a big issue for me. I was just responding to the WikiProject note. When I have more time, I'll give the page a careful look-over and make some edits myself if I see anything where I could improve it. Happy editing, --Tryptofish (talk) 19:14, 13 October 2010 (UTC)
Thank you. Just in case, I think I gave Whitaker as the source for every sentence. -SusanLesch (talk) 20:41, 13 October 2010 (UTC)

Reply to Anypodetos[edit]

Regarding, "Tryptofish's solution of marking the statements as Whitaker's is definitely less work." I am sorry but I don't read Typtofish's comments to make any such suggestion. I thought he was saying that the article is a good way of saying exactly what it says. -SusanLesch (talk) 18:59, 13 October 2010 (UTC)

Hm. I read "so long as the page indicates..." as meaning that it does not yet (at least not consistently). My apologies, Tryptofish, if I read you wrong. Susan, regarding your answer to Tryptofish: We don't need to say "Wikipedia says" if we are dong it. I still think that some sentences do not make clear what is Whitaker's view and what WP claims to be a fact. If you don't object, I'll try to fix that. Feel free to rephrase if you are not happy with the result. --ἀνυπόδητος (talk) 19:11, 13 October 2010 (UTC)
OK. I'll be happy to help you once I figure out what it is you'd like to see. Thanks again for your comments. -SusanLesch (talk) 19:31, 13 October 2010 (UTC)
Feel free to restore the "unbalanced" flag if you need to. I hope we're okay now. -SusanLesch (talk) 20:42, 13 October 2010 (UTC)
Thanks very much for taking the trouble! I'm fine now. --ἀνυπόδητος (talk) 16:58, 14 October 2010 (UTC)