Oliver James: From pill to post

Who would have thought that OM readers would feel so passionately about antidepressants? My antiquated laptop has nearly melted from the heat of the emails I received in response to my brief sally into this topic three Sundays ago. Most were from irate GPs (6), some from psychiatrists (4) and some from members of the public (4).

To the patients, or parents thereof, I apologise for having caused distress. Regarding the docs, I am less penitent, although I want to stress that I have the highest respect for the work they do.

I know I could not cope with being either a GP or a psychiatrist. The GP workload would soon flatten me, if I had not already been overwhelmed by the daily diet of tragedy. Psychiatry would soon upset me as well.

A significant proportion of a psychiatrist's caseload is unhelpable using medication, the main weapon in their armoury in the battle against mental illness. For instance, about one quarter of depressed patients do not respond to any drugs.

So much of the time, psychiatrists are faced with virtually unchangeable electro-chemical damage to the brain caused by decades of extreme social deprivation and childhood maltreatment. No wonder they have such a high suicide rate - the psychiatrists, that is.

The main point of all the docs was my lack of medical training and consequent irresponsibility in recommending one antidepressant (Lustral) over the others. Some point out that a proportion of people have stomach pains if they take it. Others say that in their experience, insomnia and anorexia are made worse by it whereas certain other pills do not have that effect.

But I was careful to avoid insisting that one pill fits all. What I wrote was: 'Lustral is probably the least worst. I would be very firm with your GP - if they try to give you anything else, unless they can come up with a strong reason, I would absolutely insist.'

If you had insomnia or were under-eating and the doctor said Lustral was inappropriate, that is what I meant by a 'strong reason'. I am only saying that, based on interviews with a number of psychiatrists, Lustral has the 'least worst' side effects.

What none of the docs mentioned was the shocking lack of any research into the different psychological effects of the different pills. While they were happy to assail me with evidence, or with my lack thereof, they did not seem to be aware of how inadequate and biased towards its drug-company commissioners a lot of this evidence is. None admitted that there simply are no proper studies of how, for example, Prozac might affect sociability compared with Lustral.

This is because, post-Thatcher, independent research into such matters has all but ended. The drug companies pay for their own studies of their drugs and they determine which aspects are researched.

They are absolutely scared stiff of anyone who wants to examine the psychological effects on personality. They know that the public could rapidly become very paranoid about living in a Brave New World.

· Oliver James is unable to enter into any personal correspondence.

Thanks to guardian.co.uk who have provided this article. View the original here.