Published: 20/06/2002, Volume II2, No.5810 Page 42 43

The Creation of Psychopharmacology By David Healy

Publisher: Harvard University Press. ISBN: 0674006194. 416 pages,£27.50 (hardback).

David Healy gained notoriety after an invitation to be professor of psychiatry at Toronto University was withdrawn.He claimed that pharmaceutical companies, and certain influential psychiatrists who receive consultancy fees from them, swayed the decision to rescind the job offer, and he sought redress for breach of contract, libel and violation of academic freedom.This led to an out-of-court settlement.

A principal thread running through the conflict is Healy's controversial belief that the SSRI group of antidepressants, which includes Prozac, may have the potential to trigger suicidality in some users.

While taking paroxetine, an SSRI antidepressant, Donald Schell shot his wife, daughter and grand-daughter, before turning the gun on himself.A unanimous jury, primarily on Healy's evidence, found that paroxetine can cause some individuals to commit suicide and/or homicide, and awarded a total of $8m in damages to the families involved.

I suspect Healy enjoys the limelight.

He tends to adopt an idiosyncratic, maverick position in psychiatry.His best book, The Antidepressant Era, gives an account of the antidepressant phenomenon.The Creation of Psychopharmacology is a follow-up, telling the story of the development of anti-psychotic medication, such as chlorpromazine and haloperidol.There are nuggets of information in this book.

Most of them derive from interviews with prominent people in the field of psychopharmacology, which Healy has published in three volumes entitled The Psychopharmacologists.

For example, I was not aware that Dr Jean Delay, who, with Dr Pierre Deniker, was the first to proclaim the antipsychotic properties of chlorpromazine, had his office ransacked in the protests of 1968 at Paris University.Healy makes grand links between this event and the overall history of psychopharmacology that he describes.He sees 1968 as the culmination of the Enlightenment begun by Rousseau and Voltaire.He makes connections, however tenuous, with the antipsychiatry movement.

But the generalisations and tangentiality of this book are serious weaknesses.At times, it is difficult to follow the juxtaposition of ideas.

Some of the references Healy gives are useful and well worth following.

However, more time and effort should have been expended distilling the essence of the material and providing coherence to the argument.

Commentators have made these criticisms of Healy's books since The Suspended Revolution.He has never hidden his personal style, which is why it is surprising that a rambling lecture led to the revocation of the job offer in Toronto.The university should have known what kind of person they were taking on.

The commendation for the book comes from Edward Shorter, social historian of medicine at Toronto University.Shorter suggests that The Creation of Psychopharmacology is the most important contribution to the history of psychiatry since Ellenberger's Discovery of the Unconscious.Do not believe the blurb.Healy's book is not without value.But more work is needed to produce a longlasting, consequential account from his material.