Book Review: Anatomy of an Epidemic. Robert Whitaker. 2010. Broadway, Random House Reviewed by: Terry Birchmore “When it comes to dead bodies in current psychotropic trials, there are a greater number of them in the active treatment groups than in the placebo groups. This is quite different from what happens in penicillin trials or trials of drugs that really work” David Healy, Professor of Psychiatry at Cardiff University, Wales (2008). This is an account of how drug trial data is being buried in order to make drugs appear to be more effective than they really are; how drug companies are exploiting peer review publications; how doctors are taking large sums of money from Big Pharma to push drugs that don't work; and how all are making spurious claims about the biological causes of mental illness. At the beginning of this book Robert Whitaker explains how he became curious about why there had become such a large increase in the incidence of disabling mental illness in the USA: in 1987, the mental illness disability rate was 1 in every 184 Americans, but by 2007 the mental illness disability rate had more than doubled to 1 in every 76 Americans. He summarises here the extensive research evidence indicating that psychotropic medication of whatever variety is relatively ineffective compared to placebo treatment. This is a relatively familiar and well known story. The conclusion that these medications are relatively ineffective, when taken over the course of more than a few months, and contribute very little or perhaps nothing to a normal course of improvement over time, is unavoidable, and the research evidence amassed over the course of decades is impressive. It is much less well known that extensive research supports the view that psychotropic medications may well be actively harmful to most of those who take them for a more than a brief period of time and Robert Whitaker impressively outlines the amassed and cumulative research evidence stretching back over the past three or four decades, which points to this conclusion. This evidence indicates that psychotropic medications produce worse outcomes than would be the case with unmedicated psychological episodes and convert short- term illnesses into chronic and severe disabilities. Whitaker’s review of this evidence is compelling. He is able to compare outcomes of illness episodes in the pre-drug and post-drug eras and his conclusions will come as a surprise to many – that in the pre-drug era illnesses were generally short term and less severe and, with the introduction of drug treatment, illnesses became increasingly chronic and impairing leading to a lifetime of disability. Additionally, there is compelling research evidence, from the 1950’s onwards, indicating that psychotropic medication produces worse outcomes than comparable unmedicated disorders. Thus, Whitaker examines research on anti-depressants, anti-psychotics, stimulants prescribed to young people considered to be overactive, benzodiazepines, and tranquilisers, arriving at similar conclusions in each case. It is also clear that a convincing model of drug action contrary to the standard model of drug action, which asserts that psychotropic medications normalise an abnormal state of brain chemistry, can be built from the research evidence and Robert Whitaker proceeds to create such a model in this book, based on the research literature he examines. Far from these drugs normalising an abnormal state of brain chemistry, he writes, psychotropic medications invariably produce an abnormal brain state that leads the brain to attempt, in various ways, to normalise the drug-induced abnormality. Then, if medication is continued over more than the short term, discontinuation of the drug is likely to produce a relapse of symptoms and the longer the drug is continued the more likely it is that the illness will be chronic and increasingly severe. At some point, the