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Views & Reviews Review of the Week

The origins of the Prozac nation

BMJ 2009; 338 doi: (Published 27 May 2009) Cite this as: BMJ 2009;338:b1784
  1. Gwen Adshead, Broadmoor Hospital, Crowthorne, Berkshire
  1. Gwen.adshead{at}

    This cultural history of pill popping will make doctors think twice before writing their next prescription for antidepressants, thinks Gwen Adshead

    In the United States of the early 1970s about 200 million prescriptions for psychotropic drugs were made each year. The most commonly prescribed types were sedatives and anxiolytics, such as meprobamate (Miltown). By 2005 the annual number of prescriptions had reached 350 million, the vast majority of these being for antidepressants. How US culture changed such that the biggest mental health problem apparently switched from anxiety to depression is the subject of this fascinating book.

    David Herzberg is a cultural historian; and here he weaves three strands of cultural history together: the rise of consumerism in the 1950s, the politics of identity and autonomy, and the professional ideal of altruism in medicine. He shows how the consumerist maxim that “things can make you happy” was applied to mental health. Anxiety came to be seen as a disorder that stopped people fulfilling their proper social role; the treatment for this became a “thing” (in the form of …

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