Drugs on the brain

As the First Lady hopeful, Tipper Gore has found her cause: Just say Yes to prescription drugs.

Speaking at the Democratic convention in August, Mrs. Gore told convention delegates and millions of television viewers about the "clinical depression" that she suffered after her son was injured in an accident. Two months earlier, at a White House conference on Mental Health, President Clinton had praised Mrs. Gore as his top mental-health advisor.

Yet, at the same time, the dark side of psychotropic drugs is gaining publicity.

The same month the White House was holding its conference, the Boston Globe revealed that Lilly, the pharmaceutical company that manufactures Prozac, had suppressed evidence that the drug produces suicidal behavior in a number of patients. The company changed physicians' reports mentioning suicide attempts to "overdose," and suicidal thoughts to "depression." Also that month a new book appeared by Cambridge psychiatrist Joseph Glenmullen titled Prozac Backlash, highlighting the drug's link to suicide and other negative symptoms.

On the heels of these revelations, two court cases raised the possibility that anti-depressants had caused violent and suicidal thoughts. One case involved an elderly man who fatally stabbed his wife and himself after being on Prozac for 11 days. The man's son and daughter are suing the drug maker. The second involved a 13-year-old boy who hanged himself after being on Zoloft (a chemical cousin of Prozac) for a week.

What makes this controversy more disturbing is the soaring number of younger children now on psychotropic drugs. A study released last February by the National Institutes for Mental Health found that the number of preschoolers on psychiatric drugs increased by half between 1991 and 1995. The FDA has not approved many of these drugs for use by children. Dr. Donald Rosenblitt, medical director of the Lucy Daniels Center for Early Childhood, a "therapeutic nursery" in Cary, N.C., told The Washington Times that Prozac frequently causes side effects in children, such as nervous agitation. "I've seen some disturbed children who've become psychotic" after taking Prozac, he said.

The issue here is not whether mental illness is real; clearly, a physiological base exists for certain psychological disorders. Rather the problem is the overreliance on drugs with unreliable effects-often as an easy substitute for dealing with emotional and relational issues.

The tendency to overmedicate is driven by an unspoken assumption that humans are essentially controlled by chemical factors in their biological makeup. At the White House conference, Harold Koplewicz of the New York University Medical Center insisted that mental problems are strictly physical, beyond personal control or remedy. "Essentially, these diseases are no-fault brain disorders," he said. An article four years ago in the Bulletin of the American Academy of Psychiatry and Law even urged forensic psychiatrists to bone up on biochemistry and take it into account when assessing personal responsibility in court cases.

The larger issue, says Donald Calbreath, chemistry professor at Whitworth College, is an intensification of the nature/nurture debate over the past three decades, due to an outpouring of new discoveries in the neurosciences. "There's a growing body of scientific literature suggesting that many behaviors are associated with biochemical changes in the brain," he told WORLD. "As a result, we're seeing a variety of conditions-from depression to overeating to sexual immorality-chalked up to our genetic makeup or to biochemical imbalances."

Mr. Calbreath's own research has been on the role of serotonin, a neurotransmitter. Prozac and related drugs work by increasing the amount of serotonin in the brain. The theory is that lower levels of serotonin are linked to depression and violence. However, Mr. Calbreath has found that the link between serotonin concentrations and behavior is mixed and far from conclusive. "Low serotonin levels are related to a wide range of psychological disorders, so it cannot be used to predict any specific problem," he said. It's even possible that cause and effect have been reversed. "We know that stress and emotional problems can affect brain chemistry, so it's just as plausible scientifically that emotions are causing low serotonin levels, rather than the other way around."

Christians working in the sciences have a responsibility to make sure that their colleagues do not skip over these inconvenient scientific facts in the rush to find a simple solution to violence and other social problems. "We need to challenge the naturalistic paradigm that reduces behavior to chemistry-the biological determinism that denies personal responsibility," Mr. Calbreath said. "Theologically that's wrong, and scientifically it's simply not supported by the facts."