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Ordinarily Well: The Case for Antidepressants, by Peter D. Kramer
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Review
A New York Times Book Review Editors' ChoiceOne of the Top 10 Health and Medicine Books of 2016, Booklist"Dr. Kramer, who has written so well about the curse of melancholia . . . has done something very valuable: He has waded into the contentious debate about the efficacy of antidepressants . . . [Kramer] has done some much-needed synthesizing and debunking . . . his dissections of the most incendiary studies are careful, and his conclusions―that they overestimate placebo effects and underestimate the potency of antidepressants―will invite a reckoning of some kind . . . his 'interludes' describing his own experience treating patients . . . are beautiful, philosophical, ambivalent." ―Jennifer Senior, The New York Times "Ordinarily Well is an ambitious, persuasive, and important book . . . [Kramer] doesn’t just make a case for antidepressants.He makes a case for psychiatry itself as a humanistic science . . . Kramer is an excellent guide as he subjects evidence-based purism . . . to the scrutiny he believes it needs . . . Kramer also works in a courteous fashion, respectful of his opponents and his readers, in whose patience and capacity for reason he places great faith." ―Jonathan Rosen, The Atlantic "Careful and measured and fair . . . Kramer evinces such humility that no one could accuse him of being a promedication ideologue . . . Kramer is out to win the 'antidepressant wars' in favor of the antidepressants. Is he right? . . . in my judgment he is . . . You will most likely come away convinced by his argument for the efficacy of antidepressants―and moved by his humane concern for his patients, and for the needless suffering of unmedicated patients around the world." ―Scott Stossel, The New York Times Book Review"Offers a carefully argued and convincing case that antidepressants not only work but also are an essential tool in the treatment of depression . . . Anybody who wants to hear what Prozac has to say will be interested in this book." ―Ann Levin, The Associated Press"Kramer reaches into his own practice and into the scientific literature―amply documented here―to show that the charge of ineffectiveness is false. Antidepressants, he says, have given many patients back their lives, and some of these anecdotes are quite moving . . . [Kramer] comes across as modest and self-deprecatory, and giants such as Gerald Klerman, the onetime dean of American psychiatry, spring to life in these pages." ―Edward Shorter, The Washington Post"[Ordinarily Well] seeks to restore public confidence in antidepressants through a combination of reporting, research analysis and [Kramer's] own experience with patients . . . it is certainly an important [read] for those who seek help for depression and the providers who treat them." ―Damon Tweedy, Chicago Tribune "Peter D. Kramer provides a forceful rejoinder to this growing tide of skepticism [toward antidepressants]. Kramer has been a prominent voice on matters of mental health for some time . . . His new book takes a unique approach: though at times passionate and personal, it is mostly a detailed excavation of the thorny landscape of the empirical evidence for antidepressant medications." ―Adam Gaffney, The New Republic "[Ordinarily Well] sheds new light on this controversial matter . . . After more than 20 years [since Listening To Prozac], Kramer wants to address properly what he thinks is a potentially dangerous level of ignorance and confusion about antidepressants . . . I enjoyed reading this book and I totally agree with the author when he argues that both clinical experience with real patients and randomised evidence from studies point in the same direction in a complementary way." ―Andrea Cipriani, The Lancet"For its articulate, heartfelt demonstration of all those problems [surrounding antidepressants], the book is invaluable." ―Abigail Zuger, M.D., The New York Times "Kramer is a fine writer with a gift for the evocative turn of phrase. His patients come alive on the page, and his account of the changes in psychiatry over the last forty years rings true . . . I recommend Ordinarily Well to everyone who prescribes antidepressants, and to psychotherapists, other health professionals, patients, and members of the public who may have doubts about their effectiveness." ―Burns Woodward, Psychiatric Times "An engaging book about a complex topic, arguing throughout that antidepressants work well and have been given a bum rap . . . Despite the complexity of the topic and the breadth of his research reviews, Dr. Kramer tells the story of antidepressant research in a way that a lay reader can follow . . . The complexities are explained without medical lingo and, in the end, he concludes what psychiatrists see every day: Antidepressants work." ―Dinah Miller, Clinical Psychiatry News"Kramer mounts a comprehensive, spirited, and completely convincing defense [of antidepressants], dispelling any doubts about their efficacy and life-changing capability . . . Kramer is at his best when he reflects on the privilege of being a psychiatrist, the value of a doctor’s steady judgement, and the vulnerability of physician and patient alike. He is unwavering: 'Placebos don’t prevent depression, and antidepressants do.' Case closed." ―Tony Miksanek, Booklist (starred review)"I have always loved Peter Kramer's writing for the reflective way he weds his own practice and personal experiences with extant science to lead us to new and profound insights into the psyche. Listening to Prozac exemplified his ability to define a new paradigm. In Ordinarily Well, he brings a lifetime of treating patients to a consideration of antidepressants, looking carefully at the nature of evidence. The work of one of the few voices out there without ties to industry, this reasoned and beautifully written narrative is another breakthrough, one that brings us to a new and humane understanding of depression and its treatment." ―Abraham Verghese, author of Cutting For Stone"In previous books, Peter Kramer has been an insightful clinician, a sensitive novelist, and a social critic. Here he is a thoughtful teacher. Using both the scientific literature and the lived experience of his own patients, he explains brilliantly the evidence supporting the use of antidepressants. As he notes, depression is a serious, life-threatening illness. Antidepressants work, keeping depression at bay. For some they are not sufficient. And for an unfortunate few, they are not effective. But remembering the hopeless state of treatment only a few decades ago, Kramer reminds us with compelling prose and compassionate insight that today millions of us are much better off with access to these medications." ―Thomas R. Insel, M.D, former director, National Institute of Mental Health"Written with the compassion, verve, and style that are the author's trademark, this book offers an invaluable overview on the state of treatment and the options available." ―Kirkus Reviews"Kramer makes an energetic and personal case for the role of antidepressants in easing crippling depression." ―Publishers Weekly"Kramer has done it again. First, he showed the world the potentially transformative efficacy of antidepressants in Listening to Prozac. Now, in Ordinarily Well, Kramer dissects the controversy and misinformation about the effectiveness of antidepressants with impressive clarity and fairness. Kramer is a masterful teacher and clinician who gives readers a rare gift: an insider's understanding of this complex subject, including statistics and the design of clinical trials. Anyone who wants to know the truth about antidepressants should read this book." ―Richard A. Friedman, M.D., Professor of Clinical Psychiatry at Weill Cornell Medical College and contributing Op-Ed writer for The New York Times"In this provocative and personal book, Kramer begins with the premise that he speaks in the voice of 'clinician as sinner.' For Kramer, the clinician's sin is to complicate the simpler story told by the randomized trials, the clerical voice in drug research. He makes the case that the studies need the narrative and the narratives need the studies. We have taken sides in a culture war in psychiatry that we can’t afford. Patients' well-being, indeed their very lives, depend on a declaration of peace. Ordinarily Well makes a compelling case for humility. Sometimes medications work but imperfectly or they work for a while but need to be changed. And sometimes they work when supplemented by the insight that only conversation can provide." ―Sherry Turkle, Professor of the Social Studies of Science, MIT, and author of Reclaiming Conversation: The Power of Talk in a Digital Age and Alone Together: Why We Expect More From Technology and Less from Each Other"For anyone with depression or anyone who loves someone struggling with it, this book is essential. It's cutting edge psychiatry at its best―all the important questions, data, and controversy surrounding antidepressant treatment made crystal clear. Dr. Kramer is one of the rare experts who is, at once, analytically astute, vastly knowledgeable, clinically experienced, and personally very wise." ―Sally Satel, M.D., Yale University, and coauthor of Brainwashed: The Seductive Appeal of Mindless Neuroscience"Biological psychiatry has shown that depression―poetically called 'malignant sadness'―is as biologically 'real' as cancer (or any other disease). This is most apparent when a drug changes the patient's neurochemistry and, with greater than chance frequency, the darkness lifts. Nonetheless, the value of antidepressants has been questioned in both scientific and pseudo-scientific circles. In Ordinarily Well, Peter Kramer, arguably the wisest clinician thinking and writing about depression, emphatically supports the efficacy of using antidepressants in the right place and time. Given the pandemic of malignant sadness that we face, this is a deeply important book." ―Robert Sapolsky, professor of biological sciences and of neurological sciences and neurology at Stanford University"Ordinarily Well is vintage Peter D. Kramer: compassionate, thoughtful, provocative. This book makes a case for the clinical wisdom that anti-depressants can work and can save lives―and that for individual patients, they can be even more effective than the research suggests." ―Tanya Marie Luhrmann, Watkins University Professor in the Anthropology Department at Stanford University, and author of When God Talks Back
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About the Author
Peter D. Kramer is a psychiatrist, writer, and Brown Medical School professor. Among his books are Against Depression, Should You Leave?, and the New York Times bestseller Listening to Prozac. His articles and book reviews have appeared in The New York Times, The Washington Post, Slate, and elsewhere.
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Product details
Hardcover: 336 pages
Publisher: Farrar, Straus and Giroux (June 7, 2016)
Language: English
ISBN-10: 0374280673
ISBN-13: 978-0374280673
Product Dimensions:
6.3 x 1.2 x 9.4 inches
Shipping Weight: 1 pounds
Average Customer Review:
3.7 out of 5 stars
17 customer reviews
Amazon Best Sellers Rank:
#797,987 in Books (See Top 100 in Books)
Regardless of whether you're interested in the treatment of depression, this book is an eye-opener regarding drug testing. That's mostly what the book is about. Peter Kramer is generally pro-medication, though he believes that talk therapy can be helpful too, and that there's no one-size-fits-all treatment for depression. Also, he comes down on the side the doctor's individual judgment and observation, based on careful assessment of the patient's needs, rather than simply "evidence based medicine." For those unfamiliar with the term, that means making medical decisions solely based on gross empirical data (as I understand it).However, the heart of the book is a defense of medication, based on Kramer's analysis of various "trials" or tests of anti-depressants, placebos and other treatment options. Thus, the book is somewhat technical and requires careful reading and thought (by the layman, as I am). However, Kramer persuaded me that much anti-depressant drug testing is very poor, with badly structured and/or interpreted trials. The scary thought is that the drug companies, testing labs, academic researchers and so get away with these shenanigans.Unsurprisingly, the author believes that tests run by academic institutions are likely to be the best designed and most objective. On the other hand, as reported in the New York Times of June 28, 2016, "New York University's medical school has quietly shut down eight studies at its prominent psychiatric research center and parted ways with a top researcher after discovering a series of violations in a study of an experimental, mind-altering drug." Among the violations: "records had been falsified." Although good for NYU in ending the "studies," bad for NYU in trying to keep the problem quiet (assuming the author of the NYT article, Benedict Carey, is correct in that characterization). Also bad for NYU's institutional control of it's "prominent psychiatric research center" and for Peter Kramer's deference to academic institutions.I recommend the book, not just for those interested in the treatment of depression, but for anyone with a scientific bent who wants to know what can go on in the drug testing world (clearly, not all bad, but enough to be scary).
Excelent as source of information for both non-pychiatrist physicians and general public. An eye-opener for those that believe double blinded randomized trials are the ultimate in evaluating treatmen's and medicies. Not in the mental halth field. The language is unnececessarily complex, at times circumvulalated
excellent update of "better than well" data in "Listening to Prozac"
Very well written. There will always be controversy about meds for anxiety and depression. It is important to keep an open mind.
Excellent history of anti-depressants and the problems with clinical studies testing the efficacy of antidepressant. Very readable.
The books reads like a 250 page journal article. Although there are interesting parts, especially the section on how drug company trials are actually conducted, in general, the author's central points could have been made in a 10 page article.
I found this work to be uplifting and not above the level of a concerned layman. If you are involved in a lifelong relationship with one who is victim of a depression malady this book will elucidate the problems that are faced and the progress being made.Having read this immediately after finishing _The Gene_ has encouraged me to be positive and thankful that we have so many great minds working on these eternal challenges.Both will be classics.
It was a little boring......
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