Prozac, psychedelics, and the social meaning of mental health: historian David Herzberg on medicine, marketing, and profit

David Herzberg argues that Prozac reshaped depression treatment by popularizing a simplified story in which suffering is primarily a brain chemistry problem that can be corrected with a consumer product. Although Prozac helped some people, he says its commercial success also narrowed psychiatric care, reduced time with patients, encouraged attention away from social conditions, and exposed patients to harms including increased suicide risk among some young people. He describes the trials supporting SSRIs as distorted by corporate interests, selective reporting, placebo and measurement problems, and a broader bias toward positive findings. Herzberg sees similar pressures in psychedelic medicine, where substantial investment may favor fast, mass-producible treatments over preparation, guided sessions, integration, and changes to the circumstances contributing to distress. His central warning is that psychedelics may be valuable, but commercialization can reproduce the same fantasy that complex human suffering can be solved without addressing social structures, relationships, or justice.