Side Effects: Ask your doctor to prescribe

As a general rule, I find films about forensic psychiatrists tolerable but usually not that entertaining. They inevitably involve serial killers, criminal profilers or other tropes that have little to do with the reality of forensic life. When I saw a trailer for the new film "Side Effects," I expected much of the same. Surprisingly, I enjoyed it.

Jude Law plays Dr. Jonathan Banks, a forensic psychiatrist who somehow manages to juggle work in an emergency room, a private outpatient practice, and inpatient work in a forensic hospital with private expert testimony for both the prosecution and the defense. I was exhausted just watching him. With a child in private school, a Manhattan lifestyle and an unemployed wife, he supplements his income with pharmaceutical money as well.

Dr. Banks takes on the treatment of a suicidal young woman, Emily Taylor (Rooney Mara), who suffers intolerable side effects to most antidepressant medications and who has a bad habit of driving into walls. Psychiatrists watching the film will find the recitation of brand-name medications a bit distracting and there's enough discussion about treatment-resistant depression to get me wondering what I'd try next if I was in Dr. Banks's shoes. Even Emily's friends and co-workers have suggestions about medication, and judging from the buzz in the audience near me, this spurred some discussion among viewers as well.

The film nails the pharmaceutical industry head-on, with breezy television and magazine ads featuring happy and content young women enjoying carefree days, drug reps meeting with doctors to talk money and even the obligatory drug rep lunch. At times this verged on medical insider humor, particularly when one doctor offers another a free brand name drug pen. No worries about ethical standards here, the psychiatrists have no qualms about accepting tens of thousands of dollars in pharmaceutical money.

When Emily finally asks her doctor to prescribe the new medication, Ablixa, things get complicated. I'm not giving away any spoilers since the murder is mentioned in the movie trailer, and the fairly predictable plot featured an equally-predictable insanity defense. Nevertheless, many of the twists and turns featured more than expert testimony and questions of defendant malingering. The question becomes what role, if any, the new medication played in the murder and who knew about this strange, rare, potentially deadly side effect. Dr. Banks is flung into personal and professional complications not usually covered in the typical psychiatric thriller. I won't go into detail on that aspect since it verges into spoiler territory.

I can't help comparing "Side Effects" to other movies with a "is he crazy or is he malingering" insanity theme, most notably "Primal Fear" featuring Ed Norton. "Side Effects" is more than a murder mystery and has more depth than "Primal Fear." With side commentary on the stigma of mental illness, trial-and-error prescribing practices, corruption of the medical profession and duplicitous expert witnesses, there would be enough substance here to carry the film even without the murder.

Whenever a new movie featuring a psychiatrist comes out we wonder how this will impact the public perception of our profession or the perception of the mentally ill. This movie won't deter anyone from seeking care. It will, however, deter me from ever prescribing Ablixa.

—Annette Hanson, M.D.

DR. HANSON is a forensic psychiatrist and co-author of Shrink Rap: Three Psychiatrists Explain Their Work. The opinions expressed are those of the author only, and do not represent those of any of Dr. Hanson’s employers or consultees, including the Maryland Department of Health and Mental Hygiene or the Maryland Division of Correction.

As a general rule, I find films about forensic psychiatrists tolerable but usually not that entertaining. They inevitably involve serial killers, criminal profilers or other tropes that have little to do with the reality of forensic life. When I saw a trailer for the new film "Side Effects," I expected much of the same. Surprisingly, I enjoyed it.

Jude Law plays Dr. Jonathan Banks, a forensic psychiatrist who somehow manages to juggle work in an emergency room, a private outpatient practice, and inpatient work in a forensic hospital with private expert testimony for both the prosecution and the defense. I was exhausted just watching him. With a child in private school, a Manhattan lifestyle and an unemployed wife, he supplements his income with pharmaceutical money as well.

Dr. Banks takes on the treatment of a suicidal young woman, Emily Taylor (Rooney Mara), who suffers intolerable side effects to most antidepressant medications and who has a bad habit of driving into walls. Psychiatrists watching the film will find the recitation of brand-name medications a bit distracting and there's enough discussion about treatment-resistant depression to get me wondering what I'd try next if I was in Dr. Banks's shoes. Even Emily's friends and co-workers have suggestions about medication, and judging from the buzz in the audience near me, this spurred some discussion among viewers as well.

The film nails the pharmaceutical industry head-on, with breezy television and magazine ads featuring happy and content young women enjoying carefree days, drug reps meeting with doctors to talk money and even the obligatory drug rep lunch. At times this verged on medical insider humor, particularly when one doctor offers another a free brand name drug pen. No worries about ethical standards here, the psychiatrists have no qualms about accepting tens of thousands of dollars in pharmaceutical money.

When Emily finally asks her doctor to prescribe the new medication, Ablixa, things get complicated. I'm not giving away any spoilers since the murder is mentioned in the movie trailer, and the fairly predictable plot featured an equally-predictable insanity defense. Nevertheless, many of the twists and turns featured more than expert testimony and questions of defendant malingering. The question becomes what role, if any, the new medication played in the murder and who knew about this strange, rare, potentially deadly side effect. Dr. Banks is flung into personal and professional complications not usually covered in the typical psychiatric thriller. I won't go into detail on that aspect since it verges into spoiler territory.

I can't help comparing "Side Effects" to other movies with a "is he crazy or is he malingering" insanity theme, most notably "Primal Fear" featuring Ed Norton. "Side Effects" is more than a murder mystery and has more depth than "Primal Fear." With side commentary on the stigma of mental illness, trial-and-error prescribing practices, corruption of the medical profession and duplicitous expert witnesses, there would be enough substance here to carry the film even without the murder.

Whenever a new movie featuring a psychiatrist comes out we wonder how this will impact the public perception of our profession or the perception of the mentally ill. This movie won't deter anyone from seeking care. It will, however, deter me from ever prescribing Ablixa.

—Annette Hanson, M.D.

DR. HANSON is a forensic psychiatrist and co-author of Shrink Rap: Three Psychiatrists Explain Their Work. The opinions expressed are those of the author only, and do not represent those of any of Dr. Hanson’s employers or consultees, including the Maryland Department of Health and Mental Hygiene or the Maryland Division of Correction.

As a general rule, I find films about forensic psychiatrists tolerable but usually not that entertaining. They inevitably involve serial killers, criminal profilers or other tropes that have little to do with the reality of forensic life. When I saw a trailer for the new film "Side Effects," I expected much of the same. Surprisingly, I enjoyed it.

Jude Law plays Dr. Jonathan Banks, a forensic psychiatrist who somehow manages to juggle work in an emergency room, a private outpatient practice, and inpatient work in a forensic hospital with private expert testimony for both the prosecution and the defense. I was exhausted just watching him. With a child in private school, a Manhattan lifestyle and an unemployed wife, he supplements his income with pharmaceutical money as well.

Dr. Banks takes on the treatment of a suicidal young woman, Emily Taylor (Rooney Mara), who suffers intolerable side effects to most antidepressant medications and who has a bad habit of driving into walls. Psychiatrists watching the film will find the recitation of brand-name medications a bit distracting and there's enough discussion about treatment-resistant depression to get me wondering what I'd try next if I was in Dr. Banks's shoes. Even Emily's friends and co-workers have suggestions about medication, and judging from the buzz in the audience near me, this spurred some discussion among viewers as well.

The film nails the pharmaceutical industry head-on, with breezy television and magazine ads featuring happy and content young women enjoying carefree days, drug reps meeting with doctors to talk money and even the obligatory drug rep lunch. At times this verged on medical insider humor, particularly when one doctor offers another a free brand name drug pen. No worries about ethical standards here, the psychiatrists have no qualms about accepting tens of thousands of dollars in pharmaceutical money.

When Emily finally asks her doctor to prescribe the new medication, Ablixa, things get complicated. I'm not giving away any spoilers since the murder is mentioned in the movie trailer, and the fairly predictable plot featured an equally-predictable insanity defense. Nevertheless, many of the twists and turns featured more than expert testimony and questions of defendant malingering. The question becomes what role, if any, the new medication played in the murder and who knew about this strange, rare, potentially deadly side effect. Dr. Banks is flung into personal and professional complications not usually covered in the typical psychiatric thriller. I won't go into detail on that aspect since it verges into spoiler territory.

I can't help comparing "Side Effects" to other movies with a "is he crazy or is he malingering" insanity theme, most notably "Primal Fear" featuring Ed Norton. "Side Effects" is more than a murder mystery and has more depth than "Primal Fear." With side commentary on the stigma of mental illness, trial-and-error prescribing practices, corruption of the medical profession and duplicitous expert witnesses, there would be enough substance here to carry the film even without the murder.

Whenever a new movie featuring a psychiatrist comes out we wonder how this will impact the public perception of our profession or the perception of the mentally ill. This movie won't deter anyone from seeking care. It will, however, deter me from ever prescribing Ablixa.

—Annette Hanson, M.D.

DR. HANSON is a forensic psychiatrist and co-author of Shrink Rap: Three Psychiatrists Explain Their Work. The opinions expressed are those of the author only, and do not represent those of any of Dr. Hanson’s employers or consultees, including the Maryland Department of Health and Mental Hygiene or the Maryland Division of Correction.