Off Label: Film Review

Conversation-starting doc may cause you to scrutinize your medicine cabinet

Michael Palmieri and Donal Mosher raise questions about the use of psychiatric drugs.

A look at America's complicated relationship with pharmaceuticals that generates discussion more than it answers questions, Michael Palmieri and Donal Mosher's often dispiriting Off Label introduces a half-dozen or so people whose lives have, at best, not been helped much by prescriptions. Though it lacks the specific argumentative point of view that might have carried it into the mainstream, its sympathetic approach to subjects offers a compelling human perspective on questions that get too little attention in debates about health care.

While the term "off-label" refers to the use of a drug to treat conditions for which the FDA has not approved it, this practice is only a small part of the doc's discussion -- though it does feature in one of its most disturbing scenes, where a former drug sales rep recalls the verbal sleight of hand with which he used to obey the letter of the law while trampling its intent.

More often, what we see are cases in which patients with conditions from bipolar disorder to PTSD are over- or improperly medicated by a system intent on selling more and more pills. In one case, we meet not the patient but his mother: Mary Weiss, whose mentally ill son was enrolled in a clinical trial for a new psychiatric drug, recalls trying and failing to get him out of the trial as his emotional condition deteriorated. He killed himself while enrolled, in a manner so grisly she feels it could only have been caused by the drugs.

Palmieri and Mosher don't interview outsiders to bolster or dispute this assertion and others, preferring to give as much screen time as possible to those whose lives have been directly affected -- including the "guinea pigs" who have tested drugs, either for pay or, as with an ex-con, involuntarily.

In the film's second half, the filmmakers observe moments in subjects' lives that have little or nothing to do with pharmaceuticals -- a wedding, a gambling trip to Vegas, a church service. Though it doesn't say so, the film seems to invite discussion of the nonchemical ways people have dealt with suffering through the ages. None are foolproof, but some seem to work better than others.

Production Companies: Filmscience, Wishbone Films

Directors: Michael Palmieri, Donal Mosher

Producers: Anish Savjani, Vincent Savino, Michael Palmieri

Music: Ted Savarese, Danny Grody

Editor-Director of photography: Michael Palmieri

No rating, 76 minutes.