Off Label

The title of this documentary by Michael Palmieri and Donal Mosher refers to the use of any drug in a manner for which it was not originally intended or prescribed. The film, however, might more aptly be named The Guinea Pigs as it takes us on a guided tour of drug testing - both voluntary and less so - that is just one of the manifold ways that big pharmaceutical companies have knitted themselves into the very fabric of western, and specifically American, society.

Among the interviewees are professional guinea pig Paul Clough, former guinea pig and author of Guinea Pig Zero, Robert Helms, an ex-con drug test 'volunteer' still reaping the whirlwind of complaints he is convinced are a result of a jail drug trial he took part in back in the Sixties and a couple who are using cash from drug testing to pay for their wedding.

At the opposite end of the spectrum, the documentary also takes a look at the issues surrounding "polypharmacy" - the act of prescribing someone a smorgasboard of drugs without stringent monitoring. And, as if that weren't enough, Palmieri and Mosher also explore the the ethics of placing those who are already receiving mental health treatment on trials which may do more harm than good, as evidenced by the shocking story of one young man's horrific act of suicide.

Although the film is well shot and edited and raises some interesting questions about the unhealthy impact of pharmaceutical power, particularly on the most poor and vulnerable, the approach is frustratingly scattergun and lacking in detailed focus. With the exception of a former drugs rep, who details how GPs are increasingly prescribing drugs they lack in-depth knowledge of and how reps themselves encourage GPs to give it to patients in 'off-label' ways, voices from the medical profession are glaringly absent.

With no hard endorsement from any sort of doctor or a counter-argument to kick against, the assertions regarding psychiatric drugs feel dangerously flimsy. And though the actual off-label usage of pyschiatric drugs - the point at which a medicine is used by a doctor for something that it was not tested for, for example, using a depression treatment for insomnia - is mentioned in passing, it also feels like an under-explored opportunity missed. The result is an impressionistic portrait of a nation in thrall that, for the want of cold, hard facts, fails to leave any lasting impression.