Warning: There are a few possible spoilers for the book The Couple Next Door.

I recently read The Couple Next Door by Shari Lapena.  This is not a review of the book, rather it is a comment on how mental illness is portrayed in novels in general, using this book as the example.

In the second chapter of The Couple Next Door the following is said: “Rasbach takes the clear plastic container from Jennings and studies the label: ANNE CONTI, SERTRALINE, 50 MG.  Sertraline, Rasbach knows, is a powerful antidepressant.” When I read this I almost put the book down.  I was worried the book was not going to be very good.  The author had so obviously not done any research about depression, I worried that if she was so flippant about this detail, what about the rest of the book?

Let’s go back a little though, and take a look at why what she said was incorrect.  Sertraline is the generic name for Zoloft.  I think everyone probably knows someone who takes or has taken Zoloft.  According to lists published on Sunrise House, Zoloft is among the top 10 antidepressants prescribed and taken in the United States.  It is an SSRI (selective serotonin reuptake inhibitor), which is the class of drugs most often used as a first line of treatment for many conditions, such as: depression, obsessive compulsive disorder, social anxiety, posttraumatic stress, etc.  Zoloft comes in 25mg, 50mg, and 100mg.  The effective dose listed on various websites, including Pfizer and drugs.com is 50mg-200mg.  This means that the character, Anne Conti, was on the lowest effective dose of a common medication.

This raises the question, is it an author’s ethical responsibility to write accurate information about mental illness and other easily verifiable stigmatized issues?  In a non-fiction book, that is obviously the case.  But what about in fiction?  A quick google search would have fixed this issue very quickly.  It’s well established that different people respond to different medications and dosages very differently and what may be a powerful drug for one, may not have an effect on another.

Simply changing the wording to say that Rasbach knows it is an antidepressant (leaving out the word “powerful”) would have allowed the story to go where it needed to without stating an incorrect piece of information.  By listing sertraline as a powerful antidepressant, Lapena, likely inadvertently, increased the stigma for those who take that antidepressant.  Many people, unless they are taking a medication, do not know the generic name.  This means that they do not know that Sertraline is Zoloft, and they also now believe that 50mg of Sertraline is a powerful dose.

Even in fictional books, there is, for many readers, an expectation that the details that are based in reality are accurate.  Not only does it make the story more believable, but it shows the author has done their research.  Some might call inaccurate details sloppy writing, while others may say it is an unimportant, trivial detail…except in this particular book, it is not trivial or unimportant.  Much of the story focuses in on Anne Conti’s mental health, including following through with this medication and her post-partum depression that it was prescribed for.

This brings me back to ethics.  Many types of writers have ethical guidelines, but novelists do not.  This allows more creativity, but also means there is little encouragement to write accurately about topics such as mental illness.  Authors should have the freedom to write what and how they want, but perhaps in a world where information is so easily accessible, they should take in upon themselves to dispense correct information.  Doing so would not only tie their work up nicely, but it would also show respect to their readership.

Sources:

https://sunrisehouse.com/depression/antidepressants/

https://www.drugwatch.com/zoloft/

https://www.drugs.com/dosage/zoloft.html