Doctors today are liberally writing prescriptions for psychotropic drugs such as Aderall, Ambien, Zoloft, Paxil, Seroquil, Prozac, Wellbutrin and Effexor, to name but a few. Often these drugs are combined in polypharmacy cocktails or are given out for off label use, meaning for unapproved or untested indications, leading to abuse, dangerous side effects and heavy dependence.
CanCulture: How did you come across Carl Elliot, the person who inspired the creation of Off Label?
Donal Mosher: Our producers, who had the original concept, read his article in the New Yorker, and then we went to meet with him about the work he was doing. He’s a bioethicist and a medical philosopher and teaches at The University of Minnesota. A lot of the sprawling nature of the film came from his work.
CC: How did you come to meet some of the characters in the film?
DM: Some of them came from [Elliot’s] original articles. Almost all of the people working in the human guinea pig field came from Carl’s articles and other articles about this in the US. And then we did a website asking people to write to us and tell us who they are if they’re working in the field of human testing, and that’s where the married couple came from. They wrote us a really snazzy letter about how awesome it would be if we filmed their guinea pig wedding. One person came from a random conversation in an airport. The issue is so pervasive, that as soon as you tell people you’re working on this issue, someone tells you a story. A lot of it was just following leads that way.
CC: Was there ever a thought to include sources from the pharmaceutical companies?
DM: When we started we spent a long time exploring two ways of doing it: focusing on the characters, which is really our strong point; but we also approached pharmaceutical reps and we did a lot of interviews on both sides. But we only got a certain amount of lip service from the pharmaceutical companies. And we don’t have the resources to push in, and we couldn’t have legally protected ourselves if a giant corporation thought we’d pushed our boundaries.
CC: One compelling part of the film was when a mother described how her son committed suicide. In situations like those how do you get to know your subjects before delving into those hard-hitting questions?
DM: With Mary that story was publicly known but we had a long email exchange back and forth, and that was just a moment where i asked her. She didn’t want the details made public and we said if you share them with us it could be the one weapon that will propel anger and heartbreak about this story. And she did, but then she wrote back to us saying she didn’t want it in the film and we were going to take them out. And then we spoke back and forth [and she agreed].
CC: Stylistically there were little bits of humour interspersed within a very serious film. Could you explain the motivation for that?
DM: Well you just can’t suffer that much trauma, but you can’t make light of it either. So black humour, those little ironic bits of humour, or even the musical interludes with associative imagery—the poetic approach. With those things, you never loose the tension of the issue or the film, but you’ve relieved the pressure a little bit.