Side Effects: Making of Hitchcockian Thriller

Over a decade ago screenwriter Scott Z. Burns spent several weeks doing research at New York’s famed Bellevue Hospital psychiatric facility. Burns, who was then writing for the acclaimed TV medical drama Wonderland, spoke with the psychiatrists on staff and watched them at work with mentally ill patients, including many who had a criminal past.

“It was one of the most extraordinary experiences of my life,” says Burns. “There were people there who were truly terrifying criminals. There were also people who were so ill they were unable to understand the rules of society and couldn’t possibly be expected to play by them.”

The experience planted a seed in Burns’ imagination. “I wanted to write a noir-style thriller that took the audience in and spun it around, like Double Indemnity or Body Heat, set in the world of psychopharmacology,” says Burns. “I was inspired by films that involve crafty, clever scams, set against the society the audience is really living in. People seem to have stopped making those, but I have always loved the genre.”

Burns began to develop the script that would eventually become Side Effects with the help of Dr. Sasha Bardey, who was at the time Deputy Director of Forensic Psychiatry for Bellevue Hospital. “Sasha and I met working on ‘Wonderland,’” says Burns. “His input was essential because this movie needed to be firmly rooted in reality.”

Bardey too had always been intrigued by the idea of a thriller involving psychiatry. “Once we came up with the backbone of this story, Scott did the writing, and I provided the context.”

The combination of Burns’ storytelling skills and Bardey’s expertise resulted in an eye-opening thriller. “It looks at the idea of where reality ends and mental illness begins,” says Bardey. “You don’t know if things are what they appear to be. In that sense, it’s got a Hitchcockian feel to it. And the ending is fantastic, a great lesson and a lot of fun.”

As he constructed his narrative, Burns also conducted extensive research on the growing use of anti-depressants in this country with the help of Dr. Bardey, who ultimately served as on-set adviser and co-producer.
Burns found evidence in the news stories of the day that the same medications used to treat depression, anxiety and other psychological ailments were also creating inexplicable behavior in a small but significant number of patients. Commonly prescribed drugs were being blamed for crimes ranging from vehicular homicide to physical assault. A man in California was acquitted of charges in a non-injury vehicular accident while under the influence of a popular sleep remedy.

One widely prescribed antidepressant was even implicated in a shocking kidnapping and rape.

Just as fascinating to Burns were stories he uncovered about the misbehavior of respected doctors. “There was a story in the news about a psychiatrist who tried to hire one of his patients, a convicted criminal, to kill his mistress,” says Burns. “When the patient went to the police, they didn’t believe him because he’s obviously a crazy person. Our story is completely different than that one, but it’s full of plot twists and turns that have you constantly questioning what actually happened and who is telling the truth.”

Producer Gregory Jacobs, who also worked with Soderbergh and Burns on The Informant! and Contagion, notes that Side Effects is perhaps the first thriller set in this milieu. “I hadn’t seen anybody do something about the drug industry or the prevalence of antidepressants and anti-anxiety medication in our society,” he says. “At the same time, it’s just such an entertaining thriller.”

As his script continued to evolve, Burns turned to a pair of trusted collaborators: Academy Award-winning filmmaker Steven Soderbergh and producer Lorenzo di Bonaventura. “Lorenzo hired me to write The Informant! for Warner Bros. at a time when I wasn’t qualified to lead a tour at Warner Bros.,” says Burns. “But he trusted me and believed in me. He had just started his production company, so I called him first. He was there when the movie had no home. He was open to casting ideas. This is a man who has made some giant movies, but he just loves filmmaking and he wants to make a lot of different kinds of movies.”

Di Bonaventura threw his full support behind the project. “I loved the idea of making an authentic thriller,” he says. “Hollywood has sort of abandoned the genre, so this is somewhat different in the marketplace. We developed it together. Scott wrote I don’t know how many drafts, but he always stayed true to his original vision. It was a long road, but a fun one.”

Over the period he was writing Side Effects, Burns worked with Soderbergh on The Informant! and Contagion, as well as PU-239, which Burns wrote and directed, and Soderbergh executive produced. He shared the script with Soderbergh as it developed and the director closely followed his progress.