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The Effect 

Lucy Prebble

National Theatre, until 7 October 2023

Review by Karla Williams


Lucy Prebble’s critically acclaimed play The Effect first examined mental health and the pharmaceutical industry back in 2012 when it was produced at the National Theatre with an all-white cast. This time round, the cast is all-black (thanks – Black Lives Matter movement!) and the themes of depression and medication feel even more resonant.  

Connie (played by Taylor Russell) and Tristan (Paapa Essiedu) are paid volunteers in a clinical trial, assessing the side effects of an antidepressant. As the trial continues, the pair begin a passionate and, at times, toxic relationship. How can they be sure if these feelings are genuine or side effects of this new drug? The trial is being monitored by Dr Toby Sealey (Kobna Holdbrook-Smith) and Dr Lorna James (Michele Austin), but it soon becomes apparent these medical professionals have challenges of their own.

The staging of The Effect is the first thing to grab attention – the National’s Lyttleton Theatre has been transformed into a large traverse stage with the audience on either side. The set design is loud and bold, but is in disappointing contrast to the slow-paced first half of the play. Except for a funny and flirty scene between Tristan and Dr Lorna, much of the beginning is either Connie and Tristan getting to know each other, or Dr Lorna and Dr Toby engaging in dry medical exchanges. While both are essential to the story, they lack the engagement the dynamic set had promised.

Things begin to pick up when Connie and Tristan fall in love, with a beautiful and emotive montage depicting the tenderness and joy of a budding new relationship. Things really gain momentum after the couple have sex, and Connie’s suspicions take over. She fears their feelings cannot be trusted, leading to one of the most intense and dramatic scenes I’ve ever seen on stage. The relationship between the doctors also begins to fall apart, while revelations about their pasts and their own mental health are explored. Also in this second half, Prebble asks interesting questions about whether depression should even be medicated in the first place.

It’s the performances that hold The Effect together. Kobna Holdbrook-Smith is utterly convincing as Dr Toby, maintaining a professional distance from the patients and from the audience. Michele Austin is compelling as Dr Lorna, who initially walks the line of professionalism before descending into emotion and unrestraint. I am yet to see Paapa Essiedu give a bad performance and his take on Tristan is no exception. He seamlessly and convincingly transitions from cute and flirty, vulnerable and loving, to aggressive and dangerous. Taylor Russell as Connie provides a well-matched opponent to Essiedu, remarkably switching from aloof and distant to needy and suffocating. 

Despite its slow start, the play builds into an engaging investigation of the origins of love and whether our feelings can ever be trusted. But its commentary on depression, and whether that needs to be medicated, is even more thought-provoking in this post-pandemic world.