OBSERVER, UK - Twenty years on, Prozac remains the most widely used
antidepressant in history, prescribed to 54m people worldwide, and many
feel they owe their lives to it. It is prescribed for depression,
obsessive compulsive disorder, panic disorder, eating disorders and
premenstrual dysphoric disorder (formerly known as PMT. . .
Strangely, depression has reached epidemic levels. Money and success is
no defence: writers, royalty, rock stars, supermodels, actors, middle
managers have all had it. Studies suggest that in America, depression
more than doubled between 1991 and 2001. . .
The theory that emotions are governed by serotonin levels is highly
simplistic and works just as well the other way around (i.e. our
emotions, our stress levels alter our brain chemistry, so it's at least
a two-way street). Other important factors that contribute to depression
include life experience, family history, hormones and diet. However, the
oft-repeated 'chemical imbalance' theory (the fault is not in ourselves,
but in our precious bodily fluids) is promoted on depression websites
owned by drug companies and in advertising.
And just like scuds, Prozac turned out to be less precise than
originally supposed. Experiences with it range from miraculous to
mediocre. . . Interestingly, reports gained through the Freedom of
Information act revealed that in half the 47 trials used to approve the
six leading antidepressants, the drugs failed to outperform the sugar
pills. When they did, it was by only two points on a 52-point depression
rating. Frosties, anyone?. . .
In the US, a survey of drug companies found that between 1995 and 1999,
use of Prozac-like drugs for children aged seven to 12 increased by 151
per cent, and in those aged under six by 580 per cent. In 2004, children
aged five and under were America's fastest-growing segment of the
non-adult population using antidepressants. . . In America, the SSRIs,
including Prozac, now carry a 'black box' warning that the drugs could
increase suicidal behaviour in children. It's thought that prescriptions
are falling in both countries as a result. . .
Prozac has long been rumored to help weight loss. Louise, 44, from Kent,
was prescribed it for depression, but stayed on it longer than was
strictly necessary when she found it suppressed her appetite. 'It was a
very mild cocaine sort of feeling, an amphetamine speedy thing,' she
says. 'I didn't get hungry and I was always doing stuff. I lost nearly a
stone. My sister bought some online when she saw what it did to me.'
Brazilian Diet Pills, also widely available on the internet, contain
fluoxetine, Prozac's active ingredient. In America, some doctors now
prescribe Prozac to treat obesity - though it hasn't been approved for
this purpose. The weight-loss company Nutrisystem also launched a diet
program, 'Phen-Pro' - a combination of Phentermine and Prozac - despite
Eli Lilly's strong reservations.
In fact, trials have suggested that Prozac can result in an average,
short-term weight loss of up to 7lb 4oz in obese patients. However, it
has also been associated with weight gain after the initial loss of
appetite wears off. . .
Sexual dysfunction has turned out to be one of Prozac's hidden extras. .
. The implications go beyond mere sex. According to Helen Fisher,
anthropologist and author of Why We Love: The Nature and Chemistry of
Romantic Love, SSRIs could seriously impede our ability to fall and stay
in love. The bliss we feel when we're loved up - that elation,
exhilaration and slight insanity - are the result of high levels of
dopamine. SSRIs increase serotonin and curb dopamine. The result is that
anti-love feeling, a contented, non-discriminatory 'well, whatever.'
Though initial tests put sexual dysfunction as present in fewer than 30
per cent of cases, the figure is now generally accepted to be more than
60 per cent, and a recent study put it at 98 per cent. With 54m people
taking Prozac worldwide, that's a lot of sexual dysfunction. . . . On
the upside, Prozac is now offered to men suffering from premature
ejaculation. . .
Prozac has been persistently dogged by claims that it can trigger
suicide - not just in depressives but also in healthy volunteers. Some
SSRI users have reported agitation and an inability to keep still, a
preoccupation with violent, self-destructive fantasies and a feeling
that 'death would be welcome'. . .
According to most psychiatrists, the risk of not taking an
antidepressant when suffering depression far outweighs any risks of
taking them. For many users, the drugs can restore, even save, lives.
Though depression appears to be on the increase, in this Prozac-enriched
era the UK suicide rate - 8.5 deaths per 100,000 - is actually at its
lowest level since records began. . .
Interestingly, there is also evidence that SSRIs lower non-suicide death
rates in depressed patients. A study from Finland published in the
British Medical Journal found antidepressants could reduce incidents of
strokes and heart attacks. . .
In 2004, Prozac was discovered in our drinking water. The Environment
Agency said the drug was building up in British rivers and ground-water
supplies, probably via the sewage system. Some used it as evidence that
Prozac was over-prescribed. The Lib Dems called it 'a case of hidden
mass medication upon the unsuspecting public'. The government's Drinking
Water Inspectorate said the quantities were too diluted to have an
effect. . .