U.S.
Selling Prozac as the Life-Enhancing Cure for Mental Woes
TO SEE VIDEO:
http://www.nytimes.com/2014/09/22/us/selling-prozac-as-the-life-enhancing-cure-for-mental-woes.html?smprod=nytcore-ipad&smid=nytcore-ipad-share&_r=1
Prozac: Revolution in a Capsule
When Prozac was introduced in 1988, the
green-and-cream pill to treat depression launched a cultural revolution
that continues to echo.
Video Credit By Retro Report on
Publish Date September 21, 2014.
When
it came to pharmacological solutions to life’s despairs, Aldous Huxley
was ahead of the curve. In Huxley’s 1932 novel about a dystopian future,
the Alphas, Betas and others populating his “Brave New World” have at
their disposal a drug called soma. A little bit of it chases the blues
away: “A gramme” — Huxley was English, remember, spelling included — “is
better than a damn.” With a swallow, negative feelings are dispelled.
Prozac, the subject of this week’s video documentary from Retro Report,
is hardly soma. But its guiding spirit is not dissimilar: A few
milligrams of this drug are preferable to the many damns that lie at the
core of some people’s lives. Looking back at Prozac’s introduction by
Eli Lilly and Company in 1988, and hopscotching to today, the
documentary explores the enormous influence, both chemical and cultural,
that Prozac and its brethren have had in treating depression, a concern
that gained new resonance with the recent suicide of the comedian Robin Williams.
In
the late 1980s and the 90s, Prozac was widely viewed as a miracle pill,
a life preserver thrown to those who felt themselves drowning in the
high waters of mental anguish. It was the star in a class of new
pharmaceuticals known as S.S.R.I.s — selective serotonin reuptake
inhibitors. Underlying their use is a belief that depression is caused
by a shortage of the neurotransmitter serotonin. Pump up the levels of
this brain chemical and, voilà, the mood lifts. Indeed, millions have
embraced Prozac, and swear by it. Depression left them emotionally
paralyzed, they say. Now, for the first time in years, they think
clearly and can embrace life.
Pharmacological
merits aside, the green-and-cream pill was also a marvel of commercial
branding, down to its market-tested name. Its chemical name is
fluoxetine hydrochloride, not the most felicitous of terms. A company
called Interbrand went to work for Eli Lilly and came up with Prozac.
“Pro” sounds positive. Professional, too. “Ac”? That could signify
action. As for the Z, it suggests a certain strength, perhaps with a
faint high-techy quality.
(X
is a pharmacological cousin to Z. Both letters are somewhat unusual,
worth many points in Scrabble. It is surely not a coincidence that a
striking number of modern medications contain either Z or X, or both, in
their names, like Luvox, Paxil, Celexa, Effexor, Zantac, Xanax, Zoloft,
Lexapro and Zocor, to name but a few. Not surprisingly, confusion can
set in. Zantac or Xanax — remind me which one is for heartburn and which
for panic disorder?)
Pendulums,
by definition, swing, and the one on which Prozac rides is no
exception. After the early talk about it as a wonder pill — a rather
chic one at that — a backlash developed, perhaps unsurprisingly. Grave
questions arose among some psychiatrists about whether the S.S.R.I.s
increased chances that some people, notably teenagers, would commit
suicide or at least contemplate it. No definite link was confirmed, but
that did not end the concern of some prominent skeptics, like a British
psychiatrist, Dr. David Healy. He has dismissed the notion of S.S.R.I.s
as saviors as “bio-babble.”
If
some users deem Prozac lifesaving, others consider it
sensory-depriving. A loss of libido is a common side effect. Some
writers and artists, while often relieved to be liberated from
depression’s tightest grip, also say that Prozac leaves them mentally
hazy. In his 2012 book, “Antifragile: Things That Gain From Disorder,”
Nassim Nicholas Taleb offered this: “Had Prozac been available last
century, Baudelaire’s ‘spleen,’ Edgar Allan Poe’s moods, the poetry of
Sylvia Plath, the lamentations of so many other poets, everything with a
soul would have been silenced.”
Then,
too, S.S.R.I. critics express doubts that these drugs have proved
themselves significantly more effective than placebos. Some among them
question the very concept that serotonin levels, on their own, cause
depression or prevent it. One psychotherapist in that camp is Gary
Greenberg, an author of several books on mood disorders. Writing in The New Yorker last year,
Dr. Greenberg said that scientists had “concluded that serotonin was
only a finger pointing at one’s mood — that the causes of depression and
the effects of the drugs were far more complex than the
chemical-imbalance theory implied.”
“The
ensuing research,” he continued, “has mostly yielded more evidence that
the brain, which has more neurons than the Milky Way has stars and is
perhaps one of the most complex objects in the universe, is an elusive
target for drugs.”
More
broadly, this retrospective on Prozac introduces a discussion of
whether the medical establishment, and perhaps society in general, has
gone too far in turning normal conditions, like sadness, into
pathologies. And have we paved a path — shades of soma — toward wanton
reliance on drugs to enhance life, not to conquer true illness?
This
is what a prominent psychiatrist, Dr. Peter Kramer, has called
“cosmetic psychopharmacology,” a Botox approach, if you will, to matters
of the mind: Why not take Prozac and its S.S.R.I. mates even if you are
not clinically depressed but believe that they can boost your
confidence, or maybe help you make a stronger pitch at the sales
meeting?
A
response from others in Dr. Kramer’s field is that we are taking traits
that are normal parts of human nature and casting them as diseases
simply because remedies now exist. For instance, shyness is now regarded
by some as a condition in need of treatment. In its more severe form,
it is placed under the heading of social anxiety disorder. Then there
are those much-heralded life enhancers, Viagra and its erection-aiding
cousins. They are marketed not only to men with sexual dysfunction but
also to those whose aging bodies are enduring normal wear and tear.
One
area of shyness that the S.S.R.I. class has helped overcome is
discussion of depression. Decades ago, Hollywood stars and other
celebrities dared not touch the subject. Now they routinely go public
with their anguish. Robin Williams was an example.
Of
course, there are those in other realms of society for whom the topic
remains taboo. Take one man who confesses to his wife that he is on
Prozac but cautions her to tell no one. “I’m serious,” he says. “The
wrong person finds out about this and I get a steel-jacketed
antidepressant right in the back of the head.” This is Tony Soprano
talking to his wife, Carmela. An extreme example from a work of fiction?
Sure. But in all likelihood many Americans have similar fears about
what others might think, and keep depression to themselves.
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