Antidepressants: In the news

Last modified: Thursday, 25. December 2008 - 5:56 am


Prozac is the most commonly prescribed antidepressant in the United States. In 1999, 135 million prescriptions were written for antidepressants, with Prozac (fluoxetine) the most commonly used.

Among the newer drugs, Prozac and other serotonin reuptake inhibitors (SSRIs) are as effective as the drugs formerly used for depression, but have fewer serious side effects. Another advantage is their effectiveness with other psychiatric conditions, such as post-traumatic stress disorder, anxiety, panic disorder, and eating disorders. In 2002, the U.S. Food and Drug Administration approve Prozac for bulimia nervosa, a disorder characterized by binge eating followed by purging or other efforts to lose weight.

Prozac blocks the reuptake of the chemical serotonin, which is believed to be plentiful in the areas of the brain controlling emotion. However, the brain’s biochemical pathways, and serotonin’s effect on emotion and mood, are not quite so simply understood. Scientists do not exactly know how the serotonin works in the brain and on mood.

Some psychiatrists warn that Prozac is not the cure-all for emotional problems, which are usually brought on by crisis situations and not necessarily by chemical imbalances in the brain. Although Prozac is widely used, some warn that the long-term effects on the brain are not yet known. The drug should always be used under close medical supervision.

Crisis use of antidepressants

Anticipating “Y2K” (year 2000) switch-over in computers, Americans increased their purchases of drugs, along with other supplies. The recent anthrax scare in America also resulted in people stockpiling Cipro, the antibiotic effective against the disease.

The attack on the World Trade Center resulted in a similar reaction from the public in New York City. After about three weeks, pharmacies and physicians received many calls for sedatives and antidepressants, with some requesting these drugs for the first time. While it is not uncommon for some people to use a sedative or antidepressant at the time of traumatic stress and anxiety, the demand was clearly much higher after September 11, 2001.

Two specific groups sought relief: those closely affected by the loss of a loved one, and others who became anxious with the threat to their security. As a temporary means of coping, the sedatives helped some people sleep, and the antidepressants helped in dealing with stress. However, psychotherapists cautioned that these drugs are only a temporary relief, and that people may want to get to the underlying feelings through psychotherapy.

This reaction to an extremely threatening or frightening experience is called post-traumatic stress disorder. It is characterized by general anxiety, nightmares or haunting recollections, and emotional detachment. Psychiatry has only accepted the existence of this specific disorder for the past 20 years, although it used to be known under different names. For example, during World War I, the term used for post-traumatic stress disorder was shell shock; in World War II, it was called combat fatigue; and after the Vietnam War, it was post-Vietnam syndrome.


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