What is Prozac?

Prozac is a trade name for fluoxetine, one drug in a family of antidepressants called selective serotonin re-uptake inhibitors (SSRIs). Other drugs in this family include sertraline (trade name Lustral), paroxetine (Seroxat) and fluvoxamine (Faverin). There are other families of medications that are also antidepressants. 

Until the advent of the impotence treatment Viagra, Prozac was probably the most high-profile new treatment to be launched in a generation. It was initially hailed as a miracle cure, but became a victim of its own success as patients who were not clinically depressed demanded the drug as a quick fix for their personal problems. 

Effects of Prozac

As an SSRI, Prozac makes serotonin more available in the brain. Serotonin is a chemical that affects mood. SSRIs have potential benefits that include:

• People who take SSRIs usually need just one dose per day
• SSRIs are safer to take with other drugs and pose less risk in overdose

All the drugs commonly prescribed for depression are roughly equal in effectiveness. This often surprises people who assume that Prozac is best. On average, antidepressants seem to help 60 per cent to 80 per cent of the people who take them. This is true both of the earlier developed drugs, including tricyclics such as amitriptyline, as well as the newer drugs such as SSRIs. 

Many people combine Prozac with psychotherapy. 

Psychiatrist Peter Kramer, in his best-selling book Listening to Prozac, claimed that the drug could be use to alter personality traits like shyness and lack of confidence. However, there is scientific evidence to suggest that claims that Prozac can transform personality are exaggerated. People may become more gregarious and easy-going when taking the drug, but this can be attributed to recovery from depression, rather than any magical properties of Prozac itself. 

Risks of Prozac

There is evidence to suggest that taking Prozac may trigger suicidal thoughts in some people. Other side effects may include:

• Nausea
• Headaches
• Diarrhoea
• Insomnia
• Sexual difficulties, such as delayed orgasm

Managing Prozac use

In England, the Department of Health has recommended that fluoxetine should be the only drug of its type prescribed to patients under 18, although specialists in the area of paediatric psychiatric illness are able to prescribe other medications in certain circumstances. However, an analysis by the US Food and Drug Administration concluded that the drug posed a similar risk to young people as other SSRIs. 

Eli Lilly, the makers of Prozac, argued that in no case studied by the FDA did Prozac actually lead to a suicide, and that depressed people were probably prone to suicidal thoughts regardless of what medication they took. They also warned that the risk of not treating depressed young people at all was probably greater than any risk posed by taking their product.