Patients On Prozac Experience Suicidality example essay topic

Abstract At first it was the cure all people were looking for. Then it became the drug they were afraid to take. Somewhere between these two extremes lies the truth about the drug Flouxetine, better known as Prozac, the most widely prescribed drug on the globe. It is mainly prescribed to patients suffering from clinical depression. It was first brought to the market in 1988 by the pharmaceutical giant Eli Lilly co. Even though it was originally prescribed for depression, it has been prescribed for everything from eating disorders to insomnia.

It was first considered the wonder drug of the new decade because of the way it helped depression patients when no other anti-depressant could and then also found to help many other personality disorders as well. But now it is frowned upon by many. Some of the side effects contributed to the growing opposition of Prozac include nausea, constipation, memory impairment, and excess sweating, just to name a few. What is depression Depression can result from a physical disease, a mental illness, or it can be a recurring reaction of the body. According to the National Institute of Mental Health, major depressive illnesses are often the result of imbalances in neurotransmitters in the brain. It is these critical chemicals that send messages between nerve fibers and control mood (Creamer, 3).

Older anti-depressants worked on three different neurotransmitters, serotonin, norepinephrine, and dopamine. However, it has been found that serotonin is the specific chemical in the brain that controls moods. Its job is to carry an impulse from one nerve fiber to the next. Serotonin is released by the nerve into the space between nerve fibers, carries the impulse to the next one, and is then reabsorbed by the first. when it is reabsorbed to quickly, a perso feels depressed (6). Clinical depression includes at least five of the following nine symptoms: 1. Feelings of sadness or irritability.

2. Loss of interest or pleasure in activities once enjoyed. 3. Changes in weight or appetite. 4. Changes in sleeping pattern.

5. Feeling Guilty, hopeless or worthless. 6. Inability to concentrate, remember things, or makes decisions. 7. Fatigue or loss of energy.

8. Restlessness or decreased activity noticed by others. 9. Thoughts of suicide or death. Dr. Brian K. Martin, President of the Mental Health Association of Hawaii, recommends that anyone who has suffered five or more of these symptoms for two weeks or longer see a doctor (7). Nationally, the Mental Health Association estimates that only one-third of those suffering from depression actually seek help.

Most are restrained, according to the association, by fear, lack of knowledge, misinformation, and stigma. Depression is also the leading cause of suicide. It is estimated that 15 percent of seriously depressed people take their own lives (7). The cons of Prozac Historically, the use of drugs as fixers of the worlds private ills has run into serious, if unanticipated, snags. At the turn of the century, the medical community thought that Cocaine was a completely appropriate, nonaddictive drug, and widely prescribed it. In the 1950's and 60's, first barbiturates and then amphetamines were recommended for various psychological ailments. we now know that each of these drugs came with significant risks.

So what yet-to-be-imparted knowledge may cause science, once again, to admit sheepishly that the exuberance over Prozac was somewhat premature, if not wholly overblown Possibly, the biggest argument against this drug is merely the fact that it is prescribed for just about anything. It is estimated that it brought in over 1 billion dollars last year to Eli Lilly, the pharmaceutical company that brought us this wonder drug about ten years ago. It is prescribed for everything from eating disorders to panic to helping with premenstrual syndrome (PMS). David Dolan, Clinical director of one of the psychiatric programs at Jefferson Hospital in Jeffersonville Ky., agrees with many that Prozac is way oversold as a cure-all when it first hit the market. All of a sudden, Prozac was the medication for everything, then all of a sudden it was anything but. Almost overnight, a new phenomenon hit Louisville: Prozac panic.

Instead of asking for, people were afraid to take it (Aprile, 2). The change occurred in the weeks following Joseph Wesbeckers rampage, where he fatally shot eight people and injured 12, only to finally kill himself. After the shooting, lab tests revealed therapeutic levels of Prozac in his blood. Three other antidepressants and two other prescription drugs were also found in his blood in tiny amounts. Wesbeckers medical charts indicated that his psychiatrist thought Prozac may have been contributing to his worsening condition. At that time, Jefferson County Coroner Richard Greathouse rose speculation about Prozacs possible link to Wesbeckers violent behavior.

No connection was ever established, although the inquest jury later ruled that side effects from various drugs may have been a contributing factor (2). Researchers from Harvard Medical school issued a sort of warning about Prozac in an issue of the American Journal of Psychiatry. In a case study report of six depressed patients with complicated psychiatric histories, researchers from the schools psychiatry department describe what they call a surprising and unusual side effect of taking Prozac. Persistent obsessive and violent suicidal thoughts were experienced in patients not having those thoughts prior to taking the prescription. Though they admit much further study is needed to determine whether this is a widespread or valid concern, they urge other doctors to ask about suicidal thoughts in patients who the study suggests may be at risk, including those who develop intense fatigue, restlessness or hypersomnia while taking Prozac (4). In February, 1990, Dr. Martin Teicher, a psychiatrist at the highly regarded McLean Hospital in Belmont, Mass., and two of his colleagues reported that six depressed patients began to have suicidal thoughts after using Prozac.

Writing in The American Journal of Psychiatry, Teicher said that when they began taking the drug, none of the six patients were suicidal and all were hopeful and optimistic about the treatment. After that, a sudden flow of reports told of violence and suicide among Prozac users. And the drug acquired a tenacious enemy in the Los Angeles-based Citizens Commission on Human Rights, which has ties to the Church of Scientology, a movement that, amongst other things, opposes some aspects of psychiatry. The Scientologists claim that by Sept.

16, 1993, no fewer than 1,089 suicides had been recorded among patients taking the capsule. If that figure is correct, than it works out to be about. 01 percent of the 11 million people who have used the drug (Nichols, 3) Dr. Lorne Brandes, A Winnipeg cancer researcher, claims to have evidence that Prozac may promote the growth of cancerous tumors. Im very concerned about Prozac, says Brandes, who reported in 1992 that rats and mice with artificially induced cancer showed an increased rate of tumor growth when they were given Prozac and another antidepressant not mentioned. Brandes findings alarmed some cancer researchers and prompted federal scientists to launch similar studies (Nichols, 1). Although Prozac has fewer side-effects that earlier antidepressants, it does have some.

Users may experience nausea, nervousness and insomnia, and their sex lives may suffer some: a U.S. study, published in The Journal of Clinical Psychiatry, found that among 160 patients on Prozac, 54 reported that sexual desires or responses diminished after they began taking the drug (1). Sidney Wolfe, director of the Public Citizen Health Research Group, a Washington based consumer advocacy organization, compares Prozac to Valium, the popular tranquilizer that was on the market for more than 10 years before doctors discovered its highly addictive properties during the mid-1970's. Prozac has become the Valium of the 1990's, declares Wolfe (Nichols, 4) Finally, one of the weaker arguments against Prozac is that it is very expensive, with a cost of about fifty dollars for a months supply. It costs more than older drugs now available as generics, like amitriptyline (Aprile, 3). The Pros of Prozac In defense of Prozac, Eli Lilly officials say that it is one of the most thoroughly tested medications in history: more than 32,000 people took part in Prozacs clinical trials, and scientist have conducted at least 3,000 separate studies. Nothing alarming has shown up, says Cameron Battle, corporate affairs manager for Lilly.

He also insist that, despite reports of the drug being used to treat people who do not really need an antidepressant, there is absolutely no indication of any inappropriate use of Prozac (Nichols, 2). When Eli Lilly and Co. won Federal Food and Drug Administration (FDA) approval for Prozac in December of 1987, it was specifically for the treatment of depression. But theres been plenty of publicity about the drugs potential for helping people with a host of other maladies, ranging from obesity and bulimia, to panic attacks, alcoholism, PMS, smoking addictions and obsessive-compulsive disorders (Aprile, 1). Although Jefferson County Coroner Richard Greathouse was quoted earlier to suspect Prozac in Joseph Wesbeckers violent rage, he says, I want to go on record saying I am not indicting this drug. He says he only raised questions; he never drew conclusions. I personally am not afraid of the drug, he said.

In fact, Greathouse prescribes it in his own private pediatrics practice. He also goes on to say that his investigation-which included a study of a complete FDA file on Prozac about yea-deep-convinced him that there was no proven link between the use of the drug and violent behavior. The whole problem is, would they have done it anyway Would they have taken a violent, destructive path regardless Thats the $64,000 question (Aprile, 2). Drugs to fight depression have existed for more than thirty years.

The first type was Tricyclic antidepressants, like Elavil. Those were then followed by MAO inhibitors, like Par nate or Nardi l. Both of these types of drugs relieve depression by acting on substances in the brain that regulate emotional highs and lows. Prozac is considered a breakthrough because of the selective way it works.

Unlike tricyclics, Prozac rarely causes the adverse effects typical of Tricyclic antidepressants-dry mouth, confusion, constipation, dizziness, blurred vision, heart problems, and weight gain. Also, it is easy to take a 20-milligram pill, once a day, which is a standard beginning regimen, and tends to lift depression relatively quickly and appears difficult to overdose (3). According to Edward West, director of corporate communications for Lilly, the company knows of fewer than ten physical assaults and two murder-suicides committed by anyone on the medication. These do however, include Wesbeckers rampage.

West told a Courier-Journal reporter that the firm sees no trend that suggests a casual relationship between Prozac and assaultive type of behavior. The FDA agrees. Eva Kemper, a spokeswoman for the federal agency, said the number of Prozac-related homicides and violent incidents is not-high for an antidepressant as popular as it is (4). In the 1992 British Journal of Psychiatry, authors, A.C. Power and P.J. Cowen analyzed a broad number of studies involving Prozac and suicide. They concluded that controlled trials do not show Prozac leads to a worsening of suicidal ideas.

Eli Lilly spokeswoman, Kelly Weston, says that the drugs suicidality was repeatedly tested in clinical trials and results actually showed that patients on Prozac experience suicidality less frequently than patients on a placebo or another antidepressant. The same thing has been shown in terms of violent behaviors. Antidepressants like Prozac seem to have a protective effect. The tendency toward violence will actually decrease. Dr. James Brookes, a Toronto general practitioner, says that there is generous praise from doctors and patients for an antidepressant that has made it easier to treat a debilitating illness. The side-effects of older antidepressants-including a parched mouth, difficulty in urinating and feeling of psychological detachment- made them hard to take.

There were serious problems involved in getting patients to tolerate those drugs in therapeutic doses, says Brooks, but, with Prozac, you dont have this. Im really pleased with Prozac. (Nichols, 2) Many patients are equally enthusiastic. William Pringle, Vancouver special events organizer, was flattened by a major depression. His doctor put him on Prozac. I fell into a dark pit, says Pringle.

Prozac pulled me out and got me relaunched on my life. Maria Theresa Spagnuolo of Toronto began taking it in 1989, after three automobile accidents left her with chronic pain throughout her body. And she also suffered serious depression. Spagnuolo found that she was crying about everything, spilled milk was a catastrophe. But Prozac gave me energy and changed my outlook so that I can cope with life. I dont think I could function without it (2).

For one Hawaiian business woman, who had a steady diet of antidepressants and psychotherapy off and on for 20 years before Prozac, but never lost her sense of despair, the past three years with Prozac have been miraculous. I felt fabulous not as in 'up', but as in 'my god, I started to be normal,' she said. Now I get sad when theres reason to be sad, but I dont feel hopeless (Creamer, 1). In conclusion, the positives of Prozac definitely outweigh the negatives. All medications will have some side-effects, that is a given. Everything from Aspirin to Advil to prescription Penicillin have some kind of side effects, but everyone still takes these medications.

Why, because they work. No-one can argue that Prozac is working for many people, considering that it is the most prescribed drug in the world. But if it is not right for you, then you need to find what is good for you, not everyone can take every kind of medicine. Some people have allergies, thats going to happen.

The bottom line is, it is difficult to argue with clear results.

Bibliography

Aprile, Diane. Prozac. Courier-Journal Feb. 18, 1990 B ihm, Barbara;
Wilson, Billie Ann. Understanding Fluoxetine (Prozac). Med surg Nursing Feb. 1, 1996 Creamer, Beverly.
Prozac: Its Effects Still Subject to Debate. Honolulu Advertiser May 30, 1993 Mauro, James;
Breggin, Peter. And Prozac for All... Psychology Today July 1, 1994 Nichols, Mark.
Questioning Prozac. Maclean's May 23, 1994: 36-41 Fluoxetine (Prozac) fluoxetine (Prozac) The Pros and Cons of Prozac Ken Berard is.