Doctor responds to Prozac warnings
A letter from Andrew L. Morrison
Last updated 03:30 PM, EST, Thursday, November
16, 2000
(Mon. April 17, 2000) -- The recent articles in
The Star concerning Dr. Joseph Glenmullen's new book
Prozac Backlash deserve a response.
The second of these articles describes Eli Lilly and
Co. physician Stephen Paul as suggesting that the author may be
out to make a name for himself.
I'm in no position to know what Glenmullen's
intentions are. He may well be doing what he thinks is right. So
was Timothy McVeigh.
Not that I think Glenmullen is another McVeigh, but
you get my point.
Sure, the antidepressants (there are 23 of them on
the U.S. market now) can have side effects. Sure, there are
reports in the psychiatric literature every month of patients who
experience significant health problems while taking
antidepressants (though these occurrences don't always mean the
medication caused the problem). Sure, these medications at times
lose some of their efficacy after a period of full effectiveness.
So what's new? All drugs can have side effects.
People die from penicillin and people get Reye's Syndrome from
aspirin. After a period of time at the same dose, blood pressure,
heart and gastrointestinal medications can also "poop out." This
happens every day, and the doctor-patient team then makes the
necessary adjustments.
To write a book, as Glenmullen did, emphasizing such
negatives to the general public is a careless thing for a
psychiatrist to do. To write that these medications "may effect a
'chemical lobotomy' by destroying the nerve endings they target"
is flat-out irresponsible.
Glenmullen exaggerates, and this sensationalism may
frighten people who need these antidepressant medicines as much as
diabetics or asthmatics need their medications.
There is one completed suicide in the United States
every 20 minutes. People suffering from depression, and
obsessive-compulsive disorder and other disorders, are more likely
to get better with the combination of medication and
non-pharmacological therapies; treatment doesn't have to be just
one or the other.
To opine that 75 percent of patients in his
experience are needlessly on these drugs may be based on the type
of patient Glenmullen usually sees or in his personal bias, but it
certainly isn't based on any scientific study.
An alternative to Glenmullen's book is The
Antidepressant Sourcebook: A User's Guide for Patients and
Families, released in January by Doubleday but without the
sensationalized fanfare. I am the author. Like Glenmullen, I am
independent and receive no stipend or research grants from any
pharmaceutical company. I am a past president of the Indiana
Psychiatric Society.
Finally, there are 56 pages of references in the
Antidepressant Sourcebook, most of which are scientific
articles, texts and double-blind, placebo-controlled studies, not
anecdotal case reports.
The antidepressants can vastly improve, and even
save, the lives of many people whose current depression is
untreated. The positive effects of these medications far outweigh
their potential negative effects. It's too bad the potential
negative effects get far more public attention than their positive
effects.
My fear is that the negative effects of Glenmullen's
book will far outweigh whatever positive effects he hopes to
accomplish. I can only hope that "one bad apple" won't deter
people from receiving a proven, safe, effective medical treatment.
Dr. Morrison, of Indianapolis, is a staff psychiatrist at St.
Vincent Stress Center.
