|The Perils of Prozac
Note: If you or anyone you know
are currently taking an SSRI and are doing well on it do not
discontinue your medication based upon this article. Although the
information presented here may be disturbing, it does not mean that
you will become violent while taking SSRIs. In fact, if you
discontinue a medication that is working well for you, you may risk
withdrawal symptoms, depression or suicidal feelings. You should
never discontinue any medication on your own. Always consult your
I we took a look at what some have speculated is a causal link
between SSRIs and rising rates of violent crimes. Almost immediately
after the article appeared, I began to receive reader feedback on
this controversial topic. A heated discussion began on the tAPir
message board as well. I invite you to read these emails as well
as the tAPir
discussion. I also hope you will head on over to our boards and share
your own thoughts and feelings about this topic.
This week we look at one person's
experience and what the experts say may have caused this type of
A PATIENT'S EXPERIENCE
Like many of you who wrote in, I have
been hearing about the dark side of Prozac for several years now.
When I first began my own treatment with Prozac four and half years
ago I read everything I would get my hands on. I have a whole
library of books like Talking
Back to Prozac and Listening
to Prozac. I pooh poohed the idea that Prozac could be
dangerous. I felt that Peter Breggin's claims were grossly
exaggerated and sensationalistic. After all, he just wanted to sell
books, right? Also, I wanted desperately for Prozac to be the answer
to all my problems. For the most part, it did work great. Sure, I
had to take benzodiazepines to control the anxiety it caused me.
Also, my moods were flattened. I had no extreme lows anymore, but I
also didn't have even the normal ups and downs that make life
interesting. Perhaps worst of all were the sexual side effects,
which can put a strain on even the best of marriages. All in all, I
still thought Prozac was worth these tradeoffs if it kept me from
feeling so depressed I wanted to die.
At this point, you may be expecting
that I will say that I had a bad reaction to Prozac. No, the worst
of it was what I've just described. What I would like to tell you
about is a story I recently heard from a friend; a story which
prompted me to reexamine my own beliefs about Prozac's
This is her story in her own
Yes, I have had a bad experience with Prozac. I was in
need of seeing my regular Psych. Unfortunately he was booked
up and was not able to see me anytime soon. He suggested that
I see my regular MD. The next day I made an app to see my
regular MD and seen him the very same day. After explaining to
him that I felt as if my meds were no longer of any benefit,
he then prescribed Prozac. I had the prescription filled the
very same day. The next day I started taking the med. I was
prescribed to take one in the morning and one in the evening
(I can't remember the mg's) but that morning I got up and took
one of them. By afternoon I started to feel a bit funny, kind
of out of it. As the day progressed I started feeling more and
more depressed. By that evening I was suicidal. I just thought
that I was going through a mood swing and that it would soon
pass. By the time the second dosage was due I was totally
suicidal. By totally I mean I had even had a plan as to how to
kill myself. Passing it off as a mood swing I thought that the
second dose of Prozac might pull me out of it, so I took the
second dose. Three to four hours later I was nearly out of my
mind. My thinking was totally distorted. In my mind I had no
reason to live. Later that night after a short confrontation
with a neighbor, I had made my mind up to kill her. At that
point I really didn't care if I died in the electric chair (I
am not the type of person to even confront a person in a mean
way). But that night I was out of it. Thank God it was late at
night because I went home and went straight to bed. By the
next day the feelings of suicide and homicide had eased. Until
I decided to take another dose of Prozac. That morning as
scheduled I took my third dose. Again three to four hours
later all feelings had progressed into a deeper state.
Suicidal and homicidal feelings where both more intense. By
late afternoon I was so suicidal and homicidal I was thinking
of ways and times to kill my neighbor and then kill myself.
After a realization from me of what I was actually thinking
and even at that point plotting I come to the understanding
that my suicidal and homicidal feelings seemed to be
progressing with every dose of Prozac I was taking. So I
decided to stay locked up in my bedroom and NOT leave the
house at all until these feelings were completely gone. At
that point I also decided NOT to take any more Prozac.
Thankfully, within a couple of days all of these awful
feelings were gone. Now I understand that Prozac has and is
still helping many people but it is definitely not a wonder
drug for all people. I hope that this has helped
What my friend described to me might
well be written off by some as just a manifestation of a depression
she was already being treated for. Some medical experts, however,
say that this reaction to Prozac is not an isolated case. Dr.
Robert Bourguignon, MD has the following to say about
"It is my opinion that
Prozac can induce psychotic episodes in a small percentage of
patients (5-7%), especially those with borderline or manic
personalities. In a small minority of these people, psychosis
manifests itself by dangerous behaviors such as self-mutilation
and suicidal/homicidal ideation and acts. So far, Lilly has
refused to conduct (or publish the results of) double-blind
studies specifically developed to find out more about these
possible side effects. In my opinion, by refusing to do so, Lilly
fails to meet normal standards in health care."
In a letter to the
prominent medical journal, Lancet, he further details his
concerns for his colleagues in the medical community. He cites
aggressiveness, tremor, convulsion, and liver disorders as further
side effects of Prozac usage that need to be given more attention by
physicians. He further makes the allegation that Eli Lilly's
reassurances to the medical community that Prozac is safe and
effective have caused physicians to not monitor their patients as
closely as they should.
Perhaps the most vocal critic of Prozac
has been Dr.
Peter Breggin, author of Talking
Back to Prozac.
In his book Talking Back to
Prozac Breggin makes some devastating claims about Eli Lilly.
After researching clinical trials of the drug before it was marketed
he concluded that these trials were inadequate because:
- they were too short (four to six
- they did not include children, the
elderly or the suicidal;
- many patients dropped out following
- patients were given sedatives to
reduce Prozac's stimulating effect;
- fewer than one in three trials
showed Prozac to be effective; even these suggested that it was no
more effective than previous antidepressants.
"The FDA supports the drug industry and
its needs at the expense of the public and the consumer," writes
Breggin. He adds that an early in-house FDA report, ignored by the
organization's top decision-makers, described Prozac as a stimulant
that could, in a few cases, over-stimulate the central nervous
system and worsen depression.
Most recently Breggin has spoken about
Luvox, another Selective Serotonin Reuptake Inhibitor (SSRI). Eric
Harris, the "leader" in the Columbine High School tragedy, was
taking this medication for depression. Although this drug, in the
same class of drugs as Prozac, is approved for the treatment of
obsessive compulsive disorder, doctors often give it for depression,
since it is in the same SSRI class as Prozac and Zoloft.
"According to the
manufacturer of Luvox, Solvay, 4% of children and youth taking
Luvox developed mania during short-term controlled clinical
trials. Mania is a psychosis which can produce bizarre, grandiose,
highly elaborated destructive plans, including mass murder.
Interestingly, in a recent controlled clinical trial, Prozac
produced mania in the same age group at a rate of 6%). These are
very high rates for drug-induced mania--much higher than those
produced in adults. Yet the risk will be even higher during
long-term clinical use where medical supervision, as in the case
of Harris, is much more lax than in controlled clinical trials.
These drugs also produce irritability, aggression or hostility,
alienation, agitation, and loss of empathy." (Author's note: No
information was given in the Breggin article about where the rates
of mania in Prozac patients was obtained
HOW PROZAC MIGHT PRODUCE VIOLENT
Prozac is a drug that is prescribed to
treat depression, calm people down, and help them cope better with
life. For most people it does just that. How could it have just the
opposite effect on some people?
In a Web article entitled The
Dangers of Prozac, Gary Null, Ph.D. and Martin Feldman, M.D.
provide a discussion of the potential undesirable side
effects of Prozac and how these may lead to suicidal and violent
feelings. In summary these are:
Akathisia - This is a sense of anxiety, which makes a person feel
compelled to move. It may manifest itself as pacing, foot shuffling
or other similar behaviors. Dr. Breggin has described it as "like
chalk going down a chalkboard, only it's your spine." Prozac also
can cause extreme agitation, and this condition often is associated
Akathisia has been related to a
breakdown in the ability to control impulses. Several journal
articles have reported an association between akathisia and suicidal
or homicidal thoughts. References for these and all scientific
journal articles referred to below can be found within Null and
Psychosis - A person's nervousness may reach a psychotic
level when the overstimulation of the nervous system is severe.
People can become paranoid, extremely depressed, suicidal and
dangerous to others around them. They may behave in bizarre ways.
Prozac's ability to induce mania in patients has been documented in
a number of medical journal. Dr. Breggin holds the position that a
drug's therapeutic effects and its toxic effects are simply a matter
of degree in the same continuum. In fact, says Dr. Breggin, "Many
patients who swear by Prozac are probably experiencing imperceptible
or barely perceptible degrees of mania.".
Suicide - Beyond the link between akathisia and acts of violence, some
users of Prozac have said that the drug caused them to develop
suicidal thoughts and obsessions. In some cases, the use of Prozac
allegedly has prompted people to commit murder. This aspect of the
drug has generated controversy and led to discussions in both
medical publications and the general media about the connection
between Prozac and acts of violence.
It should be noted that in several
studies, the findings suggested that Prozac did not lead to suicidal
preoccupation or found that the drug was not associated with an
increased risk of suicidal acts. Other reports on clinical
experiences with Prozac and its effects following an overdose
support the safety of the drug.
However, other research supports the
contention that Prozac leads some users to become suicidal or
violent. In his book, Dr. Breggin says that it is the drug's ability
to cause a variety of psychological and neurological disorders that
underlies such destructive behavior. Five of these
disorders--agitation, panic, anxiety, mania and akathisia--can
prompt suicidal or violent acts, says Breggin. Four other conditions
caused by Prozac--depression, paranoia, obsessive-compulsive
thoughts and behavior, and insomnia--may precipitate the irrational
fears, suicidal thoughts and despair that lead to violent thoughts
can you do if you've had a bad reaction?
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