The Cultural Side Effects Of Prozac

Retro Report dusts off coverage of the antidepressant:

John M. Grohol celebrates the marketing legacy of the drug, despite it not being “as great an antidepressant as its makers claimed”:

Prozac showed how a mainstream marketing effort targeted toward a specific mental illness could change the entire conversation. Before its introduction, depression was stigmatized, people were embarrassed to admit they had it, and they often hid it from others. It was because of Prozac’s marketing campaign that, for the first time in American society, we could have a serious and real discussion about mental disorders like depression.

Not only was it suddenly O.K. to be taking an antidepressant, for many it became a badge of honor. Its marketing let everyone know, “hey, depression isn’t a personal failing or due to poor morals or bad parenting. It’s a biochemical thing that a medication can help with.”

Lisa Schwartz and Steve Woloshin differ:

Prozac has clearly been effective in its marketing campaign but may have faltered, remarkably, in treating depression – especially mild depression, that muddy realm between normal sad emotions and disease. Here, Prozac-type drugs are barely better than placebos and no better than talk therapy, which has a longer-lasting effect, no sexual side effects or withdrawal symptoms.

It’s also unclear if these drugs reduce suicide, the worst outcome of depression. The F.D.A. actually requires a black box warning because of increased suicidal thoughts in young adults.

The pharmaceutical treatment of severe depression has undoubtedly helped many people. But many more have been overtreated for symptoms that don’t require drugs.

Jerry Avorn looks at the broader impact:

Prozac helped usher in the era of the blockbuster drug – a product that brings in over $1 billion of annual sales. With broadening expectations of what medications can do to increase life satisfaction, and the allowance of direct-to-consumer advertising in the mid-1990s, sales of these drugs went into orbit. Psychotherapy withered on the reimbursement vine (“a pill is worth a thousand words” and is much cheaper), and weltschmerz became reason for patients and doctors alike to seek solace from the pharmaceutical industry.