In September of 1989, Joe Wesbecker, a long-time employee at the Standard Gravure printing plant in Louisville, Kentucky, walked into work carrying an AK-47 and three spare clips. He opened fire on his coworkers, killing eight, maiming two, and wounding ten more. The assault ended when Wesbecker shot himself with an automatic pistol.
The incident mimicked other workplace shootings except for one key factor: Wesbecker, who had been diagnosed with depression, had just recently started taking the antidepressant drug Prozac. Claiming that the drug was responsible for Wesbecker’s violent behavior, the widows of Wesbecker’s victims brought suit against Eli Lilly, the company that makes Prozac. Eli Lilly won the suit after a settlement had been made in which the company paid the plaintiffs to exclude certain evidence from the trial.
The Wesbecker suit marked the first of several allegations that Prozac incites violent behavior—none of which has succeeded in court. In fact, Prozac’s success seems virtually immune to such charges. Despite the Wesbecker case, Prozac sales skyrocketed in the early 1990s. In 1995, Prozac was the most commonly prescribed medicine internationally, with sales totaling over $2 billion. The drug, which has been authorized to treat depression, obsessive-compulsive disorder, and bulimia, is awaiting approval for the treatment of such diverse conditions as chronic fatigue syndrome and premenstrual syndrome. Prozac impacts a wide range of personality disorders, researchers claim, because it increases brain activity. Along with other selective serotonin reuptake inhibitors (SSRIs), Prozac works by raising the brain’s level of serotonin—a chemical that regulates behavior. Psychiatrist Michael J. Norden describes serotonin as “a surrogate parent” because it “discourages behavior that might get us in trouble and comforts us when trouble nevertheless arrives—soothing worry, pain and most forms of stress.”
In addition, proponents contend that SSRIs, unlike other antidepressants, have no serious side effects. Previously, the best drugs available for depressed patients were tricyclic antidepressants, which bring on frightening symptoms such as heart problems and memory loss—and can be extremely dangerous when mixed with alcohol. With the introduction of Prozac and other SSRIs, researchers maintain, people suffering from depression and similar disorders can obtain relief without the risks of harsh side effects, addiction, or overdose.
Since SSRIs have been lauded as an antidote for everything from timidity to compulsive eating, it is hardly surprising that Prozac has acquired an almost cultlike following. In 1995 alone, nearly 19 million prescriptions for Prozac were dispensed in the United States—a number that continues to rise. Furthermore, some veterinarians are even prescribing it to antisocial dogs and cats. Enthusiasts have an easy explanation for Prozac’s popularity: It works. According to psychiatrist Peter Kramer, one of Prozac’s most avid proponents, Prozac can “do in a matter of days what psychiatrists hope, and often fail, to accomplish by other means over a course of years.” Some psychiatrists see no end to the potential uses of Prozac. For example, Dr. Joel Yager of the University of California at Los Angeles says that “he has no qualms with the use of SSRIs to smooth over troublesome personality characteristics, even when a clinical disorder is not apparent.” According to Yager and other psychiatrists, if Prozac will improve a person’s quality of life, there is nothing wrong with prescribing it.
Critics, on the other hand, balk at the notion that antidepressants should be freely dispensed. Some fear that the popularity of Prozac brings society closer to the one depicted in Aldous Huxley’s novel Brave New World, in which the fictional drug Soma was used to subdue all unpleasant emotions. Critics contend that the prescription of antidepressants should be limited to clinically depressed individuals who demonstrate a genuine need for drug intervention.
Others maintain that Prozac is not an effective way of treating depression. According to Peter Breggin, a vocal opponent of Prozac, “Many people . . . on Prozac . . . react with a narrowing of their emotional spectrum. They lose touch with themselves and others, and may perceive this as a kind of relief. . . . [Prozac] disconnects a person from the rest of the world and from his or her own real-life issues.” Breggin and others argue that while Prozac alleviates depressive symptoms, it fails to address the underlying issues behind these symptoms; therefore, it is a temporary fix, not a long-term solution.
Other protests against Prozac center around a different issue: the use of Prozac on children. As of this writing, Eli Lilly is awaiting Food and Drug Administration (FDA) approval for a peppermint-flavored children’s Prozac. However, doctors can legally write children prescriptions of adult Prozac—and many have not hesitated to do so. In fact, Arianna Huffington reports that “children’s prescriptions of adult antidepressants have soared from 342,900 in 1994 to 579,700 in 1996.” Criticisms of this practice range from fears that Prozac may affect children’s brain development to moral questions about whether it is right to treat children’s emotional problems with medication. Some warn that Prozac teaches children that pills, rather than personal responsibility, are the way to solve problems. According to columnist Cal Thomas, “If drugs are used to alter the mood of a child, what moral authority do adults have to persuade a teenager not to alter his or her mood with marijuana, heroin or cocaine?”
The debate over Prozac reflects the larger question of whether drugs are the best way to treat mental illness. Those in favor of Prozac believe that drug treatments have revolutionized mental health care. They contend that mental illness is caused by chemical imbalances in the brain that can be easily corrected with drug therapies. On the other hand, critics of Prozac argue that the popularity of SSRIs is emblematic of a dangerous cultural trend toward the desire to solve problems instantaneously and easily. They allege that Prozac and other mindaltering medications eliminate normal human responses to life problems. This debate is among the topics addressed in Mental Health: Current Controversies. Throughout this anthology, authors offer contrasting perspectives on the medical, social, and legal issues surrounding mental illness.