Prozac celebrates 10th birthday

Thursday, January 21, 1999 Published at 06:45 GMT:  Prozac - the=
 anti-depression drug which has revolutionised the treatment of clinical=
 depression - celebrates 10 years on the market this week.

Initially hailed as a miracle cure, the drug has received a mixed report.

Some doctors raised fears that it was addictive and linked to suicidal=
 thoughts.

There was also concern that the drug was being used by people who were not=
 suffering from clinical depression, but who wanted a "quick fix".

Those concerns have led to several US health maintenance organisations using=
 alternative modern anti-depressants from the same class as Prozac - the=
 SSRIs, or selective serotonin reuptake inhibitors.

However, depression expert Dr Andre Tylee, a GP in Sutton, Surrey, said that=
 Prozac is now routinely prescribed by GPs to patients who exhibit the signs=
 of major depression.

Approximately one million people in the UK now take the drug, and sales run=
 at approximately =A3100m a year.

In a practice of 2,000 patients this can be as many as 100 patients at any=
 given time.

"Prozac has revolutionised the treatment of clinical depression in primary=
 care," said Dr Tylee, one of the organisers of the national Defeat=
 Depression Campaign launched by the Royal College of General Practitioners.

"Prior to Prozac there were older drugs available that had more side effects=
 and were less safe.

"But with Prozac we had a medication that was safe, easily tolerated and=
 easy to take, and which effectively helped to reduce the symptoms of=
 clinical depression in a way that enabled us to improve the effectiveness=
 of the talking treatments as well."

Dr Tylee said the medical approach to treating depression was to offer=
 "pills for the symptoms and talk for the problems".

The talking therapies include:

* Problem solving: Used to help patients tackle soluble problems in their=
 lives;=20
* Coping stategies: To help patients deal with problems that can not be=
 easily solved;=20
* Cognitive therapy: For use with patients who exhibit persistent and=
 automatic negative thoughts about life. This helps patients to substitute a=
 more appropriate thought for the negative feelings they may experience;=20
* Behaviour therapy: Designed to encourage people to try something new as=
 way to overcome their depression.

Dr Tylee said he would always consider Prozac for patients who exhibited=
 signs of major depression.

This he defined as a combination of symptoms exhibited every day for a=
 period of at least two weeks.

Symptoms include:

* Persistent feelings of sadness, emptiness, despair and irritability;=20
* Loss of pleasure from activities previously enjoyed;=20
* A change in weight or appetite;=20
* Sleep disturbance, including over-sleeping;=20
* Feelings of guilt and helplessness;=20
* A lack of self-worth; * Inability to concentrate;=20
* Excessive worry or anxiety;=20
* A reduction in energy or libido;=20
* Thoughts of death or suicide.

Dr Tylee estimated that approximately 5% of the population suffered from the=
 symptoms of major depression at any one time.

He said that every day one or two people who attended his surgery exhibited=
 symptoms.

However, there is still stigma associated with depression. Approximately 50%=
 of sufferers do not seek help from their GP.

A survey conducted by ICM for the drug's makers Eli Lilly and Co found that=
 although 75% of women regarded depression as a serious illness only 52%=
 would be prepared to take Prozac as a treatment.

Dr Allan Young, Honorary Consultant Psychiatrist at Newcastle General=
 Hospital, said: "Ten years ago people had a very poor understanding of=
 depression and consequently, society attached considerable stigma to it.

"Not only was the introduction of Prozac a medical advance but its=
 popularity has helped lead both to an increase in the awareness of=
 depression and the number of patients who are prepared to seek help.

"Now we need to work towards destigmatisation of treatment options available=
 for this seriously understood mental illness."

Dr Matt Muijen, director of the Sainsbury's Centre for Mental Health, agreed=
 that Prozac was a "good, modern" anti-depressant.

However he said: "It is very much a new Labour drug: good marketing and good=
 PR."

"It is a good anti-depressant - like many other good, effective=
 anti-depressants that are also available."

Dr Muijen, a psychiatrist who carried out one of the first trials of Prozac=
 in the UK, said he took exception to some of the more extravagant claims=
 made for the drug. Some people have claimed that it can transform the=
 personality.

"I thought it was rather over-hyped," he said.

Alison Faulkener, manager of the Strategies for Living project run by the=
 Mental Health Foundation, said that patients had reported mixed feelings=
 about using Prozac.

Ms Faulkener took the drug herself, and found that it did little to improve=
 her symptoms.

"For the first couple of months it did lift my depression," she said.

"But subsequently I suffered from increased anxiety and from physical=
 shaking and became very panicky. After about four months I had to change to=
 another medication."

In contrast, Ms Faulkener said she had interviewed patients who had found=
 taking Prozac to be a very positive experience.

"My overall feeling is that people need much more than just a drug to treat=
 depression," she said.

"They need the opportunity to talk about the problems they are experiencing.

"Whenever a new drug comes onto the market there is a risk that it is=
 portrayed as a cure-all, a wonder drug. People need to be more cautious."

http://news.bbc.co.uk/low/english/health

janet paterson - 51 now /41 dx /37 onset - almonte/ontario/canada
http://www.newcountry.nu/pd/members/janet/index.htm
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