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Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil, and Other Antidepressants with Safe, Effective Alternatives

by Joseph Glenmullen, M.D.

Simon & Schuster, 2000. 320 pages. Hardcover: $25.00
Review by David Seaman, Donna Sorenson, and Kathleen Boylan, NAMI Literature Committee

This is yet another of the recent Prozac books alerting us to possible dangers of the wildly popular new antidepressants and urging alternative (particularly talk) therapies. The conclusions and recommendations of Dr. Glenmullen seem more sensible and restrained than usual, but his image of the wonder drugs is still rather unflattering.

The main problem, Glenmullen believes, is that possible long-term adverse effects of Prozac and its chemical cousins are not yet understood (they could not be, since the SSRIs have been around for only about ten years); nevertheless, millions of prescriptions are dispensed, often for children, by general-care physicians for frequently quite ordinary psychological problems. The author quite sensibly urges that use of powerful mind-altering drugs be limited to patients demonstrably suffering from moderate to severe mental illness.

The difficulty with this sensible approach is that Prozac really does seem to "work" for many who experience not only major depression and OCD, but also minor depression, anxiety, shyness, and the like, which is why it has become so popular. Although there are potential unpleasant side effects (sexual dysfunction, in particular), many users do not experience them, or they overcome or disregard them. HMOs love the pills, which are a lot cheaper than extended talk therapy. Glenmullen, a successful practicing psychotherapist himself, of course disapproves-as we all do-but this unsatisfactory and possibly threatening situation is not likely to change soon.