PROZAC BACKLASH

A psychiatrist cites research and his own clinical experience to sound a compelling warning about the hazards of selective

serotonin reuptake inhibitor (SSRI) antidepressants. Glenmullen (The Pornographer's Grief and Other Tales of Human Sexuality,1993), a clinical instructor at Harvard Medical School, uses the term “Prozac backlash” to describe the brain's reaction to changes in serotonin levels brought about by SSRIs such as Prozac. These reactions are, he believes, responsible for serious neurological side effects such as tics, agitation, muscle spasms, and parkinsonism. Other drawbacks of SSRIs cited by Glenmullen are disturbing withdrawal symptoms, drug dependence, sexual dysfunction, and an association with violence and suicide. While acknowledging they have short-term value for symptomatic relief, Glenmullen asserts that some 75 percent of patients are on SSRIs needlessly. He argues vehemently against their casual, long-term use and demands better monitoring of patients. He explores (and deplores) the influence of cost-conscious HMOs, psychopharmacology's application of a biological model to psychological syndromes, and the power of the pharmaceutical industry on the increase in the use of SSRIs. Using patients' stories from his own practice, he illustrates both the dangers of long-term SSRIs use and the benefits of alternative approaches. Numerous case studies demonstrate his success in treating patients suffering from anxiety, depression, addictions, and eating disorders using psychotherapy of various kinds—cognitive, behavioral, twelve-step, group, individual, family, or couple—sometimes in combination with herbal remedies such as St. John's wort, kava, or valerian, and when necessary with Valium-type drugs. Glenmullen concludes by calling for more research on the neurotoxicity of SSRIs, better warnings to doctors and patients about their potential side effects, curbs on excessive promotion of these drugs, and closer scrutiny of their use with children.

A controversial message, alarming for SSRI-takers and anathema to SSRI-makers, but bound to please his fellow talk therapists.