Posted by Adam on April 11, 2000, at 18:55:35
I very much enjoy tuning in to Christopher Lydon's "The
Connection" on public radio. Last night I listened with
great interest (and discomfort) to Dr. Glenmullen pitch
his new book "Prozac Backlash", which I guess came out
just last month. I'd never heard of Dr. Glenmullen before
(he is a professor of psychiatry at Harvard Medical
School and also has a private practice), and wondered if
he is a relative newcomer to "popular psychiatry" or if he
has been preaching his message publically for some time.The gist of the interview was essentially that Prozac (his
paradigm for the SSRIs), while useful for some severely
depressed patients, was probably not worth the potential
risks for "less serious" conditions, and that alternative
treatments were being underutilized as a result of Prozac's
pervasive presence in modern psychiatry and primary care.Having been on two SSRIs myself, as well as venlafaxine, I
would be the last person to disagree with the assertion
that Prozac has been overhyped, its potential side-effects
minimized in the manufacturer's literature, and that over-
prescription, especially driven by the corner-cutting
endemic to today's American health care system (read: HMOs)
is exposing many to unnecessary hardships while ignoring
the usefulness of psychology. For me SSRIs were more or
less of no use therapeutically, caused cognative as well as
sexual deficiencies, and distressing weight gain. I'm all
for a methodical and realistic discussion of such issues.Dr. Glenmullen claimed several times that his only intention
was to promote a fair assessment of the real costs and
benefits of SSRIs, and stressed that when appropriate, he
himself prescribed SSRIs to his patients. I felt there was
an obvious tension, though, between his stated intent and
the real message of the interview (and his book?): Prozac
has a host of potentially disfiguring and debilitating side-
effects, its potential for permanent harm is unknown and
underappreciated, its producer is engaged in a capaign of
disinformation about Prozac's adverse effects, and under only
the direst of circumstances should it be used. His favorite
example was the purported ability of Prozac to cause, in some
patients (real or even estimated numbers were never discussed)
side effects remeniscent of the major tranquilizers, complete
with parkinsonian tremors and tardive dyskinesia.This did not strike me as a measured form of discourse. I
can't imagine anyone lacking an informed view of psychiatry
coming away with any other message than Prozac is only for
very sick people for whom the cost of such adversity is
outweighed by their pathology. I myself have known a number
of people for whom SSRIs (not a one actually takes Prozac)
has been of true benefit. I'm in a serious relationship with
one of them. None of these people suffered depression nearly
as debilitating as my own (I would argue that SSRIs are, for
many, not as effective for major depression as MAOIs and
TCAs) and yet the change SSRIs brought to their lives has
been enormous. Furthermore, they suffer few, if any serious
side-effects.Whether such information was felt to be too implicit for
lengthy consideration, or was deliberately ignored, I do not
know. It certainly received short shrift in the context of
this interview, and I do not feel it was a judicious discussion
about SSRIs. I will have to read the book to make up my mind
about Dr. Glenmullen (a much-needed public critic or a Breggin-
in-sheep's-clothing?)Are any of you familiar with his work? Do you feel he is a
beneficial presence or someone who is out to cash-in on the
zeitgeist of disenchantment with modern psychiatric
interventions (which Glenmullen himself claims is a cyclical
phenomenon with a 30-year turnaround), a la Peter Breggin, MD?
poster:Adam
thread:29656
URL: http://www.dr-bob.org/babble/20000411/msgs/29656.html