In his book, ‘Listening to Prozac’, Peter Kramer (1993), a psychiatrist, initiates a debate on the use of SSRIs to bring about transformations in the personality traits of persons with enhanced confidence levels and reduced pessimism, arguing that Prozac enables the users to feel, “better than well”. Most persons, using Prozac, whether for therapeutic use or otherwise, feel that their behavior has been enhanced in positive ways and Prozac has shown highly positive results in patients with depression. The drug, patients revealed, produces the effect of a transitory “cosmetic pharmacology” enabling the user to be more confident and dynamic rather than shy and pessimistic.
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It is this phenomenon of the drug that Kramer labels, “listening to Prozac”, which resulted from the benefits of the drug to his patients after taking Prozac. Following these positive personality transitions in patients, Kramer affirms his belief that attitudes and personality traits that people are supposed to have been born with are actually “neurotic” in function, and can be altered substantially by the use of personality-enhancing drugs like Prozac. Kramer argues that the drug is actually a means to discover the true characteristic behaviors of persons, making them feel more attractive and optimistic, increasing their chances of success in life.
It is this self-transformation effect of the drug that James Mauro expresses his concern for in his article, “And Prozac For All”. The article begins with the title question, “Is Prozac right if you’re not truly sick?” revealing the anxiety and apprehension of the author. Mauro agrees that the drug has become a huge success with the Americans due to the visibly positive character enhancements it produces in the users. The euphoria over the drug, he believes is “premature”, and states that there is a great likelihood that the drug will cause side-effects like the earlier drug Valium which was also highly popular at one time. He states that previously, both “traditional” and “non-traditional” patients would be first put on therapy, but presently, the drug Prozac is prescribed for one and all alike, whether there are serious psychological problems or not, even to the extent of elevating the moods of persons. Mauro affirms that the side effects of the drug may be lower than the earlier drugs, but “not zero” (Robert Trestman). Mauro cites the example of the dominant use of cocaine between 1950 and 1960 when it was used for psychiatric treatments, the risks of which became apparent later. He thus states that the over-use, over-advertisement, and over-prescription of the drug Prozac should then be doubly considered by the scientific community, since no drug comes without side effects, especially when it is used by such a large population.
Mauro quotes a researcher Jesse Rosenthal (M.D., director of psychopharmacology at Beth Israel Medical Center in New York), who was amazed at the response to an advertisement in the New York Times and Village Voice, for the purpose of study and research to test the effectiveness of the drug Prozac in treating “Dysthymia”. Rosenthal affirms that there were “thousands of phone calls” from people belonging to diverse walks of life. What appalled him was the fact that there were reasonably good persons, educated, hardworking and successful, who retorted in large numbers.
Of course, Prozac does have relatively fewer side-effects than some other rugs used for similar purposes, but the side-effects do exist. Mauro argues that if one can alter personality traits in people to suit their needs, then even the slightest faults or differences in behaviors would be termed as dysthymia. He states that if a drug has powerful effects in transforming a personality, then it is bound to have side effects too. He states that persons should therefore not be in a great hurry to get addicted to Prozac and the companies and all those in the field connected with such drugs should adopt a slower approach in recommending the drug, liberally. Mauro voices his concerns over Kramer’s affirmation that Prozac does have the potential to prompt aggression and suicidal tendencies in patients who use the drug repeatedly.
Mauro wonders if Prozac and the other similar drugs are actually effective in curing patients with severe symptoms of depression and psychological disturbances, or they are mere “mood brighteners”. He worries over the fact that the use of pharmacological drugs to address the problems of the mind and behavior is similar to putting “Band-aid”, rather than gaining an in-depth knowledge of the societal causes and the root causes of these problems, leaving the patients treated temporarily rather than permanently.
The ethical issue surrounding this concern is that the problem should not be addressed on a temporary basis; rather the quest and study should be regarding why so many people “in ever-increasing numbers” are seeking help with regard to psychological disturbances. Mauro wonders what the reaction of the brain would be to these drugs. He wonders about the intrusive action of these types of drugs in impeding the normal functioning of the brain, which would at some point in time, react in a disastrous manner. Mauro argues that the brain is the organ of the human mind and plays a substantial role in shaping the character of a person. He then speculates what should be the limit in addressing the problems caused due to the different functions of the brain. He does agree that as long as it is safe to treat a disorder, the therapies could continue. He states that the use of Prozac to transform personalities, would make the people so intolerant of the minutest of problems that even “the slightest wrinkle”, with no symptoms of clinical depression would be termed as a “disorder’, his apprehension being, that if the existing scenario continued, wouldn’t America would soon become a “Prozac Nation”?
Kramer P. 1993, ‘Listening To Prozac’.
Mauro J., 1994, ‘And Prozac For All: Is Prozac right if you’re not truly sick?’ Psychology Today.