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Prozac Backlash provides authoritative, balanced information on the efficacy of these drugs, explaining how they react chemically in the body, when they should and should not be prescribed, and what risks they present. Equally important, the book informs readers of the many safe, effective alternatives to using such drugs -- alternatives that can restore your spirits, keep your weight down, and make your sex life as vital as ever. Dr. Glenmullen argues that antidepressant drug therapy is justified only in moderate to severe cases -- no more than 25 percent of patients currently taking these drugs -- and that we should avoid patients' exposure to these drugs whenever possible. The dangerous side effects, he points out, are caused byProzac backlash, which is the brain's reaction to artificially elevated levels of serotonin.
Using vivid real-life stories from his work at Harvard, his private practice, and the latest medical research, Dr. Glenmullen explains the real role of serotonin in depression and challenges the popular, hypothetical notion of a "serotonin deficiency" allegedly corrected by the drugs. He relates the research history of Prozac and similar drugs, and includes disturbing facts about the influence of drug companies and HMOs on media representation of that research.
Prozac Backlash offers new hope to millions with effective alternative treatments, including psychotherapy, cognitive-behavioral treatment, herbal remedies like St. John's wort, family therapy, and twelve-step programs. Dr. Glenmullen shows how these alternatives work not only for depression but for a wide range of problems, such as anxiety, phobias, obsessions, compulsions, sexual addictions, drug and alcohol abuse, and eating disorders. He also provides countless examples of the successful application of these treatments where drug exposure has been reduced or eliminated altogether.
Written by a doctor with impeccable credentials, Prozac Backlash is filled with compelling, sometimes heartrending stories and is thoroughly documented with extensive scientific sources. It is both provocative and hopeful, a sound, reliable guide to the safe treatment of depression and other psychiatric problems.
"...documents the long-term side effects of serotonin-boosting medications, such as neurological disorders, sexual dysfunction, withdrawal symptoms, and a decrease of antidepressant effectiveness."
PART I. The Dangers of Prozac-Type Antidepressants
1. The Awakened Giant's Wrath: Risking Brain Damage
2. Held Hostage: Withdrawal, Dependence, and Wearing Off
3. Not Tonight, Dear -- I'm on Prozac: Sexual Dysfunction
4. Bones Rattling Like Tuning Forks: Startling New Information on Suicide and Violence
PART II. Balancing Medications with Alternative Approaches
5. Behind-the-Scenes Forces: Understanding the Prozac Phenomenon
6. Unraveling Depression: Stifled Anger and Sadness
7. Surmounting Anxiety: Training for Elevators, a Patient's Story
8. Conquering Addictions: Substance Abuse, Sexual Addictions, and Eating Disorders
Epilogue: Effecting Personal Change
Chapter One: The Awakened Giant's Wrath (Risking Brain Damage)
Maura: A Case of Disfiguring Tics
Late in her therapy, Maura took to lying back in the chair in my office, so relaxed she looked as if she drifted into a peaceful, tranquil state as we spoke. This involved a whole ritual for Maura: taking off her glasses and gently placing them on the small table beside the chair, leaning her head back into the soft headrest, closing her eyes, and relaxing her body, which seemed to melt down into the chair.
I would especially watch Maura's face at these times. A thirty-nine-year-old native of Ireland, Maura had milk-white skin and soft, delicate features framed by ringlets of auburn hair. As she continued to converse, reminiscing about her past, her face was a study in repose.
Unfortunately, this peace, hard won throughout a year of psychotherapy, was shattered by a chance observation on my part as I gazed at Maura's face. Suddenly I began to notice intense twitching all around her eyes. Her closed eyelids pressed more tightly shut. Waves of muscular contractions circled around her eyes. Bursts of this abnormal twitching punctuated periods of relative calm in which the muscles appeared to relax with just faint background activity.
How long had this twitching around Maura's eyes been present? I wondered. Was I just imagining that it was new? But I had been scrutinizing her resting face for months. Surely I would have noticed before. After I had observed the distinctive twitching for a number of weeks, I began to look for it when Maura was sitting upright with her eyes open and glasses on. Sure enough, the twitching was present at this time,too.
The image of Maura lying with her head as though on a pillow with twitches dancing around her eyes like fire came to haunt me because of what it portended. Maura had been in treatment with me for nearly a year. She originally had come for a second opinion about her medication, and had decided to stay on as a psychotherapy patient. The year before, her primary-care doctor had put her on Prozac for mild depression, because of her complaints of feelings of anxiety and tearfulness whenever she drove on highways. In two brief follow-up appointments, her doctor had doubled Maura's dose to 40 milligrams a day and given her a year's prescription for the drug. Primary-care doctors often see patients just once a year for an annual checkup. They frequently write year-long prescriptions for a host of drugs, from blood pressure medications to birth control pills. So when they prescribe serotonin boosters, writing a year's supply fits the routine for primary-care doctors even though this is not really appropriate to psychiatric drugs. At the end of the year, Maura consulted with me.
Maura grew up in war-torn Northern Ireland, in the small town of Ballymena. When she was eleven years old, she and her parents were innocent victims of a car bomb that exploded while they were driving to Belfast. Maura was badly injured, but she survived both the explosion and the trauma of witnessing the brutal death of both her parents. After living with an aunt for several years, Maura first came to the United States while in college. At the time that I met her, she was living in a Boston suburb with her American husband and their two daughters. As we pieced together her long-ignored, painful history, Maura realized that her depression began shortly before her elder daughter's tenth birthday. Like many parents, Maura would occasionally find herself daydreaming about what her life had been like at an age similar to her child's. As we talked, she realized her daughter was approaching the age Maura had been when her parents died. Her sudden sense of sadness and loss was worst while driving on highways, perhaps because it was a reminder of the fateful trip from her town into the city of Belfast. After several difficult months of reliving some of her traumatic memories and gaining a greater understanding of her symptoms, Maura gradually achieved the calm I was seeing when she leaned back in the chair. In anticipation of the well-earned end of therapy, we had decided to take Maura off Prozac and had lowered her dose from 40 to 20 milligrams.
"Have you noticed your eyes twitching lately?" I asked after observing the phenomenon for several weeks.
"No," said Maura, surprised.
I decided to write off the twitching as an anomaly, although now I wish I had made more of it. Not that this would have changed Maura's clinical course. A week later we stopped the Prozac. Prozac is a particularly long-lasting drug, lingering in the body for weeks. Two weeks after her last dose Maura called one day, frantic. "Something dreadful is happening to me," she said. "I need to see a neurologist. My lips are twitching and my tongue keeps darting out of my head." I told Maura that I would make time to see her, and to come to my office immediately. When she came, I was flabbergasted to see Maura's symptoms firsthand. Her lips now displayed twitching similar to that which I had observed around her eyes. But worst of all was the tongue-darting: fly-catcher-type movements in which her curled tongue darted in and out. The tongue-darting together with the twitching was disfiguring.
"Have I had a stroke? Do I have a tumor?" asked Maura, distraught.
"No," I said. "I don't think so. I believe this is a medication side effect."
"A medication side effect?" said Maura, dumbfounded.
"Yes. It looks like a tic disorder called tardive dyskinesia."
"Tardive dyskinesia. It's a medication-induced tic disorder."
"But I'm not on any medication. I've just stopped the Prozac."
Could Prozac be causing Maura's tics? I wondered. I hadn't heard of Prozac causing these tics, but I had a lot of experience with them in association with major tranquilizers.
"I don't know why you're having these symptoms," I said, "but with other drugs they often worsen or emerge after patients stop taking them."
"What are you talking about?"
My mouth dry, feeling anxious and confused myself, I explained that tics are a well-known side effect of major tranquilizers. Not only do these earlier drugs cause tics, they can also suppress or mask them, as long as the patient is still on the drug. The tics emerge only after the medication is stopped.
"You're not taking any other medications, right?" I asked Maura.
"Right," she confirmed.
"Have you ever been prescribed any other psychiatric medications?"
Since Maura had been on Prozac for two years and had not taken any other psychiatric medication, it seemed that Prozac was probably responsible for the tics.
"How can the drug be causing something when it's gone?" asked Maura.
"No one knows the exact process by which the tics come about," I said. "But we do know that they are caused by long-term exposure to certain drugs. Sometimes the tics become severe enough to overcome the drug suppressing them. But sometimes they only appear after the drug is gone. Removal of the drug brings out the tics."
In fact, with major tranquilizers the tics are a result of brain damage brought on by the medication, but in our initial conversation I avoided using these words with Maura, because she was already terribly upset.
"Will this go away?" asked Maura.
"There's a good chance it will."
"A good chance? What are the chances?"
"I don't know. I've never heard of this with Prozac."
"What are the chances with other kinds of drugs?"
"Major tranquilizers? In about half of those cases, the tics slowly go away."
"And the other half?"
"Sometimes they get a little better."
"But they're permanent?"
"Can they get worse?"
"In some cases."
"Oh, my God. Is there any treatment?"
This is one of the most difficult questions to answer, becaus
Posted June 29, 2000
Despite the pharmaceutical company's obvious dislike for this book, I think it's great and anyone on Prozac or a similar 'anitdepressant' or who knows someone on one of these anitdepressants should definately read this informative, well-researched, well-written book!Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted April 18, 2000
I am writing this because I know for a fact that pharmaceutical companies are very concerned about this book. Last week, my employer (a large manufacturer of a very popular SSRI) sent a voice-mail to its entire sales force, telling us about this book. The sales force has been told to tell any doctors who mention the book that the book was written 'only to make money', and that there is no validity to it whatsoever. I have not read the book yet, but I am concerned that some of the earlier reader reviews that slammed the book may have been written by employees of pharmaceutical companies. I want people who read these reviews to be aware that some of the writers may have hidden agendas. I believe that some of the alternate medicines are effective and I resent big business manipulating and suppressing the truth. I am so strongly against the manipulative marketing tactics that my employer uses that I am leaving the company.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted April 15, 2000
Readers should not be put off by this book's alarmist title. It actually contains a well reasoned message, that psychiatric drugs carry with them potentially serious side effects. The book clearly does NOT advocate that patients suddenly go off their medication, or self-medicate their depressions with herbal remedies. To the contrary, the book encourages people to seek help from professionals who will take the time to evaluate each patient's individual case and weigh the pros and cons of using medication, as well as other alternatives including (and especially) psychotherapy. The book is not anti-medication, but rather pro-information. It is also an enlightening look at the lengths to which pharmecutical companies will go to protect their drugs, and the extent to which pharmecutical company money permeates the research conducted on these drugs. If anyone should be frightened by this book, it should not be patients or their caretakers, but rather the pharmecutical companies who fear educated consumers. Read the book for yourself, and form your own educated opinion.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted April 12, 2000
While Dr. Glenmullen makes some interesting points, I take issue with St. John's Wort as an alternative for treating depression. Sure, it can be effective for minor, situational depression, but it is well known that herbal remedies are not regulated and can vary greatly in effectiveness. Prescription medications are well studied, closely scrutinized and closely regulated. There are 19 million Americans who suffer from depression. If left untreated this illness can result in years of suffering and even suicide. Only about half of the 19 million actually seek and receive appropriate treatment. I'm concerned that people with major depression may read this book and 'self-medicate' themselves with herbal remedies, without getting seen by a professional and getting a proper diagnosis and treatment recommendations. People with depression do best when under the care of a doctor and receive treatment designed for their particular situation. Medications, such as Prozac, may be or may not be part of the treatment package. As someone who has worked in the medical field for many years, I urge people who might consider only taking herbal remedies to get properly diagnosed first.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted April 10, 2000
Dr. Glenmullen uses scare tactics to warn people away from prescription medications that have helped millions of people overcome a variety of mental illnesses. By attacking these proven medicines, Dr. Glenmullen is causing needless alarm in current patients and may inhibit people suffering from depression from seeking such life-saving drugs. The case studies he cites, including excerpts from Internet message boards, sound like patients who don't have good, open communication with their doctors. All medications affect individuals differently, and should be closely monitored by a physician in order to ascertain the proper medication, dosage, and length of use. Diet, exercise and additional prescriptions, vitamin and herbal remedies should always be a consideration in an individual's health regimen. Dr. Glenmullen's work is a further disappointment when he recommends St. John's Wort, a popular herbal remedy as an alternative treatment. He writes that 'the lack of an adequate public health policy for monitoring long-term side effects for prescription drugs' has hindered public awareness of the possible long-term side effects of those drugs. Although St. John's Wort has been proven effective for mild depression, as an herbal remedy, it is not regulated by the FDA. There is no agency monitoring the short- or long-term effects of St. John's Wort. It is well-known that over the counter herbal remedies vary widely in their content and effectiveness. In addition, recent studies have shown that St. John's Wort has potentially dangerous blocking effects when taken in conjunction with a wide variety of prescription medications including those used for AIDS patients, heart disease, certain cancers, transplant patients and birth control. In effect, Dr. Glenmullen is proposing that people substitute a home remedy that has very little scientific understanding in place of prescription medications that have been tried and tested.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted April 3, 2000
Dr. Glenmullen joins a growing group of scientists who find prescription drugs an easy target for criticism. He seems to favor unregulated herbs and supplements, which are not regulated by the government and have contributed significantly to injury and death. Genuine problems with prescription drugs can be addressed by the Food and Drug Administration, 'home remedies' are sold over the internet, on the advice of store clerks and there is no guarantee of purity or potency.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.