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2001 Second Web Report
A friend of mine's therapist recently gave her a prescription for Prozac, an anti-depressant. We have discussed her problems in depth as we are very close and I realize that she does not seem to have total control over her moods. Still, the very thought of needing to depend on medication to ensure one's sanity is very frightening to me yet I am still aware that there are people everywhere who depend on chemical substances for a variety of medical reasons. So, how exactly does an anti-depressant effect the body and the mind? I will examine Prozac, in particular, as it is a commonly prescribed drug for depression and anxiety.
What is depression?
Depression is an illness that comes in three major forms: Major depression is a combination of symptoms that can cause interference with the ability to partake in everyday activities such studying, sleeping, and eating. It can occur several times throughout ones lifetime. Dysthymia involves long-term, chronic symptoms that are not disabling, but they do keep one from functioning normally. The third type of depression is bipolar disorder, also known as manic-depression. Bipolar disorder is rarer than the other types of depression. An individual experiences severe highs and lows. The individual's mood can switch dramatically and rapidly, but more often is a progressive change. The severe highs, also referred to as mania, can affect thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. Mania, left untreated, has the potential to worsen to a psychotic state. (1)
What causes depression?
There is lots of research regarding what causes depression. Those who prescribe medication such as Prozac are operating under the belief that Depression is caused by a chemical imbalance. Prozac, in particular, among other drugs, works to keep a greater amount of serotonin in the brain. (2) Research in the 1990's began to center around the effects of serotonin in the brain because of the success of Prozac. It is believed that defects in serotonin-using circuits could cause signaling problems in the nervous system. Serotonin-producing neurons project from the brain to neurons in diverse regions of the central nervous system, including those that secrete or control the release of norepinephrine. (It is suggested that too much norepinephrine in the brain causes mania.) The lack of serotonin may contribute to the specific symptoms of Depression because serotonin-producing neurons extend into many regions of the brain. The effects could extend to the amygdala, an area involved in emotions, the hypothalamus, and area involved in appetite, libido and sleep, and cortical areas, an area involved in cognition. (3)
How do the new medications work?
Prozac, or Fluoxetine as it is referred to scientifically, is in a class of drugs known as selective serotonin reuptake inhibitors, or SSRIs. SSRIS block the nerves from breaking down serotonin, thus allowing a greater amount of serotonin to remain in the brain. (2)
What are the side effects?
There is a long list of frequent side effects associated with Prozac. They include: rash, pruritus (skin inflammation), headache, tremor, dizziness, asthenia, insomnia, anxiety, nervousness, agitation, abnormal dreams, drowsiness and fatigue, excessive sweating, disturbances of appetite, diarrhea, bronchitis, rhinitis (inflammation of the nasal mucous membranes), yawn, weight loss, muscle pain, back pain, joint pain, painful menstruation, sexual dysfunction, urinary tract infection, frequent micturition, and chills. (4) Although the list of frequent side effects seems endless, there are longer lists of additional side effects found in only one in one thousand people and another longer list for those found in fewer than one and one thousand people.
Although I realize the importance of the medication and that it has been fairly successful, the list of side effects only made me more ambivalent about depending on a chemical substance for one's mental health. I have to believe that there are more natural ways to fix the levels of serotonin in the brain. I did not find much research regarding the possibility that lower levels of serotonin in the brain could be a result of environmental factors and individual behavior. However, all articles regarding Depression say something about the fact that it can be aggravated by environmental factors and/or behavior.
On a Personal Note...
I also think that it's very strange that my friend, who has started taking Prozac, was never tested for the level of serotonin in her brain. It just seems that if the drug is being prescribed to correct that particular problem then they would have developed some test to identify whether or not that really is the problem. I have even less faith in the drug because therapy is so qualitatively analyzed. Every therapist could have a different idea of how to correct an individual's problem. A patient could just go from therapist to therapist looking for the one who will provide them with the treatment that they want.
3) The Neurobiology of Depression
4) Prozac Side Effects
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