From J. M. Duckworth
Cambridge
Discussions about a drug such as Prozac should take into consideration the
view that the seriousness of side effects from a prescribed drug should always
be considered in relation to the seriousness of the disease
(This Week, 6 December, p 14).
Depression is a potentially fatal illness (up to 17 per cent of untreated
patients kill themselves). Prozac and related selective serotonin re-uptake
inhibitors (SSRIs) are widely prescribed despite their known side effects and
withdrawal problems, because they have at least three advantages over older
antidepressants which are not mentioned in your article.
Firstly, they are far less lethal in overdose, a very important gain in a
drug of this class.
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Secondly they often work more quickly—in two weeks rather than six,
which may also save the life of a suicidally depressed patient.
Thirdly, the side effects, while common, often decrease or disappear once the
patient stabilises on the drug.
A further point is that the article compares data on the tranquillisers (not
antidepressants) temazepam and diazepam, dating from 1963, with much more recent
data on the SSRIs. But medical and lay awareness of the importance of reporting
side effects and withdrawal symptoms has greatly increased over that time
period, elevating the number of adverse reports.
