But 25 years since the birth of Prozac, we’ve reached that rare moment when it seems possible, and even necessary, to do something new with the genre: to take stock of the experience of a generation that has grown up with antidepressants. So we are left wondering: does depression last forever, or can it resolve itself in 20 sessions? Can the drugs do the trick?įrom William Styron’s Darkness Visible to Andrew Solomon’s The Noonday Demon to Wurtzel’s famous memoir, there has been no scarcity of books on depression. When it comes to therapy, insurance companies are moving in the opposite direction, often paying only for short-term treatment. Only two weeks of symptoms are required for a diagnosis, but then-somewhere along the line-depression becomes a lifelong disease that requires lifelong drug treatment. Psychiatrists often prescribe them without an endpoint, and this attitude toward prescription has changed the way depression is conceptualized. Wonder drugs or not, it is now considered culturally acceptable to take SSRIs indefinitely.
A mere two years of proven safety is sufficient. There is also another reason for the startling lack of long-term safety studies: the Federal Drug Administration doesn’t require them. Tentative hypotheses suggest that feedback mechanisms could permanently alter serotonin levels in the brain, but unsurprisingly, pharmaceutical companies are not eager to fund this kind of research. We still don’t have a conclusive answer about whether antidepressants work, or about their long-term effects.
According to the research of Harvard Medical School’s Irving Kirsch, selective serotonin reuptake inhibitors (SSRIs), the broad category of drugs including Prozac, Zoloft, and Lexapro, are more effective than placebos only in cases of severe depression.īut 10 percent of the American population continues to take them because the message from psychiatrists and from the culture more broadly is, “Why not?” I can just hear the words inoperable brain cancer being whispered to me by some physician 20 years from now.” But 15 years after Wurtzel’s memoir, Prozac is no longer considered to be so transformative-or even so effective.
In her bestselling 1997 memoir Prozac Nation, Elizabeth Wurtzel was already expressing concern about the long-term effects of her new antidepressant: “I can’t help feeling that anything that works so effectively, so transformative, has got to be hurting me at another end, maybe sometime further down the road.
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