Pubdate:  Sat, Jan 30, 1999
Source: Irish Times (Ireland)
Copyright: 1999 The Irish Times
Contact:  Features
Author: Kitty Holland


Prozac has become the most prescribed branded antidepressant in the
Republic since its launch here in June 1989. It has "revolutionised"
the management of depression because the same one-capsule-per-day
dosage is prescribed for every sufferer, and because it acts on
numerous mental illnesses. In the majority of cases it is the sole
antidepressant taken by the patient.

"Before Prozac," says Dr Patrick McKeown, chairman of Aware, the
charity for sufferers from depression, "there were numerous
anti-depressants, such as lithium, which were just as good but had to
be measured very specifically for each individual and often had to be
taken several times a day. With Prozac there are fewer side-effects;
there's almost no danger of a fatality with overdose, and it can be
used in the treatment of obsessive-compulsive disorders, eating
disorders and panic attacks, as well as depression."

Prozac is an SSRI, or selective serotonin reuptake inhibitor. As Dr
McKeown explains, it increases the levels of the brain chemical
serotonin, which regulates mood. Over time, as the levels increase,
the transmission of electrochemical signals in the brain improves (in
a depressed person the transmission of electrochemical signals occurs
less efficiently), and the depression lifts.

Dr McKeown stresses that antidepressants should not be used to treat
all mental illnesses on a permanent basis. He points out that there
are different types of depression, some induced by circumstances such
as a bereavement or relationship problems, and others due to chemical
problems in the brain, which may have genetic or biological causes.
While Prozac may be useful in some cases as a once-off to lift the
depression - which should then be treated with psychotherapy -
biological or chemical depression may need longterm medication.

More than 200,000 people in the State suffer major depression, while
one in three will have an episode of major depression in their life.
It has been linked to the majority of the 380 suicides in the Republic
each year (on average). Dr McKeown says Prozac is not the "miracle"
answer to end all research into the medical treatment of depression.
"We are still looking forward to an antidepressant which has no
side-effects such as tummy upset or reduced libido - both of which can
be brought on by Prozac."
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