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You can't pick up the New York Times or Newsweek without seeing pictures of huge green and white Prozac (fluoxetine) capsules. In fact, you can't turn on the television without a talk show host or the evening news featuring a story on it. The publicity and popularity of this relatively new antidepressant has led patients to exaggerate symptoms to get the "new upper," led the general public to consider taking Prozac just to lose weight, and led cynics to suggest that Prozac will be on the cover of Time magazine as "Man of the Year." But is it the pill of the year?
Since its introduction onto the US market 2 years ago, Prozac has become the most widely prescribed antidepressant. The popularity of Prozac has led to further trials in a variety of other psychiatric disorders and as an aid to weight loss. Different from the tricyclic and other antidepressants, Prozac is a novel agent that works specifically as a serotonin reuptake blocker.
In studies of its efficacy, Prozac appears to be equally effective as other antidepressants in the treatment of major depression (Stark, 1985). It was developed as one of the new age antidepressants, and one of its main attractions is its very different side effect profile. However, Prozac is not without its share of bothersome and difficult adverse reactions. And although some patients have had very favorable and dramatic responses, others have had partial or no improvement. Nonetheless, for the treatment of acute depressive symptomatology, this antidepressant is clearly indicated and some patients respond quite favorably (Benfield, 1986).
Who are the candidates for Prozac? Clearly, any patient who is suffering from a major depression; patients with sustained depressed mood and concomitant symptoms (change in appetite and sleep, suicidal ideation, decreased concentration, lack of energy, etc) for a 2- week period. Recent reports have studied the efficacy of Prozac in bulimia, borderline personality disorder, panic attacks, and obsessive compulsive disorder. Prozac is not indicated for patients suffering from a mild form of depression or for those people who want to drop 5 pounds. As with any antidepressant trial, the choice of medication is based largely on diagnosis, symptom presentation,...