Peter Kramer, psychiatrist, 1993.
Prozac was launched in 1987 and became popular faster than any drug previously used in psychotherapy. It starred on magazine covers and was the hot topic on talk shows. Compared to other anti-depressants Prozac had fewer side effects and made people feel ‘better than well’. It was believed to be a modern ‘wonder drug’.
The era of ‘wonder drugs’ began after WWII when penicillin and other antibiotics made a huge impact on people’s lives. A British company manufacturing penicillin after the war also made and distributed the sedative thalidomide, one of the first ‘wonder drugs’ to enter the cycle of glory and blame.
Distillers Company (Biochemicals) Ltd began supplying their brand-name thalidomide, Distaval, in 1958. Distillers publicised its comprehensive safety – even for pregnant women – although it had never undergone rigorous clinical trials. By the end of 1961 Distillers and the founding German manufacturers, Chemie Grünenthal, had withdrawn the drug. Research showed that women taking just one tablet in the 20th-36th day after conception were at risk of delivering a child with a condition called phocomelia, or shortened limbs. Between 8,000 and 10,000 children were affected worldwide.
Prozac’s glory lasted for less than three years. A paper in the American Journal of Psychiatry in 1990 reported the ‘intense, violent suicidal preoccupations’ of six patients on Prozac. Seroxat, released in 1991, initially benefited from the Prozac backlash, but it too faced criticism about severe side effects including suicide. Opinion was divided. Some argued that the evidence was indisputable. Others believed that suicide represented the natural course of depression in these people.
Patients have mixed attitudes to drugs. Praise has often given way to criticism. This could be explained in two ways – as a result of debate over the costs as well as the benefits of scientific discoveries or because side effects become more apparent the more people use the drug.
Even when the side effects of a drug are known, it does not necessarily damage its reputation. Seroxat is still prescribed to millions of patients in more than 100 countries. Sometimes patients consider the benefits to be worth the risks. Thalidomide was re-released in 1998 for the treatment of leprosy, with strict control over its prescription.