Abstract

Trouble in Prozac Nation

The author argues that a group of antidepressants know as selective serotonin reuptake inhibitors (SSRIs) may cause some patients to become violent, and should no longer be routinely prescribed. The possibility that a group of widely prescribed antidepressants, including Prozac and Paxil, might trigger suicide and other violence in a small percentage of users has been the subject of isolated reports in the major media since they first arrived on the market. Recently, however, the concern has been recognized by the federal government. In June, following actions taken by British drug authorities, the FDA released a statement recommending that physicians refrain from prescribing Paxil to new patients under 18. Reports of a possible link between adult SSRI use and violence, including suicide, first appeared in 1990. Meanwhile, incidents of extreme mental agitation involving SSRIs have not abated. Instead of at least warning physicians of a risk of drug-induced agitation, SSRI makers continue to insist that the violence linked to SSRI use is the product of the "illness" the drug is said to treat. In many instances of SSRI-related violence, however, the drugs were prescribed not for clinical depression but only as an adjunct treatment for other health problems (such as back pain). What has become clear is that the SSRIs should not be the first line of pharmacological treatment for depression.