America’s new drug of choice is quite a balancing act
Prescribing Prozac

Story by Mary Reynolds, illustration by Sean Vincent.

Will Prozac replace caffeine as Richmond’s drug of choice?

It seems like you can’t go anywhere without someone giving their personal testimony about this wonderful antidepressant.

In the 50s, housewives veged on Valium and 80s-overachievers gobbled Xanax, but today’s gloomy Generation X prefers Prozac.

On Prozac, people say they feel more secure and confident about themselves. While some worry about the ethical questions of lifetime mood stabilizing drugs like Prozac, many patients praise it for helping them live normal lives . . .

Faculty at Virginia Commonwealth University report that students write stories about life before and after Prozac, or talk to them about it during their office hours. During the first day of classes when students introduce themselves, one undergraduate told his upper-level history classmates, “I was really stressed out about this class, but I started Prozac this summer and I feel a lot better now.”

Surprisingly, you don’t have to see a psychiatrist to get Prozac.

“I know people who got it from their family doctor or even their dentist,” says one licensed practicing counselor who asked not to be identified. College health centers around the country are giving the drug to clinically depressed students and sometimes to students who are just a little homesick or bummed out about a relationship.

“We don’t have much experience with Prozac, we cannot prescribe it,” says psychologist Warren Hopkins, director of the University of Richmond Psychological Services and Counseling Center. “We may send some students to a psychiatrist who makes that kind of determination.”

VCU’s counseling center has its own psychiatrist, David Webber, who refused to be interviewed for this article. Psychiatrists at the Medical College of Virginia did not return Caffeine’s telephone calls. VCU counseling director Jack Corazzini admitted that depression is the reason many of the 1,200 students come to the counseling center each year.

More than six million Americans take Prozac on a daily basis to combat chemical depression, biochemical depression and sometimes just plain crabbiness. Prozac, manufactured by Eli Lilly & Co., effects the neurotransmitter called serotonin. People diagnosed with clinical depression often have low levels of serotonin in their brain. By maintaining stable levels of serotonin, Prozac lessens anxiety and makes depressed or moody people happy. But not too happy.

“On Prozac, I didn’t feel intense feelings either way,” says 26-year-old Jane Doe (obviously not her real name). Jane praises the drug which kept her from committing suicide when she first started taking it in college. “It was like night and day, I went from barely having a grip on my life to being completely overwhelmed about what I could do, my potential. It was incredible, all my grades went up and I felt more like myself.”

While Prozac certainly helps many people overcome their depression and lead relatively normal lives, it also has adverse side effects. According to medical research, one-third of people taking it experience insomnia. When they do sleep, they have nightmares or dream with such intensity that the mind does not rest.

In his bestselling book, Listening to Prozac, Dr. Larry Kramer discovered that about 40 percent of Prozac patients experience sexual dysfunction. Patients reported general loss of interest in sex, difficulty in reaching orgasm and impotence. Other patients reported weight loss and suicidal tendencies.

Prozac is not for everyone. According to research, serotonin compounds like Prozac do not work for 20-40 percent of depressed or anxious people who start taking them.

Getting back to our friend Jane, she happily ingested the miracle drug for about two years. She could not afford psychiatric counseling and Prozac, so she chose the drug with a cost of about two dollars a day. After two years of bliss, Jane’s Prozac paradise started to unravel.

“I had problems with getting very, very anxious. I had just moved to a new city so I messed around with my own dose. I ran out of money, so I was on and off it.”

“I started seeing a new psychiatrist and started taking Prozac regularly again,” she continues. “I became more than anxious, I was manic. I felt out of control—jumpy and angry. I didn’t feel very safe about myself around other people or behind the wheel of a car. “ After trying a different drug which made her sick, the psychiatrist upped her Prozac dosage.

With the new higher dosage, Jane stayed in her apartment. She was afraid to go outside because she might hurt somebody, including herself. “I felt so incredibly aggressive, like if I got in my car, I would drive really fast into a wall and kill myself. I could relate to homicidal maniacs, the aggressiveness, how they feel.”

Finally, she switched psychiatrists again and started taking Zoloft, a drug similar to Prozac. So far, so good.

Dr. Kramer believes Prozac’s popularity hails the beginning of a new era he calls “cosmetic psychopharmacology,” when people will take legal drugs to avoid feeling angry or sad. In addition, Prozac and related drugs prevent extremely happy moods on the other end of the spectrum: no pain means no joy, no struggle means no victory.

All intensity of feeling is sacrificed for baseline bliss, the 90s version of “I’m OK, You’re OK.”

On the other hand, caffeine makes you feel invincible, ready for action, gets the heart racing, and sparks the mind.

Maybe you should wash down your Prozac capsule with a can of Jolt.