There is no problem with Prozac. That's the official word fromthe Food and Drug Administration, after recent hearings examined claims that Prozac's behavioral side effects might include suicide and violent behavior. But what about the attitudinal effects of this profitable and popular drug. Is Prozac changing how we feel about feelings?
What if Hamlet had had Prozac?
In Shakespeare's play the young prince returns to Denmark for ** his father's funeral. He is sad and upset. In a very short time his mother has remarried her dead husband's brother. Hamlet, outraged, is obsessed with revenge. Shakespeare tells us that Hamlet suffers from ''melancholia.'' The anger and grief result in five deaths. Reading the play now, we can wonder if Prozac might have saved all this carnage.
This very popular anti-depressant was introduced by Eli Lilly and Co. in 1988. The green and white capsules are appearing in more medicine chests and cosmetic bags each day. Mental-health practitioners say that this anti-depressant, also known as fluoxetine, cuts the intensity of strong feelings and helps to calm and lighten moods. Because Prozac works with the chemistry of the brain as a serotonin uptake inhibitor, it only really works for those who have the corresponding biochemical need for their serotonin to be reduced.
Prozac cuts into compulsive behavior; all those people repeatedly washing their hands, counting steps and stepping over the cracks in the sidewalk are freed from those intensive drives. For this reason Prozac is frequently prescribed for obsessive-compulsive disorders. It is also used for conditions such as anorexia, bulimia, alcoholism, cigarette addiction and insomnia.
The other thing that Prozac does well is to lessen the intensity of strong emotional reactions. Fears are less, compulsions are less and anger is less. With Prozac the world is lighter, calmer and easier. People on Prozac are just generally less upset. And being upset seems to be the basis for getting a prescription.
It's not easy to make a case against something that quells anger. Nobody likes anger. Isn't it a good thing to get rid of anger and similar strong and disturbing feelings? Isn't it a relief for all concerned if you can just chill out, lie back, let go and ease up.?
Well maybe. And maybe not.
What do users of Prozac report? Many say that since taking Prozac, whenever they encounter an old pain or something that used to upset them, they can say, ''so what.'' When something occurs that used to create rage, Prozac fans say, ''I didn't let it bother me.''
That probably is fine if you have been screaming at your secretary for making typos, or driving your husband nuts because he doesn't do everything right. But if you are constantly saying ''I'll do it tomorrow,'' or if you no longer care if someone is treating you or others unfairly, or if you no longer have strong feelings about bad things happening in your life or in the world -- then maybe Prozac is not a good idea.
Sadness tells us when we have lost or are losing something important. Anger tells us that something wrong or bad is going on. Our complex emotional systems are what clue us in to what is happening; they show us what we care about, and they define us within our society's rules and moral codes. If we cannot feel and make judgments and decisions based on those feelings, and the intensity of those feelings, then we are missing a crucial barometer for what is happening to us and around us.
Strong feelings are uncomfortable and even inconvenient, but would we have revolutions, spiritual awakenings or art without them? Without anger, or even rage, would we have justice and law?
Let's go back to the melancholy prince in Denmark and imagine what he would have been like if the castle alchemist had mixed up a bowl of fluoxetine for him. Maybe Hamlet would have grieved for his father in a quiet way, and been mad at his mother and thought his uncle was a criminal, but nobody would have gotten killed. If he had had Prozac he might have gone back to school, or gone to Paris with Laertes. He might have been mad, but not murderous. That would have been Neil Simon, not Shakespeare.
Hamlet's preoccupation with the nature of man has led critics to refer to him as the ''first modern man.'' What they celebrate is Hamlet's angry preoccupation with the unjust break in the moral code of Elsinore. (According to church law at that time a man marrying his brother's widow was entering an incestuous relationship.) Psychopharmacology might have drastically changed this play. Is it changing our lives?