The Wizardry of Prozac 6-year-old anti-depressant gets bum rap as a quick fix-it for whatever troubles you

September 21, 1993|By Jean Marbella | Jean Marbella,Staff Writer

Few would have gotten the joke if the exasperated Woody Allen character in "Manhattan Murder Mystery" had said to his ditzy wife: "There's nothing wrong with you that Elavil and a polo mallet wouldn't cure."

And a poem in the New Yorker last year would have seemed even more obtuse if it had read:

"The stick

Figures on Capitol Hill. Their rhetoric,

Gladly -- no rapturously (on Wellbutrin) suffered!"

But say "Prozac" rather than those other two antidepressant drugs, as Mr. Allen and poet James Merrill did, and the punch lines deliver.

Prozac entered the popular lexicon almost immediately after its introduction six years ago. It's been on the cover of Newsweek and shared the stage with Phil and Geraldo; it continues to turn up in the monologues of comedians and the cultural references of the ironic. It's a designer label, a buzzword, a brand name familiar to not only the 4.5 million Americans who have taken it, but also those who wonder if they, too, might find a cure for whatever ails them in the little green-and-off-white capsule.

It's no wonder, then, that a new book, "Listening to Prozac," by Dr. Peter D. Kramer (Viking, $23), has been on the best-seller lists for the past 10 weeks, jumping on soon after it was published in June. The book has been well-reviewed and recently went into its 11th printing, bringing to about 160,000 the total number of copies in print.

Subtitled, "A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self," it weaves case studies of the author's own patients with research from the intriguing field of personality study. In the book, Dr. Kramer raises some highly provocative questions: Is Prozac being used "cosmetically" on people who are not ill but merely, say, shy or overly sensitive? Does Prozac numb you to your problems rather than force you to confront -- and fix -- them? Does Prozac work too well, to the point that it

transforms the taker's nature, his or her very self?

Despite there being no pat answers -- or, rather, because of that -- "Listening to Prozac" has struck a nerve among readers.

"Five of my patients have told me they read it -- they're either on Prozac or about to go on it," says Susan Walen, a psychologist in private practice who teaches at Towson State University. "They say, 'I saw myself on every page.' "

Indeed, it's hard to read "Listening to Prozac" and not project yourself into it. And, that, some say, is the problem with Prozac, or rather, Prozac's image: People hear about it and think it's a magic pill to cure their everyday sadnesses and disappointments rather than a serious drug for serious illness.

"Prozac is a very fine antidepressant, no question about it. But it is not the end-all and be-all," says Dr. Lois Conn, a Timonium psychiatrist whose patients also have been talking up the book. "People say 'my sister's on it, my neighbor's on it,' and they think it's going to take care of everything, from marital discord to financial problems."

"There are a lot of people out there looking for the elixir. This is the problem with Prozac: It's become the Coca-Cola of $l antidepressants," says Paul Hoagberg, 55, who has been diagnosed as manic-depressive and currently takes Prozac. "It was developed for a specific purpose. It's not a 'happy pill.' "

Mr. Hoagberg, a former intelligence worker who now heads the Baltimore-based educational group Depression & Related Affected Disorders Association (DRADA) believes the misconceptions about Prozac mirror those about mental illness in general.

Not everything is depression

"People have to make a distinction between depression and just the vicissitudes of life," he says.

While misconceptions remain, mental illness has emerged, at least partially, from the tight secrecy that used to shroud it. Books like "Listening to Prozac" -- which, with its anecdote-based narrative style, follows in the footsteps of previous best sellers about mental illness such as, "The Boy Who Couldn't Stop Washing" and "The Man Who Mistook His Wife for a Hat" -- reflect an increased interest in the subject.

"I think people are becoming more serious about mental health questions," Dr. Kramer says during a telephone interview from ,, Providence, R.I., where he is in private practice and teaches at Brown University. "People are becoming more aware of new ways of viewing the self. I hope by writing a popular book, I've helped open up some of these issues."

One issue he raises is how Prozac triggers what one researcher termed "pharmacological Calvinism," our tendency to distrust mood-altering drugs and suspect that if something feels good, it somehow must be morally bad. Dr. Kramer recalls a patient whom he counseled for a while before suggesting she might be helped by medication; she responded, "Wouldn't that be cheating?"

"Medication is not a panacea, but neither is talking about [your problems]. No one would ever think to say, 'You've got high blood pressure,you've got an ulcer, just tough it out,' " says Dr. Conn.

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