Prozac as a Way of Life (Studies in Social Medicine) [Paperback]

Carl Elliott (Author)

Book Description

Publication Date: September 15, 2004 | Series: Studies in Social Medicine

Prozac and its chemical cousins, Paxil, Celexa, and Zoloft, are some of the most profitable and most widely used drugs in America. Their use in the treatment of a multitude of disorders--from generalized anxiety disorder and premenstrual syndrome to eating disorders and sexual compulsions--has provoked a whirlwind of public debate. Talk shows ask, Why is Prozac so popular? What, exactly, do these drugs treat? But sustained critical discussion among bioethicists and medical humanists has been surprisingly absent.

The eleven essays in Prozac as a Way of Life provide the groundwork for a much-needed philosophical discussion of the ethical and cultural dimensions of the popularity of SSRI antidepressants. Focusing on the increasing use of medication as a means of self-enhancement, contributors from the fields of psychiatry, psychology, bioethics, and the medical humanities address issues of identity enhancement, the elasticity of psychiatric diagnosis, and the aggressive marketing campaigns of pharmaceutical companies. They do not question the fact that these antidepressants can, in some cases, provide great benefit to alleviate real suffering. What they do question is the abundant popularity of these drugs and that popularity's relationship to American culture and ideas of selfhood.

Editorial Reviews

From The New England Journal of Medicine

In the first flush of its successful seduction of American psychiatry, Prozac engendered a compelling myth. Spurred by Peter Kramer's lucid recounting of his clinical experiences in Listening to Prozac (New York: Penguin Books, 1997), the idea arose that Prozac could make well people feel "better than well." Freud used to say that the best psychoanalysis could do was to turn neurotic suffering into common unhappiness, but Prozac seemed to promise something more. "Better than well" was a concept that not many people could resist. As a psychiatrist, I was drawn to the promise of the drug. One evening, I decided to try a little myself. I was well, but if I could be better, I wanted to be. I soon noticed my stomach becoming queasy and a quickening of my pulse. Maybe this was the price I would have to pay, I thought. But that night, I did not sleep. I struggled through the next day feeling worse than ever and resolved to put the Prozac away. Better to leave well enough alone. Some of my patients, however, especially those plagued with anxious preoccupations, have responded very nicely to Prozac. They have felt "back to themselves," freer, and able to expand their range of thinking beyond obsessive rumination. Yet many others have found that although the drug has made them agitated, given them headaches, or made it more difficult to have an orgasm, it has done nothing to transform their personalities. Prozac, it turns out, is not a panacea and not a way of life. It is just another drug, one that helps a certain number of people but does nothing beneficial for the rest. Despite recent advances in psychopharmacology, we still do not know much about how Prozac's chemical modification yields cognitive and behavioral change. How does the prolongation of the life span of serotonin in the synaptic cleft enable someone to stop obsessing about his upstairs neighbor's heavy footsteps? What does it suggest about our notions of temperament or character that certain aspects, like anxious preoccupation, can be modified by a pharmaceutical agent? Prozac as a Way of Life steers clear of the biologic issues but takes on the philosophical ones. Most of its essays take the "better than well" myth as a reality and dwell on the ethical implications of cosmetic psychopharmacology, treating the drug as a threat to creative introspection. Only a few address the question of how our culture's spiritual yearnings have attached themselves to a drug. Although the concerns of these medical ethicists may prove to be prescient, there is nothing to suggest that Prozac actually has the power to medicate away alienation in the manner suggested by Aldous Huxley in Brave New World. The selective serotonin-reuptake inhibitors are interesting drugs, but their muting of sexuality, their tendency to produce agitation, and their occasional association with suicidal thoughts and behavior will forever limit their appeal. Although there is much to chew on in this provocative collection, its central premise is flawed. The vast number of people who take Prozac for common unhappiness will notice nothing but side effects. Mark Epstein, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to the Hardcover edition.

Review

"An important contribution to a debate on how one becomes who one is."
— Choice

"This book is one of the finest examples of today's interdisciplinary bioethics scholarship.
(Paul Brodwin, University of Wisconsin-Milwaukee, editor of Biotechnology and Culture: Bodies, Anxieties, Ethics) "

"Anyone interested in the question of whether spiritual suffering ought to be treated medically will find this fascinating reading.
(Hilde Lindemann Nelson, Michigan State University, author of Damaged Identities, Narrative Repair)"

See all Editorial Reviews

Product Details

• Paperback: 224 pages
• Publisher: The University of North Carolina Press; 1 edition (September 15, 2004)
• Language: English
• ISBN-10: 0807855510
• ISBN-13: 978-0807855515
• Product Dimensions: 9.2 x 5.8 x 0.5 inches
• Shipping Weight: 9.6 ounces (View shipping rates and policies)
• Amazon Best Sellers Rank: #1,863,945 in Books (See Top 100 in Books)

More About the Author

Carl Elliott prefers to write about himself in the third person in order to give the impression that he is too important to submit his own biography. A native South Carolinian, Elliott teaches bioethics and philosophy at the University of Minnesota and writes occasionally for magazines such as The New Yorker, The Atlantic Monthly and Slate.com. His estranged younger brother ridicules him periodically at the unfortunate website, www.whitecoatblackhat.com. His attorneys are addressing the situation.