Prime Time Replay:
Dr. William Appleton
on Prozac, Paxil, and other anti-depressants
MsgId: *brain_storm(3)
Date: Fri Apr 4 22:14:34 PST 1997
From: Rob_Killheffer At: 38.254.181.13
Good evening everyone and welcome to Brainstorms. Our guest tonight is Dr. William Appleton, author of PROZAC AND THE NEW ANTI-DEPRESSANTS. Millions of people are taking these new drugs, prozac and paxil, zoloft and wellbutrin. How effective are they? What are their side-effects? Should *you* be on one? Stay tuned and find out.Dr. Appleton, let's begin with the basics: what are these new drugs? That is, how do they work, and what conditions are they effective in treating?
MsgId: *brain_storm(6)
Date: Fri Apr 4 22:18:56 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
These drugs are mostly work at the space between two nerve cells called the synapse and they affect the various primary transmitters, primarily serotonin and norepinephrine. In fact, it is thought that they work beyond the body of the cell because the change in the synapse is immediate and the change in the cell takes longer.
MsgId: *brain_storm(7)
Date: Fri Apr 4 22:19:56 PST 1997
From: Rob_Killheffer At: 38.254.181.13
And are they effective only in treating depression, or other illnesses as well?
MsgId: *brain_storm(8)
Date: Fri Apr 4 22:22:19 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
They have been used in almost every psychiatric condition successfully. The official use almost always lags behind what is happening out in the field. These drugs have been used in Obsessive-Compulsive Disorder, Premenstrual Tension, people with poor impulse control, people with Post Traumatic Stress Disorder, schizophrenia, to name just a few. The reason that the drug use has been so wide-spread is that serotonin imbalance is not confined to depression, but crosses over into almost every psychiatric condition.
MsgId: *brain_storm(9)
Date: Fri Apr 4 22:25:10 PST 1997
From: Rob_Killheffer At: 38.254.181.13
If that's true, then it raises the question of what the relationship is between those various conditions. Is it conceivable that serotonin imbalance is an after-effect of these problems, and not a cause?
MsgId: *brain_storm(10)
Date: Fri Apr 4 22:27:07 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
If a lion walked in to your living room, you would have chemical imbalances within your bloodstream and your brain. The cause is not a chemical imbalance necessarily, it could be psychological stress. Human beings are composed of chemicals and these chemicals reflect their experience both real and imagined.
MsgId: *brain_storm(11)
Date: Fri Apr 4 22:28:29 PST 1997
From: Rob_Killheffer At: 38.254.181.13
Many people out there must be wondering whether they would be better off taking one of these drugs. How can they tell? How do you know if you're experiencing "normal" levels of depression or axiety, or are in need of help?
MsgId: *brain_storm(12)
Date: Fri Apr 4 22:32:01 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
This question is very good and the answer is very complicated. If a person has a severe depression, such that they cannot get out of bed, the decision about whether to take the drug or not is easy. When a depression is lifelong, it becomes entwined with the person's whole being, so that it is difficult for the individual to realize what is their normal state for them and what is a condition that needs treating. A doctor or a therapist can help evaluate the person's functioning to try to determine whether the condition would be helped by drugs. Sometimes it is helpful to also consult with people who know the individual well to try to help in this decision.
MsgId: *brain_storm(13)
Date: Fri Apr 4 22:33:41 PST 1997
From: Rob_Killheffer At: 38.254.181.13
Just how effective are these medications? If someone does decide to take them, how much relief should they expect?
MsgId: *brain_storm(14)
Date: Fri Apr 4 22:35:22 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
These drugs, for the right person, are extremely effective. Some people make the mistake of looking to a drug to supply them with a life. People need a good self-diagnosis and a good psychiatric and medical diagnosis to try to understand what the drug is called-upon to do for them and whether the request is reasonable.
MsgId: *brain_storm(15)
Date: Fri Apr 4 22:36:40 PST 1997
From: Rob_Killheffer At: 38.254.181.13
How do these drugs interact with psychotherapy? Should they always be used in conjuction, or will the drug alone sometimes take care of the problem?
MsgId: *brain_storm(16)
Date: Fri Apr 4 22:39:13 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
Upon the rare occasions a person whose life is altogether in order suffers a first time severe depression or acute depression because of some event that occurs, such as being fired, or losing a loved one, these drugs can then often pretty much restore the person's psychology state to the previous health. Most people do not have such clearcut depressions, but their depressions are complicated by many other factors, including drinking, including complicated and unhappy relationships, including self-defeating patterns of behavior, which make them unhappy, and all these need to be addressed along with the symptoms of depression and therefore require psychotherapy as well.
MsgId: *brain_storm(17)
Date: Fri Apr 4 22:39:49 PST 1997
From: Rob_Killheffer At: 38.254.181.13
What are some of the common side effects associated with these drugs, and how severe are they?
MsgId: *brain_storm(18)
Date: Fri Apr 4 22:42:25 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
There are very few severe side effects associated with these drugs. The severe side effects are so rare that they may not be related to the drugs at all, but simply occur in the same time that the individual was on the drug. The main side effects can be labelled as primarily annoying and include disturbances of the stomach and digestion, and feelings of sometimes being wired and anxious, or drugged and tired, and sometimes individuals have sexual problems that are well known of these drugs.
MsgId: *brain_storm(20)
Date: Fri Apr 4 22:44:18 PST 1997
From: Rob_Killheffer At: 38.254.181.13
There have occassionally been stories -- urban legends -- in which someone on Prozac becomes violent or delusional. Is there any factual basis for such anecdotes?
MsgId: *brain_storm(21)
Date: Fri Apr 4 22:45:47 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
More than 11 million people have taken Prozac. Of these, some are violent and I suppose some are delusional. Noone has been able to show that this is prozac's fault, although attempts have been made. Careful study has shown that prozac *reduces* rather than increases violence, and does not cause delusions.
MsgId: *brain_storm(22)
Date: Fri Apr 4 22:47:32 PST 1997
From: Rob_Killheffer At: 38.254.181.13
Nevertheless, there remains a noticeable stigma attached to taking these drugs. Do you think that's likely to change in the near future? Will people become as accepting of mental illnesses as they are of most physical ones?
MsgId: *brain_storm(23)
Date: Fri Apr 4 22:48:53 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
Unfortunately, I think the answer is the stigma does continue, although I think it has lessened with the acknowledgement of leading personalities that they have suffered these conditions. Nonetheless, there is a stigma that remains and I hope it will continue to diminish.
MsgId: *brain_storm(24)
Date: Fri Apr 4 22:51:03 PST 1997
From: Rob_Killheffer At: 38.254.181.13
Some people have suggested that the high incidence of depression, anxiety, and related disorders in our society is a symptom of our culture's decline. Do you think there are more people suffering from these ailments now than there might have been many years ago, or is it just more often recognized?
MsgId: *brain_storm(25)
Date: Fri Apr 4 22:57:15 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
These questions are a little bit out of my expertise as a psychiatrist. People have their favored reasons for why there is so much depression nowadays. Some attribute it to the decline of the cohesiveness of family, others to the lack of religion, others to decline in manners and morality. People have their favorite reasons for why there seems to be more depression. Whether there in fact is more depression now than there was a thousand years ago, is almost impossible to say. As recently as 100 years ago, the word depression was rarely used in psychiatry and when people don't have a name for something, it doesn't exist.Nonetheless, twenty-five hundred years ago, the condition of depression, with it's symptoms of difficulty sleeping, loss of appetite, etc., was described. Depression has always been with us and that hasn't changed. What has changed is the willingness to call it depression rather than simply the human condition.
MsgId: *brain_storm(27)
Date: Fri Apr 4 22:59:07 PST 1997
From: Rob_Killheffer At: 38.254.181.13
As we learn more and more about the workings of the brain, it may become possible to design better and better drugs to treat mental illnesses. Do you know of any exciting new developments underway in the area of anti-depressants or anti-anxiety agents? Any sign of what the next generation of such drugs will be like?
MsgId: *brain_storm(28)
Date: Fri Apr 4 23:00:26 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
My book lists twenty-three drugs that are in various stages of development or available in other countries. None of them seem to provide a magic breakthrough. I have hope for the future, but there is no immediate drug on which I can focus.
MsgId: *brain_storm(29)
Date: Fri Apr 4 23:03:02 PST 1997
From: Rob_Killheffer At: 38.254.181.13
I think we're about out of time, Dr. Appleton. Thank you for being with us tonight. We can only skim the surface of these questions in our one-hour show, so if anyone out there wants a more complete and detailed description of the new anti-depressant drugs and their effects, check out Dr. Appleton's book, PROZAC AND THE NEW ANTIDEPRESSANTS. On that note, goodnight for Brainstorms!
MsgId: *brain_storm(30)
Date: Fri Apr 4 23:04:18 PST 1997
From: Dr_William_Appleton At: 207.172.39.96
Thank you very much! I have enjoyed talking to you. Goodnight!
Home || Prime Time || Live Science || Machine Dreams || Project Open Book || SF-Fantasy-Horror
Continuum || Antimatter || Mind-Brain Lab || Interactive IQ || Gallery || OMNI ToonsQuestions, comments and suggestions can be mailed to the webmaster.
Copyright (C) 1997 by Omni Publications International, Ltd. All Rights Reserved.