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Selective serotonin reuptake inhibitors (SSRIs)

Art work representing treatment of depression with a SSRI, Prozac.

Art work representing treatment of depression with a SSRI, Prozac.

Credits:Rowena Dugdale, Wellcome Images

SSRIs, a class of antidepressants, transformed the psychiatric drugs market in the 1980s and 1990s, and also inspired much popular discussion as well as drug development. SSRIs were the first antidepressants to control the activity of a specific neurotransmitter, in this case serotonin. This helped reduce side effects. Doctors prescribed them to severely depressed patients in mental hospitals as well as people experiencing mild depression or anxiety.

The first and most famous SSRI was fluoxetine hydrochloride, introduced in 1987 under the trade name Prozac. The American pharmaceutical company that developed Prozac was cautious and tested its safety and effectiveness for over a decade before releasing it. This eased concerns about addiction, which had troubled anti-anxiety drugs in the 1970s, particularly minor tranquilisers such as Valium.

Prozac sold so well that its success became a common topic of conversation and even inspired popular books. Some were written by psychiatrists and patients, with titles such as Listening to Prozac and Prozac Nation. The best of these books wrestled seriously with difficult questions. Where is the line between depression and ‘ordinary’ dissatisfaction? What is the relationship between drug therapy and psychotherapy?

Bibliography

D Healy, The Anti-Depressant Era (Harvard University Press, 1997).

P Kramer, Listening to Prozac (London: Fourth Estate, 1994)

E Wurtzel, Prozac Nation: Young & Depressed in America, a memoir (London: Quartet, 1995)

J Metzl, Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs (Durham: Duke University Press, 2003)

 

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