Millions of people have taken Prozac
Until the advent of the impotence treatment Viagra, the anti-depressant drug Prozac was probably the most high profile new treatment to be launched in a generation.
It was initially hailed as a miracle cure, but became a victim of its own success as patients who were not clinically depressed demanded the drug as a "quick fix" for their personal problems.
There are concerns that the drug is addictive and that in some cases it can lead to thoughts of suicide. But despite the controversy surrounding Prozac it has become the first-line treatment for most patients exhibiting the signs of major depression.
More than 35 million people worldwide have been prescribed Prozac - including more than 500,000 in UK alone - since its launch in 1989.
What is prozac?
Prozac (fluoxetine) is one drug in a family of antidepressants called selective serotonin re-uptake inhibitors (SSRIs). Other drugs in this family are Lustral (sertraline), Seroxat (paroxetine), and Faverin (fluvoxamine). There are also other families of medications that are antidepressants.
SSRIs make serotonin more available in the brain. Serotonin is a chemical that affects mood.
SSRIs have potential benefits:
People who take SSRIs usually need just one dose per day.
SSRIs are safer to take with other drugs and pose less risk in overdose.
How effective is Prozac?
All the drugs commonly prescribed for depression are roughly equal in effectiveness. This often surprises people who assume that Prozac is best.
On average, antidepressants seem to help 60% to 80% of the people who take them.
This is true both of the earlier-developed drugs such as tricyclics such as Elavil (amitriptyline), as well as the newer drugs such as SSRIs.
Many people combine Prozac with psychotherapy.
Are there side effects?
There is evidence to suggest that taking Prozac may trigger suicidal thoughts in some people.
In England, the Department of Health has recommended that Prozac should be the only drug of its type prescribed to patients under 18.
However, an analysis by the US Food and Drug Administration concluded that the drug posed a similar risk to young people as other SSRIs.
The FDA recommended the drug should carry the strongest possible warning that it could cause children to harm themselves.
Eli Lilly, the makers of Prozac, argued that in no case studied by the FDA did Prozac actually lead to a suicide, and that depressed people were probably prone to suicidal thoughts regardless of what medication they took.
They also warned that the risk of not treating depressed young people at all was probably greater than any risk posed by taking their product.
Other side effects can include:
Nausea;
Headaches;
Diarrhoea;
Insomnia;
Sexual difficulties, such as delayed orgasm.
Does Prozac transform personality?
Psychiatrist Peter Kramer, in his best-selling book Listening to Prozac, claimed that the drug could be use to alter personality traits like shyness and lack of confidence.
However, there is scientific evidence to suggest that claims that Prozac can transform personality are exaggerated.
People may become more gregarious and easy going when taking the drug, but this can be attributed to recovery from depression, rather than any magical properties of Prozac itself.