Prozac, Beginning of the Anti-Depressant Era
The integrity of medical literature has been called into question.
- Drug makers spend significantly more money on advertisements than on the actual research and development of the drug.
- The media targets the consumers with ads, acting as the marketing arm of the pharmaceutical industry, with great financial interest.
- Much of the research results are misreported or false.
The psychopharmaceutical complex is described as a large network fueled by billions of drug company dollars exerting major influence over schools, researchers, state and federal governments, insurance companies, medical and psychological institutions, prescribers, the media and the vast majority of healthcare providers.
The push and marketing for antidepressants was based on a false theory which has been refuted by evidence though continues to be cited by doctors and hence is still believed by lay people.
Psychoactive drugs have not proven to be effective and side effects can be devastating and fatal.
The last blogs led us to ask the following questions:
- Could it be the financial interest of the psychopharmaceutical industry bringing in an average of 35 billion dollars a year championing these drugs, preventing a thorough investigation into a link between them and violence?
- Are we providing our patients ammunition for healing or ammunition for self and societal destruction?
The following goes into the history of one of the most commonly prescribed and known SSRIs and how it became distributed in massive amounts.
History of Prozac
Fluoxetine, commonly known by its brand name Prozac, was the first SSRI to be marketed in the US and is one of the most commonly prescribed SSRIs. In 2020, fluoxetine ranked number 25 of the top 300 drugs prescribed. The estimated number of fluoxetine prescriptions in the US in 2020 was 23.4 million. This number has since risen.
Manufactured by Eli Lilly, Prozac was first discovered in the early 1970s and suggested to be used as an antidepressant. Prozac was initially FDA-approved in 1987 and marketed the next year. It became FDA-approved in 2002 for the treatment of depression in children and adolescents based on data from two peer-reviewed clinical trials.
The trials concluded no major safety concerns and a small benefit over placebo for the treatment of depression. Initially marketed to women, a lot of money was spent advertising Prozac directly to consumers resulting in skyrocketed prescriptions.
The Psychopharmaceutical Complex
Historian of medicine and psychiatry, Edward Shorter is quoted as saying, “One could call psychopharmacology the creation of the drug industry, rather than of the academy or clinicians.”
Concerns using chemical manipulation of humans via drugs dates back to the 1970s as described in an article entitled “Treat Her with Prozac: Four Decades of Direct-to-Physician Antidepressant Advertising.” The chemical imbalance theory as the cause of depression was repeated and used in drug advertisements leading the general public to believe depression and other mental illness is simply an imbalance of brain chemicals that can be cured with a pill.
“Pharmaceutical companies spent enormous amounts of money on marketing in the 1970s and 1980s, primarily for advertising and direct mailing to physicians. Studies show ‘there was one pharmaceutical sales representative for every 8 physicians in the United States and for every 18 physicians in the United Kingdom’; these numbers are directly reflected in the number of prescriptions written for these drugs. Coincidentally, the number of depression diagnoses surged during this period, from less than one hundred cases of depression per million in the early 1950s to one in ten, or more than one hundred thousand per million in 2000.”
A 1999 article from the Los Angeles Times writes, “By producing the ads, Prozac manufacturer Eli Lilly & Co. is aggressively stepping up to the plate in a controversial new area of marketing that many pharmaceutical companies see as their best hope for new sales in the era of managed care. More and more, since rules on advertising drugs on television were eased in late 1997, drug makers are turning to consumers, rather than doctors and hospitals, to create demand for their products. The question of marketing a psychiatric drug directly to consumers, however, goes to the heart of the controversy over whether pharmaceuticals should be advertised on television.”
Restoring Invisible and Abandoned Trials
An initiative called Restoring Invisible and Abandoned Trials (RIAT) is an international effort to overcome misreporting and bias from clinical trials, allowing a correction of the record providing people accurate information. “Randomized controlled trials (RCT) are known as medicine’s ‘gold standard’ for reliable evidence. However, they are falling short of standard, in large part due to fundamental problems: 1. Misreporting: many trials published are inaccurately or incompletely reported, 2. Invisibility: not all trials conducted are published.”
Researchers can “restore” the original trial publications by analyzing the data and documents originally submitted to drug regulators by the drug companies. RIAT corrects misreporting and invisibility by publishing an unpublished trial, republishing a trial or just the parts initially misreported.
Restoring the Original Fluoxetine (Prozac) Trials
As we have seen with the Women’s Health Initiative (WHI), testosterone replacement therapy (TRT), and antidepressant studies, even after a trial is re-analyzed or restored, journals may still refuse to make the corrections, the mistruths continue and are cited by doctors and perpetuated by the media.
The original fluoxetine trials leading to its approval in 2002 were re-analyzed and restored, deeming it both unsafe and ineffective. The next blog will summarize the findings of this study.
Have an Awesome Day! Dr D