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Posted by j0hn on July 2nd, 2007 — in Prozac Top News
A week after Chicago’s Katharine Pflaum adopted a temperamental calico cat named Stella, she knew she had a serious problem on her hands. Stella wasn’t just warlike during the day; she also pounced on Pflaum in the middle of the night.
But Pflaum didn’t want to give up on the cat, who already had been abandoned twice. So she started her on a behavioural program that included Prozac, the same antidepressant given to humans.
“Prozac has been an amazing thing for her,” says Pflaum, a nanny who works away from home 12 hours a day. “I definitely had reservations, but it has calmed her. Since we started, she hasn’t bitten anyone.”
Once derided as a cop-out for treating behavioural disorders in animals, medications such as Prozac that contain serotonin-reuptake inhibitors are now a routine part of veterinary care.
They are given to cats that spray walls with urine, pet parrots that might self-mutilate when bored, dogs that get spooked by thunderstorms or obsessively lick their paws, and zoo animals suffering outside their natural habitats.
The US Food and Drug Administration approved psychotropic drugs for dogs in 1999. This year, targeting dogs with separation anxiety, it licensed beef-flavoured Reconcile tablets containing fluoxetine hydrochloride, the generic name for Prozac.
In Australia, Prozac isn’t specifically registered for use by animals but vets are able to prescribe it for so called “off label use”.
“Pets are an important part of society these days; they’re family members,” says Thomas Graves, chief of the small-animal internal-medicine section at the University of Illinois Veterinary Teaching Hospital. “If there are ways to keep them healthier and living longer, you’re doing a favour for the pet and the people that love them. The idea that they shouldn’t get high-quality health care is one that is fading away.”
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But are medications such as Prozac really high-quality health care? Or are they the easiest way to calm a pet when you’re out of the house all day? After the FDA approved Reconcile, the Royal Society for the Prevention of Cruelty to Animals in Britain charged that giving dogs drugs to treat behavioural problems merely masks symptoms of a deeper problem. Instead of medicating, it said, dogs should be given more exercise or companionship.
“Cats and dogs are basically people-pleasers unless they are forced into situations that are contrary to their instincts,” says, Illinois-based artist and cat owner Jeanine Coupe Ryding, who considers Prozac to be a last resort before euthanising a pet with major problems. “Abuse and loneliness affect pets like they would people. Prozac is not a cure, it just makes it easier on everyone who has to live with the person or pet who takes it.”
Most animal behaviourists agree: Pill popping alone won’t eliminate the problem. But there is a place for medication if it’s used with other behaviour-changing strategies, said Valerie Chalcraft, a psychologist who consults on companion-animal behaviour.
“Medication doesn’t teach new responses; it can only bring down the dog or cat’s level of anxiety to a point where he or she can learn more efficiently,” said Chalcraft, who turned Stella into a purring lap cat. “Just like a person, a calm dog or cat learns more easily than an anxious one.”
If you’re comfortable using prescription drugs, medicating your pet may not be an issue. If you’re ambivalent, Chalcraft recommends it only for chronic cases.
“The longer it has been going on, the more entrenched it is in the dog or cat’s behavioural repertoire, so it takes longer to correct with behaviour modification,” she says.
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Posted by j0hn on June 30th, 2007 — in Prozac Top News
Children born to mothers who take antidepressant drugs during the early stages of pregnancy have an increased risk of several rare birth defects, say two studies published in the New England Journal of Medicine.
Scientists, however, caution that the defects are so rare that the drugs’ risks are outweighed by the risks of maternal depression.
Two research groups — one from the CDC, the other from Boston University and funded partly by GlaxoSmithKline — analyzed the records of 20,000 newborns with birth defects and 10,000 without them.
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Focusing on selective serotonin reuptake inhibitors — the most common antidepressant class, including Paxil, Prozac, Zoloft and Celexa — the researchers looked at antidepressants taken by their mothers during the first three months of pregnancy, then searched for a connection to defects.
Paxil tripled the risk of a serious heart defect that cuts blood flow to the lungs, and Zoloft raised risks of omphalocele, in which abdominal organs protrude from the navel. The chances of several other serious defects were doubled.
But despite the warning bells that words like “tripled” and “doubled” set off, the actual numbers of these defects were so small that they could have been a statistical anomaly, or else represent a risk less pressing than depression. As the US News and World Report noted,
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Posted by j0hn on June 25th, 2007 — in Prozac Top News
Imagine that you are depressed and see a psychiatrist who explains that you have clinical depression and would benefit from an antidepressant. So far, so good. But then the doctor tells you there is a 60 percent chance that you’ll feel better with this antidepressant and that it could take as long as four to six weeks to find out, during which time you’ll probably have some side effects from the drug.
I have just described the state-of-the-art pharmacologic treatment of major depression in 2007. Don’t get me wrong; we have very effective and safe treatments for a broad array of psychiatric disorders. But in everyday clinical practice, we have little ability to predict which specific treatment will work best for you.
Laura is a case in point. A successful management consultant in her late 30s, she sought help for lifelong depression. Her treatment began with four weeks of the antidepressant Lexapro, a selective serotonin reuptake inhibitor, or SSRI, without any effect. Next, I switched her to Zoloft, another SSRI, since the chance of response to another member of the same drug family is about 60 percent. Again, no response. Then we moved on to Wellbutrin, an entirely different type of antidepressant, but this didn’t work either. Laura was now ready to call it quits, and who could blame her?
After nearly three months, I had still not found an effective treatment for her. Then she came in one day and said her father had recently revealed that he had been depressed and had done well on Prozac, another, and she wondered if she could try it. Within three weeks, she felt markedly better, and the symptoms of her depression began to melt away.
Instead of the hit-or-miss approach I had to use with Laura, it will soon be possible for a psychiatrist to biologically personalize treatments. With a simple blood test, the doctor will be able to characterize a patient’s unique genetic profile, determining what biological type of depression the patient has and which antidepressant is likely to work best.
Scientists have identified genetic variations that affect specific neurotransmitter functions, which could explain why some patients respond to some drugs but not to others. For example, some depressed patients who have abnormally low levels of serotonin respond to SSRI’s, which relieve depression, in part, by flooding the brain with serotonin. Other depressed patients may have an abnormality in other neurotransmitters that regulate mood, like norepinephrine or dopamine, and may not respond to SSRI’s.
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In a report last October in the journal Science, Francis Lee, a colleague of mine at Weill Cornell Medical College, identified a genetic mutation that could potentially predict patients’ responses to an entire class of antidepressants.
He inserted into a mouse a defective variant of the human gene for brain-derived neurotrophic factor, a protein that is increased in the brain with SSRI treatment and is critical to the health of neurons. Then he subjected these “humanized” mice to stress and found that they did not respond to Prozac with decreased anxiety. The clear implication is that people with this variant will not be able to respond to any SSRI, which requires normal neurotrophic-factor function to work. A psychiatrist could identify this genetic variant and then steer his patient to a different class of antidepressants.
This new field of pharmacogenomics will also enable psychiatrists to predict which drugs might produce toxic side effects for certain patients. Nearly all drugs are metabolized by a group of enzymes that vary greatly in activity from person to person. If patients have a genetic mutation that results in either deficient enzyme activity or none, they would be likely to have serious side effects if exposed to the drug that is metabolized by the enzyme.
Within a few years, patients could be routinely screened for these genetic variations, which will tell a doctor which drugs to avoid. This could potentially prevent unnecessary drug toxicity, a major cause of illness and death.
Aside from the potential to transform clinical psychiatric practice, these new developments will surely change the relationship between doctors and the drug industry and between the industry and the public. Direct-to-consumer advertising will become nearly irrelevant because the drugs will no longer be interchangeable, but will be prescribed based on an individual’s biological profile. Likewise, doctors will have little reason to meet with drug company representatives because they won’t be able to give doctors the single most important piece of information: which drug for which patient. For that doctors will need a genetic test, not a salesman.
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Posted by j0hn on June 23rd, 2007 — in Prozac Top News
A week after Chicago’s Katharine Pflaum adopted a temperamental calico cat named Stella, she knew she had a serious problem on her hands. Stella wasn’t just warlike during the day; she also pounced on Pflaum in the middle of the night.
But Pflaum didn’t want to give up on the cat, who already had been abandoned twice. So she started her on a behavioral program that included Prozac, the same antidepressant given to humans.
“Prozac has been an amazing thing for her,” said Pflaum, a nanny who works away from home 12 hours a day. “I definitely had reservations, but it has calmed her. Since we started, she hasn’t bitten anyone.”
Once derided as a cop-out for treating behavioral disorders in animals, medications such as Prozac that contain serotonin-reuptake inhibitors are now a routine part of veterinary care.
They are given to cats that spray walls with urine, pet parrots that might self-mutilate when bored, dogs that get spooked by thunderstorms or obsessively lick their paws, and zoo animals suffering outside their natural habitats.
The U.S. Food and Drug Administration approved psychotropic drugs for dogs in 1999. This year, targeting dogs with separation anxiety, it licensed beef-flavored Reconcile tablets containing fluoxetine hydrochloride, the generic name for Prozac.
“Pets are an important part of society these days; they’re family members,” said Thomas Graves, chief of the small-animal internal-medicine section at the University of Illinois Veterinary Teaching Hospital. “If there are ways to keep them healthier and living longer, you’re doing a favor for the pet and the people that love them. The idea that they shouldn’t get high-quality health care is one that is fading away.”
But are medications such as Prozac really high-quality health care? Or are they the easiest way to calm a pet when you’re out of the house all day? After the FDA approved Reconcile, the Royal Society for the Prevention of Cruelty to Animals in Britain charged that giving dogs drugs to treat behavioral problems merely masks symptoms of a deeper problem. Instead of medicating, it said, dogs should be given more exercise or companionship.
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“Cats and dogs are basically people-pleasers unless they are forced into situations that are contrary to their instincts,” said Evanston, Ill., artist and cat owner Jeanine Coupe Ryding, who considers Prozac to be a last resort before euthanizing a pet with major problems. “Abuse and loneliness affect pets like they would people. Prozac is not a cure, it just makes it easier on everyone who has to live with the person or pet who takes it.”
Most animal behaviorists agree: Pill popping alone won’t eliminate the problem. But there is a place for medication if it’s used with other behavior-changing strategies, said Valerie Chalcraft, a psychologist who consults on companion-animal behavior.
“Medication doesn’t teach new responses; it can only bring down the dog or cat’s level of anxiety to a point where he or she can learn more efficiently,” said Chalcraft, who turned Stella into a purring lap cat. “Just like a person, a calm dog or cat learns more easily than an anxious one.”
If you’re comfortable using prescription drugs, medicating your pet may not be an issue. If you’re ambivalent, Chalcraft recommends it particularly for chronic cases. “The longer it has been going on, the more entrenched it is in the dog or cat’s behavioral repertoire, so it takes longer to correct with behavior modification,” she said.
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Posted by j0hn on June 17th, 2007 — in Prozac Top News
A SCOTS mum is to sue drugs giant GlaxoSmithKline after claiming their antidepressant Seroxat made her scared to leave her home.
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Diane Smith claims she became agoraphobic when she tried to wean herself off the controversial drug.
She even missed her son’s wedding and could not go to see her dying father as she has bec
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Posted by j0hn on June 13th, 2007 — in Prozac Top News
COLUMBIA, S.C. - The South Carolina Supreme Court upheld the murder conviction Monday of a teenager who claimed antidepressants led him to kill his grandparents and set their house on fire when he was 12 years old.
The court ruled against several arguments made by Christopher Pittman’s attorneys, including the contention that he was denied a speedy trial before he was sentenced to 30 years in prison in February 2005. He was 15 at the time of his sentencing.
Three years earlier, he had shot his grandparents, Joe and Joy Pittman, with a pump-action shotgun as they slept, then set fire to their home in Chester County.
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His attorneys argued unsuccessfully that he had been involuntarily intoxicated by the antidepressant Zoloft at the time of the shooting and didn’t know right from wrong. In appealing, his attorneys said the trial judge should have used a different standard for jurors to determine involuntary intoxication.
Paul Waldner, one of Pittman’s attorneys, said an appeal was possible.
“Obviously the decision is a setback for us, but our resolve to continue to try to obtain justice for this boy who committed the only violent act of his life only days after he was given a mind-altering drug is strong,” Waldner said.
The case generated outrage that Pittman was held so long before his trial. In October, dozens of supporters and relatives gathered in Columbia as defense attorney Andy Vickery argued before the state Supreme Court that his client’s confession was influenced by Zoloft and his youth.
Pfizer Inc., the manufacturer of Zoloft, has said the drug “didn’t cause his problems, nor did the medication drive him to commit murder.”
Zoloft is the most widely prescribed antidepressant in the United States, with 32.7 million prescriptions written in 2003. In 2004, the Food and Drug Administration ordered Zoloft and other antidepressants to carry “black box” warnings about an increased risk of suicidal behavior in children.
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Posted by j0hn on June 10th, 2007 — in Prozac Top News
Mylan Pharmaceuticals announced FDA approval for its generic version of Eli Lily’s Prozac, while IMPAX Laboratories announced agency approval for its generic version of Pharmacia and Upjohn’s Xanax.
Mylan said its abbreviated new drug application approved by the FDA covered 40-mg strength generic Prozac (fluoxetine) capsules. The company previously received approval for — and is currently marketing — the 10- and 20-mg strength capsules of the product.
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IMPAX said it received approval to market the 0.5-, 1-, 2- and 3-mg strength extended-release generic Xanax (alprazolam) tablets. The company said its global pharmaceuticals division plans to launch the products — its third FDA approval this year — soon.
In addition, IMPAX announced May 25 that the patent infringement suit brought against it by Purdue Pharma pertaining to IMPAX’s generic version of OxyContin (oxycodone HCl) has been dismissed by the U.S. District Court for the Southern District of New York pursuant to a settlement reached by both companies in March.
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Posted by j0hn on June 5th, 2007 — in Prozac Top News
INDIANAPOLIS — Eli Lilly & Co., world’s biggest maker of psychiatric drugs, dropped its fight to block Barr Pharmaceuticals Inc. from selling a generic version of the antidepressant Prozac in a weekly dose.
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The companies ended Indianapolis-based Lilly’s May 2006 patent-infringement suit, which could have kept Woodcliff Lake-based Barr from selling Prozac Weekly until Lilly’s patent expires in 2017. Barr, a generic-drug maker, still needs U.S. Food and Drug Administration approval to sell a 90-milligram version of the pill.
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Posted by j0hn on June 2nd, 2007 — in Prozac Top News
Mylan Laboratories Inc. said Wednesday it will begin shipping 40-milligram tablets of fluoxetine, a generic version of Prozac, after receiving final federal approval.
The 40-milligram strength of Prozac tablets, made by Eli Lilly & Co. (NYSE:LLY), had U.S. sales of about $118 million for the 12 months ended March 31, according to IMS Health, a Fairfield, Conn.-based recorder of health data.
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Mylan (NYSE:MYL), a generic drug maker, is based in Cecil Township, south of Pittsburgh. It already sells 10-milligram and 20-milligram versions of fluoxetine.
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Posted by j0hn on May 29th, 2007 — in Prozac Top News
Last May I went to a pharmacist with one of the 31 million prescriptions issued in Britain each year for some form of anti-depressant, and picked up a month’s supply of Prozac.
The three blister-packs of green and cream pills were the solution to a depression that had hit hard. My partner of three years had walked out of our home eight months earlier, and I had fallen apart. Susceptible to my emotions, I had taken a different anti-depressant, Seroxat, some nine years before; after a less-than-pleasant few months on that pill, I had been determined not to go down the chemical route again.
But, despite my best efforts, nothing would lift the black wave that had engulfed me. And so I sat in my doctor’s surgery, sobbing and asking for help.
It is 20 years since Prozac was launched. The compound LY110141, now known as fluoxetine, was developed in 1971 by the global pharmaceutical company Eli Lilly, and was originally earmarked as a medication for high blood pressure. However, it wasn’t successful in human trials, so new uses were examined. It was given to five mild depressives and found to cheer each of them up. By 1999, Prozac was providing Eli Lilly with more than 25% of its annual revenue.
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Prozac is an SSRI - a selective serotonin reuptake inhibitor. Other such drugs have since hit the market - Seroxat among them - and each has had its detractors. A lot has been written about how easy it is to prescribe anti-depressants and what those who have depression should do instead of taking pills. Get out and walk or run, people say.
I couldn’t lift my head off the pillow. For days on end I lay there, motionless, as the hours ticked by. On the advice of my brother and his wife, I went to a therapist for one session, but I felt that a deeper probing of my problems at that time would just make matters worse. I needed a quick fix, I admit it - and that’s what Prozac offered.
Of course, it didn’t really: it’s no wonder drug. But it was the gentle shove I needed. And, in a way, it did become my personal wonder drug. Propelled by my Prozac, I re-entered the world. Two months on it, and I was out of the house. I was no longer crying every day; I was living my life again. I even met a new man. My boyfriend - we are still together - was the perfect spirit to my chemical tonic. Prozac didn’t save me; he didn’t save me. But the combination did. It’s not for everyone, and perhaps at times it is too easily dispensed, but I can’t bring myself to denounce Prozac.
It is a strange drug to be on. Initially you feel nothing; then, as it seeps into your system after a couple of weeks, there’s a period of euphoria, almost mania, where everything just seems so good. My boyfriend took me camping on Skye. Camping! I hadn’t done it since I was a kid and I loved every minute. I laughed for the first time in months. I picked up my discarded, half-written novel and found my writer’s voice again. Only a few months earlier, I had spent days pacing up and down my flat, crying, sobbing, pulling at my hair, and, dare I say it, not caring if I lived or died. There were moments in my deepest depression when I wished I could close my eyes and not wake up. And the fact that taking Prozac removed those thoughts from my mind, I think, allows me to champion its cause for ever.
It has its side-effects, like any medication. For the first four months or so, my mouth was constantly dry because I was so dehydrated. Don’t drink alcohol on it, my doctor instructed. When I did, I realised why she’d said that. It took just two glasses of wine to knock me out, and when I woke in the morning it felt like someone had smashed me over the head with a sledgehammer (and removed my memory). My doctor kept a close eye on me, and still does.
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I loved every minute of camping on Skye. I laughed for the first time in months
After almost exactly a year on the drug, I decided I was well enough to stop using it. And this is the crux: many Prozac users do become dependent on their pills. There is an element of fear in it: if I stop taking it, will I relapse into depression? Can I ever live without it?
A week and a half into my reduced dosage of half a dose a day, my boyfriend and I had an argument, and I got tearful and sobbed my heart out. Uh-oh, I thought, I’m not better at all. But I took a step back and realised it was more likely a mixture of over-tiredness, PMT and Prozac withdrawal that had caused me to break down, not a recurring depression.
Prozac is not a medication for manic depression, but for my own depression - a reactive bout of the clinical variety attributed to a “bad event” - it got me there. I do know, however, that having suffered from the illness two or three times in my life, I am susceptible to it. But I don’t care. If I ever feel it clouding up my life, I know how to deal with it.
It has been said that some people think being depressed is “cool”, and that celebrities use it like a status badge. If so, more fool them. If I had never needed to take Prozac in my life, I’d be happy. Believe me, as someone who has been there, there is nothing “cool” about depression.
Coming off my drug has, understandably, been difficult. But I’m down to half a regular dose of Prozac every third day now, and my withdrawal hasn’t been too bad. The withdrawal from Seroxat all those years ago was one of the reasons I didn’t want to go back on this type of drug again. Thankfully, Prozac hasn’t been quite so bad. The main symptom I have is a sort of electric shock-type sensation, which occurred at times when I was on the drug, too. It’s a sensation unlike anything else, and hard to describe. Extreme tiredness is another side-effect, as are the most vivid, exhausting dreams that have had me waking up feeling like I’ve run a marathon. But there is nothing that’s too hard to cope with; nothing as bad as the way I felt before Prozac.
It is definitely with a strangely fond farewell that I leave Prozac behind. But it is with a large Prozac-assisted two-fingered salute that I bid goodbye to my depression. Prozac did exactly what it said on the tin.
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