Of late, the marketing men at several drug companies have been mounting an assault on Prozac, the antidepressant that seems to have become a lifeline for a nervous generation.
As Prozac is seen as a powerful agent that can seemingly alter personalities, the approach of its rivals is surprising. In so many words, they're saying that their antidepressant is more powerful and faster-acting than Prozac. Prozac is for sissies, perhaps?
Take, for example, the claims for Efexor (which inexplicably develops a second 'f' for the US market). It is 'nearly twice as effective as fluoxetine (Prozac) in eradicating the symptoms of depression', an advertisement to doctors states, quoting a poster presented at a conference in Vienna. A poster? Stranger and stranger.
Posters aside, the effectiveness of Efexor (venlafaxine hydrochloride) for long-term use of more than six weeks has not been proved (Physicians' Desk Reference, 1998).
But what is not in doubt is that, as a powerful antidepressant, it comes with a raft of side effects. The major worry is over patients who have been taking monoamine oxidase inhibitors (MAOIs) and then immediately start a course of Efexor. Serious adverse reactions in these groups have been reported, including tremor, nausea, vomiting, flushing, dizziness, seizures and death.
Even without MAOI usage, 19 per cent of Efexor patients had to stop treatment prematurely because of some adverse reaction. The most common problem was nausea, but others included insomnia, dizziness, nervousness, dry mouth, anxiety and sweating.
Like Prozac, abnormal personality changes have also been noted. In one trial, 11 per cent of patients developed anorexia, and significant weight loss was also reported in those who did not intend it. A five per cent loss in body weight was reported in six per cent of patients.