The psychotropic drugs have so revolutionized psychiatric treatment that the number of patients in public mental hospitals in the USA alone has decreased by approximately 200,000 in the last 15 years. The influence of the new psychotropic drugs has been even greater in private practice and the office physician can now effectively treat many psychiatric disorders. The effectiveness of pharmacotherapy has also brought about a change in the pattern of delivery of services. The majority of patients no longer need admission to in-patient psychiatric facilities and those who have been in psychiatric hospitals can often be discharged to the care of the family doctor. As a result, the psychiatrist can be used more selectively as a consultant for diagnosis and treatment of difficult cases. As with many physical diseases, the realistic objective of psychiatric treatment is often not a complete remission but rather the restoration of an adequate level of basic functions necessary for a satisfying and productive existence. When this therapeutic goal is attained, the medication must not be discontinues abruptly. The idea that the patient can become well, or stay well without medication is false. In psychiatric illnesses, as in many physical diseases, maintenance therapy may be both legitimate and necessary. The mechanism of action of psychotropic drugs, like the causes of psychiatric diseases themselves, is large unknown. The antidepressants cause elevations in CNS levels of biogenic amines. The tranquilizing antipsychotic drugs tend to reduce amino levels. It is thus tempting to assume that elevation and depression of mood are directly related to similar changes in CNS concentrations of biogenic amines. However, this thesis remains unsubstantiated. Individual responses to psychotropic drugs vary considerably, both in degree of effect and in the period of time required to attain the peak effect. Similarly, optimal dosage schedules vary greatly for individual patients. Thus rational selection of therapy is often difficult and it is not surprising that opinions differ widely about the place of drugs in psychiatric therapy and their optimal use in specific clinical situations. The drug Prozac is one of several drugs that is looked upon as the psychopharalogical miracle of our time. It is designed for a specific group of patients, but sometimes is prescribed for anyone who wants it without being told of its side effects. The only one reaping the benefits is the manufacturer, Eli Lilly, while the public suffers.
is an antidepressant for oral administration (Zimmerman 943). It is made up of fluoxetine hydrochloride which is chemically unrelated to the older antidepressant medicines. It works by allowing the passages of a neurohormone, serotonin, into nervous system cells (Silverman 357). In turn, this increases the availability of serotonin at the critically important brain receptor cites, thought to result in normal nervous system transmission (Fieve 46). Officially, Prozac has been approved for treating only two serious mental diseases; clinical depression and obsessive-compulsive disorders (Cooper 736). It has been shown that Prozac used in treatment for depression and obsessive-compulsive disorders works for three out of four who try it for treatment (Wilkerson 74). Since its introduction, over eleven million patients worldwide and six million in