Long before I ever purchased my own snappy little pill-minder to keep my battery of psychotropic drugs, I could name one by name: Prozac.
We all did. In the 1990s and early 2000s, literally every alive human person with a working understanding of the English language knew about Prozac. It was a household name — and one that was synonymous with both being crazy and getting less crazy. It was also a status symbol, a trendy addition to a person’s medicine cabinet, and threat to the conventional view of mental health and its treatment.
Prozac was — and, you could argue but I don’t want to, still is — shorthand for the new, yuppified version of the neurotic American, a person who needed a pill to get through their day — and who reaped the myriad consequences.
But like, how? How did a drug that treated the kind of symptoms * no one ever talked about * become so very buzzy? What happened?
Prozac: A cure for Americanitis
Within just a few years of its 1988 release, Prozac - the brand name for an SSRI called fluoxetine - became one of the most popular meds on the market. Almost overnight, everyone from your too-chatty neighbor to your sister-in-law who resembles an Italian greyhound seemed to be taking it.
All those scrips flying off pads helped make Prozac into more than a treatment for anxiety; it became a household name. And not just a name you’d conjure in private, either. Prozac became something you’d discuss at a dinner party - who was taking it? Why where they taking it? What does it do for them? I heard it makes everything feel better. I heard it makes people crazy. Is it even necessary to take drugs for a little bit of depression?
In many ways, Prozac burst onto the market and presented a treatment for a condition that people were hesitant to name. The general ennui, malaise, or whatever else you want to call it of living in the post-Watergate America. What had previously been known as “Americanitis” — i.e, the general name given to a uniquely Western brand of depression — was now sort of just viewed as the curse of living in a time of cell phones and shopping malls.
In many ways, Prozac treated what had otherwise been soothed by consumerism, the pursuit of unrealistic beauty standards, and big ol’ rails of Colombia’s Finest. But that wasn’t the goal, of course.
At its core, Prozac was just another new drug in a continuing deluge of new drugs, pumped out alongside promotional clicky-pens in order to line the pockets of pharmaceutical C-suites. It was, unsurprisingly, heavily marketed. As soon as it became clear that it would be a huge commercial success — a CNN article from 2001 noted that “since it was launched in early 1988, Prozac has been one of the biggest-selling drugs in history; its $21 billion in sales represents some 30% of Lilly's revenues in that period. It's not too much to say that Lilly is the house that Prozac built” — the company started pouring funds into making sure every doctor in America was set to write a prescription.
But it was also different because it genuinely seemed like anyone who was a little tired, a little spacey, a little unhappy could get and feel better. And that was different than previous drugs.
Prozac’s release ushered in a new understanding of psychotropic drugs — who they were for, what they could treat, and how much stigma should be attached to those conditions. And many of the answers weren’t necessarily positive, as Prozac quickly became linked to less-than-helpful stereotypes about mental illness.
“On this medication, I am myself”
Prior to Prozac’s release, the bulk of mental health drugs had been both ineffective and unpleasant to take. People taking antidepressants or other psychotropic drugs were typically expected to be fairly confined in their lives; if you were taking medication for mental illness, it wasn’t expected that you’d also be, say, going to work and doing chores around the house. The expectation, instead, was that the meds would pretty well lay you out.
One of the most-prescribed medication for depression in the 1960s, for example, was ketamine, which isn’t exactly conducive to doing anything other than staring at the ceiling.
Another popular class of drugs in the 1970s and 80s were tricyclic antidepressants, which, while still considered an effective second-line option, come with risks including heart problems, excessive drowsiness, and profound disorientation.
At the same time, scientists were starting to catch on to the role of serotonin in mental illness, which is how they ultimately latched on to the potential power of selective serotonin reuptake inhibitors (SSRIs) like fluoxetine.
This new medication allowed people to live a relatively normal life — go to work or school, manage their households, take care of children — while medicated. That, in and of itself, was pretty huge.
Of his 1994 book, Listening to Prozac (which was a bestseller and also controversial because, again, everyone was very keen to talk about this pill), Dr. Peter Kramer said his patients had continually made the claim that “on this medication, I am myself at last.” Prozac made them more confident, more secure in themselves. “This self-assured state, so they believed,” he wrote, “represented their identity, themselves as they were meant to be.”
In a lot of ways, Prozac’s efficacy - the fact that it worked so well and without the many challenges of the drugs that came before it - is also what made it so ripe for mockery or maligning. Because before Eli Lily, the drug manufacturer that developed it, blew up the market with this ~ wonder drug ~, there wasn’t really this class of Depressed People who were both on medication and still functioning regularly in society.
It was also the kind of people who were taking Prozac who drew the attention of mass media and the general public. It was a uniquely upper-middle-class — celebs like Winona Ryder and Johnny Depp admitted to using it, and the fictional Tony Soprano took it as well.
It was a drug for people who should have already been happy but weren’t happy enough, and those who had money to throw at the problem. It was for the kinds of people who were expected to perform well at work, at home, and in their communities. It was the boost people needed to keep up with the Joneses.
Of course, with great popularity comes great consternation, especially when it comes to medications that might make people feel better.
“Rhonda Hala didn't kill anyone during the 18 months she took Prozac, but she blames the drug for nearly killing her.”
In 1990, Newsweek published a cover story that touted Prozac as a “breakthrough drug,” and cited that its major issue wasn’t how it worked, but rather, how much it cost as a proprietary drug. Almost exactly a year later, they’d publish a story called “The Prozac Backlash.” Because if we’ve all learned anything on the internet, it’s that anything momentarily hailed as positive must swiftly also be criticized into oblivion.
“Miracles are hard to come by,” the piece opened, “but to many Americans Prozac looked just like one.”
The article went on to outline the reasons behind Prozac’s popularity — it was easy to get, it covered a broad array of symptoms, and it didn’t cause weight gain, among others — before excoriating the drug and calling out the “horror stories” that had come with it.
From the story:
Self-described "Prozac survivors" now appear on "Donahue" to accuse the drug of turning sane people into murderers and self-mutilators. Scores of unhappy customers are filing lawsuits against Lilly, seeking huge awards for misfortunes they blame on Prozac... Some are using the drug as a criminal defense, saying they shouldn't be held accountable for crimes they committed while taking it.
In the article, the author blames Prozac for every societal ill a person can imagine — murder! Divorce! Assault! Being kind of weird! — and quotes an attorney involved in on of about a trillion lawsuits over the medication.
“People thought something was wrong," the lawyer is quoted as saying, "but nobody ever associated it with Prozac. He just kept taking this drug on the advice of his physician, and he starts going dingy.”
Medication, heal thyself!
The following year, Newsweek published yet another story, this time about the “Prozac Pipeline,” highlighting the steady stream of counterfeit drugs being shipped in from other countries. Demand for the drug was reaching an all-time high but people a.) couldn’t get their doctors to prescribe it because of the fear of over-prescription or b.) didn’t have doctors because lol America, or c.) just didn’t want to deal with the medical system (honestly, fair).
The more things change, right?
The onslaught of condemnation was swift, particularly after the release of Elizabeth Wurtzel’s Prozac Nation (and the 2001 film version starring Christina Ricci). In a Vice article about the sensation that was Prozac Nation, the author sort of accidentally sums up the entire back-and-force about Prozac in general. Sub out “Wurtzel” for “anyone taking the medication” and it’s still basically accurate:
Critics say Wurtzel is overly self-involved and whiny, and they don’t get why anyone would want to read 300 pages of a privileged college girl histrionically complaining about how much her life sucks. Fans say it is an extremely detailed and realistic depiction of what it’s like to suffer from depression and that it should be required reading for psychiatric professionals and anyone who has ever battled with the disease or had antidepressants prescribed to them. We just think it’s fun to read about crazy teenagers being crazy.
It can’t be surprising that a medication designed to treat squishy symptoms —fatigue, sadness, generally feeling shitty — might have engendered such a rich collection of responses. How else could it have been received when the claims about it were so polarizing and the reporting was so aggressive?
Prozac was a cultural moment and a shift in the rhetoric around mental illness. It was both a lauded breakthrough in mental health treatment and the end of humanity as we knew it. It was for whiny teens and yuppies with too much money and tough guys who couldn’t always access their emotions and moms who wanted a boost and kids whose moms wanted them to be quiet already. It was a medication that made it OK to talk about depression and also one that might cause a side-eye if a friend saw it while snooping in your medicine closet.
Unlike its predecessors, which treated depression, anxiety, eating disorders, and a range of other issues with sedation and not a lot else, Prozac was able to get at the root cause of a number of conditions without serious, life-altering side-effects. It was also a trendy name brand which made it much easier to, as they say in the commercials, ask your doctor about.
And it was a little bit of a flash in the pan - Eli Lilly’s patent expired in 2001, making generic Prozac more available and much more affordable. The company went on to find other cash cows, though (they’re comfortably selling marked-up diabetes medicine, including one of the one that all the celebrities are taking to lose weight), so don’t you worry about their bottom line!
Meanwhile, whenever I hear a mention of “Prozac” by name, I immediately assume the thing I’m listening to is at least 20 years old (or, if it’s a person, at least 50 years old). It’s kind of a dated reference and very much Of A Time. But then again, I saw a kid actually wearing literal JNCOs the other day, so maybe Prozac will have a resurgence like eyebrows plucked to oblivion and babydoll t-shirts. Everything that’s old is new again — and honestly, we still haven’t found a cure for everything that SSRIs treat, so it could happen.