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Psychiatric Times. Vol. 19 No. 5
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Patient Drug Information From Mass Media Sources

By Michael Montagne, R.Ph., Ph.D.
| May 1, 2002
Dr. Montagne is the Julias B. and Lillian S. Rombult Distinguished Professor of Pharmacy at Massachusetts College of Pharmacy and Allied Health Services.

Media Representations of Antidepressant Medications

A recent study (Montagne, 2001) examined what we know about certain antidepressant drugs and how we have arrived at our current collective knowledge. The primary goal of this study was to identify specific media representations of antidepressant drugs and to examine these images in comparison with known clinical information regarding them.

The results of this analysis portray an extensive and deeply rooted cultural awareness of these drugs. Over the past 20 years, the frequency of magazine and newspaper accounts and reports of antidepressant use peaked during three time periods: 1) 1977 to 1978, during a time of increased societal concern about depression; 2) 1980 to 1982, when a new generation of antidepressant drugs (tetracyclics like trazodone [Desyrel]) were introduced; and 3) 1990 to 1994, which represented the Prozac (fluoxetine) phenomenon.

By the spring of 1990, Prozac was on the cover of Newsweek, Time and the New Yorker and was being proclaimed as the new wonder drug and a new weapon in the fight against depression. In fact, the appearance of a Prozac capsule floating over a dry landscape on the cover of Newsweek was the first time any prescription pharmaceutical product (and any drug other than heroin, cocaine or marijuana) had been shown on that magazine's cover. Between 1992 and 1994, Prozac exploded into the mass media and the public's consciousness (1992-1994) with a number of popular books (e.g., Listening to Prozac [Kramer, 1993], Talking Back to Prozac [Breggin, 1994] and Prozac Nation [Wurtzel, 1994]), a theatrical play (Prozac Sisters), an electronic video game (Virtual Prozac) and talk show visits by enthused therapists (Montagne, 2001).

Media accounts suggested that Prozac did a lot more than just influence serotonin in a person's body, extending perceptions of the indications of use beyond those recognized and accepted by most health care professionals (Montagne, 2001). For antidepressant users, this drug obviously relieved conditions such as depression and premenstrual syndrome, and certain symptoms such as anxiety. Users, however, also reported that Prozac produced other types of effects such as: elevated or changed mood, nervousness, anorexia, insomnia, enhanced performance, calmness, reversed shyness, reduced or enhanced sex drive, changed personality even in nondepressed people ("cosmetic psychopharmacology"), enhanced spirituality, mania, drowsiness, tremor, dizziness, weight gain or weight loss, feeling "out of it," excessive laughing or weeping, and a loss of concentration (Elfenbein, 1995; Karp, 1997; Montagne, 2001). Early media reports referred to Prozac as the pill that will "cheer you up without side effects" and described "how science will let you change your personality with a pill" (Beyond Prozac, 1994).

In these media reports, Prozac was referred to primarily as the Happy Pill, the Feel-Good Pill and the Personality Pill. It also was presented in some accounts as an "upper." Patients used a variety of images and metaphors to understand and describe their reasons for using Prozac and for the effects they experienced (Montagne, 2001). These metaphors ranged from "magic bullets" to "like insulin for my mind/mood." In March 1994, Eli Lilly and Company launched an advertising campaign to condemn and counter the ever-growing role of mass media in exaggerating the drug's effectiveness (Listening to Eli Lilly, 1994).

A popular book of anecdotal accounts from Prozac users, almost a decade after its introduction, suggested other therapeutic uses for Prozac including: attention-deficit/hyperactivity disorder, obesity, chronic fatigue syndrome, ulcers and other gastrointestinal disorders, and chronic pain (Elfenbein, 1995; Montagne, 2001). The rationale for these uses, as stated by a promotional blurb on the book's back cover, is, "In these pages, the real expert--sthose who are taking antidepressants nowoffer frank testimonies that explore what it is like for them to take Prozac."

Mass Media and Antidepressant Use

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