Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self by Peter D. Kramer

From the Publisher

Over 5 million Americans have taken the antidepressant Prozac. Many have become more confident, popular, mentally nimble, & emotionally resilient. The author looks at evidence from a variety of disciplines — cellular biology, animal ethology, medical ethics, literature, & at his own patients stories — to explore the implication of drugs that reshape temperament. A major contribution to late 20th century psychiatry & an extraordinarily eloquent, provocative, & moving tale about ourselves. A fascinating & beautifully written overview of the biology & psychology of mood-state. A richly philosophical meditation upon the basic nature of human nature.

Publishers Weekly

Tracing the development of mood-altering drugs, in particular the widely used antidepressant Prozac, psychiatrist Kramer ( Moments of Engagement ) synthesizes recent biochemical research, psychological and biosocial theories in a comprehensive, provocative study. Citing cases from his practice and the conclusions of such researchers as Donald Klein, Jerome Kagan and Robert Post, among others, he examines current thinking about what determines personality traits and character. Observing the effectiveness of Prozac in releasing confidence and energy in patients who are somewhat inhibited by depression, compulsiveness or timidity, he raises important questions about the way drugs can influence diagnoses. He sees application of medication as particularly valuable in cases where a patient's symptoms become functionally autonomous, appearing independent of their originating stimuli. Calling for an approach that combines psychotherapy with psychopharmacology, Kramer urges careful, studied use of Prozac with continuing attention given to the philosophical, moral and sociological issues its effectiveness raises. (June)

Library Journal

Kramer, a practicing psychiatrist, finds that the antidepressant Prozac is a powerful drug that lifts the veil of depression from most patients without significant side effects. While he unquestionably supports the use of medication to alleviate illness, he questions using drugs to make a person feel ``better than well.'' It is the remarkable ability of Prozac to create personality changes that he finds disturbing. Is it ethical to prescribe a drug that increases a person's self-confidence, resilience, and energy level without any ill effect, when there is no underlying manifestation of illness? What is the essence of personhood and what are the philosophical implications of using drugs to alter personality? Both Kramer's unequivocal endorsement of Prozac for the treatment of depression and the questions he raises about the use of drugs for mood alteration are controversial. A glossary would have been a useful addition for lay readers. Recommended.-- Carol R. Glatt, VA Medical Ctr. Lib., Philadelphia

Booknews

Kramer (psychiatry, Brown U.) writes on "the capacity of modern medication to allow a person to experience, on a stable and continuing basis, the feelings of someone with a different temperament and history," as "one born with a different genome and exposed to a more benign world in childhood"--p.195. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Kirkus Reviews

A provocative volume that sets up the mood-altering Prozac as a tool to examine the growing—and often troubling—use of drugs in the treatment of psychological illness. Brown University professor Kramer (Moments of Engagement, 1989—not reviewed) is a practicing psychiatrist who uses traditional techniques of therapy but also prescribes Prozac and other psychopharmaceuticals for his patients when they seem appropriate. Thanks to exposure on TV talk shows, Prozac is associated in many people's minds with suicide and violence, but only in the last chapter here—an appendix, really—does the author argue directly against these charges. What he explores instead are the far-reaching implications of the generally positive changes in temperament triggered by Prozac and other drugs prescribed to relieve anxiety and depression, and what these medications have taught us about how character and temperament are shaped. Prozac relieves mild depression, for instance, by elevating levels of serotonin in the brain. Knowledge of that fact opens the door to further investigation of chemical pathways in the brain, individual variations in levels of serotonin and other neurotransmitters, and perhaps even to early diagnosis and treatment of mood disorders. But, as Kramer points out, it also opens the possibility of altering brain chemistry to order, perhaps transforming a shy, sensitive individual into a sociable, assertive personality—the kind that present society most values. Acquisition of such a temperament, in fact, is the effect that Prozac has on many of Kramer's patients. But what has been lost when sensitivity is replaced by assertiveness? What is the "real" personality?Such thoughtful questioning is supported throughout by case histories and meaty reports on recent research. Some of the material suggests that if Freud was wrong about the content of childhood trauma (the Oedipal attachments), he was not wrong about its far-reaching effects. A wise and unflinching examination of the ramifications for society—and for the individual—when the capsule replaces the couch.

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Table of Contents