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American Morning

Prozac Nation

Aired January 14, 2003 - 08:41   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BILL HEMMER, CNN ANCHOR: We want to get to medical news quickly. This morning, we are paging Dr. Sanjay Gupta and company today about the growing popularity of Prozac, and other mood enhancers. More than 11 million Americans, 11 million Americans, take some type of antidepressant known as SSRIs, which include Zoloft, Nuvof (p), Paxil and Celexa. Those are the more popular kinds.
Joining us today to share their views on the possibility of a Prozac nation, in Atlanta, Dr. Sanjay Gupta is back with us.

Good to see you, Sanjay.

In Philly, Dr. Art Caplan, a medical ethicist, here with us, and here in New York, Lizzie Simon, author of "Detour, My Bipolar Road Trip in 4D." If nothing else, great title.

Good morning to all three of you. Thanks for sharing your stories today.

Sanjay, quickly, medically speaking, how do these antidepressants work on the body and the brain?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: We've known for a long time that serotonin is a neurotransmitter. If you actually increase the levels of this particular neurotransmitter in the brain, it serves to elevate mood, an important point, and it seems to work not only in people who have clinically diagnosed depression, but really in just about anyone, as sort of a mood elevator -- Bill.

HEMMER: All right, Dr. Caplan, to you know. What are the implications if you stop and consider the possibilities of a Prozac nation, essentially saying so-called -- I don't want to put them in a normal people category -- people who do not use these drugs initially? If there are no side effects, what is the problem for taking them on a mass scale for people that just want to feel better?

ART CAPLAN, MEDICAL ETHICIST: There's three major ethical things to talk about. First, you can take a mood elevator, but you're not solving your problem. If you are in a bad relationship, if you're somehow at a job you don't like, you are not getting out of that; you just feel better in a rotten job, and that's not getting to the core problem.

Drugs cost a lot. The most rapidly rising part of a health care budget is the cost of drugs. It's not going to be easy to be a Prozac nation. And all of us would be engaged in a kind of giant medical experiment, because I'm not sure we know what it's like for, let's say, quote, unquote, "normal people" to take drugs 30, 40, 50 years. So we're not really sure what that would do long term.

HEMMER: So you're bottom line is, you have to determine, first of all, why you're in a bad mood, right?

CAPLAN: Yes, basically, I noticed today there is a story out double the number of kids from years ago are taking mood elevators. What's bugging the kids? I'm happy we can make them feel happier, but I'd kind of like to know, what's the problem here?

HEMMER: Lizzie, here in New York, you've been on lithium for 10 years, right, and you still insist that you have to work on yourself in another way outside of the medicine.

LIZZIE SIMON, AUTHOR, "DETOUR": Absolutely. These drugs are incredibly important. Mood stabilizers and antidepressants are incredibly for people with psychiatric disorders, like I have. I am bipolar. And I interviewed people are over the country for my book "Detour" who really rely on these meds to have normal, stable lives, integrated into society.

But for everybody else, the pills just aren't even going to work. Like Art said, a pill is not going to get you out of a bad relationship. A pill isn't going to make you feel more connected to yourself, to your family, to your lovers. It's just won't do the trick, and I think what's going to happen is people who take this kind of shortcut is that eventually they'll see that it's just not doing the trick.

HEMMER: Because you have to get to the core, is what you're saying.

SIMON: Right, you have to do the hard work of self discovery.

HEMMER: If your not bipolar, if you already have a good foundation, you believe your quite comfortable with yourself and understand the way you think, and act and feel, what's the problem?

SIMON: Then what's the problem? Why would you be on a pill in the first place? But if you just have a certain sense of malaise, it's probably because of the world we live in, and you aren't actively engaged in your life, and you ought to go out and rock the world in your own way. But taking a pill isn't going to help. It may help temporarily, it might elevate your mood, but it isn't going to sustain any kind of life change.

HEMMER: Very interesting.

Sanjay, is there a problem here in oversubscribing at this point?

GUPTA: Well, I think you can look at that really two ways. There probably is a problem with overprescribing. Certainly when Prozac, the first medication was released, it was approved for symptoms of depression, which are very specific symptoms. However, it's clearly used for people who don't meet those criteria, at 11 million, the number you quoted. There's about 18 million people, on the other hand, who have depressions, though, and psychiatrists I spoke with said there are a lot of people undiagnosed or underdiagnosed, and that's sort of a flip side of the argument.

Clearly, folks beyond psychiatrists are now prescribing this medication. A lot of family practitioners, the first doctor you would see might give you this medication.

HEMMER: You're shaking your head, Liz.

SIMON: The real story here is that most of the people who really need to be on these medicines don't take them, either because our health care system is prohibitively expensive or because the stigma in our culture is so great that people avoid taking the very medicine that they need.

HEMMER: Doctor, you had mentioned earlier that it takes some time right now to really examine the potential for side effects over a longer period of time. But you also do admit there is an upside to these drugs, even for, again, as I mentioned, the so-called normal people. Talk about the upside.

CAPLAN: The upside is there is no doubt that you can wind up feeling better in the short run. You can have a better mood. You can function better. There are certainly there are people out there who are taking these drugs to pass tests, there are people using certain kinds of medication who don't have any obvious psychiatric illness to get a better performance.

The problems comes when we get these drug really moving, what if your boss says, you've got to take this drug to stay on the job.

HEMMER: So you think that's a possibility.

CAPLAN: I'm a little nervous that as we go out there, and we see things that can increase your attention span, boost your memory, do more than just elevate your mood a little bit, we might be in kind of a race between us in the workplace to say if you are not taking these drugs, you're going to fall behind.

HEMMER: Very interesting. Wish we had more time. Bit of a philosophical question here and issue. We can blame Gupta for that, because you wrote about it in "Time" magazine.

GUPTA: Everybody blames me.

HEMMER: Yes, we do. Dr. Art Caplan in Philly, in New York Lizzie Simon, and, Sanjay, thanks for your time again.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired January 14, 2003 - 08:41   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BILL HEMMER, CNN ANCHOR: We want to get to medical news quickly. This morning, we are paging Dr. Sanjay Gupta and company today about the growing popularity of Prozac, and other mood enhancers. More than 11 million Americans, 11 million Americans, take some type of antidepressant known as SSRIs, which include Zoloft, Nuvof (p), Paxil and Celexa. Those are the more popular kinds.
Joining us today to share their views on the possibility of a Prozac nation, in Atlanta, Dr. Sanjay Gupta is back with us.

Good to see you, Sanjay.

In Philly, Dr. Art Caplan, a medical ethicist, here with us, and here in New York, Lizzie Simon, author of "Detour, My Bipolar Road Trip in 4D." If nothing else, great title.

Good morning to all three of you. Thanks for sharing your stories today.

Sanjay, quickly, medically speaking, how do these antidepressants work on the body and the brain?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: We've known for a long time that serotonin is a neurotransmitter. If you actually increase the levels of this particular neurotransmitter in the brain, it serves to elevate mood, an important point, and it seems to work not only in people who have clinically diagnosed depression, but really in just about anyone, as sort of a mood elevator -- Bill.

HEMMER: All right, Dr. Caplan, to you know. What are the implications if you stop and consider the possibilities of a Prozac nation, essentially saying so-called -- I don't want to put them in a normal people category -- people who do not use these drugs initially? If there are no side effects, what is the problem for taking them on a mass scale for people that just want to feel better?

ART CAPLAN, MEDICAL ETHICIST: There's three major ethical things to talk about. First, you can take a mood elevator, but you're not solving your problem. If you are in a bad relationship, if you're somehow at a job you don't like, you are not getting out of that; you just feel better in a rotten job, and that's not getting to the core problem.

Drugs cost a lot. The most rapidly rising part of a health care budget is the cost of drugs. It's not going to be easy to be a Prozac nation. And all of us would be engaged in a kind of giant medical experiment, because I'm not sure we know what it's like for, let's say, quote, unquote, "normal people" to take drugs 30, 40, 50 years. So we're not really sure what that would do long term.

HEMMER: So you're bottom line is, you have to determine, first of all, why you're in a bad mood, right?

CAPLAN: Yes, basically, I noticed today there is a story out double the number of kids from years ago are taking mood elevators. What's bugging the kids? I'm happy we can make them feel happier, but I'd kind of like to know, what's the problem here?

HEMMER: Lizzie, here in New York, you've been on lithium for 10 years, right, and you still insist that you have to work on yourself in another way outside of the medicine.

LIZZIE SIMON, AUTHOR, "DETOUR": Absolutely. These drugs are incredibly important. Mood stabilizers and antidepressants are incredibly for people with psychiatric disorders, like I have. I am bipolar. And I interviewed people are over the country for my book "Detour" who really rely on these meds to have normal, stable lives, integrated into society.

But for everybody else, the pills just aren't even going to work. Like Art said, a pill is not going to get you out of a bad relationship. A pill isn't going to make you feel more connected to yourself, to your family, to your lovers. It's just won't do the trick, and I think what's going to happen is people who take this kind of shortcut is that eventually they'll see that it's just not doing the trick.

HEMMER: Because you have to get to the core, is what you're saying.

SIMON: Right, you have to do the hard work of self discovery.

HEMMER: If your not bipolar, if you already have a good foundation, you believe your quite comfortable with yourself and understand the way you think, and act and feel, what's the problem?

SIMON: Then what's the problem? Why would you be on a pill in the first place? But if you just have a certain sense of malaise, it's probably because of the world we live in, and you aren't actively engaged in your life, and you ought to go out and rock the world in your own way. But taking a pill isn't going to help. It may help temporarily, it might elevate your mood, but it isn't going to sustain any kind of life change.

HEMMER: Very interesting.

Sanjay, is there a problem here in oversubscribing at this point?

GUPTA: Well, I think you can look at that really two ways. There probably is a problem with overprescribing. Certainly when Prozac, the first medication was released, it was approved for symptoms of depression, which are very specific symptoms. However, it's clearly used for people who don't meet those criteria, at 11 million, the number you quoted. There's about 18 million people, on the other hand, who have depressions, though, and psychiatrists I spoke with said there are a lot of people undiagnosed or underdiagnosed, and that's sort of a flip side of the argument.

Clearly, folks beyond psychiatrists are now prescribing this medication. A lot of family practitioners, the first doctor you would see might give you this medication.

HEMMER: You're shaking your head, Liz.

SIMON: The real story here is that most of the people who really need to be on these medicines don't take them, either because our health care system is prohibitively expensive or because the stigma in our culture is so great that people avoid taking the very medicine that they need.

HEMMER: Doctor, you had mentioned earlier that it takes some time right now to really examine the potential for side effects over a longer period of time. But you also do admit there is an upside to these drugs, even for, again, as I mentioned, the so-called normal people. Talk about the upside.

CAPLAN: The upside is there is no doubt that you can wind up feeling better in the short run. You can have a better mood. You can function better. There are certainly there are people out there who are taking these drugs to pass tests, there are people using certain kinds of medication who don't have any obvious psychiatric illness to get a better performance.

The problems comes when we get these drug really moving, what if your boss says, you've got to take this drug to stay on the job.

HEMMER: So you think that's a possibility.

CAPLAN: I'm a little nervous that as we go out there, and we see things that can increase your attention span, boost your memory, do more than just elevate your mood a little bit, we might be in kind of a race between us in the workplace to say if you are not taking these drugs, you're going to fall behind.

HEMMER: Very interesting. Wish we had more time. Bit of a philosophical question here and issue. We can blame Gupta for that, because you wrote about it in "Time" magazine.

GUPTA: Everybody blames me.

HEMMER: Yes, we do. Dr. Art Caplan in Philly, in New York Lizzie Simon, and, Sanjay, thanks for your time again.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com