ALEX COHEN, host:
This is DAY TO DAY from NPR News. I'm Alex Cohen.
MADELEINE BRAND, host:
I'm Madeleine Brand. Antidepressants sometimes seem as normal in today's world as, well, an aspirin. They've been around for several decades now. They're commonly prescribed. They are big moneymakers for drug companies. And so we thought we'd check in on their affect on mental health in this country.
Dr. David Fassler is a professor of psychiatry at the University of Vermont College of Medicine, and he joins us now. Welcome to the program.
Dr. DAVID FASSLER, (Professor of Psychiatry, University of Vermont): Thank you very much.
BRAND: And is it fair to say that when Prozac came on the market - 1989, I believe - that that was a turning point?
Dr. FASSLER: I think it was a significant event. And there was also a lot of advertising certainly to physicians connected with these medications, and I think that that also increased their utilization.
BRAND: This story was on the cover of Time magazine.
Dr. FASSLER: Right. So there was a broad, general awareness. People started taking the medication and they would talk to their friends about it. And soon people would come to their physicians and they were asking for these medications.
BRAND: And then these books came out, "Prozac Nation," "Listening to Prozac."
Dr. FASSLER: And with all things there are both positives to negatives. Certainly, I can tell you as a psychiatrist that these medications have helped millions of people; they have saved numerous lives. But they're also not for everybody. If there's one message from our talk today, it's that if people think that they may have depression, they should really get a good evaluation and look at the full range of treatment options. Medication is right for some people, but there are a lot of people who have depression who can be and are effectively treated without medication.
BRAND: These drugs suffered a setback recently during highly publicized FDA hearings on their possible link to suicidal thoughts. Have the drugs recovered from that?
Dr. FASSLER: What we've seen is a significant reduction in the use of these medications for children and adolescents. So, depending on the study you look at, there has been a reduction of between 20 percent and a third in the number of prescriptions for kids under 18. For adults we've seen less of a change, maybe more of a leveling off. But of significant concern is we've also seen an increase in the adolescent suicide rate for the first time since the early 1990s.
So my concern as a psychiatrist is that there are now a lot of kids in particular who aren't getting the effective and appropriate treatment that they need.
BRAND: Well, do you make the link between the reduced use of SSRIs and the increased suicide rate?
Dr. FASSLER: I would say that we don't know for sure yet. There's a lot of evidence and data to suggest that that's the case. We can't definitively demonstrate the cause and effect yet, but it's certainly an area of major concern and something that we're continuing to watch very closely.
BRAND: It's been nearly 20 years since Prozac came onto the scene. How are these drugs evolving and what are the newest versions of antidepressants, what are they like?
Dr. FASSLER: We keep trying to find medications that have less side effects. We've improved in that. Now, we have medications that can be taken once a day. We don't yet really have medications that work faster. That would be a next step. And also we're starting to really look at the genetics of who responds to which medication to try to figure out if we can predict in advance which medication might be most appropriate for a particular patient.
BRAND: Dr. Fassler, thank you for joining us.
Dr. FASSLER: My pleasure. Thank you.
BRAND: Dr. David Fassler is a professor of psychiatry at the University of Vermont College of Medicine and a practicing child and adolescent psychiatrist in Burlington, Vermont. He joined us from the studios of Vermont Public Radio.
Copyright © 2007 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.