WHAT ABOUT THE CLAIM THAT TREATMENT OF PERSONALITY DISORDER WITH PROZAC MAY CAUSE COMPLETE TRANSFORMATIONS?

Claims like these lead inevitably to disappointment for most patients, although transformation does occur in a chosen few. Even on Prozac, shy depressive with personalities like that of the poet Emily Dickinson—unless they have a history of extreme highs and lows or family history of mood disorders – would not turn into extroverted rock and roll singers.

For most people, the changes created by Prozac are more subtle; the depression clears, the symptoms disappear, and positive life changes occur, A few of my patients who report feeling like themselves again say that they can’t imagine living without Prozac. Indeed, it can offer a certain brightening, a new equanimity, or a boost in self-confidence. However, in patients who have major depression, this is a phenomenon that also occurs with most other antidepressant drugs.

Prozac is not a magic wand: seldom does it turn a wallflower into the belle of the hall. Nonetheless, like other psychiatrists, I have witnessed a few transformations and my interpretation of why they happen and how they can be predicted may surprise both patients and physicians.

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