Talking Back To Prozac, Peter R. Breggin, M.D., St Martins Press, New York, NY, 1994

Reviewed by John A. Speyrer

Dr. Breggin believes that "(t)he most common and crucial sources of disabling depression lie in childhood losses and abuses. . ." but feels that ingesting Prozac should not be the solution to depression. Indeed, a very large portion of Breggin's rebuttal of Listening to Prozac (see book review) is that there are too many untoward side effects of prozac, the most serious being that its use sometimes results in violence and suicide.

The author believes that prozac as well as other psychiatric medications have dangerous and unsuspected effects which often cannot be foreseen. He feels that even though prozac was approved by the Food and Drug Administration, there is no assurance that it is safe. He explains the procedure of regulatory approval, and writes that the FDA itself does not perform validating experimental procedures, but relies on the drug companies themselves to furnish the scientific data. And therein lies the rub, Dr. Breggin believes. Sure, some feel better after being on prozac but the same can be said for other and more dangerous drugs, such as cocaine, the author writes. He cites studies which show that prozac is hardly better than a placebo and warns that sometimes, activating a depressed person can cause suicide. In any event, the author does not believe that depression is caused by defective brain chemistry, and thinks that this common, though miserable experience, is part of the normal cycle of life.

Dr Breggin never prescribes psychiatric drugs to his new patients. Instead he advocates "caring psychotherapeutic interventions." He says that most psychiatrists would prefer being less supportive and more controlling and would have no qualms prescribing drugs, but Breggin believes the involvement and care on the part of the therapist helps the patient to understand the roots of his depression. He says what the depressed person needs is love and hope for the future and that the passage of time, by itself, can often alleviate many depressions.


Of course a depressed person needs hope for the future. That's like saying that what a starving person needs is food. The author is in a curious position concerning the "over-sensitivity" which many psychiatric patients exihibit. Breggin says that there really is no such thing! But if an incident triggers feelings of excessive humiliation, for example, well, that person should "understand" and then "overcome their vulnerability." Now that these triggers, which are the bane of most NP patients, have been so easily disposed of with a few sentences, Breggin states that a depressed person should feel empathy for himself at the present time and/or for what he went though as a child.

He feels that this self-empathy will help the depression to lift, since the patient will then no longer hate himself after he realizes what he survived as a child. Were it that simple! How can the person know, understand or even suspect the depth of his repressed feelings? After all they are repressed. Futhermore, there is no way for a person who has never felt pre- and peri natal trauma or trauma from infancy, to relate those feelings to the present. Even if he could become that perceptive, insight has proven to be a futile and fruitless remedy.

One characteristic of melancholic depression (the severest form of depression), is the lack of desire to do anything. Oftentimes, such a depressed person lacks even the energy and ability to get out of bed, so acting on impulses of suicide or murder becomes remote. But, paradoxically, it is possible for an anti-depressive, in shifting the depressive's mind towards an agitated state (on his road to feeling better) to become suicidal or violent when these tendencies were not able to have been acted out before. Undoubtedly, this can account for some lamentable effects of prozac. In any event even a drug-free release from melancholic depression would also pass through this phase which undoubtedly accounts for many suicides. With the large number of patients taking prozac it would be reasonable to assume that some have repressed feelings of anger and violence.

In spite of all his criticisms, it was interesting to read of the non fool-proof procedures for regulatory approval of new medicines. Dr. Breggin has performed an admirable service in pointing out some infrequent, though potential harmful side-effects, of the latest psychiatric wonder drug, - prozac.