Prozac's Irish life

Prozac has become the most prescribed branded antidepressant in the Republic since its launch here in June 1989. It has "revolutionised" the management of depression because the same one-capsule-per-day dosage is prescribed for every sufferer, and because it acts on numerous mental illnesses. In the majority of cases it is the sole antidepressant taken by the patient.

"Before Prozac," says Dr Patrick McKeown, chairman of Aware, the charity for sufferers from depression, "there were numerous anti-depressants, such as lithium, which were just as good but had to be measured very specifically for each individual and often had to be taken several times a day. With Prozac there are fewer side-effects; there's almost no danger of a fatality with overdose, and it can be used in the treatment of obsessive-compulsive disorders, eating disorders and panic attacks, as well as depression."

Prozac is an SSRI, or selective serotonin reuptake inhibitor. As Dr McKeown explains, it increases the levels of the brain chemical serotonin, which regulates mood. Over time, as the levels increase, the transmission of electrochemical signals in the brain improves (in a depressed person the transmission of electrochemical signals occurs less efficiently), and the depression lifts.

Dr McKeown stresses that antidepressants should not be used to treat all mental illnesses on a permanent basis. He points out that there are different types of depression, some induced by circumstances such as a bereavement or relationship problems, and others due to chemical problems in the brain, which may have genetic or biological causes. While Prozac may be useful in some cases as a once-off to lift the depression - which should then be treated with psychotherapy - biological or chemical depression may need long-term medication.

More than 200,000 people in the State suffer major depression, while one in three will have an episode of major depression in their life. It has been linked to the majority of the 380 suicides in the Republic each year (on average). Dr McKeown says Prozac is not the "miracle" answer to end all research into the medical treatment of depression. "We are still looking forward to an antidepressant which has no side-effects such as tummy upset or reduced libido - both of which can be brought on by Prozac."