Preliminary results from a recent Duke study indicate that Prozac is a safe and effective treatment for depression in adolescents. Although not yet published, this research suggests that concerns about Prozac's safety are exaggerated.
The study, conducted by Professor of Psychiatry Dr. John March, provides the first concrete evidence of the efficacy of Prozac, said Dr. Terrill Bravender, assistant professor of pediatrics. Bravender noted that despite the popularity of Prozac, limited sampling and measurements made prior studies on its benefits less conclusive.
March's study examined treatment with a placebo pill, psychotherapy alone, Prozac alone and a combination of Prozac and psychotherapy. The study's early findings indicate that the combination of Prozac and psychotherapy was effective for 71 percent of the adolescents studied. Prozac alone worked favorably for 61 percent of the subjects and psychotherapy alone saw positive results in 43 percent.
Despite the apparent benefits of Prozac, there has been much recent debate about the linkage between Prozac usage and adolescent suicide.
"Every drug has side effects," Bravender said. "[But] there are worries about increased suicide risk in adults and children [when they take Prozac]."
John Barrow, assistant director of outreach services for Counseling and Psychological Services, noted that anyone who is depressed is at an increased risk for suicide.
Barrow and Bravender both warn health care professionals and patients to exercise caution with Prozac as they would with any antidepressant, but Bravender said Prozac is a very safe drug. "It is very difficult to hurt yourself by overdosing, and the majority of side effects are very minor," he noted.
The results from March's research also highlight the importance of combining treatment with Prozac and psychotherapy--an especially critical observation because Prozac has been a long-standing treatment for depression in adolescents.
Bravender, who said he has seen positive results from Prozac, frequently prescribes the drug to his patients and welcomed the new findings.
"Having this new data available is very reassuring," he said, noting that this study is not a green light for physicians to stop monitoring their patients carefully. "I am a firm believer that psychotherapy is as important as any drug."
Barrow said that as a result of a decrease in side effects and social stigma, students are more inclined to use antidepressants than ever before. "I think sometimes people are more open to taking medication than doing therapy," he said. "Therapy requires coming to terms with problems and many adolescents can find that very threatening."
Natalie Leithem, Trinity '04, started taking Prozac in combination with psychotherapy for depression when she was 18 years old and described her experience with Prozac as critical in her recovery.
"Prozac enabled me to get out of bed in the morning so I could get treatment," Leithem said. Although she has since stopped taking the medication, she said the combination of medicine and therapy worked extremely well for her.
Success stories such as Leithem's may become more frequent as physician and patient confidence in Prozac increases. Bravender said practitioners may now be more likely to use Prozac, relative to other antidepressants, but he cautioned the public to remember that Prozac is most effective when combined with therapy.
"The one thing I would not want to see happen is for a primary care physician to not monitor kids as closely as they should," he said.
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