Prozac’s anniversary and “patients” without a choice or voice

This week marked the 20th anniversary of Prozac.  Columnist Anna Moore shared insights and 20 observations on the drug, its history its legacy and uncertain future in "Eternal Sunshine," this recent op-ed  published in the U.K.'s Observer.  The drug, and other treatments for psychological conditions, are being given to patients who have absolutely no say in their treatments. Maybe we can understand its being given to some pets.  Maybe. Over 10 years ago, before there was an FDA-approved form of the drug for dogs, Michael Moore (of SiCKO fame) aired a "Pets on Prozac" segment in his series, TV Nation.  The five-minute clip follows one Long Island pooch's road to recovery from OCD, touching on a parrot's experience as well.  To view, click here.  Treatment for each veterinarian patient is estimated to cost $100 per month for each pet, begging the question: just who is (or should be) the patient here? But, as Anna Moore writes, Prozac and drugs like it are being prescribed to young children and even toddlers.  Between 1995 and 1999, use of antidepressants to treat children aged 7 - 12 increased by 151%, and treatment of those under 6 grew by 580%.  In 2004, children ages 5 and under were the fastest growing non-adult patient group. Antidepressants, she writes, have been most often used in this age segment to treat "selective mutism" (a "condition" in which children do not speak up in preschool class).  There's no way that this could be caused by an overbearing parent or teacher, or an aggressive classmate.  Or simply getting used to the structure of school after the freedom of all-day play. Nope. Must be a neutrotransmitter imbalance.   Selective mutism has  joined other disorders that we never knew existed, such as social anxiety disorder (once known as shyness) or  oppositional defiant disorder, in which children do not listen to or comply with elders' requests. It used to be called "backtalking."  Some might argue that this isn't the result of inconsistent parenting, but rather an organic condition. But, ODD is often linked to ADD and ADHD, thus all roads lead straight to the medicine cabinet. And all too often, schools, although well-meaning, appear to become the first stop in the path to unnecessary medication. It's tempting to imagine how great figures in history would have turned out in a system such as the one that we see at many schools in the "no child left behind" U.S. today. Attached, a  riff on Mrs. Mozart's encounter with the school principal before her son's first IEP meeting. mrs-mozarts-iep.doc