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edited by Carl Elliott and Tod Chambers (Studies in Social Medicine), 211 pages, $39.95, ISBN 0-8078-2880-7, paper, $19.95, ISBN 0-8078-5551-0, Chapel Hill, University of North Carolina Press, 2004.

JAMA. 2005;293:237-238.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Prozac has brand recognition, having permeated our culture as few medications have before. We live in the Age of Prozac.

In the 1993 bestseller Listening to Prozac,¹ Kramer meditated on "cosmetic psychopharmacology": fluoxetine targeting not only depressive episodes but, seemingly, patients’ personalities. Responders often felt "better than well." This book’s authors generally interpret this as personality change, but it usually indicates lifting of depression so chronic that patients themselves consider it their personality.² The phenomenon largely reflects selective serotonin reuptake inhibitor (SSRI) effects on dysthymic patients without prior adequate treatment for chronic depression and anxiety. Treating superimposed major depression clears both acute depression and dysthymic disorder, granting newfound euthymia.

"Cosmetic psychopharmacology" may be misleading: SSRIs matter for their widespread benefit for previously undertreated individuals with mood and anxiety disorders. The advent of fluoxetine improved American public health, providing broad spectrum antidepressant/anxiolytic/antiobsessive medication that nonpsychiatrists can comfortably prescribe. SSRI dosing, . . . [Full Text of this Article]

John C. Markowitz, MD, Reviewer
New York State Psychiatric Institute
New York
jcmarko@med.cornell.edu