QUESTION:
Dear Dr. Heller,
I have read recently that there was a major study in which the users of Prozac showed corkscrew-like serotonin receptors in comparison to control subjects. This bothers me as a user, and the many others who may be too. The article said the receptors look comparable to long term MDMA (E or X) users. I don't know if they were using very high doses of Prozac and if the trial was even on animals - which may well be the case, because I do not have it in front of me. Regardless, the findings are disturbing, along with research pointing out that Prozac lowers dopamine transmission by 54%. Couldn't that cause Parkinson's? As this wonder-drug has been on the market, it appears to be showing more and more thorns. What's the deal? Is there some cover-up, as of course the manufacturer would want at high cost to protect its multibillion dollar invention, or what? Is the risk/benefit ratio worth it?
Please give some insight.
ANSWER:
I've heard nothing about it. You don't know if a change in receptor shape is a good or
bad thing - you've assumed it's a bad thing. How any drug affects the entire brain,
including relationships of the various receptors is an important factor.
Like everything else in life, one has to evaluate the benefits VS the risks. It's
dangerous to drive a car, but most people consider the risks worth taking because of the
benefits. Heart disease is the number one killer, depression doubles the risk of a heart
attack and triples the risk of dying from the heart attack. It's associated with many
other conditions including cancer. Suicide is the 8th leading cause of death in the US,
diabetes is number 7.
The dopamine transmission depends on the brain parts involved. A reduction in dopamine
transmission in the limbic system is likely a good thing.
Parkinson's comes from a deficiency of available dopamine in a different part of the brain
- the basal ganglia.
To the best of my knowledge no significant negative long term effects are present. I can't
guarantee there's no cover up, but it's highly unlikely - particularly as Prozac is now
off patent and will be available generically soon.
Beware of how to interpret information you get. Some is inaccurate and some out of context
particularly if it comes from the Church of Scientology which has been aggressively
attacking Prozac and Ritalin for a very long time with misinformation and scare tactics.