Life is a Prozac Deficiency Disorder



^Prozac: Before and After

I read recently that the antidepressant Prozac might have utility in the treatment of autism.  I have had very little experience with this disorder but had assumed it was a hard to fix hard-wired sensory neural deficit. Prozac raises brain serotonin levels, but whether this leads to a brain rewiring like long term psychotherapy can is unclear.

This finding piqued a desire to review my experience with this apparent  wonder drug. Prozac has shown utility in major depression, PMS, agoraphobia, panic attacks, OCD, and sexual dysfunction (later). Its use as a “cosmetic” agent however is debatable.

In 1989 I think it was, I prescribed the brand new hot off the Eli Lilly test tubes drug Prozac (fluoxetine). I was impressed with its efficacy in the treatment of depression within 3-4 weeks. It had many advantages to older antidepressants because of fewer side effects and it was essentially suicide proof in overdose. A few years later I read Listening  to Prozac  which introduced the  concept of cosmetic psychopharmacology. That is the use of Prozac  to enhance performance in otherwise normal non symptomatic  people.

So if you were shy and anxious and wanted to bold and self-assured Prozac could theoretically do the job. How much of this might be due to non specific factors like support and encouragement-the placebo effect- remains unclear.

I tried out this idea first on phobics like those with agorophobia and people with PTSD and kids who were painfully shy and withdrawn.

The results were impressive  as far as reduction  of anxiety and boosted mood goes. But these were clinical disorders. The interesting observation was that nobody wanted to stop the drug.  People would often say they felt lighter, less stressed and more outgoing, lively, and confident thus potentially ushering in this new era of “cosmetic psychopharmacology,” with non-depressed people popping pills to make themselves more attractive, energetic, and confident. As it turned out, very few people ever asked for Prozac to be popped as a happy pill. I do recall a rather high-strung man who after Prozac stated that if a cannon went off next to him he didn’t care. This observation was common in my patients, a beneficial (to them) sort of I don’t give a shit attitude.

I did experiment with cosmetic use in a woman  with extreme introversion and low self-esteem. Within weeks of starting Prozac, she became a bit less withdrawn with a rather rapid and dramatic reshaped social life. Low self-worth and poor interpersonal skills-the usual causes of social awkwardness-are so deeply ingrained and difficult to influence that ordinarily change comes gradually, if ever. But Prozac  seemed to do the trick, placebo effect not withstanding- “better living through pharmacology”.



I did try it for PMS. It helped considerably but it did delay orgasm. For this you could prescribe Periactin  an old antihistamine as an antidote, except that caused fatigue. Now you could fix that with a couple of cups of coffee except this led to a full bladder fairly quickly which sort of interfered with the flow of events. Drug therapy does have its drawbacks. However this orgasm delay, side effect could have its benefits for men and so here is what I have successfully prescribed Prozac for:

Premature ejaculation…


Being trigger happy is no joke. Once it strikes you are chronically  disabled. You  feel urges to enter the monastic life. I used to prescribe old drugs like Imipramine  or Mellaril for this, but dry mouth was a big deterrent foreplay wise. Then there was the squeeze technique (above pic) designed to build muscle stamina.

The patient lies on his back while his female partner strokes his John Thomas until orgasm approacheth nigh. At that point she squeezes the glans with thumb and forefinger. The idea was to build up strength in the detrusor muscle. After some practice if done right the female jumps on board, and hops off if our hero feels he will take off.

The number of cases I recall this procedure working in were zero. If the male didn’t  warn the female quickly enough of impending orgasm he would climax impressively into the local environment or  sometimes there was retrograde ejaculation back into the bladder. Now the anxiety from all this could lead to impotence. On that note, I used to treat the latter sometimes with yohimbine which  was from the bark of some tree  in South Africa. Thousands of Zulu warriors chewed  on the stuff over the centuries making that tribe the most populous on the continent. Well it didn’t work for my cases.

Back in the day you could treat impotence with Papaverine  injections. A loaded syringe with a small gauge needle injected right into the penile shaft. Sure. I had one fellow who had the courage to do this and it worked just fine for 3 hours.

But Prozac and later Viagra revolutionized sexual congress. Take 10 mg of the former and 50 mg of the latter an hour before carnal knowledge and you could lock and load in a blizzard for 30 plus minutes.

Better living through drugs. Molecular hydraulics.  People have been ingesting mind altering agents since they descended from the trees in Tanzania (or Morocco). Traces of opium seeds have been found on human remains 4,000 years old

Hallucinogenic cacti may have been used in Peru as long ago as 8600 BC.

So therapeutic and recreational drug ingestion won’t remit  anytime soon.

Long lasting personality change in my opinion can only occur  through months and years of psychotherapy. However, quick reduction  of suffering is always welcomed. So if a debilitating condition such as autism can be attenuated, a lot  of family suffering could be alleviated.

And so it goes for sexual emergencies.





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One Response to “Life is a Prozac Deficiency Disorder”

  1. kristina nadreau says:

    Thank you. Interesting pharmacopeia

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