It was initially hailed as a miracle cure, but became a victim of its own success as patients who were not clinically depressed demanded the drug as a “quick fix” for their personal problems.

There are concerns that the drug is addictive and that in some cases it can lead to thoughts of suicide. But despite the controversy surrounding Prozac it has become the first-line treatment for most patients exhibiting the signs of major depression.

More than 35 million people worldwide have been prescribed Prozac - including more than 500,000 in UK alone - since its launch in 1989.

What is prozac?

Prozac (fluoxetine) is one drug in a family of antidepressants called selective serotonin re-uptake inhibitors (SSRIs). Other drugs in this family are Lustral (sertraline), Seroxat (paroxetine), and Faverin (fluvoxamine). There are also other families of that are antidepressants.

SSRIs make serotonin more available in the brain. Serotonin is a chemical that affects mood.

SSRIs have potential benefits:

• People who take SSRIs usually need just one dose per day.

• SSRIs are safer to take with other drugs and pose less risk in overdose.

How effective is Prozac?

All the drugs commonly prescribed for depression are roughly equal in effectiveness. This often surprises people who assume that Prozac is best.

On average, antidepressants seem to help 60% to 80% of the people who take them.

This is true both of the earlier-developed drugs such as tricyclics such as Elavil (amitriptyline), as well as the newer drugs such as SSRIs.

Many people combine Prozac with psychotherapy.

Are there side effects?

There is evidence to suggest that taking Prozac may trigger suicidal thoughts in some people.

In England, the Department of Health has recommended that Prozac should be the only drug of its type prescribed to patients under 18.

However, an analysis by the US Food and Drug Administration concluded that the drug posed a similar risk to young people as other SSRIs.

The FDA recommended the drug should carry the strongest possible warning that it could cause children to harm themselves.

Eli Lilly, the makers of Prozac, argued that in no case studied by the FDA did Prozac actually lead to a suicide, and that depressed people were probably prone to suicidal thoughts regardless of what medication they took.

They also warned that the risk of not treating depressed young people at all was probably greater than any risk posed by taking their product.

Other side effects can include:

• Nausea;

• Headaches;
• Diarrhoea;
• Insomnia;
• Sexual , such as delayed orgasm.

Does Prozac transform personality?

Psychiatrist Peter Kramer, in his best-selling book Listening to Prozac, claimed that the drug could be use to alter personality traits like shyness and lack of confidence.

However, there is scientific evidence to suggest that claims that Prozac can transform personality are exaggerated.

People may become more gregarious and easy going when taking the drug, but this can be attributed to recovery from depression, rather than any magical properties of Prozac itself.

This page contains basic information. If you are concerned about your health, you should consult a doctor.

Newsnight Review discussed Susan Sontag’s Regarding the Pain of Others.

(Edited highlights of the panel’s review taken from the teletext subtitles that are generated live for Newsnight Review.)

TIM MARLOW:
Peter Hitchens, you are a journalist
who’s spent some time looking at this
kind of issue and putting yourself on the
front line. Do you think issues
desensitise in the end?

PETER HITCHENS:
Immensely. I can tell you that when I
went to Somalia, before George Bush I’s
great failed intervention and saw the
famine there, I was angry with myself
because I didn’t feel more when I saw
the scenes; I’m a child of all this
television coverage of famine and
disaster, I’d seen it for years. I was
simply seeing something I’d already
seen on television. It didn’t make the
impact it should have done.

I was cross with
myself because I thought I should have
felt more and I’m convinced it’s because
I’d been . When she asks in
the book, “What’s the evidence?” I can
tell her, that’s the evidence. I think if
she’s changed her mind it’s not because
the facts have changed, it’s because we
now have liberal wars and the days when
she first set out her views on this, most
wars were conservative. Now liberal
wars happen and they are by and large
set off by television coverage of some
region of doom which we are all
supposed to intervene because it will be
better if we intervene, whether it be Iraq
or Kosovo. Since that began, the liberals
have all started saying “well actually
images of war are good because they
bring this about”. I think that’s the real
change. What’s really happening, which
she gets close to here but doesn’t quite
admit it, she says, “So far as we feel
sympathy, we feel we are not
accomplices to what caused the
suffering. Our sympathy proclaims our
innocence as well as our impotence. To
that extent it can be, for all our good
intentions, an impertinent if not
inappropriate response.” Actually I
would half agree with that. What we are
doing is using these foreign parts as a
playground to let our conscience loose
and that’s what many of us do. We then
respond by wanting to make ourselves
feel better rather than make the country
involved be better.

GERMAINE GREER:
I find this essay seductive in a way, I
mean it’s written; it’s lovely
to watch her muscular mind dealing with
this issue. But the issue is ostensibly
watching the pain of other people. Its
about the iconography of victimhood. It
starts off being about the casualties of
war, including civilian casualties and it
raises issues and then leaves them
hanging. I have a feeling its intensely
self-censored. For example, she starts off
talking about the gender of war and uses
the Virginia Woolf example from Three
Guineas and then just walks away from
it; just leaves it hanging there. Then at
one point she says that war is the greatest
crime of all after arguing we must have
wars, we will always have wars. And not
accepting the idea that conflict is one
thing and technological warfare on the
scale of the Iraq war, for example, is
another. This is a very different state of
affairs where you have maximum
civilian casualties. The odd thing is its
published in 2003 but it make no
mention in the war of Iraq which
actually changed a lot of that bottom
line.

MARK KERMODE:
For a book with so many boldly
declaritive statements, I mean every
single page has statements like, you
know, “Memory freeze frames its basic
unit is the single image” and, “only
under strange will war
genuinely become unpopular”. I mean
it’s full of these little gnomic phrases
and yet actually, what it ends up being is
completely , which I think is
its greatest strength. In response to
something Peter said, whatever your own
personal experience of it may be, I don’t
buy that you would desensitise to the
real world by images of those things. I
mean that may be how its been
experienced but I don’t actually think
that that’s what happened. I think that
one of the things this book does, which
is beautifully handled, is that she
interrogates the meaning of images that
we take to be absolute and shows them
all to be completely fluid. I think that as
a piece of essay writing its wonderful.
That phrase you used, “seeing her muscular mind
work”, is exactly what…I mean it’s a
very, very physical muscular piece of
writing and I think its
is its triumph.

TIM MARLOW:
Do you think this is in some ways a
cathartic act then for Susan Sontag, she
is purging her own feelings of worry and
guilt?

PETER HITCHENS:
Well I think everybody is now
increasingly concerned by this because
we see this night after night and we are
supposed to feel something and
increasingly we don’t know what to feel.
Ought we genuinely to care? And when
we say we care, do we really care? I
think in most cases I think we probably
don’t but I think we like to think we do.
So to that extent yes but actually I don’t
think she answers the problem, which is
that you cannot because you see
something on the television or in a
photograph; you cannot be there; you
cannot have power over it because you
can see it. That is the real problem we
face and the delusion of modern
politicians that if you can see it you can
alter it comes straight out of the fact that
we are actually constantly pretending
that what we see on television is as close
to us in reality as it is on the screen.

MARK KERMODE:
But that is the answer to the question, is
that interactivity is the answer so in a
way she does answer…

PETER HITCHENS:
But actually when you have seen the
thing on television and you see it face to
face its diminished for you and you can
tell me that it isn’t so, but I can tell you
that it is.

GERMAINE GREER:
But there has been a much bigger, I
mean there’s been a huge change. In the
case of Kosovo we saw victims. We saw
victims of ethnic cleansing and so on.
Our hearts went out to them and we felt
sympathy and we felt indignation. We
felt them in manageable portions and we
took action…

PETER HITCHENS:
We felt so sympathetic we went out and
bombed the Serbs as an act of sympathy.

GERMAINE GREER:
We had to be got on side. Its all
propaganda. The other thing that she
falls between two stools in arguing about
whether photographs are records or
whether they are fiction. And its true
every picture tells a story. What it
doesn’t do is give you a fact.
We don’t know
how many civilian casualties there were
in Iraq and we were never allowed to see
any of them. The whole point of
imbedded soldiers was we took the eye
line of an aggressor. From her point of
view its enormous change. I feel
frustrated she didn’t deal with it or
acknowledge it. She seems to be, like
you, still watching black-and-white
films, still watching film noir, still living
in that world of New York and not
engaging with the fact that kids fight
wars with their PlayStations.

An Egyptian paper welcomes the refusal by 27 Israeli pilots to carry out air raids on Palestinian targets - but an Israeli paper describes the pilots’ move as “chilling”.

Other dailies examine efforts by the “quartet” in New York to relaunch the US-backed roadmap peace plan.

Twenty-seven Israeli war pilots have slammed the Sharon government for pursuing an assassination policy against Palestinian activists, likening this to other criminal guerrillas and terrorist organisations, which have no way of dealing with opponents other than killing them….

The entire world, except for the USA, has condemned the killing of Palestinian leaders, not because of the loss of civilian life, as admitted by the Israeli pilots themselves, but because it wastes an opportunity for peace.

Al-Jumhuriyah - Egypt

The collapse of the roadmap, with Yasser Arafat to blame, puts Ariel Sharon in an ideal position from his point of view. He doesn’t have to do his bit to get out of the Palestinian Territories.

Meanwhile, Israeli society is falling apart - as witnessed by the chilling letter from the 27 pilots - and if he doesn’t initiate something or start a political process, not only will the terror resume with full force, but Israel could find itself clashing with Bush.

Ha’aretz - Israel

The quadripartite committee must move effectively to achieve peace and urge the USA … to show a degree of commitment towards a political settlement, which is being delayed due to US bias and the protection of Israeli crimes.

Al-Ahram - Egypt

The current discussions of the UN General Assembly and the previous discussion in the UN Security Council indicate how the UN needs support to improve its performance to enable it to act on international crises.

Oman -Oman

Three years have passed since the Oslo war the intifada broke out… One thing is : the Palestinian leadership had no intention of reaching a settlement with Israel, unless it accepts the Palestinian conditions, including the right of return.

Hatzofe - Israel

In giving preference to US-Israel relations over any other , Sharon is articulating, in the deepest sense, the existential dilemma in which Israel finds itself. It can no longer save itself by its own means. Even Sharon… cannot free Israel from the burden of the territories and thereby guarantee its future as a Jewish state…

The most Sharon is capable of doing, and is in fact doing, though perhaps not intentionally, is to direct the mute cry emanating from our political impotence towards our superpower ally: Save us from ourselves!

Ha’aretz - Israel

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