The New York Times Book Review
July 2, 2000

In a review in the Sunday Times Book Review on July 2, 2000 by Abraham Verghese entitled "Anatomies of Melancholy" Dr. Glenmullen was described as "critical, as are many in medicine, of the excessive popularity of psychopharmacology-the use of drugs in place of talking through a patient's problem. The mystique of a biochemical imbalance at the root of every symptoms has too much allure." Said Verghese: "The use of the word 'backlash' in the title refers to the reactions in the brain that are evoked by Prozac and the other drugs, like Zoloft and Paxil, that act on serotoninŠ.Glenmullen uses 'cases,' a staple of books of this genre, to illustrate these problems."

The New York Times
June 29, 2000

In a review in the daily Times on June 29, 2000 by Janet Maslin entitled "Exploring a Dark Side of Depression Remedies" Prozac Backlash was described as "an important, deeply troubling examination of the means by which these drugs have become so widely disseminated, and the possible long-term toll they may take." Prozac Backlash "makes a tough, persuasive case that the drugs are more dangerous than generally acknowledged, that patients and doctors are insufficiently informed about the risks and that drug companies devote vast amounts of money and energy to spin control." Prozac Backlash is "as readable as it is alarming" and "argues cogently and persuasively for better research, truly independent research data, consumer skepticism about such drug company-generated phenomena as 'National Depression Awareness Day' and less readiness on the part of doctors, whose patients may see them only seldom because of insurance constraints, to hand out antidepressants as an easy fix-it without follow-up visits or closer attention." "An especially disturbing section of the book delves into a lawsuit brought against Eli Lilly by survivors of a rampage by Joseph Wesbecker, who was the company's worst nightmare: a Prozac user who went on the rampage in 1989 with an AK-47. Fortunately for Eli Lilly, the 1994 trial was concurrent with the O. J. Simpson trial, the facts were carefully manipulated, a secret settlement was made between plaintiffs and the drug company even as the trial continued, and Prozac avoided a warning label about possibly violent or suicidal behavior. All the particulars of this remarkable legal travesty are laid out here."

ABC News' 20/20
June 21, 2000

ABC News' 20/20 featured Dr. Glenmullen and Prozac Backlash on June 21st. In addition to Dr. Glenmullen, Dr. David Healy, one of Europe's leading psychiatrists, was interviewed on his new research in which healthy volunteers became suicidal on Zoloft. One of Dr. Glenmullen's patients, Julie, discussed her frightening experience becoming agitated and suicidal and making a serious suicide shortly after starting Prozac. Another patient demonstrated her severe tic disorder, flailing her arms uncontrollably, which began shortly after she started Prozac. After the program, Dr. Glenmullen was the guest on an hour-long ABC News.com chat. Click here to link to the ABC News 20/20 site for more information.

Boston Globe Editorial
June 13, 2000

After running four front page articles with information on the patent for the new Prozac which states that the existing version of the drug can cause "suicidal thoughts" and "self-mutilation" (see below), the Globe ran an a June 13, 2000 editorial entitled "The Prozac Question." The editors asserted: "The FDA should reopen the question of whether the patent language on the new Prozac is not a warning that users and prescribers of the original [i.e. current] Prozac should have been receiving all along."

The Boston Sunday Globe
June 11, 2000

In a front page article on June 11, 2000 by Mitchell Zuckoff entitled "Prozac new directions: Science, money drive a makeover," the Globe followed-up on its original May 7, 2000 article (see below) revealing that the patent for the new Prozac acknowledges that the current version of the drug can cause suicidality and violence. The article focused on Harvard psychiatrist Dr. Martin Teicher who wrote the original paper calling attention to this potentially lethal side effect. The Globe interviewed Dr. Teicher after discovering that he is one of the developers (along with the pharmaceutical company Sepracor) of the new Prozac, which is expected to be marketed by Eli Lilly in 2002. Although Lilly has actively tried to discredit Teicher's original research calling attention to this side effect, the Globe reported that "Teicher is now enjoying what he calls a 'wonderfully ironic' role as co-inventor of the Prozac replacement drugŠ.For perspective, imagine that car-safety crusader Ralph Nader identifies a major safety flaw in, say, the braking system used in all cars. The automakers deny that the flaw exists. Nader then invents a device that fixes the flaw and offers it to the automakers. Despite denying the problem, they pay him millions for it. Now substitute Teicher and Lilly in those roles, and that's what makes this a uniquely American tale about the pursuit of knowledge, the pursuit of profits, and the arranged marriages that sometimes bring them together." Describing the arrangement as an "ironic tale of science [and] profit" for the new Prozac, the Globe reported that Lilly paid Teicher and his co-inventors at Sepracor $90 million for the exclusive rights to the new Prozac and may pay ongoing royalties of as much as $200 million a year if the new Prozac becomes a $2 billion-a-year drug like the current Prozac. Commenting on Lilly's earlier efforts to discredit Teicher's research on Prozac's link to suicide and violence, Dr. Glenmullen is quoted by the Globe saying: "Lilly's efforts to discredit clinicians, scientists, and journalists trying to foster greater discussion, research, and awareness of this side effect is one of the most disgraceful chapters in American corporate history."

The Boston Globe
June 8, 2000

In a front-page article on June 8, 2000 by Mitchell Zuckoff entitled "Prozac data was kept from trial, suit says," the Globe reported: "In a federal lawsuit filed yesterday in Hawaii, the family of William Forsyth says that Lilly 'committed a fraud on the court' by failing to tell the family's lawyers about a patent that claims a new version of the drug eliminates side effects of the existing Prozac, including violent suicidal thoughts.On March 3, 1992, 11 days after he began taking Prozac, Forsyth fatally stabbed his wife multiple times with a serrated kitchen knife and then impaled himself on the blade.Of some 200 lawsuits filed against Lilly asserting that the use of Prozac led to suicide or violence, the Forsyth case was only the second to yield a verdict. Lilly settled many of the others, and the only other one to reach a jury, in 1994, was widely reported to have been a victory for the company. In fact, it was settled in a secret agreement between Lilly and the plaintiffs."

Prozac Backlash reports in detail on the secret settlement in this 1994 test case against Prozac and Lilly, which went to trial. Lilly won what appeared to be a jury verdict in the trial, which the pharmaceutical company widely publicized. But a later Attorney General's investigation revealed that Lilly had secretly settled the case during the trial although the victims and pharmaceutical company continued as apparent adversaries in front of the judge and jury. After the investigation, in 1997 Lilly quietly agreed to the final judgement in the trial being changed from a jury verdict in Lilly's favor to "dismissed as settled."

The Globe quoted Dr. Glenmullen on the patent for the new Prozac: "To me the new patent can be compared to the tobacco papers. It's a pharmaceutical company document that acknowledges this dangerous side effect which has been downplayed by Eli Lilly and other pharmaceutical companies for a decade."

The Boston Globe
May 15, 2000

In a front-page article on May 15, 2000 by Richard Knox entitled "Doctor lashes out in Prozac battle," the Globe reported that the eminent Harvard psychiatrist Dr. Jonathan O. Cole, one of the country's leading experts on psychiatric drugs, was "angered" by pharmaceutical companies downplaying link between the drugs and suicide. Said Cole: "I have seen patients and reviewed cases where an SSRI [Prozac-type antidepressant] unmistakably precipitated a driven preoccupation with suicide." The Globe reported: "Cole said no one has done the large-scale studies necessary to pin down the frequency of SSRI-related suicides." The Globe quoted Cole saying: "Although the manufacturers of SSRIs [Prozac-type antidepressants] could and should have done these studies, to my knowledge no manufacturer of an SSRI drug has ever done a study where the primary outcome of interest was to measureŠsuicidality" that emerged during treatment.

Cole said with regard to an FDA advisory panel, convened in 1991 to consider the alleged SSRI-suicide link, that the FDA "never came to grips with the reality or non-reality of the phenomenon." Prozac Backlash reports in detail on this FDA advisory panel. Five of the nine doctors on the panel had ties to pharmaceutical companies such that the FDA had to waive its own standards for conflicts-of-interest to allow them to be on the panel. Two of the doctors had done research for Eli Lilly on Prozac.

The New Yorker
May 8, 2000 in a review by Joan Acocella entitled "The Empty Couch: What is lost when psychiatry turns to drugs." The review (of Prozac Backlash and two other books) was featured on the cover sleeve of The New Yorker under the headline: "Drugs Aren't Enough." The review is accompanied by a full-page illustration of a "Psychiatric Unit" portrayed as an assembly line with patients on a conveyor belt being dispensed pills.

"Considering the tics and spasms that are turning up in SSRI takers--on which, it should be added, there seem to be no good figures yet (Glenmullen says things like 'Mild to moderate spasms may affect as many as 10 percent of patients')--some doctors are worried that Prozac and its cousins may likewise be causing 'silent brain damage,' the effects of which will not become clear for years, perhaps not until the patient reaches old age. A recent issue of Brain Research reported on a study in which rats were given high doses of either Prozac or Zoloft for four days. Afterward, their brain cells showed 'swollen axon terminals [the terminal ends of brain cells which are the target of the drugs], thick axons and corkscrew-like profiles [in other words, the brain cells became twisted into corkscrew-like shapes]." Corskcrew-like profiles! The drug doses, it should be said, were very high, ten to a hundred times the therapeutic dose for human beings. On the other hand, the rats took the drugs for only four days, whereas millions of human beings have been on SSRIs for years. Madhu Kalia, who directed the study, says, 'We don't know if the [brain] cells are dying....These effects may be transient and reversible. Or they may be permanent.' If they are permanent, and turn up in human beings as well as in rats, the law courts are going to be an interesting sight in thirty years. Unlike the hospitalized schizophrenics who developed tardive dsykinesia [the type of tics now being seen with SSRIs], the ad executives taking SSRIs have good lawyers.

In Glenmullen's view, seventy-five per cent of people on SSRIs can either go off the drug or dramatically reduce their dose. In any case, they should read this book."

The Boston Sunday Globe
May 7, 2000

The Boston Sunday Globe ran a front-page article on May 7, 2000 by Leah Garnett entitled "Prozac revisited: As drug gets remade, concerns about suicides surface." The article contained an explosive revelation on the link between Prozac-type antidepressants and suicide and violence: "Though Lilly has steadfastly defended the drug's safety and downplayed studies linking Prozac to suicide, the patent for the new Prozac, r-fluoxetine, expected to be marketed by Lilly beginning in 2002, notes that the new version will not produce several existing side effects including 'akathisia, suicidal thoughts, and self-mutilation,' which the patent calls 'one of its more significant side effects.'"

The Globe continued: "A just-published book, 'Prozac Backlash,' by Cambridge psychiatrist Joseph Glenmullen, has drawn Lilly's ire for discussing Prozac's link to suicide, tics, withdrawal symptoms, and other side effects of Prozac and similar antidepressantsŠ.Lilly has aggressively sought to discredit researchers who published data linking its product to suicide. One of its early targets was Dr. Martin Teicher, an associate professor of psychiatry at Harvard Medical School and a McLean Hospital researcher, who wrote a crucial paper on the link between suicide and Prozac in 1990; he found that 3.5 percent of patients put on Prozac either attempt or commit suicide due to severe agitation from akathisia. As a result of Lilly's campaign, many in the psychiatric community say they believe Teicher has distanced himself from his original work. But in a rare interview with the Globe, Teicher said that he stood by his work, and that the ability of Prozac to induce suicide in a minority of patients 'is a real phenomena.'"

Reporting on Lilly's reaction to Prozac Backlash, the Globe said: "Now a decade later, Lilly has targeted Dr. Joseph Glenmullen, whose book 'Prozac Backlash" has apparently incensed Lilly executives." The Globe discovered that a public relations firm had been hired by Lilly to steer the media to seemingly independent psychiatrists who, in fact, have close ties to Lilly and have been willing to criticize Prozac Backlash. The Globe said of one of these critics, Dr. Gerald Rosenbaum of Boston, "documents obtained by the Globe show that Rosenbaum's relationship to Lilly is a cozy one: he has served as a Prozac researcher and sat on a marketing advisory panel for Lilly before Prozac was launched."

Regarding the explosive revelation of the patent for the new Prozac acknowledging that the existing Prozac can cause suicidality and self-mutilation, the Globe noted Dr. Glenmullen's observations: "Glenmullen wonders whether the new Prozac will, in fact, be little more than an effort to prolong the life of a product with a soon-to-expire patent. Although it is touted as having fewer side effects, no one knows what effects may surface once large numbers of people begin taking it for months or years. In the epilogue to his book, he simply says: 'Like any new drug, it too will be an ongoing experiment.'"

Los Angeles Times
April 10, 2000 in a review by Jane Allen entitled "The Down Side of Happy Pills"

"Glenmullen contends that the easy-fix mentality of patients and cost-conscious health plans has driven many Americans into long-term use of antidepressants such as Prozac, which he rightly warns may not be as benign as they're led to believe."

The Los Angeles Times' "Health Bestsellers" List
Prozac Backlash was on the Los Angeles Times' "Health Bestsellers" list a week after the Los Angeles Times review.

United Press International
April 6, 2000

"A book on Prozac and its antidepressant cousins calls the medication overused, overhyped and dangerous....Dr. Joseph Glenmullen, a Massachusetts psychiatrist and Harvard Medical School graduate, writes in Prozac Backlash that Prozac and similar drugs like Zoloft and Paxil might be toxic to patients' brains. 'We already know enough to indicate these drugs should be prescribed far more cautiously,' Glenmullen writes."

Harper's Bazaar
May 2000 in an article by Ginny Graves on withdrawal side effects entitled "Getting Past Prozac"

"Abruptly quitting the so-called SSRIs (selective serotonin reuptake inhibitors, which include Prozac, Paxil, Zoloft, Luvox, and Celexa) can make people dizzy and nauseous, give them headaches and muscle spasms, disturb their sleep, and cause them to gain weight. Some people even suffer the disturbing sensation that electric currents are running through their bodies....Physical ills are only the half of it. People who quit cold turkey also suffer crying spells, confusion, irritability, and sadness--making them think that they're depressed again. However, says Glenmullen, 'a true relapse typically doesn't occur until weeks or months after the drug is stopped.'"

Harvard Magazine
May-June 2000 in an article by Craig Lambert entitled: "The Downsides of Prozac: Worse Living Through Chemistry"

"What is not washed out are the side effects, which include the potential for brain damage. A few years ago one of Glenmullen's patients who was taking Prozac developed a tic--tongue darting in and out of the mouth--that persisted for months after the drug was discontinued. That sent Glenmullen to [Harvard's] Countway Library. He found reports of tics and other neurological side effects, like drug-induced Parkinsonism, associated with SSRIs. 'The tics include lip smacking, lip puckering, fishlike kissing motions, and pelvic thrusting,' Glenmullen says. 'They are involuntary, disfiguring, and can be very noticeable--and may persist long after the drug is stopped. This is the dread side effect in psychiatry, and it can indicate brain damage. Such reactions are not rare. Neurological agitation is estimated to occur in 10 to 25 percent of patients, and muscle spasms in 10 percent."

Boston Herald
April 11, 2000 in an article by Michael Lasalandra entitled "Book Taps Prozac's Dark Side: Harvard author details drug 'backlash'"

"Glenmullen cites case studies of patients who've suffered from what he calls antidepressant 'backlash.' This includes violent behavior, withdrawal symptoms, memory loss and grotesque facial tics, including tongue-darting. Some of the tics do not go away when the drugs are discontinued, he said, indicating brain damage. In the days after patients go off the drugs, he said, "We're seeing all kinds of side effects. Severe perceptual problems, electric shock type sensations in the brain, tingling sensations down their arms and hands, dizziness, and emotional symptoms."

Seattle Times
April 12, 2000 in an article by Judith Blake entitled "Drugs and Depression: How Much Is Too Much?"

"Glenmullen, who teaches clinical psychiatry at Harvard and has a private psychiatric practice, has created a stir in the mental-health world with his new book, 'Prozac Backlash'....Meanwhile, what should individuals now using an antidepressant do? Glenmullen hopes they'll join their doctors in re-evaluating their need for the drug, asking: Did the original symptoms really warrant the medicine? Does the need still exist? Is the dose appropriate? Might an alternative form of therapy do the job?"

Health Magazine
April 2000 in an article by Cassandra Wrightson

"Joseph Glenmullen has a message for everyone on antidepressants: Proceed with caution. In his new book Prozac Backlash the Harvard psychiatrist links a frightening list of side effects to the class of drugs known as selective serotonin reuptake inhibitors (SSRIs)."

Publisher's Weekly
March 6, 2000

"A lucid, wide-ranging survey of recent studies on the negative effects of antidepressants and their less-publicized alternatives. His title refers not to the growing skepticism toward psychiatric medications but to the brain's compensatory reactions to the artificial elevation of serotonin, including potentially permanent tics, dependence, sexual dysfunction, memory problems, sudden suicidal feelings and violence."

Kirkus Reviews
March 1, 2000 in a review entitled "A psychiatrist cites research and his own clinical experience to sound a compelling warning about the hazards of selective serotonin reuptake inhibitor (SSRI) antidepressants"

"Glenmullen concludes by calling for more research on the neurotoxicity of SSRIs [the type of new research cited above in The New Yorker], better warnings to doctors and patients about their potential side effects, curbs on excessive promotion of these drugs, and closer scrutiny of their use with children. A controversial message, alarming for SSRI-takers and anathema to SSRI-makers, but bound to please his fellow talk therapists."