To the Editor:
I would like to underscore some of the points made in yesterday's article about Prozac ("Doctors prescribe 'wonder drug' to combat depression"). The comments of Mike DiPietro '95 are absolutely right. However, his experience with follow-up care does not reflect our usual procedure. While Prozac is a safe medication with few side effects, it is very important to be under the close supervision of a physician while taking it.
If a student presents symptoms consistent with major depression, the first thing that is done is to make sure another illness (like mononucleosis, or a thyroid problem) is not causing the symptoms.
If other medical illnesses are ruled out and antidepressant medications are indicated, then we discuss with the student at length the indications, risks, benefits, side effects, time course, interactions of the medication (i.e. with alcohol) and then answer questions. We also discuss the medical nature of depression, how it works and how to detect it early. We also discuss other treatment options; the pros and cons of using just medication, just counseling or a combination.
If a student chooses to use antidepressant medication, then our usual policy is to meet on a weekly basis initially to make sure there are no side effects and to monitor the depression. If a student has questions, has worsening symptoms or is experiencing side effects, they have access to a psychiatrist 24 hours a day through our on-call system.
Once it is determined that the depression is improving and there are few, if any, side effects, then the meetings can be decreased to every other week and, finally, once a month once the symptoms have abated.
The choice to seek treatment for depression is an important one and the necessity of consistent follow-up care cannot be underscored enough.
MARK REED, M.D.
Dick's House Staff Psychiatrist
