The Financial Times celebrates the 20th birthday of Prozac in the newspaper’s Nov 17/18th issue. It’s valuable to look at the rise and fall of Prozac, the brand; the rise of its generic equivalent; and how the drug has profoundly impacted one consumer’s life.

Prozac Market. Before it treated depression, Prozac was thought to be an anti-hypertensive. When that didn’t seem to work, Eli Lilly considered it for an anti-obesity treatment. Strike two, clinical-wise. Finally, Lilly took the drug to market to fight depression after it was approved by the FDA on December 29, 1987. In two years, Prozac became the #1 selling antidepressant sold in the U.S. It is the most widely-used antidepressant of all time; about 54 million people take some form of Prozac or fluoxetine, the generic form.

Prozac Branding. Before “Prozac” was Prozac, it was the compound fluoxetine. Somehow, Lilly figured the pronunciation of “floo-ox-a-teen” would not fall off marketers’ lips like honey. Thus, the company handed the compound over to Interbrand, a prominent branding firm which at the time was working with Microsoft, Nintendo, and Sony. The marketing gurus came up with “Prozac.” This experience laid the ground for drug naming and marketing strategy in the subsequent decades.

Prozac Downfall. When Prozac lost its patent in 2001, Eli Lilly lost $35m of its market value in one day…and 90% of Prozac prescriptions in one year. The market became flooded with generics, which prescription drug plans aggressively pushed among plan members as, the more generic fluoxetine was prescribed to plan members, the more the plans saved in prescription drug costs.

Prozac Personally. In the FT, Jessica Apple describes the positive role that Prozac played earlier in her life when she found that wads of hair appeared in her hairbrush each morning after brushing it. “Stress-related,” the doctors said. Thus, Prozac became a part of Apple’s daily regimen. Her life became joy-filled.

Then, Apple was so happy that she wanted to quit Prozac.

Since taking her first Prozac pill, Apple has tried a litany of alternatives to manage depression: psychotherapy, behavioral therapy, hypnosis, yoga, meditation, diets, flower essences, and exercise. For Apple, Prozac has worked best.

She writes, “It has taken me almost a decade of on-and-off misery and on-and-off Prozac use finally to solve the Prozac paradox, to come to terms with the pill, not as a demon or a panacea, but as a simple drug that alleviates my psychic pain.”

Health Populi’s Hot Points: According to the World Health Organisation, depression will be second only to heart disease as the world’s leading disability by 2020. Whatever stigma surrounding the disease of depression that still exists should immediately dissipate. We look forward to the day when this disease can be treated through personalized medicine — that is, when formulations are closely targeted to the individual for optimal outcomes. The current generation of depression treatments, while useful for many, are broadband meds: they take a long time to work and, if they do, only “work” in a percentage of the total population who tries the pill. As Dr. Richard Friedman, head of psychopharmacology at the Cornell Medical College, told the New York Times in May 2007, “We have little ability to predict which specific treatment will work best for you.” Still, for many people, these medications successfully treat the disease of depression on a daily basis and enhance productivity and joy in life.

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