25 years after Prozac

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Twenty-fi ve years ago, Eli Lilly’s Prozac (fl uoxetine) became the fi rst selective serotonin reuptake inhibitor (SSRI) to hit the market, where it quickly gained popularity for the treatment of depression. Soon, the drug was earning more than a billion dollars in revenues—at a time when the average American’s income was around $25,000. A quarter of a century later, treatments for depression are no more effective, but they are safer. Much has happened since the advent of fl uoxetine, but as many as half of patients still do not receive relief in the idealized situations studied in clinical trials. Why was fl uoxetine so successful? According to John Markowitz, PharmD, Professor of Pharmacy at the