Prozac, The Pill, Viagra

Prozac, The Pill, Viagra With all of these drugs similar narrative: at first, they’re miracle drugs, then problems show up & questions are asked about social consequences The Pill Contains synthetic estrogens & progestins (chemical analogues of natural hormones) that work primarily by preventing ovulation Developed in 1950s with $$ from Katherine McCormick (given to Worcester Foundation at urging of Margaret Sanger) (MIT’s McCormick Hall named for her family) Carl Djerassi claims to be father of pill, but there’s rival narrative – as so often in history of science & technology 1st clinical trials in Puerto Rico – high doses with strong side effects for some (controversial – why Puerto Rico?? Looking for Third World guinea pigs?) Licensed by FDA 1960 Comstock laws of 1873 had prohibited dissemination of contraceptives & educational material about them as obscene But, as you read in Andrea Tone, plenty of contraception going on Incidentally, medical advice of time – which got safe period completely wrong -- makes you wonder what doctors today get wrong) 1961 Griswold v CT allowed married women to use contraception 1972 Eisenstadt v Baird allowed unmarried to use as well No coincidence this = year before Roe v Wade, as ”right to privacy” = key to these decisions The Pill not approved in Japan til 1999! Concern about safety & STDs Only when Viagra was approved were Japnese women able to argue there was a double standard & get the Pill approved. But still need to see doctor for STD test & pelvic exam every 3 months if using Pill in Japan Lower dose pills now, but still side effects: Heart attacks (tho less risky than pregnancy) Weight gain Headaches (irony) decreased desire! Attributed social effects: Sexual revolution Women Æ workplace Generally seen as good for women’s rights, though Tone raises some questions about that narrative Tone argues it’s been a middle class drug Poor often seen as lacking discipline to take it In 3rd world Depo-provera or sterilization popular for this reason Similar argument on why Africans shouldn’t get protease inhibitors for AIDS, but recent studies found Africans more disciplined in use of protease inhibitors than Westerners. Viagra (Sildenafil) Discovered by accident in 90s Originally thought to treat high blood pressure & heart disease Failed clinical trials, but interesting side effect observed Redefined with side effect as desired effect Name from Sanskrit "vyāghra" (tiger). & connotations of Niagara & “V” for vigor & virile Popularized by Bob Dole Now on Big Love, HBO series (product placement fee?) Did $1 billion in sales first year Since joined by Cialis & Levitra More covered by insurance than Pill! Part of veteran’s benefits Congress voted 2005 that Medicare & Medicaid shouldn’t cover “lifestyle drugs” such as Viagra (some found to be going to sex offenders!) But are arthritis drugs lifestyle drugs? (They let you play golf). Where does a “lifestyle drug” begin and end? Side effects 132 US men died in first year from heart attacks – esp if used with poppers blue vision in some cases helped rhinoceroses, tigers – traditional sources of aphrodisiacs Some experiments with Viagra pills, patch & creams for women – for female “sexual dysfunction” (i.e. failure to be aroused) Leaking to recreational area: Gays use Viagra with methamphetamine or poppers Viagra & ecstasy too Viagra as counterweight to libido-dulling of Prozac Brief word on Prozac (Fluoxetine) Patented by Eli Lilly 1987 for depression Selective Serotonin Reuptake Inhibitor (SSRI) Replaced Tricyclics Blockbuster, touted as wonder drug (largely thanks to Peter Kramer & Lauren Slater), but recent surveys suggest no more effective than Tricyclics – just less side effects Side effects of Prozac: Nausea Diarrhea Decreased libido headaches suicide? Homicide? Questions about long term use, effects on fetus (Slater’s later book) As Prozac came off patent protection, Eli Lilly sought new diseases: PMMD, e.g. Social anexiety syndrome General Questions: Loe talks of “medical expansion” Kramer coins “cosmetic psychopharmacology” Slater worries about “psychic steroids” Question: what’s the boundary between medical & social conditions? Should HMOs, medicare pay for these “lifestyle drugs”? Is depression an illness or weakness of will? Is ADD a disease or social dysfunction caused by bad parenting, too much sugar, TV etc (as Peter Breggin argues)? Do Ritalin & prozac enable “cheating”? Is sex in your 60s “unnatural”? I can’t answer these questions, but do know that these drugs are part of: (1) Medicalization of human condition – shift to biological determinism and away from social activism (2) Rise of Pharmaceutical industry to most profitable sector in US economy (3) Emergence of postmodern body: fluid, malleable, object of choice not ground of being (4) Reconfiguration of procreative body that allows sex without procreation (Pill & Viagra – after menopause), & procreation without sex (in vitro – mechanical wombs next?) Sex being redefined as for pleasure – though source of huge contestation in our society