This Patient’s Drug of Request Is Prozac

Dolores was a mess of stress. Work worries robbed her of sleep. Her cranky intestines were waging a 10-year revolt. And she was tired of being overweight.

So Dolores went to her doctor and ordered Prozac.

If many physicians are gaining confidence prescribing the new antidepressants like Prozac, some patients find it easy to ask for them.

Dolores, who didn’t want her full name used, is no doctor. She’s a 40-year-old journalist in the Washington area. Her knowledge of Prozac, she said, was based on articles she’d read about the widely celebrated mind medicine--including weight loss among its occasional side effects--and discovery that people she knows take it.

Her intestinal ills--veering from diarrhea to bloat to constipation--were an old story. Doctors always advised an anti-constipant and exercise. “I hate exercise,” she said with a laugh during a telephone interview.

Another old problem was her weight--160 pounds on a 5-feet-4 frame.

What was new was feeling overwhelmed by work.

Small disputes magnified in her mind, until she was sulking in the newsroom, sleepless at night and worried all weekend.

“Many things were getting to me when they shouldn’t,” she said. “I had somewhere lost my normal coping strategies and I needed to find them.”

When Dolores went to her internist, it was their third or fourth meeting.

First, Dolores told the doctor about her weight problems and the bowel problems that made every mealtime a misery.

“I said, ‘What do you suggest?’ and she said, ‘Fibercon and exercise,’ and I said, ‘What about Prozac?’

“And she said, ‘I can do that. It might have a good effect on your gastrointestinal problem.’ ”

Then, Dolores said, the doctor asked if she was depressed.

“I said, ‘Well, to be quite honest, no, in the clinical sense. I don’t have a major problem. I have the same kind of mood problems everybody has. Depression with a small ‘d.’

“I said, ‘I’m not somebody who needs a shrink. I’m just somebody who needs to deal with stress.’ And she said, ‘OK.’

“And that was pretty much it.”

The doctor gave Dolores a three-month prescription for Prozac.

“At the time I joked to my friends that this is an example of how you can talk a doctor into giving you anything,” she said, adding that she felt Prozac would be safe. “It isn’t addictive.”

Dolores is pleased with her choice. It’s made her calmer and more reasonable at work, she said.

“I just don’t get as angry,” she said. “I just realize there’s no point getting freaked out about trivial things.”

Her intestines are quieter too, but she lost no weight. “As a matter of fact, I think it was quite the opposite,” she said, laughing again.