Natural Prozac: Learning to Release Your Body’s Own Anti-Depressants.

Joel C. Robertson and Tom Monte.

215 pp.

HarperCollins Publishers, Inc., New York; HarperCollins Canada Ltd., Toronto. 1997.

ISBN 0-06-251353-2

Strengths: Clearly written and easy to understand.

Weaknesses: Downplays the role of medication in the treatment of depression, which may lead patients to delay seeking medical help or to discontinue treatment prematurely; some of the program plans are not substantiated.

Audience: Patients with mild symptoms of depression or in remission who do not require drug treatment.

Natural Prozac is a useful layperson’s guide to understanding and modifying the factors that may trigger or perpetuate mild depressive symptoms. These modifiable factors include activity level, dietary habits, lifestyle behavior as well as thoughts and emotional responses. These factors are causally linked to “chemical imbalances” of 3 main neurotransmitters in the brain: dopamine, norepinephrine and serotonin. Each neurotransmitter is responsible for various states of mental functioning. Serotonin is linked to “peace, concentration and well-being”; dopamine is responsible for “alertness, energy and aggression”; and norepinephrine is involved in “speeding up your thoughts.” Alteration in the levels of each is postulated to cause malfunction of the brain and to produce an overly passive “satiation” or an overly active “arousal.” Corresponding depressive symptoms may result when triggered by 1 or more of the modifiable risk factors. Genetic, generational or conditional and situational factors are used to explain the underlying mechanisms.

To explain the effect of neurotransmitters in an easy-to-understand way, the authors use lay terms such as “gas and brake pedals.” Some concepts may be misleading and even harmful to certain patients who require continuing drug treatment. For example, references to “ending depression — safely and permanently” and to “start[ing] to taper off medication gradually” may be taken out of context by some readers. Simple outlines of the criteria from the Diagnostic and Statistical Manual of Mental Disorders are given for self-assessment of serious or suicidal depression. Situations that may trigger symptoms are well outlined with the use of case histories.

Part of the book describes “programs for healing depression,” including very specific diets and exercises to “boost the levels” of each of the neurotransmitters. Entertainment, play-acting, writing techniques and spiritual and religious practices are recommended in the context of structured daily and weekly plans for each personality type.

The book ends with a mail-in “mood optimization survey.”

The book makes indirect references to scientific studies, but there is no formal reference list or bibliography. The cover, foreword and introduction tend to exaggerate claims of “scientific proof and the “remarkable effectiveness” of the methods for “every depression sufferer.” However, there is little or no supporting evidence to substantiate these claims.

Natural Prozac is easy to read, with simple, clear vocabulary. It may be recommended for patients who have only mild symptoms of depression or are in remission. Symptoms may be attenuated in motivated readers who can modify clearly identifiable lifestyle or personality factors. However, care and caution must be exercised in regard to those who need continuing drug therapy. The book may create a false sense of security leading those with serious or recurrent symptoms to avoid seeking medical help or to discontinue therapy prematurely.

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