By Jennifer Young

Historic treatments of depression have varied, but Eli Lily and Company’s 1972 discovery of Prozac (generic fluoxetine) has proven one of the safest, most effective, and least costly treatments for the too-common mental plague.

The earliest mention of depression dates to Mesopotamia. The ancients believed it was a matter of spiritual illness—a possession by demons–and many civilizations, including Egyptians, Greeks, Romans, and Chinese, believed it to be a spiritual malady. More times than not, it was the priests who were called to deliver relief and not the physicians. Treatments for this all-too-common illness included beating, starvation, bloodletting, stoning, burning, and physical restraint.

A more humane take on this illness didn’t present itself until the 17th century, when Robert Burton published his volume, The Anatomy of Melancholy. It was Burton’s view that patients experiencing melancholic symptoms should adopt a healthy diet, get sufficient sleep, and listen to music. While a handful of the materials used in Roman medicine proved mildly effective (e.g. St. John’s Wort and valerian root), patients who displayed signs of serious depression were locked away in an asylum and subjected to quack remedies like being spun on a stool, insulin treatment, shock treatment, trepanning, and, in the early-to-mid 20th century, lobotomies.

Light therapeutics: a marginally effective treatment still used today

It was not until the mid-20th century that some medical researchers, reacting against the “scorched earth” effectiveness of lobotomies, proposed the idea that depression was caused by chemical imbalance. Up until this point, many renowned medical scholars still offered up many questionable hypotheses for depression. Freud, for example, summarized his theory on the origin of depression as an inflated and destructive effect of the super-ego on an individual.

By 1970, there were still no effective treatments for depression, or the ability to treat mild depression on a large scale. There were some antipsychotics like imipramine that were prescribed for depression but they often came with severe side effects like dizziness and seizures. Lithium salts, used as a mood stabilizer, proved very effective, but in therapeutic doses left a patient laconic.

Then, in 1971, the Indianapolis-based Eli Lilly pharmaceutical company stumbled on a compound that it was attempting to create to treat obesity or possibly high blood pressure. When the company tested this drug on those suffering from mild depression, including Eli Lilly’s great granddaughter, Ruth Lily, the result was profound; sufferers reported significant relief. The company named the drug Prozac, and it was officially approved in 1987 for the treatment of depression.

Prozac was the first drug type of drug of its class, selective serotonin reuptake inhibitors (SSRIs). Prozac opened the door to more conversations about depression, dissolving some of the illness’s stigma. Like other SSRIs, Prozac works by preventing the brain from too quickly reabsorbing the serotonin produced there. Involved in mood regulation, serotonin improves communication between brain cells, which appears to lead to a general feeling of well-being.

People prescribed Prozac reported sleeping better, feeling less anxious, experiencing improved focus, and feeling more relaxed—less fraught with worry and more interested in life. Not surprising, as the first drug of this new, innovative class, Prozac is associated with more side effects (dry mouth, indigestion, and sexual dysfunction) than newer SSRIs. Eli Lilly and Company was founded in 1876 by Civil War veteran and chemist Eli Lilly. Not only is this Indy company the maker of Prozac, it was also the first to mass produce insulin and Jonas Salk’s polio vaccine. Lilly himself was also among the first to produce quinine, the drug used to treat malaria.

Today, Prozac holds a prestigious place on the World Health Organization’s Model List of Essential Medicines, a collection of medicine deemed so effective and inexpensive that any modern country or populace should have it in good supply. In other words, a list of what countries should have in their medicine cabinets.