Jan Jarboe’s “Wonder Drug on Trial” [ TM, December 1991], on fluoxetine (Prozac), left me disappointed. As an instructor on antidepressant pharmacology for psychiatric residents, I emphasize that antidepressants are neither good nor bad but simply drugs with individual side-effect profiles and efficacies. I am appalled that the article did not mention that Skye’s death was almost certainly from amitryptiline toxicity. Overdose of tricyclic drugs like amitryptiline is probably the most common form of lethal drug ingestion worldwide. Ami-tryptiline and Prozac are roughly equal in efficacy against symptoms of depression but obviously require close monitoring by a physician.
Although we psychiatrists “earn a living by treating misery [we] can’t explain,” I would agree with Ms. Jarboe’s guess that Skye’s illness was not a strictly biochemical problem, and a drug could not be expected to “cure” it. Rather, medication might be used as an adjunct while she worked consistently on a long-term basis with a psychotherapist.
STUART D. CRANE, M.D.
The Menninger Clinic
Reclaiming Texas’ History
DANA RUBIN’S “ PAPER TRAIL” [Texana, TM, December 1991], about the theft and recovery of historical documents from the Texas State Library, is informative, but I must take issue with her conclusion that the state’s habit of quietly seeking recovery of stolen documents is sometimes the best policy. As a rare-book dealer and former state-employed rare-book librarian,