When I was depressed 20 years ago, the (then) new antidepressant drug Prozac sorted it easily. It took six weeks for it to lift me up and I stopped taking it after four months. I experienced no side effects and lived happily ever after, believing that the episode was a one-off. Marvellous. Back in January, just before my 60th birthday, the black dog came back and I was again in front of a doctor, depressed but phlegmatic, confidant that a few months worth of selective serotonin reuptake inhibitors would get me back on the dance floor with all my comfortable illusions restored. A friend had recommended I ask for Venlafaxine which, he said, worked more quickly than Prozac. So I suggested she write me a prescription for that, and she cheerfully agreed. I took it straight to the chemist and came out with a box of 30.
Venlafaxine is more commonly known by the brand name Effexor. When I got home I googled it, clicking on an Effexor chat room, and read the comments. Big mistake. ‘Electrifying brain shocks that made me fall over. Hives. Lactating right breast. Can’t remember the last two years of my life,’ said one, nevertheless awarding the drug four stars out of a possible five. ‘Effexor made it impossible to orgasm,’ said another. ‘Gained 50 pounds in weight in six months. On a reduced dose, orgasm was still difficult (but not impossible).’ A respondent who had recently started taking the drug said he suddenly felt so unmotivated that ‘vermin could have taken over the house and I would have cared not one whit. I am convinced this drug is cultivated from the brimstone-lined pits of Satan’s deepest hell. Spent three days curled up on the sofa praying for death.’ ‘Suicidal thoughts,’ warned another, ‘but only on planes, which actually made flying a whole lot easier. My breasts grew from a D to a G cup. Developed a “buffalo hump” on my neck.’
Reading about these severe side effects (reported by three out of five respondents) made me reluctant to open the packet and start swallowing the tablets. I’d rather be depressed than have a buffalo hump, I think. The friend who’d recommended Venlafaxine, a retired doctor, called to see how I was doing on the drug. ‘I looked at some Venlafaxine chat rooms and the side effects described put me off taking it,’ I told him, lamely. He went mad. ‘So you’d rather believe a lot of crazies on the web than the medical literature! I feel sorry for you.’
I took the box with me on a rail trip around Spain and Italy, staying in youth hostels, something I’d wanted to do for years. Sometimes I thought I was enjoying myself. One gets used to being depressed and can’t imagine or remember what it feels like to be otherwise. In retrospect, I travelled about like a spectre at a feast. When I worked as a psychiatric nurse at a huge hospital outside London, there was a patient whose one and only delusion, or perhaps visual hallucination, was that London has been razed to the ground by a nuclear explosion. Looking about him he saw only rubble. Seeing southeast Spain from a train — the graffiti covered low-rise flats and the barren, worn-out countryside disfigured by vast, apparently deserted, light- and heavy-industrial enterprises — I had a similar post-apocalyptic delusion. Heading west, medieval Seville was of course lovely. But even here the architectural beauty and confident solidity of the buildings seemed to mock me and the thousands of other tourists, products all of a well-fed and technologically advanced but less human and shallower civilisation. Normally, I would have shrugged off the commonplace thought. Or balanced it against the advantages and moved on. I think I was more depressed than I realised, however, and totally devoid of a sense of humour. My feeling of the inferiority of my civilisation was disproportionately magnified and I became absurdly gripped by it. I walked about the place diminished and ashamed.
A fortnight after I came back, the packet of Venlafaxine still unopened, I said to Catriona in a rare moment of insight, ‘Do you think I’m still depressed?’ Definitely, she said. I hadn’t been my usual self since, oh, last August, she added. I went straight to the drawer, opened the Effexor packet and swallowed one. That was ten days ago. The only alteration in my consciousness after ten capsules has been a further removal from reality coupled with a feeling of being heavily sedated. Instead of being depressed and worried about it, I’m depressed but don’t give a shit about it. Or about anything else. All I’ve done for the past few days is sit and read Max Hastings. And I’m constipated. So I don’t like Effexor much either. I think I’d better stop taking them and try something else.