title: The unlicensed lives of antidepressants in India: generic drugs, unqualified practitioners, and floating prescriptions.
abstract: Antidepressant uses have been rising rapidly over the past decades. Two main theories have been advanced to explain this. One claims that socio-economic change causes a global rise of depressive illness. The other holds that European and North American corporations are aggressively marketing antidepressants to expand their global reach. Both theories assume that multinational capitalism drives rising depression rates. Based on ethnographic data from India, this article shows that antidepressants are increasingly used in this country as well, but for reasons than have been little explored yet. Taking fluoxetine (Prozac) as the main example, it is argued that the spread of antidepressants in India is ;unlicensed' by Euro-American corporations in at least three ways: (i) drug marketing is driven by Indian generic producers; (ii) fluoxetine is given by practitioners who have no license to do so; and (iii) knowledge of fluoxetine is spread through unlicensed ;floating' prescriptions that patients take from one prescriber to another.
authors.affiliation: University of Edinburgh, Edinburgh, UK. stefan.ecks@ed.ac.uk
authors.forename: Stefan
authors.initials: S
authors.lastname: Ecks
authors.forename: Soumita
authors.initials: S
authors.lastname: Basu
mesh_terms: D000928:Antidepressive Agents / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects; D030861:Capitalism; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000208:ethnology; D003906:Developing Countries; D017277:Drug Approval; D004345:Drug Industry; D016568:Drugs, Generic / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D004992:Ethics, Medical; D005473:Fluoxetine / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D006801:Humans; D007194:India; D008004:Licensure; D008489:Medical Indigency / Q000191:economics / Q000208:ethnology; D055553:Prescription Drugs / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D012922:Social Change; D012935:Social Justice; D040241:Social Marketing / Q000941:ethics
chemical_list: D000928:Antidepressive Agents; D016568:Drugs, Generic; D055553:Prescription Drugs; D005473:Fluoxetine