Leonie's Blog

It always surprises me that while most medics admit that all drugs can have serious adverse effects, when there is an actual victim, consumption of the drug is often supposedly viewed as coincidental. Although antidepressant Patient Information Leaflets and drug regulatory warnings stress of an increased risk of suicidality and aggression when taking these drugs, the continuous victim-denial by the drug industry and leading Key Opinion Leaders (KOPs) is disheartening to say the least.

It seems there is another growing furore surrounding antidepressants; this time its their addictive nature, with consumers’ experiencing withdrawal effects at odds with medical professionals who continuously express that antidepressants do not cause addiction. An article today in the Limerick Leader expressed concerns on the high rate of antidepressant users. It quoted Irish TD (member of Parliament), Maurice Quinlivan, as saying: “People working locally here on drug awareness groups in Limerick tell me that it can be much harder to get young people off of these prescription drugs than heroin as it can be that addictive.” Similarly, on Sky News yesterday, Danny Lee-Frost, head of enforcement at the MHRA (U.K. drug regulator), clarified antidepressant-addiction in no uncertain terms, stating:

“The sleeping pills and antidepressants are a lot more dangerous – They are a lot more addictive, in fact they are highly addictive – That’s the reason why they are prescription only. That changes the game completely – People have committed [sic] suicide as the ultimate resort to try and get off as these are fiercely addictive once you start taking them.”  

Indeed, that the ‘newer’ antidepressants (SSRIs) can be highly addictive has been known for many years and per Peter C. Gøtzsche (Cochrane scientist):

“They surely are [addictive] and it is no wonder because they are chemically related to and act like amphetamine. Happy pills are a kind of narcotic on prescription. The worst argument I have heard about the pills not causing dependency is that patients do not require higher doses. Shall we then also believe that cigarettes are not addictive? The vast majority of smokers consume the same number of cigarettes for years.”

15 years ago Dr David Healy spoke of paroxetine withdrawal. He said:

“it was clear from early on that the company [GSK] had recognised that people who had been on this drug even for a relatively brief periods of time could go through withdrawal when they halt it. And they ran healthy volunteer trials to look at this further and found that in some instances up to 85% of the volunteers who had been on this drug for only two or three weeks had withdrawal problems when they halted.”

However, despite experts such as Gøtzsche, Healy and Lee-Frost leaving us in little doubt that antidepressants can indeed be addictive, there seems to be little consensus among medical professionals. Indeed, in Ireland medics have continuously denied that SSRI antidepressants are in any way addictive, with one Irish GP proclaiming on radio – “the drugs themselves are not dangerous, they’re not addictive, they’re not even dangerous at high levels of overdose”. (Notably, not only are SSRI antidepressants addictive, they can also be fatal in overdose; but that’s another story.) Likewise, speaking at a meeting hosted by the drug company Lundbeck, Professor Casey from the Irish College of Psychiatry, said “The outcome for those who get treatment is very good. It is also important to be aware too that antidepressants are not addictive”. 

How can it be that addiction-denial is still commonplace when MHRA, Cochrane and psycho-pharmacological experts are expressing the opposite? And why? Adverse effect denial raises issues of consent and autonomy, neither of which are fulfilled if a consumer doesn’t know what he or she is consenting to. Indeed, rather than antidepressants being innocuously-sounding ‘happy pills’, per McHenry, 2006, attempts to reduce or discontinue SSRIs can cause ‘severe adverse events, such as jolting electric zaps (paraesthesia); confusion; headaches; vomiting; dizziness; nausea; worsening depression; insomnia; irritability; emotional lability, including suicidality, and agitation that, when severe, can resemble a manic episode’. All that, without even delving into the issue that most consumers will have antidepressant-induced sexual problems, ranging from vaginal-dryness to male-impotence.

Part of the problem stems from the word ‘addiction’, which medics seem to have an aversion to, especially when it relates to drugs they widely-prescribe. According to a 2003 WHO report on drug dependence, 3 SSRIs are ‘among the 30 highest-ranking drugs in the list of drugs for which drug dependence has ever been reported’ (to their drug-monitoring database). They are fluoxetine (Prozac), paroxetine (Seroxat/Paxil) and sertraline (Zoloft/Lustral). The report found that researchers used differing terminology to avoid associating SSRIs with dependence, such as replacing ‘withdrawal-syndrome’ with ‘discontinuation-syndrome’. Considering SSRIs such as fluoxetine (and sometimes sertraline) are prescribed in children and adolescents, it is crucial that the potential for harm is acknowledged.

Thus, Fava et al suggested that while ‘clinicians are familiar with the withdrawal phenomena that may occur from alcohol, benzodiazepines, barbiturates, opioids, and stimulants, they need to add SSRIs to the list of drugs that potentially induce withdrawal phenomena. The authors concluded that the term ‘discontinuation syndrome’ minimizes the vulnerabilities induced by SSRIs and thus, it should be replaced by ‘withdrawal syndrome’.

Pretty conclusive I’d say.

Oliver Hare, shown above, was a 22-year-old linguist, working in Shanghai. In February of this year he spent a week with his mum in Dubai before returning to his family home in England. Feeling a little lost and unsure of what his goals were, he was anxious about returning to China. His dad told him not to worry, that nobody would force him to go back, but Oliver was worried about the consequences if he didn’t return. The Daily Mail reported that he had previously visited his GP, who diagnosed him with depression and prescribed Citalopram (marketed as Celexa and Cipramil). Oliver started taking the drug this February.  Four days later, on Valentine’s Day 2017, Oliver hanged himself from a window in his family home. The Coroner recorded a suicide verdict, stating “In light of the mood of the deceased that has been described and the manner by which his body was found I am satisfied that he intended to take his own life.”

However, what the Coroner did not mention (or perhaps did not know), was that all SSRI antidepressants, including Citalopram, increase the risk of suicide. There was no mention of the black-box suicide warning that is attached to this drug in the U.S., for young people up to the age of 24. Nor of the European Medicines Agency suicidality warning for under 25s. Perhaps the Coroner was not aware that Citalopram is associated with more self-inflicted deaths than any other antidepressant in the U.K. It seems pointless that SSRI suicide warnings are provided by the various medicines regulators, yet doctors, psychiatrists and Coroners seem oblivious to the risk – and have rarely attributed a person’s self-inflicted death to these widely-prescribed drugs.

As Wendy’s case shows (see previous post), there is little doubt that age is irrelevant when suffering an adverse-reaction to an SSRI, including Citalopram – see here and here. My son Shane, like Oliver, was 22 when he died of a Citalopram-induced death in 2009 – he lasted 17 days on the drug. Incidentally, my friend who runs the AntiDepAware website also wrote about Oliver (here). His son wasn’t much older than Oliver and Shane when he was prescribed Citalopram. Within days of starting the drug, he also died unexpectedly, from SIBSID (a self-inflicted but SSRI-induced death).

At one stage I asked many like-minded experts for some SSRI quotes, which, for anyone who’s interested, can be viewed here. However, the last word goes to Mr. Dainius Pūras of The Office of the United Nations High Commissioner for Human Rights, whose talk for World Health Day was published last month – titled ‘Depression: Let’s talk about how we address mental health’. The talk concerned the current paradigm of excessive medicalization within mental health and the overuse of biomedical interventions (aka drugs). Among other things, he stated:

“The use of psychotropic medications as the first line treatment for depression and other conditions is, quite simply, unsupported by the evidence. The excessive use of medications and other biomedical interventions, based on a reductive neurobiological paradigm causes more harm than good, undermines the right to health, and must be abandoned.”

So, the trial of our friend Wendy ended earlier today – and guess what, she won. The truth finally prevailed over the malevolent entity that is GlaxoSmithKline (GSK). During the trial we heard how this drug company hid suicide events and misrepresented data that showed Paxil/Seroxat could induce suicide in adults as well as in children. GSK argued that rather than Paxil causing Wendy’s husband to die, it was the work related stress he was under. The jury saw through GSK’s defence and their so-called expert witnesses (one who was paid $165,000 for his testimony), and awarded Wendy $3 million. This vindication for the very charismatic Stewart, makes it a very good day.  Be careful when taking an SSRI antidepressant; this case showed how evidence-based-medicine may not be as scientific as we would all like to believe. Studies done by drug companies with vested interests in the outcomes, now who thought that was a good idea? News article courtesy of Law 360 below..

BREAKING: GSK Hit With $3M Verdict For Reed Smith Atty’s Suicide
By Jessica Corso

Law360, Chicago (April 20, 2017, 4:20 PM EDT) — An Illinois federal jury on Thursday found GlaxoSmithKline liable for the death of Reed Smith LLP partner Stewart Dolin and ordered the pharmaceutical giant to pay $3 million to the attorney’s widow, reaching the conclusion that a generic version of GSK’s Paxil caused Dolin to take his own life.

A nine-person jury agreed with Wendy Dolin that her husband had committed suicide in 2010 under the influence of generic paroxetine, an antidepressant sold as brand-named Paxil. (AP)
Following five weeks of trial testimony, the nine-person jury agreed with Wendy Dolin that her husband had committed suicide in 2010 under the influence of generic paroxetine, an antidepressant sold as brand-named Paxil. The jury awarded Dolin $3 million for the loss of income and the emotional distress she’s suffered since her husband ended his life by jumping in front of a Chicago train in the middle of a summer workday.

The verdict is a vindication of Dolin’s belief, expressed in her 2012 lawsuit, that her husband would still be alive if it weren’t for the paroxetine prescription he began taking days before his death.

Dolin said her husband was restless and agitated in the days leading up to his suicide, symptoms of a listed Paxil side effect known as akathisia. GSK denied any link between akathisia and suicide, but the widow said that the side effect sometimes causes people to act out violently and impulsively.

What’s more, the lawsuit claimed that GSK knew about the increased risk of suicide for adults taking paroxetine, particularly in the early days of treatment. Dolin said that the company had hidden data proving the link from the U.S. Food and Drug Administration for decades. She testified during the trial that while her husband was sometimes anxious, he had developed coping mechanisms to deal with that anxiety and was seeing a therapist at the time of his death.

GSK sought to pin the blame for Stewart Dolin’s death on his yearslong battle with anxiety, particularly as it revolved around his work as co-chair of Reed Smith’s corporate and securities practice.

Therapy records shown to jurors demonstrated that Dolin had expressed concerns with a therapist in 2007 about Reed Smith scooping up his then-firm Chicago-based Sachnoff & Weaver Ltd. GSK said that Sachnoff was a much smaller, single-office firm and that Dolin had felt unprepared to tackle BigLaw life.

“He didn’t feel qualified to do some of the work,” his then-therapist Sydney Reed said in a video deposition shown to the jury. “He had no experience with international law. He had no experience with giant corporations.”

Though the fears eventually dissipated, a GSK expert who examined the therapy records appeared on the stand during the last days of trial to say that Dolin’s insecurities flared up again in the last months before his death.

The economic downturn had “played havoc” on the corporate and securities practice group, which didn’t meet revenue goals for 2009, according to Dolin’s own review of the year. Because of that, GSK claimed, Reed Smith appointed a younger attorney to co-lead the group with Dolin, 57, who was previously the practice group’s sole leader.

Dolin also received anonymous negative comments on his year-end review and was struggling with a client unhappy with a lawsuit that another Reed Smith partner had filed, University of Massachusetts psychiatry professor Anthony Rothschild told the court.

“In some ways, his nightmare of being inadequate was coming true,” Rothschild said.

But the managing partner at Reed Smith’s Chicago office testified that it wasn’t work that drove Dolin to take his own life.

“He had a challenging week, but we sorted it through,” Mike LoVallo, who said he had known Dolin for decades and considered him a close friend, told the jury.

After he died, “I searched for anything else in his office,” LoVallo said. “I don’t think there was anything work-related that could have caused this.”

Wendy Dolin is represented by R. Brent Wisner, Michael L. Baum, Bijan Esfandiari and Frances M. Phares of Baum Hedlund Aristei & Goldman PC and David Rapoport and Matthew Sims of Rapoport Law Offices PC.

GSK is represented by Andrew T. Bayman, Todd P. Davis, Ursula Henninger and Heather M. Howard of King & Spalding LLP and Alan S. Gilbert and Anders C. Wick of Dentons.

The case is Dolin v. SmithKline Beecham Corp. et al., case number 1:12-cv-06403, in the U.S. District Court for the Northern District of Illinois.

–Editing by Christine Chun.

For anyone who hasn’t heard of Jake McGill Lynch, age 14, who died following a prescription for Fluoxetine (Prozac), here’s his mom Stephanie being interviewed on RTE Radio. The journalist, Della Kiroy, also interviewed David Healy who speaks towards the end of the programme. Stephanie’s harrowing account of Jake’s life and death is a warning to all that antidepressants are far from harmless, particularly when prescribed to children. Despite the widespread antidepressant prescribing in Ireland, the European Medicine’s Agency has provided the following warning  –

“..suicide-related behaviour (suicide attempt and suicidal thoughts), and hostility (predominantly aggression, oppositional behaviour and anger) were more frequently observed in clinical trials among children and adolescents treated with these antidepressants compared to those treated with placebo. The Agency’s committee is therefore recommending the inclusion of strong warnings across the whole of the European Union to doctors and parents about these risks. Doctors and parents will also be advised that these products should not be used in children and adolescents except in their approved indications.”

A recent study by Sharma et al also found similarly. The study found that in children and adolescents taking antidepressants (SSRIs and SNRIs), the risk of suicidality and aggression doubled. Being aware of all the risks and benefits is crucial before deciding whether (or not) to take a pill – any pill. Knowing what to look out for may just save a life – it may well have saved Jake’s.