Antidepressant Addiction

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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 – Another 22-year-old victim of Citalopram?

OliverOliver 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).

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Shane

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.”

Wendy beats Goliath

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.

GSK’s Dirty Little Secret

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Dolin v SmithKline Beecham

So, myself and my friend Stephanie were in Chicago this week. We had traveled across the Atlantic to hear the opening arguments of Dolin v. Smithkline Beecham Corp (now GlaxoSmithKline – GSK). For more background to this case, see here.

We arrived straight into an unprecedented weather event, Storm Stella – described in the media as a weather bomb, having undergone bombogenesis (haven’t a clue either). Thus, while we were a little worried that the trial might be postponed, we were more concerned with the liklihood of two Irish females freezing to death. However, despite hitting a cool minus-8, with some pretty bizarre white-out conditions, we survived and the trial went ahead as planned (with the Hon. William T. Hart presiding).

This case centers on Wendy Dolin, the plaintiff, alleging that her husband’s death in 2010 was drug-induced and that GSK failed to warn of the increased risk of suicide in older adults taking the antidepressant Paroxetine. Her lawyers, Baum Hedlund, contend that GSK hid a ‘dirty little secret’ – that the drug can cause akathisia, often coded under the innocuously-sounding ‘inner turmoil’. However, this drug-induced condition is far from harmless and injury to oneself and/or others, can quickly follow. Furthermore, as alleged in this case, it can often prove fatal; see here.

At the time of his death, Stewart Dolin was 57 and was a corporate lawyer with ReidSmith. While suffering from work-related stress, he was prescribed Paroxetine by his physician, Dr. Martin Sachman – a family friend. Paroxetine is perhaps more widely recognised by its trade name Paxil, or Seroxat in Europe. Six days after being prescribed a generic form of the drug, Stewart died by jumping in front of a Chicago train. He was affluent, well-liked by colleagues and well-loved by his family. Per one of his colleagues “Stu Dolin was a close personal friend, valued colleague and a great leader in our firm. His energy and spirit benefited everyone around him. The lawsuit claims that GSK failed to adequately warn doctors (including Dr. Sachman) of the increased risk of suicidal behavior in adults. Indeed, GSK’s opening argument proclaimed that ‘Paxil does not cause suicide’. That was then contradicted by GSK’s very own literature, where a 2006 analysis showed a 6.7 times greater risk of suicidal behaviour in adults (of all ages) taking Paxil, over placebo.

Doctor David Healy was on the stand for 2 full-days, as an expert witness for the plaintiff. His testimony included an account of how GSK had hidden suicide events from the Food and Drug Administration (FDA), thus manipulating the suicide-ratio and effectively hiding the bodies. Explaining drug-induced suicides to the jury, his world-leading expert status in psychopharmacology was unquestionable. No doubt, GSK ‘s legal team will attempt to annihilate that particular status before he exposes any more ‘dirty little secrets’. Like how 100% of Paxil consumers will experience sexual dysfunction – another life changing adverse-effect he mentioned in court, and another one not precisely admitted to by the manufacturers.

Not surprisingly, GSK’s lawyers (King and Spalding), became increasingly apoplectic, interjecting every few minutes with their objections, which proved fascinating in itself. The last hour before the court adjourned for the week-end proved to be very enlightening indeed, with their team looking increasingly agitated. Doctor Healy was then asked some questions by the plaintiff’s legal team:

(1) Do you have any doubt that Paxil can cause suicide? He answered ‘No’.

(2) In your opinion, did GSK warn doctors of the increased risk of suicide in adults? Again he answered ‘No’.

There seemed little doubt to anyone listening that Paxil could cause Akathisia and/or a drug-induced suicide. However, no doubt GSK will have many experts to refute that, whatever the evidence has shown. Having listened to this week’s testimonies, there is absolutely no doubt in my mind that Steward Dolin’s death was induced by the Paxil he was taking in the final 6 days of his life. However, the trial will most-likely go on for another few weeks when the jury will ultimately decide. Sadly, as is normal in these legal cases, every aspect of Wendy and Stewart’s private life will be publicly torn to shreds, with their every move dissected to try and put doubt into the jury’s mind. Whatever the outcome, Stewart’s wife Wendy, is one very, very brave lady.

Clearly, GSK’s lawyers are particularly polished and well used to court proceedings. That said, following the jurys’ retirement for the weekend, there was a last minute crucial objection from their legal team. One of their lawyers raised a final grievance – that a lawyer for the plaintiff’s side had the cheek to say ‘have a good weekend’ to the jury. Seriously? Drug induced suicide was the issue here and this farewell gesture caused offence to GSK’s legal team?

Anyway, if you would like to see the three video depositions that were shown to the court; they were uploaded yesterday. You really don’t need to be a body language expert to determine how truthful these GSK experts are being – or not.

GSK Biostatistician John Davies Deposition in Paxil Suicide Case:
https://www.youtube.com/watch?v=C9_WvgqYkag
Former Glaxo Executive Jeffrey Dunbar Deposition in Paxil Suicide Case:  https://www.youtube.com/watch?v=K5OL0DC4xQE
Damning Testimony from Former GlaxoSmithKline CEO Jean-Pierre Garnier in Paxil Suicide Case: https://www.youtube.com/watch?
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Jake’s Mammy on DriveTime

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.

Victor Kirk – Coincidental SSRI Prescription?

 

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Some cases, like this one, are so clearly antidepressant-induced that it seems bizarre that a coroner or medic couldn’t (or wouldn’t) recognise it. That suicidality is a side-effect of antidepressants is now well established, particularly upon starting, changing dose (up or down) or discontinuation. While the suicide-warnings are provided for under 25s, it is apparent that age is irrelevant when suffering an attack of antidepressant-induced akathisia, aggression, emotional blunting, mania or suicidal ideation (all in the leaflet).

The following case has all the hallmarks of being drug-induced. The timeline and details of events, including the flu-like symptoms and repeated interactions with the doctor, struck me as being very similar to the circumstances surrounding Shane’s death (my son). These out-of-the-blue, uncharacteristic, violent deaths have been happening for decades, since the introduction of Selective Serotonin Reuptake Inhibitors antidepressants (SSRIs). In my opinion Victor is clearly another SSRI victim.

 

Victor, age 71.

Victor Kirk, 71, was suffering from high blood pressure and heart disease. On July 6th, he attended his doctor as he was feeling faint. This was possibly caused by his blood-pressure medication, as reports state that his dose was reduced for a short period and subsequently increased. There is no suggestion that Victor had any history of depression; however, he was prescribed an antidepressant for his ‘low mood’.

Less than 3 weeks later, on July 25th, Victor returned to his doctor complaining that he was suffering from side-effects of the antidepressant medication. He was switched to a different antidepressant and told to come back the following week. On August 11th, Victor once again returned to his doctor as he was ‘very worried’ about his health and felt he was getting a chest infection; he was prescribed an antibiotic. 3 days later, on August 14th, he expressed suicidal thoughts.

On the morning of August 17th, 6 weeks after he was first prescribed an antidepressant, Victor wrote a suicide-note. He then took a circular saw into his bathroom and used it to kill himself. Awakened by the loud noise, Victor’s wife found him dying on the bathroom floor, covered in blood. The coroner recorded a verdict of suicide. It looks like there was no discussion as to why Victor, who lived for 71 years and had no history of mental illness, would choose to end his life in this horrific manner. Yet again, it seems there was no discussion on his recently prescribed mind-altering-drugs, which an unwitting Victor had flagged before his death. While a coroner might be excused, as he/she often has no medical background, it is a travesty when medics ignore what is staring them right in the face.

Timeline:

July 6th – Went to GP feeling faint, prescribed an antidepressant for low mood.

July 6th-25th – Routine checks during July.

July 25th – Returned to GP complaining of side-effects. Antidepressant was stopped and replaced with a different brand.

August 11th – Returned to his GP again, very worried about his health.

August 14th – Mr Kirk expressed suicidal thoughts.

August 17th – Used a circular saw to end his own life.

GloucestershireLive Article.

The Destigmatization of Stigma ..

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Stigma: a mark of disgrace associated with a particular circumstance, quality, or person – “the stigma of mental disorder”. 

 

Comedian Al Porter was on Irish TV this week, speaking of his depression, the one brought about by his chemicals that needed re-balancing. He spoke of the stigma attached to depression, then whipped out his pills on live TV and ended with the recommendation that if people needed meds, go get them, they work. The two other guests (a journalist and a doctor) were visibly moved, with one on the verge of tears, both saying how marvellous Al was for speaking so openly about his depression. Yet no-one on the programme, not even the doctor, contradicted him on his unfounded chemical imbalance belief. No balancing scientific argument was made to say that psychotropic drugs, which target the brain, can increase the risk of suicidal behaviour and aggression. Oh and let’s not forget the high percentage that will experience antidepressant-induced sexual dysfunction (sometimes irreversibly).

I’m glad the drugs worked for AL, really I am, he seems like a lovely down-to-earth fella. Good luck to him – I only wish they worked so well for everyone. He’s on meds though, so what, who isn’t? You don’t see fertile females whipping out their oral contraceptives, shouting “I’m on the jack and jill, aren’t I feckin marvellous?” Or, half the population whipping out their benzos, screaming (albeit calmly) “long live me auld psychotropics”. Only the locale-name is already familiar, Ireland could surely be re-named ‘Statin Island’, which consumers could also whip out – if they could remember where they put them.

Stigma, stigma, stigma. It’s a word being wildly bandied around in the media, demonstrating how thoroughly modern and enlightened we all are. Al spoke of feeling a stigma attached to taking medication. Whether this stigma actually still persists, is debatable, particuarly as there are approximately 500,000 Irish people currently taking antidepressants or anti-anxiety drugs. According to the Irish Medical Organisation (IMO), 25% of Irish adults are suffering from a mental health disorder (IMO, 2016). Across the European Union, the European College of Neuropsychopharmacology (ECNP) have estimated the number to be far higher, at 38.2%. Everywhere we look, there are articles and documentaries informing us that having a ‘mental health’ issue, particularly depression, is actually quite normal. Indeed, the Pharmaceutical industry has spent years attempting to normalize mental illness. Yet, why would industry spend so much time and effort into supposedly reducing mental health stigma. Depression, being an extremely lucrative market, is hardly co-incidental?
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Destigmatizing stigma.
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One Pharma initative, Lundbeck’s ‘Art Against Stigma‘, apparently aims to create a ‘better understanding of mental illness’ and challenge the general public ‘to re-evaluate their perception of those with mental illness’. They very kindly provide a list of the drugs they manufacture for every mental illness you can imagine, down at the bottom of the leaflet. Ahead of another Lundbeck initiative, Irish psychiatrist Patricia Casey, a paid speaker for many years with this Pharmaceutical company, said –
people with depression can often suffer for years before seeking treatment because they do not recognise the condition or because they do not want to be stigmatised.
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GlaxoSmithKline also got in on the stigma train. Having done a fabulous job on this side of the water normalizing ‘mental illness’ (and touting GSK drugs), it took its de-stigmatising project (and drugs) to Japan, with their advertising slogan “Does Your Soul Have A Cold?” No doubt a dose of Paroxetine (Seroxat/Paxil) will cure your mucus-filled soul – perhaps permanently.
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 Not to be outdone, Lilly also got in on the act with ‘The Welcome Back Awards‘ program, established to ‘recognize outstanding achievements in the fight against depression and the stigma often associated with the illness’. Of course Lilly’s Fluoxetine (Prozac) was a major part of its success. It’s interesting to note, that stigma did not cause the death of 14-year-old Irish boy, Jake McGill Lynch – Prozac did.
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Depression is big business for the drug industry. If there is any remaining stigma, directed at a person in distress or otherwise, that is ignorance – not stigma. A pill will not cure ignorance. The Pharmaceutical industry sells drugs – an industry that exists because of ‘illness’, not health. An industry push to destigmatize ‘mental illness’ is similar to Diageo attempting to destigmatize alcoholism.