Brennan McCartney was 18 years old. He did not have depression. He died by a drug-induced suicide 4 days after his family doctor gave him a sample pack of Cipralex/Lexapro. You can see this talented young man in a documentary in my older post here Link.
Professor Healy looked at Brennan’s case and said, “It seemed to be a very clear cut case. This was a young man, who if he hadn’t been put on the antidepressant that he was put on, wouldn’t have gone on to commit suicide.”
These SSRI’s double the risk of suicide, so at the very least doctor’s should be aware of the difference between feeling sad and depression before prescribing them. It seems that Canadian doctors are not much different to Irish doctors, where in order to cover their own backsides, the patient will always be to blame. Of course, there is always the added advantage that they can’t answer back. The doctor who saw Brennan, who was suffering from a chest-cold, having never mentioned this in his initial notes, on further recollection, recalled Brennan as saying… “Oh, and I think I am depressed and need medication.” Does that sound like something an 18 year old would say? Blaming the patient doctor?
Brennan’s family doctor handed him a sample pack of Cipralex/Lexapro. This meant that Lexapro was not actually prescribed and therefore Brennan did not get to consult with a pharmacist. This lack of informed consent led to tragic consequences for Brennan.
Dr. Stephen Fleming, Professor of Psychology in the Faculty of Health at York University, Toronto, reviewed Brennan’s medical records and the family doctor’s response. He makes some crucial points regarding the importance of differentiating between grief and depression. He also makes an interesting observation; In the doctor’s initial notes, there is no mention of him giving Brennan samples of Cipralex.
In a later letter dated May, 2012, Brennan’s family doctor said “I recognize that my chart note for the visit (Nov, 2010) is inadequate. I realized this shortly after learning of Brennan’s death and on the advice of a peer, I wrote an additional note documenting what I remember happening.” He noted that he saw Brennan “because he was feeling ill with a cough, had a tight chest and difficulty breathing.” On examination, he diagnosed a bronchial infection, prescribed Biaxin and Symbicort, and urged that Brennan get a chest X-ray. Then the doctor added material that was not in his original notes; He recalled that, as he was terminating the examination, Brennan stated, “Oh, and I think I am depressed and need medication.” In this later letter the doctor states that Brennan’s symptoms were consistent with a diagnosis of depression and noted the following symptoms: “Brennan was finding this time of year difficult as a cousin had died some years previous, He had ‘fairly recently’ broken up with his girlfriend, Brennan was ‘eating little’, tearful, was not sleeping properly, and he ‘felt terrible’. The doctor described all of these symptoms as ‘normal reactions’ and he reassured Brennan that he would ‘get through it’.
Dr Fleming: “In spite of the doctor normalizing his responses, apparently Brennan stated he just wanted to ‘feel better’. Brennan acknowledged the presence of suicidal ideation but added that he was not capable of such an act as he was close to his family.” Dr Fleming points out that although the doctor normalised Brennan’s responses, he still gave him samples of Cipralex. “It is crucial to make the distinction between a ‘normal’ reaction to loss (eg., the breakup of a relationship) and major depressive disorder” and said “on the basis of the doctor’s description of Brennan’s thoughts, feelings, and behaviour, it is my opinion that he does not meet the threshold for depression and ought not to have been prescribed an antidepressant.” He further stated “From the material made available to me, the doctor failed to distinguish sadness (the ‘normal’ response to misfortune) from major depressive disorder. Brennan’s symptoms are principally neurovegetative and can better be accounted for by grief associated with the loss of his relationship – in other words, a ‘normal’ reaction to his life circumstance as the doctor originally and correctly noted.”
The misdiagnosis of grief as major depressive disorder may result in the unnecessary prescription of antidepressant medications.
PS. I contacted Dr Fleming and asked if he would answer some questions regarding Brennan’s treatment. He’s a really nice man and very forthcoming…
Q. Do you think that Brennan’s doctor got it wrong.
A. I think Brennan’s symptoms were not consistent with a major depressive disorder. He ‘got it wrong’.
Q. Do you think that Brennan received a sufficient ‘duty of care’?
A. The distinction between sadness and depression is critical. I don’t know the definition of ‘duty of care’ – he wasn’t diagnosed correctly. In fact, Brennan did not meet the criteria for any psychiatric disorder.
Q. Are you under the impression that the add-in “Oh, and I think I’m depressed and need medication” was an after thought put in by the doctor to cover his own backside?
A. In a word, yes.
Q. Do you think it’s a statement that Brennan would have said or a lie?
A. It sounds like an odd utterance coming from an adolescent male.
Q. What would you have done in the same circumstances?
A. I would have listened carefully to what Brennan was saying, made the distinction between sadness and depression (in other words, look at the context of his symptoms), I would not have recommended anti-depressants but rather talk therapy. And, if I didn’t have the expertise to help him, then refer him to someone who does. He didn’t know what he didn’t know.
- Brennan McCartney; 4 days on Cipralex/Lexapro (leoniefennell.wordpress.com)
- A parent’s worst nightmare–tragic death of son by suicide after taking antidepressant Lexapro, Cipralex, Escitalopram (bipolarsoupkitchen-stephany.blogspot.com)