Psychiatric Drugs: Evidence Based Medicine or Psychiatry’s Smoke Ball?
For decades doctors and psychiatrists have defended the use and efficacy of psychiatric drugs, from declaring that they ‘revolutionised the treatment of depression’ to just plain ‘lifesaving’. Indeed Irish Psychiatrist Patricia Casey has proclaimed that antidepressants are lifesaving and that for early improvement in ‘clinical’ depression, ‘antidepressants are the best and often the only option’. Today the most widely prescribed psychiatric drugs are Selective Serotonin Reuptake Inhibitors – SSRI antidepressants. Yet tragically for many, SSRIs are also thought to be the most dangerous. According to Dr David Healy, incidentally also an Irish psychiatrist, but additionally a scientist and psychopharmacologist “90% of school shootings over more than a decade have been linked to a widely prescribed type of antidepressant called selective serotonin reuptake inhibitors or SSRIs.” Dr Healy argues the opposite to Casey, stating:
“there is no research evidence to suggest that anyone’s life is saved by taking an antidepressant but if there are lives saved the research makes it clear that for every life saved there must be another lost. There are probably something between 1000-1500 extra suicides in the US each year, triggered by an antidepressant – an extra 2000 -2500 in Europe. The data is similar for violence.”
To put that number into perspective – 206 people have died since 2007 from bird flu, yet there was mass hysteria and a huge media frenzy. If Dr Healy’s statistics are correct, at least 3000-4000 suicides are induced by antidepressants each year, every year. Yet despite this huge number, the media seem reluctant to go up against the drug companies, their paid experts or the medicines regulators. Dr David Graham, who worked at the drug safety department with the Food and Drug Administration, FDA, stated that ‘all of these drugs appear to have the ability to increase the risk of suicidal behavior’. What was particularly disturbing is that he revealed the FDA (America’s Drug Safety Regulator) had suppressed a colleague’s report which found that most antidepressants don’t actually work in treating children. I assume he says ‘most’ because Eli Lilly’s Fluoxetine was approved by the FDA in the treatment of children. Yet John Virapen, who worked for Eli Lilly for 35 years, testified that he used bribery and corruption to get Fluoxetine approved, knowing full well what Lilly knew all along, that Fluoxetine increased the risk of suicide and homicide.
The regulatory warnings for increased suicidality which were eventually attached to SSRIs are for children and young people up to the age of 25. This implies that SSRIs are safe in people older than 25, an implication which is extremely misleading. In 2006 an inquest was held in Dublin, Ireland, for a 62 year old businessman. His self inflicted death occured 5 days after starting Lundbeck’s SSRI Escitalopram/Lexapro. At the inquest his wife pointed out that Lexapro was associated with suicide, a fact that she wasn’t made aware of beforehand. Professor Casey, who attended the inquest, argued that “scientific research indicates that children under 18 who are prescribed SSRI antidepressants were at increased risk of ‘suicide attempts and suicidal thoughts’ but people of 30 years and older were not affected similarly”. Not so according to Dr Healy who says the risk of drug induced suicide and violence affect all age groups, not just the young. He is not alone. Peter Gøtzsche of the Nordic Cochrane Centre also came to the same conclusion. He stated “SSRIs likely increase the risk of suicide at all ages. These drugs are immensely harmful”. A retired psychiatrist and former inspector of mental health hospitals noted that SSRIs increased Ireland’s suicide rate. Dr Dermot Walsh stated in the British Medical Journal:
“In the context of the current debate on the efficacy of antidepressants the following may be of interest. Ireland’s suicide rate has risen threefold since antidepressants became available with the greatest increase occurring following the introduction of the SSRIs.”
Not surprisingly the drug companies rarely admit liability, usually testifying that it was ‘the underlying illness’ to blame, not their drug. Despite the many contradictions to this, their ‘underlying illness’ mantra rarely changes. People like Woody Witczak are dismissed as anecdotal. Woody was 37 and lived in the US. He was prescribed Pfizer’s SSRI Sertraline, not for depression but for insomnia. Five weeks later, this ‘upbeat and happy’ man killed himself. Following his death Woody’s wife Kim acquired some internal confidential documents from Pfizer. One of these confidential documents was from Pfizer to The Irish Medicines Board (IMB). The documents referred to Pfizer’s clinical studies on Sertraline which concluded that the age group with the highest suicide rate was 31-40 and that the most dangerous time is 15-30 days after starting this medication. She also discovered that 54 of the 252 suicides that Pfizer investigated were found to be causally related to Sertraline.
In 2011 another inquest was held in Ireland, this time for Nicholas Maguire, aged 52, again a businessman. Mr Maguire’s family raised concerns over his recent prescription for Sertraline/Zoloft. They said their brother had been ‘driven mad’ by the pills and that there had been a dramatic change in his personality while taking Sertraline. Following the inquest Irish psychiatrist Timothy Dinan defended the drug, stating ‘The use of Sertraline helps to reduce suicidality and reduce depression’. Despite being on the Advisory Committee for Human Medicines at the IMB, Professor Dinan also stated ‘The public should have no concerns about these drugs’.
There is growing concern among academia that these drugs have little or no efficacy and are in fact doing more harm than good. Many will be aware of the curious case of Carlill v Carbolic Smoke Ball Company where a unilateral contract was offered by a company advertisment to the world at large. The company proclaimed that using their smoke ball would prevent the user from contracting influenza. Mrs Carlill did and the smoke ball didn’t! The company argued that they didn’t intend to be taken seriously, that the advertisment was in fact mere ‘sales puff’ and therefore not legally binding; the court held otherwise.
The drug company literature now readily admit that SSRIs are associated with an increased risk of suicide and violence. Could it be that psychiatrys’ medical model is actually the equivalent of a latter-day carbolic smoke ball? Yet unlike the harmless smoke ball, psychiatry’s medical model is actually causing many, many deaths. Will our future decendants see the demise of the SSRI as just another fraudulent snakeoil or smoke ball generation? The defenders of the medical model may yet be exposed as prescription drug pushers, albeit disguised as the caring psychiatrist or doctor.
Iatrogenic death, or prescription drug induced death, is an issue which most lay people will thankfully be oblivious to. Where Iatrogenesis is slowly becoming apparent though is in the courtroom. This was seen recently in Manitoba, where Justice Robert Heinrichs found that a 16 year old boy was driven to commit an unprovoked murder because of the adverse affects of taking Fluoxetine/Prozac. Dr Peter Breggin testified that the teenager’s actions were drug induced and he would not have committed the violence if he had not been given the antidepressant. Dr Breggin has warned of the dangers of SSRIs for decades and has been an expert witness in a number of successful drug induced cases.
It seems that deciphering scientific evidence and whether the ‘independent’ expert is in fact a paid pharma shill has yet to be argued in the courtroom. The European judiciary largely defers to the psychiatric expert when determining ‘mental health’ cases; seemingly reluctant to use its own discretion, rather deferring to the possibly biased opinion of the individual psychiatrist. According to Herxheimer et al:
“Many judges and coroners have not addressed these questions clearly and have not used expert witnesses consistently, on occasion disregarding scientiﬁc evidence. Courts need to appoint experts to explain and interpret the scientiﬁc evidence. Few judges are equipped to resolve contradictions between different experts” and “The reluctance of legal processes to implicate drugs as a possible cause of violent behaviour leads to injustice. Courts must be required to obtain appropriate expert evidence, and be given independent data on which drugs can cause such behaviour.”
A recent Plos One study ‘Prescription Drugs Associated with Reports of Violence Towards Others’found that 31 drugs were disproportionally associated with violence. 11 of these were antidepressants.
Far from finding justice, as Herxheimer said, the reluctance of the courts to implicate prescription drugs can lead to injustice. An article in the 2012 Law Society Gazette reviewed a book entitled ‘You Can’t Read This Book: Censorship in an Age of Freedom’ by journalist and author Nick Cohen. The reviewer stated that “Lawyers do not figure highly in the estimation of newspaper columnist Nick Cohen. His broadside at censorship in a liberal age paints solicitors, barristers and judges as the lackeys of oligarchs and snake-oil sellers and conspirators in liberal silence when the going gets tough”.
It is submitted that Mr Cohen may have a valid point. Despite the lack of evidence or any available test to confirm or deny any ‘mental illness’, once the psychiatric expert has given his opinion either way, the fate of the accused is sealed. It is very, very rare that prescription drug induced violence is put forward as a defence, most likely because the psychiatric expert will deny all knowledge of Iatrogenesis and the courts will defer to such wisdom. It is further submitted that a puff of the aforementioned smoke ball would be much less risky than taking a chance with an SSRI.
Declaration of Interest
In 2009 my son died by stabbing himself multiple times. He took the life of another young man on the same night. He had been prescribed Lundbeck’s Citalopram/Celexa 17 days beforehand, not for any mental illness but for a break-up with his girlfriend. He was never diagnosed with any illness, mental or otherwise, apart from a posthumous diagnosis on national TV by Professor Patricia Casey. From early on I was aware that Citalopram caused my son’s death and enabled him to take the life of another human being. I shouted this from the rooftops to anyone who would listen. Some did, some didn’t.
Dr David Healy testified at my son’s inquest stating that Citalopram (and all SSRIs) could cause a person to become suicidal and homicidal. He opined that Citalopram caused both my son’s death and the death of the other young man. The College of Psychiatry of Ireland intervened and involved themselves before, during and after the inquest. The college collectively denied that this family of drug could cause a person to become suicidal or homicidal. Professor Casey attended my son’s inquest, representing the college of psychiatry. She was refused permission to testify by the Coroner, Cahal Louth. Despite this, immediately following the inquest she stood outside the Coroner’s court and spoke on national TV stating that there were ‘issues’ with the evidence. A press statement was subsequently released by the college stating that the sworn expert evidence (by Dr David Healy) was, in their view, speculative. Referring to him as ‘the expert’, never once mentioning his name, the college of psychiatry proceeded to contradict his testimony and defend the drug. Similar to the drug companies, they blamed the ‘underlying illness’ not the drug, eg “Anecdotal cases of suicide sometimes mistakenly attribute these tragic events to the treatment rather than the illness itself”. The college denied there was any evidence linking SSRIs to suicide or violence. They further stated that “Antidepressants do not cause violence. Neither are they, nor can they be expected to be, an inoculation against violence.”
Professor Timothy Dinan also spoke to the media afterwards. He said that he could say with “100 per cent certainty, without any fear of contradiction, that modern anti-depressants such as the drug Citalopram … do not cause people to commit murder”. He also added that there was no evidence that the drugs can cause suicide.
It should be noted that professors Casey and Dinan both received numerous honoraria from Lundbeck, the implicated drug company. Professor Dinan has received honoraria from and is a member of the speakers’/advisory board for Lilly, Lundbeck, Organon and Pfizer the inventor of Sertraline, the same SSRI he defended following Mr Maguire’s inquest. Despite being in attendance at the inquest, Lundbeck’s representative remained silent. I later discovered through a Freedom of Information request that the college statement regarding my son was forwarded, via internal college email, to the pharmaceutical company Lundbeck. The ethicality of Irish psychiatry’s involvement in my son’s inquest is questionable. Individual psychiatrists defending a drug while simultaneously working for the same drug company is surely a bias too far?
Evidence Based Medicine or Psychiatry’s Smoke Ball?
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