Two Coroners, Two Deaths: The Scientist and The Chef

 

Margaret and Andre

Two recent inquests again raise concerns on the widespread practice of prescribing ‘safe’ [sic] SSRI antidepressants. Both inquests involve Citalopram.

On the face of it, Dr Sylvia Margaret Tisdale (64) and Andre Mickley (36) have very little in common. Dr Tisdale, a clinical virologist, had a long and distinguished scientific career with GlaxoSmithKline, while Andre Mickley was a former chef who was his partner’s carer at the time of his death. Mr Mickley had taken heroin and cocaine and was described in one newspaper as ‘a long term drug addict’ – but it should also be noted that he was described as a ‘gentle giant’ by his partner and was actively undergoing addiction treatment at the time of his death.

Inquests:

On April 29th 2015, Dr Tisdale left her ‘coping with stress’ book, her glasses and her antidepressant Citalopram on her bedside table and jumped from her bedroom window; she died a short time later. While the coroner focused on the stress Dr Tisdale was under, her sister Linda raised concerns ‘about the controversial side effects of citalopram’. She said “I felt that she wasn’t depressed but was instead very anxious and stressed. I was concerned about the citalopram she was prescribed, when I looked up the side effects- I don’t think she knew how serious the side effects could be.”

The coroner Tom Osborne returned a suicide verdict, dismissing Linda’s concerns. He said “If you went online and read the side effects of almost any medicine, you would never want to take any medication at all.” Wait!! What about the doubling of suicide risk? Mr Osborne is obviously not an advocate for ‘informed consent’? Incidentally, the psychiatrist testifying at Jake McGill Lynch’s inquest last week said something similar – “The Patient Information Leaflets (PILs) are too over prescriptive and it might put people off“. It might, and then there might be less use for psychiatrists or doctors to be testifying at inquests?

Andre Mickley’s Inquest and a different Coroner:

Andre Mickley was described as a ‘long term drug abuser’ who had reportedly used heroin and cocaine on the morning of 17th Feb 2015. He collapsed later that day, having suffered a subarachnoid hemorrhage (uncommon form of stroke) and died a few days later. What he had in common with Dr Tisdale was a prescription for Citalopram; he had been prescribed it just a few days before his death. There is emerging evidence that Citalopram can cause major adverse events such as heart attack and stroke, leading to death. A 2012 study published in the journal Neurology, found Patients who take Citalopram and other SSRIs have an increased risk of bleeding in the brain and stroke.

At Mr Mickley’s inquest, the coroner Professor Robert Forrest returned a ‘Narrative’ verdict. Unlike the coroner who dismissed Citalopram concerns in Dr Tisdale’s inquest, Prof Forrest sent a Regulation 28 report (with the aim of preventing further deaths) to the MHRA Director of Pharmacovigilence. In the report he stressed that Mr Mickley had used many drugs for several years “without major ill effects” but he had concerns regarding the drug Citalopram. He said there are “clear potentially adverse pharmacokinetic interactions between cocaine and the SSRI group of drugs, besides case reports” and this is not addressed in the PILs. He asked for action to be taken to prevent further deaths.

Tragically, the coroner presiding over the Dr Tisdale’s Inquest did not feel the need to initiate an investigation, but maybe, just maybe, Andre Mickley’s death might curtail the number of further Citalopram deaths and even provide some answers to Linda’s questions. Who knows – it’s a strange and sometimes wonderful world.

Thanks Mr AntiDepAware for providing me with the coroner’s Report. RIP Margaret and Andre.

Articles:

Bedfordshire News

Coroner’s Report

Lincolnshire Echo

Neurology Study


6 thoughts on “Two Coroners, Two Deaths: The Scientist and The Chef

  1. The office of coroner is an odd institution. I personally know of one who is also the GP – perhaps even prescribing the stuff that kills those for whom he may later determine cause of death. Am I being facetious? Could there be a conflict of interest? How is the institution monitored?

    Liked by 1 person

  2. Coroners decisions seem to be quite subjective in a lot of these deaths. I also find it disturbing how some of them think that by giving ‘informed consent’ they are going to scare people away from taking anti-depressants. If anything the side effects listed in the PIL’s are tame compared to the real side effect profile of SSRI’s, they’re written by drug companies so you can double or treble (or in the case of Seroxat multiply by at least seven times) the side effects listed on the PIL’s.

    The PIL’s are based on short term clinical trials, negative ones are buried, and as we have seen in the case of Seroxat study 329, often the results are spun as positive when in fact they are negative. The drug companies control the process therefore it’s inherently biased. So, really the issue of side effects listed in the PILs being somehow over-played or over-warned and thus somehow scaring people is patently ridiculous, it is in fact – the opposite- the side effects are under-played, the PIL’s use inaccessible and drug companies and regulators use confusing medicalized language (for example de-personalization and akathisa etc when describing extemely distressing drug induced emotional/psychological states), and doctors do not tell patients to read the PIL’s carefully.

    We would have less SSRI deaths for these coroners to deal with if more people were properly warned of the dangers. Personally I think some coroners are just ignorant, and they don’t have the expertise, knowledge, or insight, into the role of SSRI’s in these deaths- so they dismiss them entirely. They don’t want to appear like they are clueless. These are complex cases even without SSRI’s, so when you add these drugs into the mix it makes coroners jobs harder because these drugs are also complex. It takes a lot of time to understand even basic pharmacology, and the role of psychiatric medications complicates suicides even more when they are involved, so unless these coroners take some time to fully inform themselves -(and that would take a lot of reading and studying)- they won’t really understand. Coroners aren’t educated enough on how these drugs affect people, that’s the problem, but they can’t admit that..

    Liked by 1 person

  3. Many coroners have raised the SSRI suicide issue, including this one here http://www.cwherald.com/a/archive/open-verdict-follows-man&%238217%3bs-death-on-rail-line.207791.html The coroner Mr. Osborne said there was no evidence that this man intended to die by suicide, “but since Christmas he had dealt with the cases of six people who died shortly after being prescribed the antidepressant”.

    No matter how many coroners raise the issue, there are many more psychiatrists who will deny that these drugs cause harm. Until Ireland wakes up to its unmerited reverence of psychiatry, there will be many more deaths I fear.

    It was only 2011 when Timothy Dinan of UCC said “The use of Sertraline (Zoloft) helps to reduce suicidality and reduce depression. The public should have no concerns about these drugs”. That was at a Cork-man’s inquest where the family had raised concerns. Despite what the PIL says – NO CONCERNS?? http://www.irishexaminer.com/ireland/health/family-calls-for-more-research-into-anti-depressants-153706.html

    Liked by 1 person

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