Gareth O’Callaghan on Citalopram.

Gareth O'Callaghan
Gareth O’Callaghan
Photo by Johnny Bambury

Strange to be writing about someone who’s alive, but a nice change all the same. A survivor, who knew? Sorry, sarcasm – you can take the girl outta Sallynoggin…

Gareth O’Callaghan is a well known Irish author, radio presenter and mental health activist. He has written numerous books on depression, including the popular A Day Called Hope: A Journey Beyond Depression. Recently, he has spoken out about his experience on the SSRI Citalopram (aka Cipramil/Celexa), the same drug my son Shane was on for 17 days before his death. Why he has decided to bare all now, I don’t know, but I’m just glad that he has. Gareth said that he followed Shane’s case avidly “..not only because of the huge media coverage it received, but also because I too took citalopram many years ago. I can identify with the Akathisia (restless, aggressive inner anxiety) that Shane suffered as a result of the drug. I could really frighten people here if I was to explain in detail what Akathisia does to the mind. Thankfully I had a chance to stop taking the tablets. Shane didn’t”.

I should say that this is not news to me – I spoke to Gareth some years back; he’s a nice, friendly and very honest guy, who pulls no punches. He can be heard on 4FM every weekday afternoon here.

Akathisia (from the Greek for inability to sit) is a widely misunderstood and underestimated adverse effect of taking a drug, usually an SSRI antidepressant or a benzodiazepine. Coded in Patient Information Leaflets (PILs) as ‘inner restlessness’ and ‘restless leg syndrome’, it has been described by some survivors as the ‘worst experience ever’, a feeling of ‘inner torment’ where ‘death would be a welcome release’ and seems ‘the only, very welcome option’.

Wendy Dolin, who I had the pleasure of meeting in Copenhagen, described how her husband Stewart died while suffering with akathisia – 6 days after he was prescribed Paxil/Seroxat. She has set up MISSD, a blog specifically to warn of the dangers of akathisia –

“On July 15, 2010, (six days after beginning the medication), following a regular lunch with a business associate, Stewart left his office and walked to a nearby train platform. A registered nurse who was also on the platform later reported seeing Stewart pacing back and forth and looking very agitated. As a train approached, Stewart took his own life. This happy, funny, loving, wealthy, dedicated husband and father who loved life left no note and no logical reason why he would suddenly want to end it all. Neither Paxil nor the generic version listed suicidal behavior as a potential side effect for men of Stewart’s age.”

A recent post on MISSD reports a personal experience similar to Gareths here. David Healy also explained akathisia in his coroner’s report for Shane’s inquest here. Short excerpt below –

There is good evidence that akathisia can exacerbate psychopathology in general, and a consensus that it can be linked to both suicide and violence. A link between akathisia and violence, including homicide, following psychotropic drug use has previously been reported.

What surprises me with Gareth’s post, is that while he is telling of his awful experience and has many supporters, some people have taken offence where there is none intended. There are quite a few ‘how dare yous’. It seems that while it’s perfectly acceptable to be MedicatedAndMighty, it’s not okay to be UnMedicatedAndMighty and talk of a bad personal experience with prescription drugs. Surely his story is equally important? A selection of the comments below:

  1. you’re doing more damage by labelling those who need help
  2. I am going to unfollow u I have had enough of your one sided beliefs
  3. Please don’t make people feel bad If they need it after bereavement etc.

Giving drugs for bereavement is surely part of psychiatry’s problem but one I won’t go into here (See works of David Healy, Robert Whitaker, Peter Gotzsche, Peter Breggin, etc). It should be noted that akathisia is not always fatal but monitoring is crucial. If it occurs in the early stages of taking a prescription drug, it can occasionally wear off (but not always). If it develops later, it’s less likely to wear off.

Read Gareth O’Callaghan’s post on akathisia below; It’s well worth a read.. 

This is a true story. It is called personal experience. It happened to me. In hindsight it relates to probably the most terrifying month of my life and I would like to write about it here for the first time. It happened 16 years ago.

If you would prefer not to read how an antidepressant can destroy a human mind, and even kill, then I suggest you stop here. Otherwise please read on. It’s also worth remembering while you’re reading this that there have been hundreds of suicides in Ireland so far this year. Many of these people could still be alive if they had been told the truth about these drugs before they had been prescribed.

I have written here on a few occasions about a condition – a body and mind reaction – called ‘Akathisia’, which is directly caused by antidepressant medications. I would like to explain more about this dangerous reaction this evening and what it really is, as very few people have ever heard of it. And it is one of the most dangerous and severe side-effects of these drugs.

In 2000 I was diagnosed with depression and prescribed citalopram (aka celexa, cipramil), a drug that – to the best of my knowledge – arrived in 1996. It was still brand new. These days we now know it is also extremely dangerous as I will explain in a moment. Despite all the damaged lives it has caused and the many deaths it has been responsible for, it is still one of the most frequently prescribed antidepressants from a range of drugs known as SSRIs (selective serotonin re-uptake inhibitors). Why, if this drug can induce death, is it still widely available?

Back then we knew nothing about what this toxic drug was capable of doing because it was basically still being tested. 16 years ago most of us might agree that our education about mind-altering drugs was scant and strongly influenced by the medical profession. Consequently very few of us were prepared to share our experiences like we are today because we knew no better. We were led to believe this was ‘the cure’.

The SSRIs have for years been marketed around a shocking blatant lie, namely that a chemical brain imbalance causes depression. Back then, 16 years ago, I thought (as a result of buying into this myth) that this drug would rebalance my brain chemicals and cure my depression. If only I had known back then what I know now.

I was told that the drug would take between three and five weeks (maybe six) to really ‘kick in’. I was told to be patient. So I reminded myself each day through this anxious misery and baseline unhappiness that I was feeling that I would eventually see the sun again and appreciate the life I had forgotten existed. I waited. And waited. And then after about seven days my life changed. Something truly shocking and off-the-scale of understanding started to happen.

I started to feel more anxious, in a stomach-knotted nauseous kind of way. My heart started to beat faster and I felt like I was losing my grip on reality. My first panic attack happened in a packed shopping centre on a busy Saturday afternoon. I lost the plot. I felt like I was having some sort of seizure so deep inside me I couldn’t control my rational self.

I told my two young daughters that we needed to get back home as quickly as possible. They couldn’t understand why I couldn’t explain why we needed to go home. I was cracking inside very quickly, sweating, trembling, palpitating, even crying. I was losing all sense of reality in a way that was terrifying me. How I managed to drive home that day is still something I can’t bear to think about.

Once home I went upstairs to a room which I had converted into a small office years before, closed the door and started to cry. The crying became a full-scale panic attack and I ended up lying on the floor hugging my knees trying to stop the awful sensation of severe agitation that was tearing me apart inside.

Eventually it eased; but then the pain in my knees became so bad I had to get up and walk around. It wasn’t normal walking; it was pacing. I paced around the house, often sitting down to rub the pain out of my knees, and then standing and pacing while scratching my face and squeezing my abdomen to stop the horrendous agitation that was tearing at my gut. It was so deep inside me it was tearing at my gut with a hidden pain I couldn’t reach.

In the days that followed, the aggression I felt would play horrible games with my mind. I couldn’t be around sharp instruments, or walk near water. I found it increasingly difficult to cross busy roads, or to be in a crowded place for more than a few seconds. Panic struck me randomly. I was afraid to drive my car so I stopped driving. But most of all the desire – the irrational, unwanted, terrifying need – to kill myself was never far from my mind. Death would stop this pain but I didn’t want to die, I kept thinking. My brain was in a state of meltdown. The nightmares and the sweats were truly shocking.

I lasted for three weeks on citalopram. On the 22nd day I rang my doctor. I told him I couldn’t take it anymore. I explained to him what was happening and he was shocked. I am lucky to have a very good doctor. Many people are not so lucky.

If reading about my experience here has upset you, then please let me emphasise that this was never my intention. This may not help you but I hope it might help someone who is reading this tonight and possibly going through this awful ordeal.

I made a promise to myself years ago that I would be totally honest with myself. If I can’t be honest to me, then I definitely can’t be honest with you. My writing comes from an honesty that believes in justice and support for others who are coming through what I have come through.

I know so much more these days about mental health and what heals, and also what doesn’t. I knew nothing back then. I started to educate myself when it dawned on me just how close I had come to harming myself seriously.

Unfortunately unless you have a good doctor you probably won’t be told what you need to hear and do. That is just not acceptable. If your doctor is a dickhead, get a new doctor – simple as that. If your psychiatrist is more interested in spoofing than in healing, then leave the room.

Akathisia, we are told, is usually a ‘mild reaction’ to SSRIs. Let’s be honest here. Mild is an understatement. For many people who start these drugs, akathisia is a life-threatening condition that needs to be more fully understand by both patient and doctor.

Most psychiatrists play it down because they know that three of the most popular drugs that they claim to be suitable and ‘safe’ to take for depression, that they increasingly peddle as a cure (the same drugs they include in many of their speculative, dodgy concoctions) cause akathisia: FACT.

These three drugs are Prozac (fluoxetine), Seroxat (paroxetine), and Cipramil (citalopram/celexa).

These drugs are believed to play havoc with the brain neurotransmitter norepinephrine, which under normal conditions is secreted in response to stress. It is associated with levels of insomnia, anxiety (panic), and aggression (and violence).

Research has shown that these drugs make people ‘more prone’ to suicide (and aggression) during the first few weeks of starting to take them. So many people suffer silently from akathisia. Ask any of these people if they were experiencing these awful side-effects before taking the drugs and they will tell you most likely they were not.

A deep sense of loss of interest in life, a deep-rooted unhappiness, a feeling of morbidity … these are all feelings of depression; but unfortunately often the very drug that is taken to counteract these feelings creates a violent emotional storm that many psychiatrists (and doctors) blame on the depression – not the drug.

Psychiatry is not going to change its attitudes to SSRIs. The pharmaceutical companies who developed these drugs need psychiatrists and doctors to keep selling them. Big Pharma has too much to lose. They don’t want you to find another way of healing your life. They want you to be as depressed as you possibly can be. Otherwise their profits drop because they can’t peddle their drugs. (And that’s beginning to happen.)

If a young person dies while on their drug, they blame the so-called illness, not the toxic drug. Depression is a multi-billion euro business. The second biggest exporter out of Ireland is antidepressants.

Maybe you haven’t experienced anything like what I have just described. If so, you are one of the lucky ones. If you have any doubt or bad feeling about the medication you take, or have started to take, then go straight back to whoever prescribed it to you. Demand honest answers to your questions. You are paying a lot of money. In return you are also demanding respect.

If they tell you that you are “blowing it out of all proportion” (as one young man told me he was told by his doctor), or to “stick with it”, as others have been told, or if they tell you they know best, then change your doctor. Get someone who genuinely wants to help you. It might just save your life.


4 thoughts on “Gareth O’Callaghan on Citalopram.

  1. Thank you Leonie. If only Gareth had been so clear in his description of his depression and the effects of the medication when he wrote his first book. My daughter read his book -A Day Called Hope in her search for the meaning of the much bandied word Depression.. She had been prescribed Cipramil when she was 17. She was told that it was extremely safe. It wasn’t addictive. There was absolutely no information for her or me about a need to be aware/vigilant. She was told that she wouldn’t notice any improvement for at least 2 weeks but should stick with it. She was told that “her depression” might even get worse. Despite many problems which we both overlooked as “worsening depression” my daughter continued on this medication for close to 3 years. After about a year our GP asked if she would “like to come off ” the medication. My daughter didn’t because her exams were looming. It appears that after the exams-now aged 18 my daughter tried to withdraw from Cipramil. However her prescription record shows Xanax along with a higher dose of Cipramil were prescribed after a gap of about a month. I now suspect that this was the result of a too fast taper and a diagnosis of “The Depression Returning”. The medication continued for over another year before yet another taper attempt. The day before her suicide at 20 years old her GP told her that “The depression had returned” and she could be like this for the rest of her life. She was yet again prescribed Cipramil “because she had been on it before”
    That was in 2007, we only had dial-up internet and were at the mercy of an ill informed GP.
    I applaud Gareth for his honesty and trust that he will continue to inform. He represents one of the many for whom antidepressants were not the answer.

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  2. Hi Sarah,
    I don’t know why Gareth didn’t write about his experience on Citalopram earlier. I could hazard a guess and say it might have something to do with the fact that doctors and psychiatrists were completely unaware of how dangerous these drugs were in 2004 when he wrote the book. He was just very lucky to have a good doctor who recognised akathisia when he saw it.
    Sadly we now know so much more, even if Irish psychiatrists, like Ted Dinan from UCC, publicly maintain these drugs are safe – “The public should have no concerns about these drugs”. That’s it, just dismiss the ema and fda warnings – you’d have to wonder how effective these drug regulators are when the warnings get dismissed so readily by their own experts (and the COI statements could have been written by Hans Christian Andersen himself)..

    I so wish we knew then what we know now Sarah – all we are left with is to warn others. At least we have Whitaker, Gotsche, Breggin and David Healy now. I just wish, with all my heart that it wasn’t too late for your family and mine (and all the others that we now know). That doctors were unaware that these drugs cause discontinuation/withdrawal problems, is really no consolation to you or your beautiful daughter, is it? So very sorry for her and for your family.

    Much love,
    Leonie

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  3. Many years ago i was on cipramil ,After about twelve months i was fighting from minute to minute to stay alive, The overwhelming urge to end my life rendered me physically and mentally exhausted, I made an appointment to see a psychiatrist at Fairview strand Dublin 3, I told the psychiatrist i believed the medication was causing the problem which i never had before in my live , She said no way , There has never been any indication or reports of such problems with that medication, I said i am afraid to take the medication , She would not entertain the idea that the medication was any way responsible and quickly got rid of me even though i told her i am fighting to stay alive. At that time the leaflet in a box of cipramil did not contain any mention of suicide or self harm in the warning section , It does now .
    I wonder if i could find out if the psychiatrist reported my experience to the manufacturer of the medication as she is suppose to ? If anybody knows how i could go about this i would appreciate your help.

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  4. You’d have to check with Lundbeck. They have an office in Ireland who might put you in touch with the relevant contacts (or not). They’re not very helpful when dealing with complaints and are good at passing you around. Here’s the phone number (01) 468 9800 and website http://www.lundbeck.com/ie
    Alternatively, you could contact the HPRA to find out whether an adverse reaction report was filled out for you. Here’s their phone number (01) 676 4971 and website https://www.hpra.ie/
    Good luck.
    Leonie
    P.S. If neither was done, you could always fill out an adverse reaction report yourself on the HPRA website and then on RxISK.org

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