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.
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.
Today I attended the inquest of Jake McGill Lynch, which concluded with the Coroner returning an open verdict. Firstly, amid all the legal argument, there was an infinitely more important factor; Jake..
In 2012 Jake was diagnosed with aspergers syndrome; he was just that ‘little bit different’ ye see. He was a little too intelligent; too good; too kind; too perfect to be perceived as a ‘normal’ disruptive adolescent. I often wonder why psychiatry gets to define what is ‘normal’, considering the lack of any scientific tests to determine otherwise. Are we not all individuals with traits that others would see as abnormal? Are our strange and weird traits not what makes us likable, or even unlikable? Sure, Jake liked routine and things to be in order, a place for everything and everything in its place – not a bad trait I’d say, but nowadays it’s ‘diagnosable’. This extraordinarily intelligent young man was diagnosed, labeled forever, for being just that little too perfect.
Jake was an articulate, handsome young man. He had an online girlfriend, loved to play with his Lego and like ‘normal’ 14 year olds, spent hours on his beloved Xbox. He had joined a gun club with his mam and idolized his big brother and little dog Charlie (equally). He loved his native language and was a fluent Irish speaker.
Jake was primarily a happy camper with few problems, apart from feeling a little anxious on stressful occasions. He was attending a counsellor to help with his feelings of anxiety. When the counsellor decided that Jake didn’t need any more sessions as he was “the happiest she had ever seen him”, she referred him to a psychiatrist. His mam thought that this referral was in order to sign Jake off. Inexplicably, instead of signing Jake off, the psychiatrist prescribed Jake an SSRI Fluoxetine (aka Prozac), to ‘help with his exams’. Neither his mam or dad were given a patient information leaflet (PIL) or any information on side effects – suicidality or otherwise. Therefore, they were not told that SSRIs, including Prozac, doubled the risk of suicide.
Jake’s medication was doubled after a week, without seeing the prescribing psychiatrist. He became increasingly restless and had a meltdown in school which was totally out of character. 46 days after his prescription for Prozac, Jake’s parents found him on the floor of his bedroom – he had shot himself in the head with his legally held rifle. He was rushed to hospital but declared dead a short time later.
The psychiatrist had previously testified that she prescribed Jake with Prozac ‘to help with his exams’ because he had had ‘a meltdown’ while doing an Irish exam. This off label prescribing is truly shocking, but what is worse is the fact that Jake’s ‘meltdown’ occurred 5 days AFTER he was prescribed Prozac, not before. Why would a doctor get this so wrong? Is covering their own backsides more important than revealing the true circumstances surrounding the death of a 14 year old child? Do Jake’s parents not deserve to be presented with all the facts, not a cover-up? The HSE’s barrister spends a lot of time in the Coroner’s Court – he’s obviously very good at what he does. Personally I think an apology would be far cheaper. Jake, the 14 year old child in the middle of all this, seemed to get overlooked in copious legal argument.
The Irish drug regulator, HPRA, states that ‘Prozac is not for use in children and adolescents under 18’ here. The HPRA further states that if Prozac is prescribed off-label to a child over 8 (Sweet Jesus) with ‘moderate to severe major depressive disorder’, that it should be offered only in combination with psychological therapy. JAKE DID NOT HAVE DEPRESSION! In 2005 the Committee on Human Medicinal Products, CHMP, advised that SSRIs ‘should not be used in children and adolescents except within their approved indications – not usually depression – because of the risk of suicide-related behaviour and hostility’. If prescribed off-label, the CHMP recommends that patients should ‘be monitored carefully for the appearance of suicidal behaviour, self-harm or hostility, particularly at the beginning of treatment’. Why then was Jake’s prescription for 10mgs of Prozac doubled the following week, without even seeing the psychiatrist? I would not call that careful monitoring.
What was particularly grueling for the family, was the 13 appearances in the Coroner’s Court, mainly for legal arguments over whether the family had a right to call an expert witness (David Healy). Not surprisingly the HSE barrister was vehemently opposed to David Healy taking the stand, stating that if he was allowed to be the family’s ‘expert witness’, they (the HSE) had an ‘expert witness’ who would say the opposite. I’m sure they had! The coroner refused the family’s request, referring to the limitations of the Coroner’s Act 1962 and the case of Eastern Health Board v Farrell, but said he’d have no objection to the family having an expert to ‘advise’ them on the day. By this stage Dr Healy was in the US, so Declan Gilsenan (retired assistant state-pathologist) came to the rescue and stepped in to advise Jake’s family. He has publicly stated “Based on my experience of doing postmortems on people where anti-depressants have been started fairly recently I would have concerns about the link to suicide”.
It is of particular significance, that in May 2012 Dr Gilsenan attended Leinster House with Dr Healy, warning that these drugs were causing many deaths and asking for an investigation to be initiated. Nothing was done – NINE months later Jake was given a prescription for Prozac and the cycle continued.
What was awful today, apart from hearing the circumstances of Jake’s death, was looking into the faces of his grieving parents. That familiar look of unbearable pain etched on their faces, the unbelievable loss of their son who had so much to give – all totally avoidable. Another Irish boy lost through psychiatric drugs and another doctor being permitted to recollect ‘facts’ that just don’t add up; another mom and dad left bewildered and lost; another year, another death and still our Ministers avert their eyes and do nothing. Shame on them and the Irish Government.
The coroner, having heard arguments for the rights and wrongs of prescribing Prozac in children, said that it was “beyond his capabilities to adjudicate on Fluoxetine” but could not ‘beyond reasonable doubt’ say that Jake intended to take his own life. He then rejected a suicide verdict and returned an open verdict.
Dia leat Jake. Ní dhéanaimid dearmad ort go deo.
The last word must go to Jake. It clarifies exactly what his family have been fighting for. In an e-mail the night before his death, he said (verbatim).. “The ‘anti-anxiety’ stuff is actually an anti depressant which they didn’t tell me. Probably doesn’t make much of a difference, but I feel like I’m drugged to the point that it suppresses everything bad until it suddenly spills out.”
This week an inquest was held into the deaths of Jonathan O’Driscoll and his twin brothers from Charleville, Co Cork. Jonathan fatally stabbed his beloved little brothers before killing himself last year (September 2014). It was just one of a number of shocking Irish murder-suicides in recent years.
Jonathan was looking for help. He had many visits with doctors, mental-health teams and at least one consultation with a psychiatrist. Instead, as is now common practice, the ‘help’ Jonathan received was drugs, drugs and more drugs. His final visit with a psychiatrist (Dr Bobby Burns), a few weeks before this tragedy ensued, led to a prescription for a new (as yet unnamed) drug. The dose was due to be increased over several months. The psychiatrist testified that he was deeply concerned that Jonathan might be exhibiting the early signs of schizophrenia but following this prescription ‘Jonathan’s mental health improved’. Inexplicably, the latter would seem to contradict the subsequent actions that led to the deaths of Jonathan, Thomas and Paddy.
It was reported in the Irish Independent that Jonathan’s mother was unaware of the amount of drugs that he was prescribed. She was “totally shocked” by the number of medications he was on, further stating “I found a lot of tablets after Jonathan had passed away, God speed him. He seemed to be on a lot of tablets”.
Despite the suicide and violence warnings attached to these powerful drugs, it should be noted that these deaths are not being associated with the prescribed drugs, but rather to Jonathan stopping the drugs (aka victim blaming). Toxicology tests indicated that he may not have been taking his medication in the days prior to the stabbing. Coroner Dr Michael Kennedy was told Jonathan most likely stopped taking anti-psychotic medication over 48 hours before the tragedy. Yet far from his mental health improving as suggested by Dr Burns, Jonathan had purchased a knife and other materials at least two weeks before the killings. So which was it – was Jonathan improved or worsened by this ‘new’ wonder drug? It seems interesting that this new drug wasn’t named – wouldn’t be good for business, that’s for sure.
Although toxicology results can be hugely unreliable – if it is in fact the case that Jonathan stopped taking the drugs, he would have been in horrific withdrawal – very similar to a street-drug addict. This doesn’t seem to be the case here, as there was a certain degree of pre-planning. I am also personally aware of a number of toxicology results which failed to show SSRI antidepressant use, at least not until the families insisted on a re-test. Either way, the multiple prescribed medications, psychiatrys’ quick fix, the pill for every ill, the new wonder drug, did not work. This young man did not get help – what he did get was a cocktail of mind-altering drugs.
November 2012 – Minor road accident. Jonathan began to frequently visit his GP complaining of aches and pains. No mention of what was prescribed.
Pre-April 2013 – Dr Thomas Molloy prescribed Jonathan anti-depressants.
April 2013 – Jonathan shows first sign of aggression and was referred for a psychiatric assessment.
February 2014 – A locum GP was so concerned about Jonathan’s mental health that he referred him for an urgent psychiatric assessment.
April 2014 – Jonathan was prescribed anti-psychotic drugs.
July 2014 – Consultant psychiatrist Dr Bobby Burns prescribed a new drug, with the dose due to increase incrementally over several months, and Jonathan’s mental health (supposedly) improved over the coming months.
August 2014 – Jonathan purchased a knife and other materials to be used in the killings.
September 4th, 2014 – Jonathan and his little brothers were found dead.
The pharmaceutical industry has a long and tangled involvement within Irish politics. Besides politics, our medical ‘experts’ have built up their training and expertise while simultaneously having a fundamental collegial relationship with the pharmaceutical industry. Pharma politics may not be news to Americans, Latvians or our British neighbours – but as Ireland is my Country of birth, I claim poetic licence in focusing on my specific geographical area. Corruption within this industry has been widely publicised elsewhere but there seems to be a reticence within the Irish media to report on pharma wrongdoing or the objectivity of the psychiatric expert. My son, a young Irishman, died under the influence of 17 days of Citalopram (an SSRI antidepressant) – manufactured by Lundbeck, prescribed by a doctor, licensed by the Irish Medicine’s Board (henceforth IMB) and protected by the Irish College of Psychiatry (henceforth the College).
Despite much evidence to the contrary, our health Minister James Reilly has been quoted in the media as saying that “SSRIs aren’t addictive and treat depression effectively”. He also denied that GPs are systematically over-prescribing SSRIs. He subsequently managed to ignore two medical experts (David Healy and Declan Gilsenan) who gave testimony in Leinster House that antidepressants were the leading cause of death within the mental health field and were in fact causing hundreds of Irish deaths each year. According to the Irish Pharmaceutical Healthcare Association there are approximately 120 pharmaceutical companies that have plants in Ireland – including 9 of the 10 largest pharmaceutical companies in the world.
Last year the Irish Times reported that the Irish Government ‘came under pressure’ from the larger pharmaceutical firms over the Health Service Executives’ (HSE) decision not to approve new drugs for payment. There was an implied threat that this could ‘have implications for 25,000 jobs and future investment’ – so not surprisingly Enda Kenny and James Reilly backed down. The Times further reported that both had meetings with Abbott Laboratories and Eli Lilly, and further that Enda Kenny attended Eli Lilly’s board dinner at the Old Kinsale golf club in 2011. It is submitted that this relationship is much too close for comfort and therefore not conducive to having the Nation’s best interests at heart. Backing down under pressure from a bullying industry is never a good move, particularly when as a Nation we naturally assume that our Government is in control.
According to Dr David Healy who is regarded as the world leading expert on prescription drugs, antidepressants double the risk of suicide and violence, particularly upon starting, discontinuing and dosage change (up or down). He further stated that “antidepressants now come with black box warnings of suicide and in some jurisdictions such as Canada they come with warnings of violence also. Exactly the same mechanisms that lead to suicides lead to violence. In one case you have violence directed inward and in the other directed outwards. These mechanisms are akathisia, emotional blunting and psychosis.”
The name ‘antidepressant’ itself is pure marketing genius by the pharmaceutical industry. Who would believe that these so-called magic pills can cause death, sometimes self-inflicted and extremely violent? In protecting the medical model, referring to antidepressant-induced suicide, the College stated “Anecdotal cases of suicide sometimes mistakenly attribute these tragic events to the treatment rather than the illness itself”.This is a vastly differing stance compared to the IMB, the European Medicine’s Agency (EMA) and the Food and Drug Administration (FDA). The American regulator FDA slapped a black-box warning on all antidepressants, informing consumers of the increased risk of suicide. The EMA followed suit requiring labelling changes to all antidepressants, again informing consumers of the increased risk of drug-induced suicidality. The IMB is pretty limited in its capacity of protector of Irish citizens, deferring largely to the EMA. Interestingly, the IMB is almost fully funded by the pharmaceutical industry, so the public protector is funded by the very industry that it is supposed to be protecting the Irish people from. It should be noted that peter gøtzsche of the Nordic Cochrane Centre in Copenhagen recently stated that the IMB banned GlaxoSmithKline from claiming that Paroxetine (Seroxat/Paxil) corrects a chemical imbalance. That depression is caused by a ‘chemical imbalance’ is a pharma invention used as a tool to sell antidepressant drugs. That the IMB made an executive decision and actually suppressed GSK or any other pharmaceutical company is the exception rather than the rule.
We don’t have to look too far to see Governmental and pharma influence within the medical industry. The ‘Sherif Sultan Saga’ is a prime example of the bullying and intimidation of a medical professional. Mr Sultan is a consultant in Galway who received an official warning and a gag order from the HSE for speaking out on the dangers of taking statin drugs. This followed the publication of his paper ‘The ugly side of Statins’. Mr Sultan said what David Healy has been saying for a long time, that he and his colleagues “are fed up with trial of organizations to cover up truth about the ugly side of statin because of invested interest and commercial sponsorship.” He also stated that “We are observing the revealing of the ‘utmost medical tragedy’ of all times. It is extraordinary that the healthcare industry has inadvertently induced life-threatening nutrient deficiency in millions of otherwise healthy people.”
Similar to the attempt at suppressing Sherif Sultan, the psychiatric Professors Patricia Casey, University College Dublin, and Ted Dinan, University College Cork, involved themselves not only in my son’s inquest but also with others where antidepressants were implicated. Both had long links to the same pharmaceutical companies who manufactured the implicated drug and both without exception defended the drugs, instead blaming the supposed underlying ‘illnesses’. Both these professors are supposed experts in the psychiatric field and both fiercely defend antidepressants. It is submitted that the objectivity of the expert opinion is paramount, particularly where the law is concerned. As the coronial system is the only Court of law where a deceased’s family can get answers, in cases of drug-induced death, bias or even a perception of bias should automatically render these ‘experts’ excluded from the legal process.
The health of the Irish nation will never be of utmost importance while our medical professionals, the IMB and the Irish Government have a vested interest in upholding the existing ‘pharma funded’ regime. While it seems my son was just a number in the collateral damage of the latter – I urge you to protect your family, start asking questions and stop trusting these dubious so-called professionals.
The meeting was chaired by MP Jim Dobbins who has previously aired concerns about the pharmaceutical industry and its close involvement within academia, such as the case with Professor David Nuttcase Nutt here. I don’t really have an issue with Professsor Nutt, other than with his false declaration to the Nation (on BBC radio) that ‘it’s impossible to kill yourself with an overdose of SSRI antidepressants‘. Dr Ciara Kelly said the same thing here on Irish radio. Very dangerous propaganda!
Anyway, I’m rambling off the point again this morning. Suffice to say, as is usual, our trip did not always go as planned. We decided, as we were going to London for this talk, to bring the kids with us and maybe go to Legoland the following day. We had plenty of time as the flight was an early one and the talk wasn’t on until 2pm in Westminster. The Ryanair plane sounded decidedly dodgy, as if it was running on dirty fuel (haha, Tony will tell you I have a good mechanical ear) and unsurprisingly the pilot decided that we would have to change planes. This left us two hours behind schedule so the pressure was on, the kids were happily oblivious but the odds at arriving on time were stacked against us. In stepped my brother-in-law in his superman underpants in order to save the day and meet us in London Bridge. He took the kids to my sisters in Kent (where we were staying with 3 cousins, all girls and under the age of 3). This left us plenty of time to head to Westminster for the talk. Back on track.
There was nothing I could do about the frizzy hair at that stage but I thought I’d better change out of the tracksuit bottoms. I decided I would have to change into my ‘Westminster’ clothes in the toilet on the train. Yep, that sounds like a good idea you think? Thanks, I thought so too. The toilet doors were of the circular kind which we have here in Ireland too. There was a nice man sitting outside the toilet when I went in, who smiled at me and said hello; the English are so polite aren’t they? So I took the boots and tracksuit bottoms off and was standing in my underwear (thank God for small mercies) when the train jolted and I leaned backwards, for balance you understand. I leaned on the open-door button, which promptly left me standing in my knickers exposing myself to the poor man sitting outside. Frantic pressing on the buttons failed to close the doors for a lifetime of seconds, until the doors finally closed on the man’s shocked expression. I debated whether I could stay in the toilets until the man either got off or died from old age, whichever came first, but eventually braved the situation and departed from the toilet where I grinned at him in a stupid fashion. He couldn’t look me in the face and glanced quickly out the window. Oh well, nobody was arrested and Tony’s well used to my little accidents/incidences.
So having laughed our heads off all the way to Westminster, we finally made it with a half an hour to spare. After the talk was over, we retired to another room where a question and answer session took place. Jim Dobbins actually voiced what we all knew all along, that the pharmaceutical industry has the Government over a barrel and if the Govt were to sanction ‘industry’, they would threaten to take their business elsewhere, hence GSK et al having control in the UK. This is no doubt the case in Ireland where industries influence is palpable everywhere. If pharma can have such a huge influence over the UK Government, what chance do we have over here in our small country with a population of 4.5 million citizens and with a proven history of unscrupulously corrupt Ministers? You would have to wonder why Kathleen Lynch and James Reilly have done nothing about SSRI-induced deaths.
David Healy’s talk was brilliant as always. We also had the pleasure of meeting the lovely Brian of AntiDepAware and his equally gorgeous wife. We met with Bobby Fidd which is always a pleasure but who missed the chat afterwards having commandeered my poor husband to go outside for a smoke, and who subsequently both got lost.
The 3 gorgeous girlies under the age of 3 were hilarious, funny and little dotes. I don’t know how any household survives them, but I actually miss them already!
PS. The LegoLand experience was amazing and went without any major incident thankfully. All children accounted for, happy and alive, which is more than I can say for my eldest son’s involvement with Lundbeck pharmaceuticals and some uninformed Irish doctors.
Bob Fiddaman’s account of the meeting can be read here, while Brian’s can be read here.
It seems to me that our Irish Courts rely far to much on psychiatric ‘expert’ advise. What am I on about today, you might ask?
In a 2004 paper entitled ‘Expert Witness Perceptions of Bias in Experts’, Michael Commons et al had this to say:
“There are many ideal qualities for expert witnesses. The objectivity of the expert witness, in psychiatry or elsewhere, is one of the more valued qualities that an expert hopes to bring to the legal system, despite the latter’s necessarily partisan adversarial structure. Despite this ideal, dealing with bias constitutes one of the central challenges for expert witnesses in the legal system.”
I have never made any apologies for my caustic opinion of Irish Psychiatry (collectively) and I’m not about to now. Not just Patricia Casey and Ted Dinan but Irish psychiatry as a whole are like a pack of wolves cards ready to come tumbling down, drowning in their own chemically imbalanced pool of serotonin. They operate under the guise of helping people, and yet after my son died, while we were flailing about looking for answers, they went on the defensive and repeatedly kicked us when we were down. Protecting their medical model while bullying the living and discrediting the dead is not only unethical but inhumanity at its worst. Attending victims’ inquests as ‘independent’ experts while taking payment from the drug companies at issue is biased in the extreme.
The only reason that psychiatry Ireland were represented at my son’s inquest (by Patricia Casey who also had links to Lundbeck) was because I publicly stated that Lundbecks’ Cipramil/Celexa was the catalyst for my son’s death. What amazes me is that the Irish College of Psychiatry have ‘charity’ status here. I would have thought that being charitable would be an essential requisite for setting up a charity. Obviously not!
Getting back to my original point; After my son’s inquest the college released a statement here. Along with the implied message that Professor Healy’s testimony was fabricated, they further stated that “Antidepressants are effective in the treatment of depression and thus lead to a reduction in suicidal thoughts. The effective treatment of depression is an important means of reducing suicide rates.” Now you see, therein lies the problem. In Kinsella v Rafferty  IEHC 529, (Full Case here), the Court listened to two psychiatrists. It found on the evidence of Dr. Lane that in the case of antidepressant medication, in at least 50% of cases, perhaps up to 70%, no improvement resulted and there was no return to normal functioning. Dr. Tobin, whilst disagreeing with the higher figure of 70% as being too pessimistic, nonetheless agreed that in cases of severe anxiety disorder, the failure rate in treatment was of the order of 50%.
Put your faith in the hands of the Irish College of Phishy Psychiatry, at your own risk. Have I been clear enough on my opinion?
By the way, I did invite Patricia Casey and Ted Dinan to our Wicklow talk but neither replied!
I have always said that I never get angry, but I think I may have to revise that statement. You’d think by the following conversation, that I had lost my purse or something equally trivial, but hey, what’s a son to Lundbeck pharmaceuticals?
Sept 20 2013
RE; My son’s death (Shane Clancy)
To whom it concerns,
It has come to my attention that the CIOMS report which I have received for my son’s death is unfactual. The box marked ‘did event reappear after reintroduction’, is inexplicably blank. As you can see from my son’s medical records which I have attached for your attention, there is clearly a challenge, dechallenge and rechallenge period. The significance of my son’s suicide attempt shortly after his consumption of Citalopram and his completed suicide shortly after rechallenge surely did not go unnoticed by your pharmacovigilance department?
As this seems to be an oversight on Lundbeck’s part, can you rectify this important issue and get back to me and the Irish Medicines Board with another assessment. As I’m sure that deceased children are of huge importance to Lundbeck, this matter is surely one of utmost importance in order to prevent future fatalities.
Reply Sept 25 2013
Dear Ms Fennell,
I refer to your query below concerning the CIOMS report for your son’s case. The CIOMS form was completed in compliance with pharmacovigilance legislation which requires a revision of the form on the receipt of relevant new information. There is no requirement for a revision of the CIOMS form, as the case is considered up-to-date by the Irish Medicines Board.