cipramil (celexa) stories,, lundbeck, psychiatry, Shanes story.

The 3 musketeers? Lundbeck, the Irish College of Psychiatry and the Irish Medical Council.

The 3 MusketeersAll for one and one for all?

Now I know a lot of you may think I’m a little delusional or at the very least a slightly emotional, conspiracy theorist. Some of you may think (or not) that that’s understandable, albeit a tad hard to believe. Some may just think that I’m not the full shilling, I understand that and accept it. Either way, bear with me if you will.

I have made no secret of the fact that I thought Professor Patricia Casey and the Irish College of Psychiatry’s involvement in Shane’s inquest was, how do I put this; a little strange! I also made no secret that I found it ‘strange’ that the Irish College of Psychiatry would choose to send someone with a long history of working for lundbeck (the drug company who invented Citalopram), to my son’s inquest. Considering Citalopram is the drug I blame for Shane’s death, I wondered whether she was representing psychiatry Ireland or lundbeck that day?

Still bearing with me?

In 2010 I sent off a ‘Freedom Of Information’ request to Lundbeck which I happened to be going through this week. Most of it was newspaper clippings from the various media outlets in Ireland and a few e-mails with a lot of redaction. I came across one e-mail which I had somehow missed before. It’s an internal e-mail to members of the Irish College of Psychiatry, from the College President Justin Brophy, referring to their decision not to address the antidepressant ‘issue’ raised by the ‘Shane Clancy Affair’.

Well here’s the conspiracy theorist bit;

Why did Lundbeck have access to private ‘internal’ e-mails sent by Justin Brophy to members of the Irish College of Psychiatrists? Who forwarded this ‘internal’ e-mail to a pharmaceutical company implicated in my son’s death? There’s quite a few members of Irish Psychiatry who have financial ties to Lundbeck; does that surprise you? Me a conspiracy theorist?

The Irish Medical Council is a public body set up by statute. Section 38 of the ‘Medical Practitioners Act’ 1978, provides:“The Council shall from time to time determine, in relation to each specialty recognised by it, the body or bodies which the Council shall recognise in the State for the purpose of granting evidence of satisfactory completion of specialist training.”The Medical Council currently approves the Irish College of Psychiatry for the purpose of granting ‘evidence of satisfactory completion’ of psychiatric training. In August 2010, we made a complaint to the Irish Medical Council regarding the care, or lack thereof, that Shane received in his last few weeks. Similarly, the Medical Council also asked an expert with financial ties to Lundbeck (PJ Cowen), to compile an expert ‘independent’ report on my son’s case. So is it possible that the dubious relationship between Lundbeck and the Irish College of psychiatry, if not addressed, could lead the Medical Council, as a public body, open to a ‘perception of bias’? Or maybe it’s just a case of the old boy’s network, and the families of the victims are never invited? Well, you’ll have to make up your own mind, mine’s firmly made up!

E-mail below….

.

Lundbeck Irish College of Psychiatry_0002

Lundbeck Irish College of Psychiatry_0001https://leoniefennell.wordpress.com/2011/07/27/our-complaint-to-the-irish-medical-council-and-their-decision/

https://leoniefennell.wordpress.com/2011/04/20/professor-patricia-casey/

http://www.irishstatutebook.ie/2007/en/act/pub/0025/print.html

Newspaper and internet articles, psychiatry

Medical Council Bias?

Doctor challenged Medical Council

September 14, 2012


An Irish Medical Times Article; Link.

So no surprises here then. The High Court quashes a decision of the Irish Medical Council’s ‘Fitness to Practise Committee’. Why? The Committee decided to ignore it’s own expert’s opinion and instead go with the opinion of Professor Patricia Casey. Now that doesn’t sound too bad does it? Except Professor Casey was the one who made the complaint against this doctor in the first place. As far as I remember, she was also involved on the night this man died by suicide but was in bed when asked for advice (which she gave).

Having had previous experience with the Medical Council and Prof Casey after my son’s death, I feel I’m perfectly entitled to comment. You may find it interesting that Prof Casey writes for the Irish Independent and that the ‘Independent’ Article referring to this Case doesn’t mention Prof Casey or the reason for the High Court decision. Maybe just a blip! Here.

A person would have to wonder if all Medical Council decisions should now be reviewed. Or do all of us, who went to the trouble of making a complaint, have to take the Medical Council decisions to the High Court in order to get Justice?

Article…

Ed Madden, BL, looks at a recent High Court case in which a doctor claimed that the Fitness to Practise Committee of the Medical Council had failed to comply with standards of natural and constitutional justice when it reached a decision that he was guilty of professional misconduct.

On the evening of April 12, 2008, an African national attempted suicide by throwing himself into the river Liffey. The following morning, he was admitted to the St Aloysius Ward of the Mater Hospital in Dublin by Dr Samuel McManus, who was then a Senior House Officer in Psychiatry. During the afternoon, the patient again attempted suicide — on this occasion by hanging himself by his shoelaces from a shower rail.  While the attempt was interrupted, he never regained consciousness and died on April 28, 2008.

Prior to the suicide attempt at the hospital, Dr McManus made various clinical notes, including notes which stated: ‘… current suicidal ideation. IMP. High suicide risk… ’

Later that day, after the suicide attempt, he altered the notes with a pen using different ink in a clearly visible manner, so that they then read:

‘Denies current suicidal ideation… IMP. High suicide risk attempt.’

When this alteration to the medical records became known, Dr McManus was the subject of a complaint to the Medical Council (the Council) by Consultant Psychiatrist Prof Patricia Casey. In due course, a number of allegations of professional misconduct were made against the doctor by the Council relating to the changed notes.

Dr McManus was invited to attend a Fitness to Practise Committee Inquiry, which was scheduled to take place on October 8, 2010. He was advised of the names of the witnesses as to fact that would be called at the inquiry. These included Dr Casey, a Dr Jabber and Nurse Fowler. He was also advised that Dr Siobhán Barry, a psychiatrist, would be called as an expert witness on the matters in issue.

‘Retrospective additions’

At the hearing before the Fitness to Practise Committee (the Committee), Dr McManus admitted that he had made ‘retrospective additions and/or amendments’ to the patient’s medical records which he knew, or ought to have known, were ‘inappropriate in the circumstances’. However, he denied that this constituted misconduct.

At the conclusion of the Inquiry, the Committee found him guilty of professional misconduct. In so doing, they implicitly rejected the views of Dr Barry, whose testimony was to a significant extent exculpatory of Dr McManus, insofar as his reasons for making the alterations to the notes were concerned. The Committee also rejected the advice of its own legal assessor in the case.

For her part, Dr Barry gave evidence to the Committee in line with her written report, which had been circulated to Dr McManus’s legal advisers in advance of the Inquiry. Her view was that retrospective notes were not uncommon. A number of changes made to the notes in this case “had made no material difference”. Overall, in her view, there was very little change in the meaning of the records because they were a very small part of a much bigger history. She did, however, expect that an alteration of this kind in the notes would be timed and dated (which it was not).

Committee report

In its report to the Medical Council, the Committee recommended a sanction of ‘admonishment’ in respect of Dr McManus. However, the Council subsequently substituted that with a sanction of ‘advice’.  Because the particular sanction fell short of the imposition of conditions, or the suspension or erasure of the doctor’s name from the Register, Dr McManus did not enjoy a statutory right of appeal to the High Court. Instead, he brought Judicial Review proceedings, in which he contended that the Committee had failed to comply with basic standards of natural and constitutional justice.

When the matter came on for hearing in the High Court in August 2012, it was submitted on behalf of Dr McManus that the Committee had given inadequate reasons for its failure to rely on the evidence of Dr Barry and for its failure to follow the advice of its own legal assessor. It was also submitted that the finding of misconduct was irrational and ought not to be allowed to stand.

Giving his judgment in the case, Mr Justice Kearns said there was no obligation on the Committee to give detailed reasons or a discursive judgment as to why it decided not to accept the views offered by the legal assessor in the present case. Those views “were directed almost entirely to the weight of the evidence, which was, peculiarly, a matter for the Committee itself to determine”.

The judge was also satisfied that there was “adequate evidential material” before the Committee to enable it to reach the particular conclusions which it did reach. Having regard to “the relatively mild sanction imposed in the case”, it was difficult to see how that sanction was disproportionate, particularly in circumstances where the facts of the case were admitted by the doctor and the inappropriateness of amending or altering the notes was also admitted.

The judge said that “the keeping of accurate medical records was a matter of such basic importance to the discharge of the functions of any medical practitioner” that expert evidence on the topic would not have been required at the Inquiry. The importance of such records was “self evident”. They constitute a vital safeguard for both medical practitioners and patients alike.

The judge said, however, that the decision of the Committee in the present case was to call an expert witness, Dr Barry. He said that: “It was hardly fair or appropriate to reject or ignore the views of its own expert and elevate to that status for the purpose of its decision the evidence offered by Prof Casey.”

The judge continued: “Whatever her qualifications and experience, Prof Casey was the complainant in the case and it had never been intimated that the Committee would regard her as anything other than a witness as to fact. The cross-examination of Prof Casey was predicated on the assumption that Dr Barry would be giving the material expert evidence on misconduct.”

It was contended on behalf of Dr McManus that different decisions as to the strategy and conduct of the defence might have been made, had it been appreciated that the Committee “would switch from the opinion of its own expert and substitute in its place the view of a witness as to fact who was also the complainant”. It was submitted that at the very least, Dr McManus should have been given due warning of any such intention so as to permit an effective cross-examination to take place.

‘Utmost gravity’

The judge said that the hearing before the Committee “was a matter of the utmost gravity” to Dr McManus, who “hitherto had an unblemished record”. The imposition of any finding of professional misconduct or sanction could be justified only in circumstances where the Committee ensured that all the requirements of fair procedures were scrupulously followed.

One of these requirements was the right of Dr McManus to cross-examine by counsel. That right of cross-examination must “be free and unrestricted and not one undertaken under a mistaken assumption created by the tribunal and for which [Dr McManus] is in no way responsible”.

In the present case, while he was satisfied that Dr McManus, in altering the medical notes, “did something wrong (and for which he accepts responsibility)”, he might also have been “disadvantaged to an appreciable degree” by the procedures adopted by the Committee.

In these circumstances, the decisions arrived at by the Committee and the Council would be quashed by the Court.

Reference: 2012 IEHC 350

lundbeck, Our story., psychiatry, Shanes story.

The Medical Council of Ireland and Prof Cowen of Oxford University

I wrote a while back about our complaint to the ‘Medical Council of Ireland’ and their decision here. The MCIRL’s website state that their purpose is “to protect the public by promoting and better ensuring high standards of professional conduct and professional education, training and competence among doctors.

As I said before, they had a copy of Professor Healy’s Report which I had sent to them. They said they needed an ‘independent’ expert to do a report as the MCIRL did not have ‘sufficient expertise’ in the area regarding Shane’s case. They asked Professor P. J Cowen of Oxford University for this independent report. They refused to furnish me with a copy. Following a Freedom of Information request coupled with permission from Prof Cowen, they finally sent me this other report.

I had voiced my concerns whether Prof. Cowen was capable of doing an ‘independent’ report considering he (among others who involved themselves in Shane’s case) is involved with Lundbeck, the makers of the said drug/poison Citalopram. Surprisingly (maybe I owe him an apology) after corresponding with Prof. Cowen, he has admitted some interesting points:

(i) “I do think it’s possible that in some circumstances SSRIs can lead to people behaving violently to themselves and others. It seems that the risk is apparent early in the course of treatment, particularly in younger people, and that’s why the NICE guidelines stress the importance of careful follow-up early in the antidepressant treatment of young, at risk patients. From this point of view Shane should have had weekly follow-up after the start of SSRI treatment.”

(ii) Could Citalopram have contributed to or caused Shane to commit suicide and homicide? “It’s certainly possible. Leonie. What I was trying to say is that the judgement has to be made on an individual basis in the light of all the facts, and I know very little about what happened after the appointment with Dr Coetzee.  However, it looks as though David Healy has looked carefully at the circumstances for the inquest and he is an expert at these kinds of assessments.”

So, the MCIRL’s own expert agrees that these drugs can cause a person to become suicidal and homicidal but admits he didn’t have enough facts to deal with the case, and yet they thought that they were sufficiently protecting the public from this happening again…how? Professor Cowen also acknowledged that Prof Healy was more qualified to assess Shane’s case and the MCIRL still chose to do nothing, why?

Professor Healy stated that these drugs DOUBLE the risk of suicide and Double the risk for aggressive acts. He covers these points and more in much detail on his blog here. What warnings will be given to future consumers of antidepressants by the MCIRL? Maybe if every doctor had access to Prof. Healy’s “Antidepressants for Prescribers” here and listed side-effects of all medications here, the world would be a much safer place.

Doctors and Psychiatrists, while defending antidepressants, will sometimes use this old trick as seen on the MadinAmerica website here: “Do you want to be responsible for a suicide because a person didn’t get treatment?

Do YOU feel responsible Doctor, when a person dies by suicide CAUSED by the drug? These drugs double the risk of Suicide and aggression!!

cipramil (celexa) stories,, Newspaper and internet articles, Our story., psychiatry

Medical Council Letter

I have a funny feeling that I’m wasting my breath here. Will I be ignored? Probably! The President of the Medical Council is a member of the Irish College of Psychiatry. As I’ve said before, the Irish College involved themselves before, during and after Shane’s Inquest. The College have collectively made their opinion clear here.

Ref: D108/10

To whom it concerns,

Thank you for the Freedom of Information documents. Having now received access to Professor Cowen’s report, I have some queries regarding the decision of the Medical Council that there was ‘not sufficient cause’ to take my complaint further.

Professor Cowen states in his report that he ‘did not have experience of what would be regarded as the appropriate standard of practice for General Practitioners’ but this was considered sufficient for the Medical Council? Roslyn Whelan advised Professor Cowen that his opinion was being sought regarding his expertise in Psychopharmacology. I find it astonishing, that when I corresponded with Professor cowen, he answered questions regarding SSRI’s and Citalopram in particular that you never thought to ask.

When asked by me if the drug could have caused the events of Aug 09, he answered: “I do think it’s possible that in some circumstances SSRIs can lead to people behaving violently to themselves and others. It seems that the risk is apparent early in the course of treatment, particularly in younger people, and that’s why the NICE guidelines stress the importance of careful follow-up early in the antidepressant treatment of young, at risk patients. From this point of view Shane should have had weekly follow-up after the start of SSRI treatment.”

He further opined on the question of whether Citalopram could have contributed to or caused Shane to commit suicide and homicide? “It’s certainly possible. Leonie. What I was trying to say is that the judgment has to be made on an individual basis in the light of all the facts, and I know very little about what happened after the appointment with Dr Coetzee. However, it looks as though David Healy has looked carefully at the circumstances for the inquest and he is an expert at these kinds of assessments.”

So the Irish Medical Council’s own expert admits that these drugs can cause suicide and homicide and you didn’t have ‘sufficient cause’ to investigate further? He further admits that he didn’t have enough facts to deal with this case but acknowledged that Professor Healy did and that he is the expert in this area. The IMC had both reports so how did you come to the conclusion that there was ‘not sufficient cause’ to take further action?

Your purpose is to protect the public from the same circumstances recurring; could you tell me how you are protecting the public from another drug-induced incident, namely suicide and/or homicide?

Regards,

Leonie Fennell

cipramil (celexa) stories,, Newspaper and internet articles, Our story.

IHRC Recommendations on SSRI Prescribing

IHRC (Irish Human Rights Commission)

Finally somebody is asking for changes in the way that SSRI’s are being prescribed by medical professionals in Ireland.

I wrote many letters and e-mails in the last 2 years regarding the care (or lack thereof) that Shane received from the medical professionals in the last month of his existence. I wrote e-mails and letters to, among others, the EMA, FDA, IMB, Lundbeck, Brian Cowan, Kathleen Lynch, Bertie Ahern, James Rielly, Dick Roche, Jan O’Sullivan, Liz McManus (before I found out she was previously married to John Mc’Manus, the GP in Bray who prescribed Shane a months supply of Cipramil), Barack Obama (always an optimist), the college of Psychiatry of Ireland and Mary McAleese.

Most of the replies I received were the usual apologetic but automated response apart from the IHRC.

After reviewing Shane’s medical records, Citalopram PIL’s, Professor Healy’s report, the statements from the doctors, my correspondence with the Irish Medical Council and their subsequent decision, the IHRC have decided to take some action…

The IHRC have written to the Medical Council requesting that, among other things, patients are informed of the potential side effect of suicide ideation with SSRI’s and for closer monitoring and ongoing supervision when SSRI’s are initially prescribed.

.

Recommended IHRC Guidelines:

(i)

Discussion of alternate therapies

(ii)

Referrals for counselling/psychiatric review

(iii)

Within medical practices seek to ensure the same doctor deals with the person at all stages if at all possible;

(iv) 

Oral explanation of risks/side-effects of SSRI’s in advance of prescription, together with relevant written information;

(v)

Guidelines regarding prescribing SSRI’s from initial stage through ongoing treatment;

(vi)

Level of monitoring and ongoing supervision required when SSRI’s are initially prescribed

(vii)  

Maintenance of adequate consultation notes; and

(viii)  

The necessity to obtain a full patient history before prescribing SSRI’s

Though quite why the Medical Council have not done this already is beyond my comprehension! Then again, considering that the IMC see no harm in doctors prescribing a months supply of potentially lethal medication to a depressed person, would seem to show their level of understanding/misunderstanding of the dangers of these drugs.

The Irish Medical Council is a statutory body set up by the state; On their website it states “Our statutory role, as outlined in the Medical Practitioners Act 2007, is to protect the public by promoting and better ensuring high standards of professional conduct and professional education, training and competence among registered medical practitioners”.

Protect the public?

By allowing doctors to prescribe a months supply of potentially lethal SSRI’s with known suicidal side-effects to a first time patient; How are they protecting the next poor vulnerable patient who gets a months prescription of SSRI’s from their GP?

Whether the IMC will implement these changes remains to be seen, but the next time that some other unfortunate family raises this issue, the IMC won’t be getting off quite so lightly, as there will be a record of the IHRC’s letter recommending that changes are introduced.

“A medical practitioner who establishes that he followed a practice which was general and approved by his colleagues of similar specialisation and skill is nevertheless negligent if the plaintiff thereupon establishes that such practice has inherent defects which ought to be obvious to any person giving the matter due consideration” (Dunne (an inf.) v. National Maternity Hospital [1989] IR 91.)

https://leoniefennell.wordpress.com/2011/10/22/medical-negligence-in-ireland/

https://leoniefennell.wordpress.com/2011/10/10/update-on-our-complaint-to-the-irish-medical-council/

Random

Update on our complaint to the Irish Medical Council.

Our complaint to the Irish Medical Council and their decision.

In August 2010 we made a complaint to the Irish Medical council (IMC) about Shane’s treatment from the Doctors he saw in his last 17 days. 

The basis of our complaint was “Why were these doctors not aware that when a person starts an antidepressant, there is a markedly increased risk of suicide ideation and also that there is a certain percentage of people who can react violently and deadly to this medication?”. We wanted to know, considering the above, why was Shane allowed to get a prescription for a months supply of this drug and if this is common policy, then surely this practise should be revised.

We were very aware that antidepressants caused this horrific event in our lives and that of another family and we had a report from a medical expert (Prof. Healy) who testified to this, so we were particularly concerned that if this practise is not changed, the potential is always there for another family tragedy.

The first step in a complaint to the Irish Medical Council is a meeting to decide if the complaint will go further and if the Doctors in question will or wont have anything to answer for. This meeting has been put off twice now, the last time because the IMC needed a report from an independent third party. I asked if they were aware that professor David Healy had written an extensive report for Shane’s inquest and insisted on forwarding the same to the IMC. They said they were awaiting a report from a Professor Philip Cowen from Oxford University, so naturally enough the first thing I did was Google this professor along with the name Lundbeck. I discovered that Conflict of interest is clearly an issue here and I e-mailed the IMC to notify them of my concerns…

 May 16 2011

Hi Roslyn,
I trust you received Professor Healy’s report?
I did a quick google search of Professor Cowen and I would have thought, under the circumstances of my son’s death and the fact that lundbeck are the makers of citalopram, the engagement of this professor would surely be a “conflict of interest” but I’m sure you know better than I how to go about investigating these matters!
I would like to be kept informed, if you do go with this professor or indeed any other expert the medical council decide on.
Yours Sincerely,
Leonie Fennell

I also attached this to the bottom of my e-mail…

Philip J. Cowen, MD, FRCPsych
University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Email: phil.cowen@psych.ox.ac.uk
Declaration of interest
P.J.C. has been a paid member of boards that have advised different drug companies on the development of antidepressant drugs. In the past 3 years these companies have included Eli Lilly, Lundbeck and Servier. P.J.C. has also received remuneration for scientific advice given to legal representatives of GlaxoSmithKline.
Link… http://bjp.rcpsych.org/cgi/content/abstract/198/5/333

19/07/2011

The Medical Council meeting is scheduled for July 21th but I think I already suspect what the outcome will be, considering P.J. Cowens afilliation with Lundbeck, is it  possible for him to give an independent unbiased opinion? Why would anyone who gets paid by a company, subsequently acknowledge that these drugs have the potential to drive a person to commit acts of “self harm and harm to others”, a fact already acknowledged by Lundbeck but denied by the very same company on Irish T.V.

Why would he even be asked by the Irish Medical Council to do a report? How much money are these distinguished Professors receiving from pharmaceutical companies each year, and can you call yourself an independent medical advisor if you are “a paid member of boards that have advised different drug companies on the development of antidepressant drugs”.

Rather than getting myself into trouble again, I’ll let you decide for yourself if Philip J. Cowen was the right man for the job….

2002 study, Citalopram was a gift from Lundbeck. Link.

2002 paper, Declaration of interest. PJC has advised Lundbeck, Eli Lilly and Servier in the last 2 years. Link.

2007 paper. Declaration of interest. P.J.C. has served as a paid member of advisory boards for Eli Lilly, Lundbeck, Servier and Wyeth. Link.

2009, BJPsych declaration of interest. P.J.C. has been a member of advisory boards of pharmaceutical companies marketing antidepressants. Link.

2010 Paper. Declaration of interest. PJC has been a paid member of advisory boards of Diagnostic and Statistical Manual of Mental Disorders, Eli Lilly, Servier, Wyeth, and Xytis and has been a paid lecturer for Eli Lilly, Servier, and GlaxoSmithKline. He has received remuneration for scientific advice given to legal representatives of GlaxoSmithKline. Link.

Feb 2010. PJC was a speaker at the Royal College of Psychiatrists Annual meeting sponsored by Lundbeck and Bristol-Myers Squibb. Link.

BJPsych 2011. Declaration of interest P.J.C. has been a paid member of boards that have advised different drug companies on the development of antidepressant drugs. In the past 3 years these companies have included Eli Lilly,Lundbeck and Servier. P.J.C. has also received remuneration for scientific advice given to legal representatives of GlaxoSmithKline. Link.

April 2011. PJC was a speaker at the Athens Lundbeck Symposium. Link.

Updated, 20/07/2011.

I have just found out that the head of the Irish Medical Council is Prof. Kieran Murphy, a psychiatrist. He is also on the Board of the Irish College of Psychiatrists. The Irish College of psychiatry have been very verbal in their opinion since Shane’s Inquest and have been very outspoken in their denial that antidepressants can cause either suicide or homicide. They also dismissed Professor Healy’s report as “based on speculation”. Two examples of their opinion..Here and Here. I find it ironic that the Irish College of psychiatry can say this report is based on speculation when their whole profession is based upon the same.

Considering this information, have the Irish Medical Council already made up their minds as to the outcome of our complaint?

In my opinion, the flagrant and multiple conflict of interest here is a disgrace and if we had any chance of getting a fair and unbiased hearing, our complaint should not have been dealt with by either professors (Cowen or Murphy).

 

Random Facts…

The Medical Council Members were appointed by Minister Mary Harney who incidentally opened the new Dublin Offices of Lundbeck. Another random (or not) thought…Dr. Mc’Manus is the guy that I have a major issue with, because he gave Shane a months supply of Citalopram, despite the fact that according to his medical records, Shane admitted to having suicidal thoughts. Dr.Mc’Manus was married to Liz Mc’Manus who was the deputy leader of the Labour Party and party Spokesperson for health from 2002–07 (now retired). He is also reported to be one of the top earners in North Wicklow. In 2005, he earned €438,245 in medical card fees alone. Link.

Another random (or not) political fact, She who must not be named, also from the college of psychiatry of Ireland, who was at Shane’s Inquest and has had “issues” with the verdict since she voiced her opinion on RTE afterwards, is reported by the Irish Independent to be instrumental in the nomination of Mary McAleese for president.

A few days after a visit to Knock, Mary (McAleese) phoned Patricia Casey, with whom she had become friendly after their appearance on The Late Late Show. Casey was prepared to  use her considerable influence on Mary’s behalf. The Cork-born psychiatrist was well-placed to exert some influence on the Fianna Fail organisation. Patricia Casey contacted the Wicklow TD, Dick Roche, for whom she had canvassed in the previous election. Link.

Why, you might ask, am I going in this direction? Mary McAleese is the patron of “the Irish Association of suicidology” and when I wrote to her asking for an investigation into these drugs, she replied that she was “prevented from intervening in matters which are the responsibility of the government”.

 

Update,  22/07/2011

Sent the IMC an e-mail to see what the outcome was yesterday…No response.

Update 27/07/2011

Decision.

Update 10/10/2011

The Irish Medical Council decided not to give me a copy of Professor Cowen’s report, now there’s a surprise! Wonder why? They had a copy of Professor Healy’s report that said, in his opinion Lundbeck’s Citalopram had made Shane suicidal and homicidal and they had Professor Cowen’s report which said what?? Considering the dire possible consequences to other consumers of ssri’s and the medical council’s job to protect people from dangerous medical situations, Professor Cowen’s report must have been very convincing. His expertise must have been superior to Professor Healy’s. His links to Lundbeck are easy to find on the Internet but his expert ssri qualifications are not!

 The second letter states that the Irish Medical Council are not taking my complaint any further because there is insufficient cause to warrant further action.  So the medical council’s job is to protect people from harm and they think it’s o.k for medical professionals to hand out a months supply of potentially fatal medication with known risks of suicide ideation, to already vulnerable patients? In my opinion, the Medical Council didn’t do it’s job!

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles, psychiatry, Random, Shanes story.

Our complaint to the Irish Medical Council and their decision.

In August 2010 we made a complaint to the Irish Medical council (IMC) about Shane’s treatment from the Doctors he saw in his last 17 days. 

The basis of our complaint was “Why were these doctors not aware that when a person starts an antidepressant, there is a markedly increased risk of suicide ideation and also that there is a certain percentage of people who can react violently and deadly to this medication?”. We wanted to know, considering the above, why was Shane allowed to get a prescription for a months supply of this drug and if this is common policy, then surely this practise should be revised.

We were very aware that antidepressants caused this horrific event in our lives and that of another family and we had a report from a medical expert (Prof. Healy) who testified to this, so we were particularly concerned that if this practise is not changed, the potential is always there for another family tragedy.

The first step in a complaint to the Irish Medical Council is a meeting to decide if the complaint will go further and if the Doctors in question will or wont have anything to answer for. This meeting has been put off twice now, the last time because the IMC needed a report from an independent third party. I asked if they were aware that professor David Healy had written an extensive report for Shane’s inquest and insisted on forwarding the same to the IMC. They said they were awaiting a report from a Professor Philip Cowen from Oxford University, so naturally enough the first thing I did was Google this professor along with the name Lundbeck. I discovered that Conflict of interest is clearly an issue here and I e-mailed the IMC to notify them of my concerns…

 May 16 2011

Hi Roslyn,
I trust you received Professor Healy’s report?
I did a quick google search of Professor Cowen and I would have thought, under the circumstances of my son’s death and the fact that lundbeck are the makers of citalopram, the engagement of this professor would surely be a “conflict of interest” but I’m sure you know better than I how to go about investigating these matters!
I would like to be kept informed, if you do go with this professor or indeed any other expert the medical council decide on.
Yours Sincerely,
Leonie Fennell

I also attached this to the bottom of my e-mail…

Philip J. Cowen, MD, FRCPsych
University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Email: phil.cowen@psych.ox.ac.uk
Declaration of interest
P.J.C. has been a paid member of boards that have advised different drug companies on the development of antidepressant drugs. In the past 3 years these companies have included Eli Lilly, Lundbeck and Servier. P.J.C. has also received remuneration for scientific advice given to legal representatives of GlaxoSmithKline.
Link… http://bjp.rcpsych.org/cgi/content/abstract/198/5/333

19/07/2011

The Medical Council meeting is scheduled for July 21th but I think I already suspect what the outcome will be, considering P.J. Cowens afilliation with Lundbeck, is it  possible for him to give an independent unbiased opinion? Why would anyone who gets paid by a company, subsequently acknowledge that these drugs have the potential to drive a person to commit acts of “self harm and harm to others”, a fact already acknowledged by Lundbeck but denied by the very same company on Irish T.V.

Why would he even be asked by the Irish Medical Council to do a report? How much money are these distinguished Professors receiving from pharmaceutical companies each year, and can you call yourself an independent medical advisor if you are “a paid member of boards that have advised different drug companies on the development of antidepressant drugs”.

Rather than getting myself into trouble again, I’ll let you decide for yourself if Philip J. Cowen was the right man for the job….

2002 study, Citalopram was a gift from Lundbeck. Link.

2002 paper, Declaration of interest. PJC has advised Lundbeck, Eli Lilly and Servier in the last 2 years. Link.

2007 paper. Declaration of interest. P.J.C. has served as a paid member of advisory boards for Eli Lilly, Lundbeck, Servier and Wyeth. Link.

2009, BJPsych declaration of interest. P.J.C. has been a member of advisory boards of pharmaceutical companies marketing antidepressants. Link.

2010 Paper. Declaration of interest. PJC has been a paid member of advisory boards of Diagnostic and Statistical Manual of Mental Disorders, Eli Lilly, Servier, Wyeth, and Xytis and has been a paid lecturer for Eli Lilly, Servier, and GlaxoSmithKline. He has received remuneration for scientific advice given to legal representatives of GlaxoSmithKline. Link.

Feb 2010. PJC was a speaker at the Royal College of Psychiatrists Annual meeting sponsored by Lundbeck and Bristol-Myers Squibb. Link.

BJPsych 2011. Declaration of interest P.J.C. has been a paid member of boards that have advised different drug companies on the development of antidepressant drugs. In the past 3 years these companies have included Eli Lilly,Lundbeck and Servier. P.J.C. has also received remuneration for scientific advice given to legal representatives of GlaxoSmithKline. Link.

April 2011. PJC was a speaker at the Athens Lundbeck Symposium. Link.

Updated, 20/07/2011.

I have just found out that the head of the Irish Medical Council is Prof. Kieran Murphy, a psychiatrist. He is also on the Board of the Irish College of Psychiatrists. The Irish College of psychiatry have been very verbal in their opinion since Shane’s Inquest and have been very outspoken in their denial that antidepressants can cause either suicide or homicide. They also dismissed Professor Healy’s report as “based on speculation”. Two examples of their opinion..Here and Here. I find it ironic that the Irish College of psychiatry can say this report is based on speculation when their whole profession is based upon the same.

Considering this information, have the Irish Medical Council already made up their minds as to the outcome of our complaint?

In my opinion, the flagrant and multiple conflict of interest here is a disgrace and if we had any chance of getting a fair and unbiased hearing, our complaint should not have been dealt with by either professors (Cowen or Murphy).

 

Random Facts…

The Medical Council Members were appointed by Minister Mary Harney who incidentally opened the new Dublin Offices of Lundbeck. Another random (or not) thought…Dr. Mc’Manus is the guy that I have a major issue with, because he gave Shane a months supply of Citalopram, despite the fact that according to his medical records, Shane admitted to having suicidal thoughts. Dr.Mc’Manus was married to Liz Mc’Manus who was the deputy leader of the Labour Party and party Spokesperson for health from 2002–07 (now retired). He is also reported to be one of the top earners in North Wicklow. In 2005, he earned €438,245 in medical card fees alone. Link.

Another random (or not) political fact, She who must not be named, also from the college of psychiatry of Ireland, who was at Shane’s Inquest and has had “issues” with the verdict since she voiced her opinion on RTE afterwards, is reported by the Irish Independent to be instrumental in the nomination of Mary McAleese for president.

A few days after a visit to Knock, Mary (McAleese) phoned Patricia Casey, with whom she had become friendly after their appearance on The Late Late Show. Casey was prepared to  use her considerable influence on Mary’s behalf. The Cork-born psychiatrist was well-placed to exert some influence on the Fianna Fail organisation. Patricia Casey contacted the Wicklow TD, Dick Roche, for whom she had canvassed in the previous election. Link.

Why, you might ask, am I going in this direction? Mary McAleese is the patron of “the Irish Association of suicidology” and when I wrote to her asking for an investigation into these drugs, she replied that she was “prevented from intervening in matters which are the responsibility of the government”.

 

Update,  22/07/2011

Sent the IMC an e-mail to see what the outcome was yesterday…No response.

Update 27/07/2011

Decision.

Update 10/10/2011

The Irish Medical Council decided not to give me a copy of Professor Cowen’s report, now there’s a surprise! Wonder why? They had a copy of Professor Healy’s report that said, in his opinion Lundbeck’s Citalopram had made Shane suicidal and homicidal and they had Professor Cowen’s report which said what?? Considering the dire possible consequences to other consumers of ssri’s and the medical council’s job to protect people from dangerous medical situations, Professor Cowen’s report must have been very convincing. His expertise must have been superior to Professor Healy’s. His links to Lundbeck are easy to find on the Internet but his expert ssri qualifications are not!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The second letter states that the Irish Medical Council are not taking my complaint any further because there is insufficient cause to warrant further action.  So the medical council’s job is to protect people from harm and they think it’s o.k for medical professionals to hand out a months supply of potentially fatal medication with known risks of suicide ideation, to already vulnerable patients? In my opinion, the Medical Council didn’t do it’s job!

psychiatry, Shanes story.

My latest e-mail to the Irish Medicines Board.

I have been asked (quite a number of times) why have I not brought all this to the attention of the Irish Medicines Board because they would surely do something about it. I would have thought so too. So for everyone out there who thinks that the i.m.b. is out there to protect the Irish people from dangerous medicines, here’s my latest e-mail…

16/03/2011

F.A.O. Pat O’mahony.

Hello again,

I am sending this e-mail to you despite the fact that I’m not sure you have taken much notice of my previous numerous e-mails. I have been asked…”Are you sure the I.M.B. are aware of all the information out there?” and “surely if they know, they will have to do something about this drug?” So just to pacify everyone, I will do it again!

As you already know I have serious issues with citalopram and what I believe are the very flimsy warnings that are attached to these types of drugs (ssri’s) in the patient information leaflets. The reason I have such issues is very simple, I know my son and what he was capable of, or not capable of in this instance.  I believe that “Failure to warn” is a major flaw on your part considering the facts of the numerous warnings from the E.M.A. and the F.D.A. and of which I have already brought your attention to.

I believe an investigation should be instigated with citalopram but I also realise you don’t have to take my word for it, that’s why I’m drawing your attention to some coroners reports around the world particularly as the coroner at Shane’s inquest reported his findings as “of medical Importance”. As you may be aware the jury at my son’s inquest refused to return “a suicide verdict” and instead chose the only other option open to them…an open verdict.

The jury was obviously strongly influenced by the evidence of Professor David Healy and that of assistant state pathologist Dr Declan Gilsenan, who testified to “toxic” levels of citalopram in my son’s blood. Both doctors also stressed that the high levels of the drug were not necessarily due to an overdose, but could have resulted from a build-up of citalopram resulting from it being slower to metabolise in Shane’s body.

Prof Healy stated categorically that “it is the drug that causes the problem”, at least in susceptible patients who can form a small but significant minority. He added that the higher the dose taken, the greater the likelihood of serious adverse effects and behaviours. In my son’s case, the post mortem had shown levels of citalopram which lay between ‘toxic’ and ‘lethal’.

Professor Healy also stated “My view is that there should be compulsory monitoring of patients in the initial period after starting to take the drug,” he said. He explained that the danger period is generally within the first two weeks and usually within the first days of taking the drug. “As many as 50% of patients prescribed citalopram [the active ingredient in Cipramil and other brands] could find it is the wrong drug for them,” he said. “If they react to it, if there is any kind of oddity, they should go back to their doctor and … have the drug changed.”

There were a few of the usual psychiatrists who tried to refute his claims namely Patricia Casey and Timothy Dinan. Patricia Casey has a long association with lundbeck and Timothy Dinan is also associated with lundbeck and has an advisory position with yourselves. Also very interestingly both psychiatrists took separate actions against Dr.Michael Corry , the latter to the Irish Medical Council against Dr.corry for remarks that he made in association with my son. He said he would stake his reputation on the fact that Shane would not have done what he did if he wasn’t on anti-depressants.

As I have previously referred to, I would like to draw your attention to some coroner’s around the world that have serious issues with citalopram and its close relationship with suicide and homicide.

1. Recommendations of Magistrate Jacqueline M. Milledge Australia… (Senior Deputy State Coroner)

Inquest of Roxanne, Luke, Grace and Michael Richardson.

To the Minister for Health and the Therapeutic Goods Administration:

That the use of Citalopram in the treatment of depression be monitored and further studied to determine its effectiveness in the treatment of depressive illness and to guard against any side effects that may exacerbate a predisposition to violent behaviour.

2. Coroner Dr.Andrew Reid, St Pancras Coroner’s Court. U.K.

Inquest of Ian Fox.

“At his inquest on Thursday, Mr Fox’s wife, Maria Fox, blamed her husband’s sudden death on the drug, and a coroner ruled the ‘adverse effects’ of Citalopram had played a part.

 “Coroner Dr Andrew Reid said he accepted that Mr Fox had jumped in front of the train, adding: ‘I’m satisfied he did so while the balance of his mind was disturbed while suffering the adverse effects of Citalopram.’”

3. Coroner Ian Smith Cumbria, U.K.

Inquest of Nigel Woodburn.

The retired bank manager, of Bardsea Green, south Cumbria, was killed at the wheel of his car on June 16, minutes after confessing to his wife he’d had suicidal thoughts. He had been prescribed Citalopram after becoming depressed through ill health.

Coroner Ian Smith is to write to the committee on the safety of medicines – an independent advisory body – following the inquest into the death of Nigel Woodburn. He said: “I have to say this is probably the fifth, if not sixth inquest I’ve heard within a period of three years when somebody either just going on to Citalopram or Seroxat, or coming off it, have killed themselves one way or another, totally out of the blue, totally without expectation, without a history of suicidal thoughts in the past. “Mr Smith returned a narrative verdict that Mr Woodburn died in a road vehicle collision.

4. Birmingham coroner Aiden Cotter U.K.

Inquest of Yvonne Woodley.

Birmingham coroner Aiden Cotter, called for more research into the drug after experts raised concerns over its side-effects.

 A coroner has ordered an urgent investigation into an anti-depressant after it turned a mother-of-two into a ‘zombie’ before she was found hanged in her attic. Housewife Yvonne Woodley, 42, visited six GPs who increased her dosage of Citalopram in the months before her death.

5. Brecon coroner Geraint Williams.

Inquest of Stephen Leggett.

The FDA warning came too late for Stephen Leggett, according to his family. On March 15, 2004, just five days after he’d taken his first dose of citalopram for stress over work, the 53-year-old Taunton teacher killed himself by dousing himself in petrol and setting himself on fire.

 Brecon coroner Geraint Williams said he was “profoundly disturbed” by the effect the drug had on Mr Whitfield. He took the first dose on Thursday and he killed himself on Monday.”

 In March last year the US Food and Drug Ad- ministration issued a public health alert about a type of antidepressant which it said could lead to deeper depression and even suicide in some people.

 It seems to fit a pattern seen in other deaths linked to this type of drug. CITALOPRAM (marketed by the brand name Cipramil in the UK) belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs).

I have attached Professor Healy’s report for your consideration. (Again)

Looking forward to hearing from you,

Leonie Fennell

Newspaper and internet articles, Random

Who regulates Psychiatry in Ireland?

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Psychiatry In Ireland  are an opinionated  lot. They seemed to have a lot to say about Shane  anyway, but I just wonder can anybody join up? Who regulates psychiatry in Ireland? Here’s a recent article from a New Zealand newspaper:

PRESS.CO.NZ

30/09/2010

A convicted drug smuggler worked as a psychiatrist in Christchurch for more than a year, but the Canterbury District Health Board (CDHB) says there were no concerns over his work.

The board said yesterday it was reviewing its procedures after Nigerian xxxxxxx xxxxxx xxxxxxx, 40, was sentenced to 16 months jail for immigration fraud on Wednesday.

The former registrar was convicted in the Christchurch District Court on three charges after he failed to declare his criminal history when applying for a New Zealand visa in 2008.

He worked in general psychiatry from January 2009 until last month, when he resigned after charges were brought by Immigration New Zealand when he applied for residency.

In 1999, xxxxx  was jailed for two years for importing 4.5 kilograms of cannabis into Britain.

In his residency application, xxxxx forged letters from Nigerian hospitals, claiming he was working when he was in fact in prison.

He received a recognised primary medical qualification from the University of Nigeria in 1996.

xxxxx  worked in Ireland from 2004 until January last year, when he qualified as a member of the Royal College of Psychiatrists. (NO SURPRISES THERE THEN)

CDHB chief medical officer Nigel Millar said there had been no problems with xxxxx’s “competency or treatment of patients”.

“His caseload has been redistributed since he left the organisation and no new concerns have arisen,” he said.

xxxxx  met all the criteria for the position and supplied a Certificate of Good Standing from the Irish Medical Council as evidence of three years good practice in Ireland.

“As with all serious incidents, the CDHB is reviewing its procedures to see if there is anything that the organisation could have done better,” Millar said.

A Christchurch woman who knows xxxxx  through a flat he rented in Addington said his family still lived in Ireland.

“He was going to get his examinations done and decide whether he was going to go back to Ireland when he had his registration,” she said.

“He was quite a clean-living guy. He was just a quiet guy who used to go about his work,” said the woman, who asked not to be named.

The Medical Council of New Zealand said xxxxx’s qualifications and work history were checked when he applied to work in New Zealand.

Council spokesman George Symmes said a gap in xxxxx’s curriculum vitae between March 2003 and July 2004 was explained as the time it took to meet the Irish Medical Council’s requirement for registration.

Three references were received with xxxxx’s application for registration, all indicating he was a good doctor.

“No disclosures regarding the conviction were made by Dr xxxxx,” Symmes said.

There had been no concerns with xxxxx’s performance in New Zealand, and he received positive supervision reports.

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I have deleted out this mans name because I have no conflict with him or opinion regarding the issue of what he did. My issue is with Irish psychiatry in general who can stick their noses into my sons inquest when it suits and condemn psychiatrists like Dr Corry when his opinion differs from the pack! So can anybody join up? Exactly how stringent are the regulations?

Jan 15th 2013, Update: http://www.irishtimes.com/newspaper/ireland/2013/0115/1224328852205.html