Newspaper and internet articles, psychiatry, Random

AntiDepAware – Addendum to the DSM-5

Vehicle fitter

Brian at AntiDepAware wrote a very interesting blog this week. If ever there was a clear cut case of prescription drug induced suicide-homicide, this surely is it?

I read this week (on Twitter) that Brian’s blog ‘just gets better and better‘ and I absolutely agree with that statement. In my opinion it should be printed as a compulsory addendum to psychiatry’s DSM 5 – before the idiots reach for the prescription pad. His blog is copied verbatim below…

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Vehicle fitter Nigel Maude (58) and his 57-year-old wife Judith (left) were described by their next-door neighbour, who had known them for 25 years, as “perfect neighbours.” He said: “They always seemed to do everything together including gardening and tidying up outside. I have never heard them argue. They were a lovely couple and totally devoted grandparents.”

Their deaths, therefore, were a “complete shock” to their family and everyone who knew them. Yesterday’s inquest revealed that, on August 11th this year, Mr Maude violently stabbed Judith to the back and neck with a kitchen knife and attempted to strangle and suffocate her at their home in the village of Hoghton, Lancashire. He then drove a short distance to a nearby railway line, where he stepped in front of a train.

The investigating police officer said that: “Mr and Mrs Maude were certainly of good character, had no real issues with debts and there were no reported crimes involving them.”

Deputy Coroner Simon Jones asked the officer: “There is nothing to suggest that this is anything but a happy and caring marriage?”

He replied: “No, nothing to suggest otherwise. This has come as a complete shock to everyone.”

It emerged, however, that Mr Maude had seen his GP 16 days before the deaths, complaining of insomnia and stress over financial worries about his mother, who was going to have to be placed in care. In a statement, GP Dr Stephen Howell said Mr Maude was a regular patient who suffered chronic arthritis but had no history of mental illness or depression.

Nevertheless, Dr Howell said he “prescribed Mr Maude prescription drugs.” Presumably, this accounted for the “low traces of a drug used to treat depression”, found by the pathologist in Mr Maude’s blood.

Recording verdicts of unlawful killing and suicide, the coroner said that the reason for Mr Maude’s actions could not be established for certain but that: “It may be stress in relation to issues relating to his mother going into a home. We don’t know.”

On the other hand, Coroner Jones, the reason for Mr Maude’s actions, in all probability, was that he had been mis-prescribed medication with known links to homicide and suicide, which NICE recommends only for moderate to severe depression.

AntiDepAware Blog.

Featured, lundbeck, Our story., psychiatry

The grieving mother is at it again!

Bad DayThis morning I was rambling around a shop in Wicklow – minding my own business. The radio was playing loudly in the background and there was a discussion on about depression. A ‘science expert’ was giving his tuppence worth, telling us how depression can be caused by low serotonin levels. I couldn’t just let that go, could I?

The shopkeeper told me it was East Coast Radio (ECR), a Wicklow based radio station. I’ll try to find out who the ‘expert’ is later but in the meantime; seriously? How can these idiots keep spouting the ‘chemical imbalance’ rubbish? It is drug company propaganda at its best and has no scientific basis, no factually based evidence whatsoever to conclude that depression is anything other than a reaction to life itself. So anyone, particularly a supposed ‘expert’ spouting this rubbish as fact is unforgivable, dangerous and completely unabashed of whether the science backs up the ‘expertise’ being publicized to the nation.

I’m having a bad day today, tears are ready to ‘go forth and multiply’ at the slightest provocation. Some unsuspecting person saying hello would be enough to set the floodgates in motion. I spoke to Shane’s friends this morning, so that probably set me off (lovely as they are). It’s nearly 4 years now and some days it feels like yesterday, 4 years since my lovely son died from 17 days of Citalopram. 4 years since he took someone elses life and his own on the same night. Sometimes I feel I have no right to be sad as I’m the mother of a guy who killed another person, whether caused by this particular drug or not. I wonder about random people who are nice to me, who want to chat about the weather, the traffic or the state of the country. Would they be nice to me if they knew I was the mother of a young man who took the life of another, or would they walk on by and pretend they didn’t see me for fear of catching something? Should I wear a placard around my neck telling randomers who I am?

The DSM-5 (psychiatric manual) would say that I have a psychiatric disorder, major depressive disorder to be precise. Being sad for 4 years is way over the 2 week period that this manual allows a person to grieve before recommending medication to fix them. Despite having a lovely husband and other perfectly happy normal(ish) children, some days I still wish I was dead. That’s not depression talking, just a fact; so much easier! Oh the joys of dying from a heart attack than to live with the pain of missing my son. And no, I’m not depressed, just having a bad day; a ‘natural’ reaction to some terrible circumstances in my life. I’ll be perfectly okay again tomorrow, particularly without the intervention of a doctor, who can and do make things so much worse by prescribing mind altering drugs. I’m sitting in my car waiting for my sons to finish Jui Jitsu (the latest craze in our house), balling like an idiot with make-up running down my face and hair like the ‘wild woman of Borneo’ (whoever she is). I care little about what people think of me anymore, my hide has been well and truly toughened in the last few years, so I’ll cry if I want to, just another mad woman, move along, nothing to see here.

It saddens me that despite the fight we put up since my son died, trying to raise awareness about the dangers of these drugs, I still get to hear idiots like your man on the radio spouting the ‘chemical imbalance theory’ as fact. Despite getting the real experts into Leinster House, who informed Minister Kathleen Lynch of the dangers of these drugs (who then nodded her head and did sweet fock all), doctors are still over-prescribing and people are still dying in our little country every day. Despite Senator David Norris bringing the issue up in the Seanad and Jan O’Sullivan bringing it up in the Dail, nothing has changed. In fact the over-prescribing is getting worse and the misinformation (like this morning on East Coast Radio) is rampant. Dr Kelly on ‘The Right Hook’ is not alone in spouting misinformation as fact. In my opinion Patricia Casey and Ted Dinan as ‘expert professors’ in psychiatry (who deny the suicide link to antidepressants) have laid a pretty solid foundation for ‘SSRI misinformation’ in Ireland. I’ll keep chipping away with the auld nail scissors and I for one will be very surprised if I don’t topple that wall! Maybe my irrational self-belief means I’m a model to be diagnosed with PTSD or even Psychosis? Pass the prescription pad, Celexa at the ready? At least my heart attack may be helped on it’s way! If my sisters or brothers are reading this, I’m fine. Don’t even think of a ‘just passing and I thought I’d call in’ visit! No family conferences to see what can be done about the grieving one! Just having a bad day; back to my old caustic self tomorrow, I promise.

Patricia Casey “Antidepressants do not cause suicide“…Lie!

Ted Dinan “There is no evidence that SSRIs can cause suicide” … Lie!

Dr Ciara Kelly “the drugs (SSRIs) themselves are not dangerous, they’re not addictive, they’re not even dangerous at high levels of overdose.”… Lie

Ps. The radio show ‘expert’ was Sean Duke. “With some people the serotonin level is extremely low and they can get depressed as a result.” OFFS!! Sean, described as ‘ECR’s science blogger’, can be heard here at ’10am hour’ at 55 mins.

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The chemical imbalance debunked….

Serotonin and Depression.

David Healy “No abnormality of serotonin in depression has ever been demonstrated.”

Dr Charlotte Blease. The duty to be well-informed: the case of depression.

Robert Whitaker “Rather than fix chemical imbalances in the brain, the drugs create them.” Anatomy of an Epidemic.

 

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

LKMC Syndrome.

Lundbeck Killed My Child DisorderSo what’s happening this week in the depressing world of suicide and ‘mind altering drugs’?

The following was meant to be tongue in cheek but actually the subject is too serious and I miss my son too much to make light of this issue.

Did you hear there’s a new syndrome that’s just been confirmed? Yep, LKMS disorder aka ‘Lundbeck Killed My Son’ Disorder. I suppose if I was being fair, it should be called ‘LKMC’ aka ‘Lundbeck killed my Child’ Disorder. There are many of us affected by this virus, although thankfully it isn’t contagious.

It should be noted that LKMC disorder is a global problem, not just restricted to Ireland or the UK. In fact America, New Zealand and China are reporting an ever-increasing rate of suicide. I have previously shown that the unsuspecting Chinese are killing themselves at an alarming rate, most likely due to the relatively new ‘depression’ advertisements, pushed by dubious pharmaceutical companies including Lundbeck, here.

The latest news regarding the DSM-5 is that grief for more than 2 weeks, even after the death of a loved one, can be seen as a symptom of Major Depressive Disorder, here. Considering that Shane is dead almost four years and I can still blubber like a lunatic at the worst possible moments; that surely means I’m decidedly unwell. I wonder if a pill could cure the death of my son? Can they miraculously make him re-appear? Even your toddler’s ‘temper tantrums’ may be diagnosed as an illness under the new and ‘unimproved’ DSM-5 and therefore medicated accordingly.

This week researchers from Duke University reported that antidepressants, including Lundbeck’s Lexapro appears to help prevent a potentially serious stress-related heart condition. You can find the study in ‘The Journal of the American College of Cardiology’ here. I’d list the conflicts of interests but there isn’t enough room on the page. You can access them yourself by clicking the ‘Author Information’. Now you will have to pardon my stupidity here, but surely these researchers know that Lexapro causes heart-attacks and sudden death? The FDA sent out a warning letter to all practitioners advising of the risk of heart problem with Citalopram in August 2011. This was revised in March 2012 to include Escitalopram, which is no surprise as they’re basically the same drug (as found in a Brussel’s Court here).

Lundbeck whose patents (and patience) are running out, have been frantically scrambling around for their next block-buster drug. Vortioxetine aka Brintellix is their latest offering.  Data concerning Vortioxetine efficacy was presented at the 2013 American Psychiatric Association Annual Meeting (APA). 4 trial results were shown, 3 for and 1 against. It’s the 1 against that I would be interested in. Was there any deaths? There was certainly a death in one of the Citalopram trials. Are they going to publish all the Vortioxetine trials as GSK are supposed to be doing? Actually no, ignore that, GSK backtracked on that particular promise!

We will have to wait and see whether Vortioxetine will get a ‘licence to kill’ by the FDA and the EMA, and if so, whether it will add to the growing cases of LKMC disorder.

Cases, cipramil (celexa) stories,, lundbeck

Citalopram in the Courts

Pills on trial

Pills on Trial.

Last week reports surfaced of a woman, Marlene Torlay 61, who killed her friend after she called to her home for ‘a cup of tea and a chat’.

After the violent killing, her son returned home and found his mother watching television, completely unaware that her friend’s body was lying in another room. Defense Council Ian Mr Duguid said that Mrs Torlay “is perhaps, on any view, the most unlikely of violent offenders to appear in these courts for some time.” Oh yeah, did I forget to mention that Citalopram was implicated in this tragedy? It got me thinking of court-cases and how often this drug has caused the particular offence and/or prescribed afterwards, no doubt worsening the offender’s problems.

Here are some cases involving Citalopram in the Courts (Courtesy of LexisNexis). The strange thing is that this drug has been prescribed for everything, from difficulty with sleeping to irritable bowel syndrome, and then there’s the case where it was prescribed to a woman for her partner’s stress. Nope, I didn’t make that up, that’s what was recorded in the case of Forrester Ketley & Co v Brent & Anor.

There’s also the ‘wee’ problem that Citalopram never seems to work, worsens depression and quite possibly has caused the initial problem. Anyway, here’s a few snippets, courtesy of Lundbeck pharmaceuticals….

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Haworth v Cartmel and another [2011] All ER (D) 23 (Mar)

Applicant seeking rescission or annulment of bankruptcy order on basis of lack of mental capacity. (Woman with heart condition prescribed high dose of Citalopram, which didn’t work but very probably increased her chances of damaging her heart further and increased her risk of sudden death. Recommended maximum dose is now 40mgs due to Citalopram causing heart problems.)

11th March 2008: prescribed Citalopram 20 mg

1st April 2008: Citalopram increased to from 20mg to 40 mg

10th July 2008: Citalopram increased from 40 mg to 60 mg

24th February 2009:  applicant ‘currently at high risk of suicide’

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Forrester Ketley & Co v Brent & Anor [2009] EWHC 3441 (Ch)

(Bankruptcy Order)

Here the applicant testified, among other things, that the woman whom he shared a house with, needed to take Citalopram, not for her stress but for his. (Now that is something I hadn’t seen before): “However and for some time, Ms Palette had been feeling the stress that I was under and she needed to take medication (Citalopram) for this.”

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R v Colgan (Lewis Daryl) (2009)

The appellant and the 17‑year old female complainant were both part‑time employees at a store in Aylesbury. The appellant was diagnosed with autistic spectrum disorder (ASD).

January 2009 he grabbed the buttocks of a woman standing at a bus stop. He claims that he thought that she was looking at him oddly and did this in an attempt to keep her away from him. He received a caution. The incident had a profound effect upon him and his anxiety levels increased to the extent that his father arranged for him to have weekly psychotherapy sessions.

Between January and March 2009 prescribed Citalopram. This relieved his depression, but according to his family appeared to make him more talkative and volatile than he had been before.

March 2009 the appellant made an inappropriate comment of a sexual nature to the complainant who complained to the store’s manager.

2 May 2009 the appellant, together with his father, attended a disciplinary meeting about the comment he had made, at the end of which he was informed that he would be disciplined by receiving a written warning. Later that day he stabbed the complainant with a vegetable knife. The police were called and the appellant was arrested. The complainant attended hospital where she received a stitch to a one centimetre wound in her back.

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R (on the application of Drinkwater) v Solihull Magistrates’ Court [2012] EWHC 765

(Magistrates – Adjournment – Discretion of justices – Claimant’s trial being listed before defendant magistrates’ court – Trial being adjourned on several occasions – Claimant being diagnosed with depression and certified as unfit to attend court)

25 May the Claimant was diagnosed with depression and started on a low dose of Citalopram.

13 June, her solicitor faxed a letter to the court stating that she would be unfit to attend court for the next two months as a result of severe depression.

Did not work and probably caused severe depression?

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Sardokie-Gyan v The Nursing & Midwifery Council  [2009] EWHC 2131

2003 – 2005 Was treated by her general practitioner on a reducing dose of Citalopram for difficulty with sleeping… ??

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R v Bailey [2011] EWCA Crim 1124

Man kills wife.

11 September 2008 the deceased spoke to her mother and informed her that she was annoyed with the appellant because he had not been taking his tablets as he should. Later that morning a neighbour heard loud banging coming from her lounge. She ran into the room and found the appellant standing outside the window covered in blood. He was behaving in a wild and bizarre fashion. She also heard him say, “I’ve killed her.”

Dr Sarkar, while not an expert in pyschopharmacology, embarked upon an investigation of the literature as to the possible effect of taking Ritalin and Citalopram in combination and with unreliable regularity.

Before trial the defence had been advised by a prominent expert in the field, Dr Peter Tavener, that neither of these drugs was likely to have been causative of the appellant’s behaviour. (Despite reports of self harm and harm to others from Lundbeck who invented Citalopram, and the known dangers of SSRI withdrawal?)

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MN (Rwanda) v Secretary of State for the Home Department [2007] EWCA Civ 1064

The claimant, a Rwandan national, arrived in the United Kingdom and was refused asylum by the Secretary of State, the immigration judge had made a rounded assessment of the risk that if the claimant was returned to Rwanda she would be driven to commit suicide, and had reached a tenable conclusion that there was no real risk that the claimant’s fears would cause her to respond to a removal decision by committing suicide in the UK, or en route to, or on arrival in Rwanda. The immigration judge had dealt with the matter with considerable care and the reasons which she had given for her findings as to the risk on return to Rwanda had adequately explained her approach to the evidence before her.

She complained of sleeping poorly despite medication in the form of Citalopram (a common treatment for depression and PTSD, which was prescribed for the appellant by her GP).

A common treatment for Post Traumatic Stress Disorder?

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Shala and another v Birmingham City Council [2007] EWCA Civ 624

The claimants were refugees from Kosovo who had been granted indefinite leave to remain in the United Kingdom. They had undergone serious ill-treatment in Kosovo, and had lost contact with three of their daughters. The wife had been diagnosed as suffering from hypertension, depression and post-traumatic stress disorder.

Further evidence initially obtained on Mrs Shala was a note of a telephone conversation with her new GP, Dr Salmon, on 8 November 2005, confirming the diagnosis of depression and recording a prescribed dosage of 30mg citalopram. (Not sure if this means she was prescibed Citalopram over the phone..)

“The applicant has a history of depression which has necessitated referral for psychiatric assessment; however her condition is currently being treated with citalopram, a standard Prozac equivalent anti-depressant drug alone and likewise there remains nothing to suggest her condition [is] of particular severity, nor that it has been in the past and nor that impairs her ability to function or significantly impedes her daily activities.” (No, her condition mightn’t but Citalopram certainly could.)

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R v Smallshire [2008] EWCA Crim 3217

Sentence – Imprisonment – Length of sentence – Wounding with intent – Six years’ imprisonment – Defendant’s state of mind at time of offence affected by medication for depression – Whether sentence manifestly excessive.

5 December 2005, after Mr Smallshire had stated that he felt “increasingly paranoid”, his general practitioner prescribed an anti-depressant, Citalopram. It was a small dose of ten milligrams, described in one medical report as half the usual starting dose, for what was recorded as “irritable bowel syndrome, with anxiety and depression features”. (So now it cures irritable bowel syndrome, anxiety, and depression?)

16 December 2005 Violently attacks man

Mr Smallshire relies, in support of his challenge to conviction, upon evidence of Dr Andrew Herxheimer, a consultant clinical pharmacologist, experienced in the investigation and evaluation of the adverse effects of drug therapy and who in recent years has studied a large number of reports of effects relating to SSRI (Select Seroxat Inhibitors) antidepressant drugs, of which Citalopram is one.

Dr Herxheimer wrote a report dated 12 February 2008 and a supplementary report dated 14 March 2008. In the former he concluded that:

“. . . citalopram very likely contributed decisively to Mr Smallshire’s actions on 16 December 2005. He had started taking this antidepressant medication 11 days earlier; its concentration in his brain would have been steadily increasing from about seven days. It is highly probable that alcohol augmented the effect of the drug: on its own alcohol would not account for his behaviour.”

In his supplementary report Dr Herxheimer stated that in his opinion that it was “more likely than not” that because of a mixture of medication and alcohol, Mr Smallshire would have been in a state of non insane automatism at the time of the incident.

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KERRY DONNELLY Pursuer against FAS PRODUCTS LIMITED Defenders 2004 Scot (D) 36/3

The pursuer is Kerry Donnelly. She lives in Holytown, by Motherwell. The pursuer was born on 1 May 1979. She sues her former employers for damages in reparation for a severe crushing and burning injury to her left (dominant) hand sustained on 5 June 2000 when she was working as a production assistant in the defenders’ factory. Liability has been admitted.

5 June 2000 Accident.

Post accident 2000. Prescribed Amitriptyline, an anti-depressant, and Loprazolam, a sedative, in order to help her sleep. Later the prescribed dose was increased.

15 February 2002 2 two episodes of self-harm through drug overdose. The pursuer was admitted to the Psychiatric Department of Monklands Hospital.

January 2003 A second anti-depressant, Citalopram, was added in… also been prescribed a further anti-depressant, Seroxat, and a tranquilliser, Thioridazine.

June 2003 Described by doctor as “still depressed”. He considered that her depression was mainly related to the accident. The pursuer was taking anti-depressant medication on a daily basis until a few weeks before the proof. As at the date of proof she was trying to manage without medication.

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McEWAN v HIGSON 2001 S.C.C.R. 579

The appellant was charged with driving while unfit to do so through drink or drugs. Police officers gave evidence that one of them had stepped into the road and raised his hand to try to stop the appellant who was driving at excessive speed. The appellant did not slow down and the constable had to go back on to the pavement to avoid the car. The appellant then braked sharply and stopped some twenty feet beyond the constable. When the appellant left his car he was slow in his movements, his speech was slurred and his pupils were contracted. There was no smell of alcohol. One of the constables had been trained in tests used to assess whether the ability of motorists was impaired by drugs. The constables formed the conclusion that the appellant was under the influence of drugs. He was arrested and admitted that he had taken a betablocker. He was examined by a doctor about an hour and a quarter later. The doctor found that at that time his ability to drive was not impaired, but that it was possible that it could have been impaired an hour earlier. The appellant was convicted and appealed to the High Court.

The appellant agreed to a medical examination which was carried out by Dr Richard Millburn, the police casualty surgeon on duty at the time. The examination commenced at 6.15 p.m. and, as a result of it, Dr Millburn concluded that at the time of the examination the ability of the appellant to drive the motor vehicle properly was not impaired through drink or drugs. Dr Millburn found that the appellant’s heart [rate] and blood pressure were normal. He noted that the appellant’s speech sounded thick. He noted that the appellant told him that he had ingested one 20 mg tablet of Citalopram and half an 80 mg dosage of Inderal the evening prior to 4th July 1999. Dr Millburn found that the appellant’s pupils were of a reduced size but were reactive normally. The appellant was slightly unsteady when standing on the left leg and on the right leg.

Reduced pupils and unsteadiness while standing on one foot may be consistent with drug taking. Citalopram is an anti-depressant. Inderal is a betablocker. When taken with alcohol, Citalopram can affect impairment of ability to drive. The appellant had taken a 20 milligram tablet of Citalopram on the night of 3rd July 1999 and 80 milligrams of Inderal on the afternoon of 4th July 1999.

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DPP v Mulder [2009] IECCA 45

On 14 January 2008 the Applicant pleaded not guilty to the murder by strangulation of his wife at their family home in Dunshaughlin, County Meath on 17 December 2004. Following a trial in the Central Criminal Court, the Applicant was convicted of murder by the jury on 25 January 2008 and received a sentence of life imprisonment.

This was the second occasion upon which the Applicant had been tried for this offence. In a previous trial in May 2006, the Applicant was also convicted of the same offence, but that conviction was set aside by this court because a brother of the deceased had spoken to a member of the jury outside the courtroom. At the time of the second trial, there had been a change in the law by virtue of the enactment of the Criminal Law (Insanity) Act 2006, which introduced into Irish law the concept of diminished responsibility. On arraignment, however, the Applicant simply pleaded “not guilty” to the offence of murder.

Dr Harry Kennedy is a consultant forensic psychiatrist and Clinical Director of the Central Mental Hospital. He was the first witness called by the defence and gave evidence which was effectively confined to a recital of his notes on the case. He interviewed the Applicant on 20 December 2004 in Cloverhill Prison and saw him on a second occasion on 6 April 2005 at the same location. His notes recorded that at the conclusion of the first interview he prescribed 10mg of Olanzapine at night for the Applicant. When he saw the Applicant on the second occasion he was already taking both this medication and 20mg of Citalopram, an anti-depressant drug. Dr Kennedy clarified that the latter medication was an anti-psychotic drug which was taken in low dosage and was commonly used to reduce agitation, anxiety and a range of related symptoms. Dr Kennedy formed the view on the occasion of his second assessment that the Applicant should come off Citalopram and move onto a different anti-depressant, Mirtazapine. Dr Kennedy confirmed in cross-examination that the Applicant was not and never had been a patient in a mental hospital. He accepted that the Applicant had been referred to him by his general practitioner because of the suicide risk which might arise by virtue of the fact that the Applicant had been charged with the death of his wife. He stated that there was a raised risk of self-harm within the first few days of being in custody. Dr Kennedy accepted that the fact that one had been charged with such a serious offence would in its own right put a person into a “depressed mode”. (Is it standard practice for prisioners to be prescribed medication?)

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Parkin [N00529] 2007

Mrs Parkin contends that she is entitled to payment of Permanent Injury Benefit (“PIB”) under the Scheme and claims that information submitted to the Agency shows that she has been unable to work since leaving employment making such a benefit appropriate. She additionally claims that she has suffered distress as a result of the way that her application for PIB has been handled by the Agency.

April 1999 “Presented in a tearful state saying she was unable to cope with her job. She was not sleeping. She said, she did not want anti‑depressants. I gave her …. and some mild sleeping tablets.”

June 1999 “because she was still showing marked panic reaction when I eventually talked of work and was still having great difficulty in sleeping I started her on Dothiepin 25 mgs … However, because of side effects, on the 5 July 1999 this was changed to an SRRI, Citalopram, the dose of which was increased”

January 2001“She continues to suffer from depression which I would now categorise as a depressive episode of mild to moderate severity…”

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Stanway [Q00530] 2007

Mr Stanway submits that the Trustees of the Novar Pension Scheme failed properly to consider his request for a Category 2, Ill Health pension, by not taking into account his medical condition at the time he originally applied for a pension.

It was during this time that he cancelled his operation for his knee, mainly because he was completely obsessed with regards to his bowel and perianal discomfort….

June 1999 the decision was taken that he should try an anti-depressant Citalopram. This caused nausea. A trial of Efexor faired little better and I tried him with Diazapam.

February 2000 and he described increasing stress and pressure at work, saying that the last 2 years had been very difficult, he had felt increasingly low and had pictures of self harm, he was not sleeping at night. On examination he was of low mood, although not actively suicidal. I gave him Fluoxetine and advised him against resigning from work…

February 2000 On review he was increasingly agitated on Fluoxetine so we swapped to Paroxetine.

March 2000 he noted he had a poor consultation with yourself and he was also finding he was more short tempered. Over the next few weeks he described himself as continuing to be angry, directing frustrations and bitterness from work towards his wife. We increased his Paroxetine which gave him some benefit along with Zopiclone at night.

Current diagnosis of Mr Stanway’s condition is one of depression and some agitation. (Not surprising!)

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Kinsella v Rafferty [2012] IEHC 529

The plaintiff in this case sues the defendant for negligence and breach of duty in the carrying out by the defendant of a Total Abdominal Hysterectomy on the plaintiff on 7th April, 2008. The defendant is a consultant Obstetrician and Gynaecologist in Mount Carmel Hospital in Dublin.

Some controversy surrounded the initial treatment undertaken by the plaintiff late in 2008, when she was prescribed a drug called Cipramil (Citalopram).

November 2008. Started Citalopram.

February 2009, Reported some improvement on this drug…

March 2009 Discontinued due to adverse-effects. Judgment of Justice O’Neill: “However, her evidence and, in particular, the evidence of her husband, was that she found it extremely difficult to tolerate this drug. Her description, and more particularly, that of her husband, was that whilst she was on it, she was a “zombie” or was constantly “out of it”. Her husband described a variety of minor domestic mishaps resulting from her absent mindedness or forgetfulness or lack of concentration while she was on this drug. Eventually, she could tolerate it no longer and gave it up about March 2009.”

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http://davidhealy.org/the-dram-of-eale/

https://leoniefennell.wordpress.com/2012/03/23/citalopram-aggression-violence-suicide-lundbeck-homicide/

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Newspaper and internet articles, Shanes story.

Ireland’s over-prescribing disaster.

Ali Bracken
Ali Bracken

In 2009 following Shane’s death, a ‘Tribune’ journalist ‘Ali Bracken’ decided to find out whether antidepressants were being over-prescribed in Ireland. She presented to 5 doctors with symptoms of mild-depression and was shocked when 4 out of 5 prescribed her an antidepressant. The article ‘A Pill For Every Ill’ can be viewed here. So what has happened in the last 4 years. Has the over-prescribing of potentially dangerous drugs been curtailed in any way? Nope, in fact it’s actually got much, much worse.

In the last few weeks, a young journalism student ‘Niamh Drohan’ posed as a mildly depressed student in Waterford. This time sheNiamh Drohan visited 7 GPs as part of her investigation; all near Waterford city. Sadly, all 7 prescribed her an antidepressant. Her article ‘Depressing Truth about Treating Depression In The Young’ can be viewed here. What is all the more shocking this time around, is that 3 prescriptions were issued for one month supply, 1 was for two months, 1 was for three months and 2 were for six months. Can you believe that? Two doctors prescribed a 6 months supply of a potentially fatal amount of drug, to a depressed person that they had only just met? Why not just give her a gun and play some Russian Roulette with a young girl’s life? Idiots!

So why are Irish doctor’s prescribing so recklessly? The National Institute for Health and Clinical Excellence (NICE) guidelines  recommend that doctors “Do not use antidepressants routinely to treat mild depression because the risk–benefit ratio is poor…” Another NICE review stated that the benefit of antidepressant medication compared with placebo in mild to moderate depression may be minimal or nonexistent.

What about the Irish Human Rights Commission who recommended, among other things, that doctors/psychiatrists are to give an ‘oral explanation of risks/side-effects of SSRI’s in advance of prescription, together with relevant written information’ and that a ‘level of monitoring and ongoing supervision is required when SSRI’s are initially prescribed’. I don’t think that equates to ‘here’s a script, now have a nice day young lady and don’t take them all at once’.

Considering Shane had access to 6 weeks of poison Citalopram and had a toxic-to-fatal level of same in his system when he died, how many horses could a 6 month supply kill? This dangerous over-prescribing is heading for disaster. As Dr Phil would say; how’s that working for ya professor? Rising suicides and increased prescribing… sometimes 2+2 really does equal 4.

IHRC Recommendations.

NICE guidelines.

NICE Review Consultation Doc.

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles, psychiatry

Are Newspaper articles doing more harm than good?

Céad Mile FailteIn a week where Ireland has seen several young people die by suicide, we had the usual rush for answers to a growing problem, which it seems, no-one can fix. Certainly the Government are pretty useless at tackling the suicide ‘issue’ and numerous newspaper articles, however well-meaning, are not helping. An ‘Irish Independent’ article this week regarding depression in teenagers states: “Most experts are in agreement that for young people in crisis, medication, in the form of Prozac-type drugs from the SSRI family, prescribed by a GP, can be helpful.” What? Which experts? I would like to know precisely who is recommending SSRIs for use in teenagers? Why are they not named and shamed in the article? Actually, why would any well-researched article not refer to the black-box warning or the EU recommendations regarding the prescribing of these drugs to teenagers?

Ten years ago the Irish Medicines Board put out a fairly stark warning regarding the prescribing of SSRIs in children: “The Irish Medicines Board today confirmed that Selective Serotonin Reuptake Inhibitors, (SSRIs) are not and have never been licensed for use in children (under 18 yrs) in the treatment of Major Depressive Disorder (MDD) in Ireland. The IMB is fully aware of the review undertaken by the UK expert group, details of which were announced today and wishes to re-emphasise that SSRIs are not recommended for use in the treatment of MDD in children in Ireland, as the risks of treatment with certain SSRIs are considered to outweigh the benefits of treatment in this condition.”

Photo courtesy of USF Health News

In 2008 the Psychopharmacological Drug Advisory Committee (PDAC) voted 6:2 that the warnings of SSRI induced suicidality be upped from under 18s to age 25. It also advised that labelling needed to address the 25-30 age group. The PDAC concluded: “Overall the conclusions reached by the FDA in its review were consistent with that of the UK/EU review. Both reviews concluded that young adults may be at an increased risk of suicidal behaviour when treated with antidepressants. The FDA discussions on an explanatory hypothesis highlighted that even in older adults the possibility that in SSRIs may increase risk of suicidal behaviour cannot be ruled out.” The Eu recommendations can be viewed here, which includes the different drug induced suicidality risk where Citalopram fares worst, doubling the suicide risk.

The same ‘Indo’ article heavily relies on quotations from Dr Tony Bates of ‘Headstrong’. On the Headstrong website Dr Bates pays tribute to his ‘good Psychiatry pharmacolleague, ally and friend’ Patrick McGorry, who recently resigned as a Headstrong board member. McGorry (born in Ireland) is an Australian psychiatrist who will retain an ‘advisory’ role within Headstrong. He is well known for his ‘early intervention’ trials, which have been fiercely criticised by mental health experts. His many conflicts of interest, including financial support from various pharmaceutical companies, such as Astra Zeneca, Janssen Cilag, Lilly, Pfizer and of course Lundbeck, certainly didn’t help McGorry’s cause. American mental health lobbyist David Oaks stated in a Time magazine article ‘Drugs before diagnosis‘, that McGorry’s trial was ‘one of the most bizarre and counterproductive human experiments on young people I know about’.

As recently as 2011, according to the ‘Sydney Morning Herald‘ McGorry “aborted a controversial trial of anti-psychotic drugs on children as young as 15 who are ”at risk” of psychosis, amid complaints the study was unethical. 13 international health experts lodged a formal complaint calling for the trial not to go ahead. They were concerned children who had not yet been diagnosed with a psychotic illness would be unnecessarily given drugs with potentially dangerous side effects.” 

It seems to me that ‘Headstrong’ should clarify its position regarding McGorry’s drugging ‘early intervention’ programme. It also seems to me that while the writer is entitled to her opinion, the indo article is highly dangerous, and quite possibly negligent, to advocate for the use of SSRIs in children without addressing the EU suicide warning. While the writer asks some good questions, such as, “How would we know if a teenager was feeling overwhelmed by academic expectation, online bullying, family breakdown, pressures at home, or simply the everyday drama of growing up?”, a pill which can double the risk of suicide, is not the answer. Extreme caution should be advised when even the Irish Medicines Board admit (albeit with ‘certain’ SSRIs) that the risks when prescribing SSRIs in children, outweigh the benefits.

If this article is factual and ‘Most Experts’ are truly recommending the use of SSRIs in children, the European Medicines Agency and the Irish Medicines Board are not doing their job properly.

More on Patrick McGorry by Bobby Fiddaman.

Professor Patrick McGorry – too influential and too much influenced?

.

cipramil (celexa) stories,, Newspaper and internet articles, psychiatry, Random

David Healy v Veronica O’ Keane

Prof Healy

Last week Professor Healy spoke on RTE radio with Professor Veronica O’ Keane, consultant psychiatrist in Trinity College. The debate (podcast) centered on the ‘increased use of sedatives and antidepressants‘.

Professor O’ Keane stated that antidepressants are not addictive drugs, where-as Professor Healy said that they are indeed highly addictive and that it’s easier to come off benzodiazepines than antidepressants. Professor O’ Keane was ‘astonished’ at this ‘claim’ and gave a little snigger to show how absurd she thought this claim was.

Speaking on the long term use of antidepressants she said “Depression is not a condition that goes away; it’s a recurring condition and if people stop taking their antidepressants with this recurring condition, their chances of killing themselves are increased by two.” Professor Healy stated that it’s actually the drugs which increase the risk of suicide and violence and that “antidepressants come with ‘black box’ warnings in the US saying that they cause suicide.”

Professor O’ Keane then went on to say that “the black box warning that David is referring to is for under 24; there is no such warning for individuals over the age of 24 and in fact it reduces suicidal ideation in those over 65”. No mention of the black-box warning in this article where she states “Anti-depressants work in young people, in terms of alleviating suicidal ideation secondary to depression.” In the radio interview, she further went on to say “It’s very important that the public are aware, that the problem here is not antidepressants, the problem here is depression. Depression is the real killer.” Ah yes, it’s the person and not the drug.

Prof O’ Keane

Professor O’ Keane has been described as an ‘expert on mental health during pregnancy’. She stated here that “There is an idea that depressed women should struggle through pregnancy without help, and stay ‘pure… But depression is a physical disorder and should be treated.” In a paper published in the British Medical Journal by O’ Keane et al, here, the study concluded that Untreated depression in pregnancy is associated with poorer maternal health practices and less favourable obstetric outcomes. 

A letter regarding this paper was later published by the British Medical Journal, written by Adam C Urato, an attending Physician (Maternal-Fetal Medicine) at Tufts University, Boston. Dr Urato made some interesting points:

(1) I have several concerns regarding the recent “Pregnancy Plus” article entitled “Depression during pregnancy” by Veronica O’Keane and Michael Marsh. I am concerned with the content of the piece as well as the lack of transparency regarding the financial associations of Dr. O’Keane.

Dr Urato

(2) In the introduction to the piece, the authors comment: “The case presented here highlights many of the key issues involved in the management of pregnant woman with depression, particularly the importance of active treatment.” Depression during pregnancy is a difficult issue and one that I deal with on a regular basis as a practicing perinatologist. Depression during pregnancy is very concerning, as is the use of antidepressants during pregnancy. Active treatment is usually with a selective serotonin reuptake inhibitor (SSRI) and there is much to be worried about with maternal and fetal exposure to these drugs. Antidepressants have not been shown to improve maternal or child health outcomes during pregnancy. And in various studies antidepressant use in pregnancy has been associated with increased rates of spontaneous abortion, congenital malformations, preterm birth, low birthweight, fetal death, seizures, neonatal withdrawal syndrome, persistent pulmonary hypertension of the newborn and a possible predisposition to psychopathology.

(3) The question many readers might have after reading a piece that emphasizes the importance of antidepressant medication use in pregnancy is whether Dr. O’Keane is being paid by the antidepressant makers.

Professor O’ Keane has in fact listed her ‘Conflict of Interest’ as being with Eli-Lilly, creators of Prozac and Duloxetine (Cymbalta); Here. In another Article here, she said Prozac belonged to a family of compounds which represents ” one of the few major breakthroughs in the treatment of psychiatric illness in the past 40 years.”

Interestingly, numerous articles have been published this week regarding the dangers of antidepressants in pregnancy, including this one in the Irish Independent. This article quotes the same Dr Adam Urato: “Doctors are putting thousands of pregnant women and their unborn children at serious risk of harm by prescribing them anti-depressants, senior doctors are warning. Senior doctors say that ‘study after study’ shows the most widely used class of anti-depressant, called selective seratonin reuptake inhibitors, or SSRIs, cause pregnancy complications including premature birth and pre-eclampsia, which can both be fatal. Emerging research also suggests SSRIs can double the rate of autism in children, and increase the risk of lung and bowel diseases. The situation amounts to ‘a large scale human experiment’, according to Dr Adam Urato, assistant professor of maternal-fetal medicine at Tufts University, School of Medicine, Boston.”

So, who’s right and who’s wrong? I know who I’d believe. Professor Healy has coincidentally been saying for years that antidepressants can cause terrible birth defects in children “…even as the evidence accumulates that these drugs cause birth defects, double the rate of miscarriages, and cause mental handicap in children born to mothers who have been taking them.”

Considering Professor O’ Keane works in Trinity, the same College that Shane attended, it wouldn’t take much out of her day to speak to Shane’s lecturers. It would be interesting to hear her views on my son, who was loved and respected by his lecturers and who was known by them as ‘An Chroí mór’ (the big heart). Yet after 17 days on Cipramil, he killed himself and another. Maybe she’s so sure of her own opinion, that she doesn’t need to listen to us mere parents!

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles, psychiatry

Was Brennan McCartney let down by Lundbeck, his family doctor, or both?

Brennan McCartney was 18 years old. He did not have depression. He died by a drug-induced suicide 4 days after his family doctor gave him a sample pack of Cipralex/Lexapro. You can see this talented young man in a documentary in my older post here Link.

Professor Healy looked at Brennan’s case and said, “It seemed to be a very clear cut case. This was a young man, who if he hadn’t been put on the antidepressant that he was put on, wouldn’t have gone on to commit suicide.

These SSRI’s double the risk of suicide, so at the very least doctor’s should be aware of the difference between feeling sad and depression before prescribing them. It seems that Canadian doctors are not much different to Irish doctors, where in order to cover their own backsides, the patient will always be to blame. Of course, there is always the added advantage that they can’t answer back. The doctor who saw Brennan, who was suffering from a chest-cold, having never mentioned this in his initial notes, on further recollection, recalled Brennan as saying… “Oh, and I think I am depressed and need medication.” Does that sound like something an 18 year old would say? Blaming the patient doctor?

Brennan’s family doctor handed him a sample pack of Cipralex/Lexapro. This meant that Lexapro was not actually prescribed and therefore Brennan did not get to consult with a pharmacist. This lack of informed consent led to tragic consequences for Brennan.

Dr. Stephen Fleming, Professor of Psychology in the Faculty of Health at York University, Toronto, reviewed Brennan’s medical records and the family doctor’s response. He makes some crucial points regarding the importance of differentiating between grief and depression. He also makes an interesting observation; In the doctor’s initial notes, there is no mention of him giving Brennan samples of Cipralex.

In a later letter dated May, 2012, Brennan’s family doctor said “I recognize that my chart note for the visit (Nov, 2010) is inadequate. I realized this shortly after learning of Brennan’s death and on the advice of a peer, I wrote an additional note documenting what I remember happening.” He noted that he saw Brennan “because he was feeling ill with a cough, had a tight chest and difficulty breathing.” On examination, he diagnosed a bronchial infection, prescribed Biaxin and Symbicort, and urged that Brennan get a chest X-ray.  Then the doctor added material that was not in his original notes; He recalled that, as he was terminating the examination, Brennan stated, “Oh, and I think I am depressed and need medication.” In this later letter the doctor states that Brennan’s symptoms were consistent with a diagnosis of depression and noted the following symptoms: “Brennan was finding this time of year difficult as a cousin had died some years previous, He had ‘fairly recently’ broken up with his girlfriend, Brennan was ‘eating little’, tearful, was not sleeping properly, and he ‘felt terrible’. The doctor described all of these symptoms as ‘normal reactions’ and he reassured Brennan that he would ‘get through it’.

Dr Fleming: “In spite of the doctor normalizing his responses, apparently Brennan stated he just wanted to ‘feel better’. Brennan acknowledged the presence of suicidal ideation but added that he was not capable of such an act as he was close to his family.” Dr Fleming points out that although the doctor normalised Brennan’s responses, he still gave him samples of Cipralex. “It is crucial to make the distinction between a ‘normal’ reaction to loss (eg., the breakup of a relationship) and major depressive disorder” and said “on the basis of the doctor’s description of Brennan’s thoughts, feelings, and behaviour, it is my opinion that he does not meet the threshold for depression and ought not to have been prescribed an antidepressant.” He further stated “From the material made available to me, the doctor failed to distinguish sadness (the ‘normal’ response to misfortune) from major depressive disorder. Brennan’s symptoms are principally neurovegetative and can better be accounted for by grief associated with the loss of his relationship – in other words, a ‘normal’ reaction to his life circumstance as the doctor originally and correctly noted.”

The misdiagnosis of grief as major depressive disorder may result in the unnecessary prescription of antidepressant medications.

……………………..

PS. I contacted Dr Fleming and asked if he would answer some questions regarding Brennan’s treatment. He’s a really nice man and very forthcoming…

Q. Do you think that Brennan’s doctor got it wrong.

A. I think Brennan’s symptoms were not consistent with a major depressive disorder.  He ‘got it wrong’.

Q. Do you think that Brennan received a sufficient ‘duty of care’?

A. The distinction between sadness and depression is critical.  I don’t know the definition of ‘duty of care’ – he wasn’t diagnosed correctly.  In fact, Brennan did not meet the criteria for any psychiatric disorder.

Q. Are you under the impression that the add-in “Oh, and I think I’m depressed and need medication” was an after thought put in by the doctor to cover his own backside?

A. In a word, yes.

Q. Do you think it’s a statement that Brennan would have said or a lie?

A. It sounds like an odd utterance coming from an adolescent male. 

Q. What would you have done in the same circumstances?

A. I would have listened carefully to what Brennan was saying, made the distinction between sadness and depression (in other words, look at the context of his symptoms), I would not have recommended anti-depressants but rather talk therapy.  And, if I didn’t have the expertise to help him, then refer him to someone who does.  He didn’t know what he didn’t know.

lundbeck, Newspaper and internet articles, Random

Is big pharma misleading the Chinese public?

There was an Article published this week in the China Daily entitled “Antidepressants do help mildly depressed“. Link.

The Article suggests that following a review of past studies, people with mild depression may benefit from taking antidepressants. The Article includes a quote from a doctor who worked on the study, Dr David Hellerstein, who stated “I think there’s a valid concern … that if someone has not-that-severe depression that hasn’t lasted that long, maybe it will get better itself or with therapy”.                                                                                         

Dr David Hellerstein, from the New York State Psychiatric Institute and Columbia University further stated that the question of whether or not to prescribe medication shouldn’t necessarily come down to how severe the depression is but rather how long symptoms have lasted. Although he states that people with “transient depression” shouldn’t be taking the risk of being on meds, the Article gives the overall impression that antidepressants can and do help the mildly depressed.

Reuters Health also reported on the study, here, where Dr Hellerstein was quoted again “Drugs may come with side effects, including insomnia and stomach aches, but they’re usually minor”. No mention of suicide or homicide Ideation then Dr. Hellerstein?

It’s no secret that the major pharmaceutical companies have targeted China in the last few years as this Article suggests, entitled “Lundbeck sees China as land of opportunity for Lexapro”. Link.

The problem is that because of the serious side effects of this medication, it is only approved for Major Depressive Disorder, MDD. Articles like the one in the China Daily are misleading the Chinese public, as it was designed to do, I’m sure.

Dr Hellerstein’s declarations of interest include Eli Lilly, Pfizer, Forest Pharmaceuticals, GlaxoSmithKline, and Bristol-Myers Squibb, all of whom manufacture psychiatric drugs.

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles

Woman 73, dies by suicide after 19 days on the depressant Citalopram.

Julie McGregor 73, a retired practice nurse, 19 days on Citalopram; result, suicide by drowning. C’mon, how many more? This article states that this woman had a history of depression; 20 years ago? C’mon! No mention of the suicide ideation that can accompany the drug then?

Did anyone inform her husband of the dangers and was Mrs McGregor informed? Maybe as an ex-nurse this poor woman believed the dangerous propaganda and lies that Lundbeck dish out to the unsuspecting public! This picture is from their “Mind yourself for older people” campaign; no mention of suicide ideation here either. Did this Coroner not hear about Birmingham coroner, Aiden Cotter, who ordered an urgent investigation into this same drug after Yvonne Woodley’s Inquest? Link. Or this other Coroner who blamed Citalopram for Mr. Fox’s death…Link

9 November 2011

A WOMAN who died after drowning in a lake at Harrold Odel Country Park had a history of depression.

 Julie McGregor, a retired practice nurse, who lived in High Street, Harrold, took her own life after a depressive illness which she had suffered from 20 years ago returned earlier this year.

An inquest on Tuesday heard how on July 31 this year the body of Mrs McGregor was pulled from the right hand lake at the country park.

Evidence was given by Charles Pavey, of Thurleigh who noticed the body at around 10.35am when he visited the park and sat on a bench close to the scene.

The inquest was told how Mrs McGregor had visited her GP on July 12 complaining of depression but that she did not report any suicidal thoughts.

She was prescribed the antidepressant citalopram, therapeutic levels of which were found in her system when she died. The court also heard how she had refused to take part in any further treatment claiming that she would be fine.

No alcohol or illegal drugs had been taken.

During the inquest the coroner expressed his sympathies to her husband and heard evidence from PC Paul Grieve.

PC Grieve attended the scene and was responsible for dealing with the identification of the body and the subsequent investigation.

He said that there was no sign of a disturbance at the scene and he was satisfied that no third party had been involved in Mrs McGregor’s death.

Delivering his verdict Coroner David Morris said: “From the circumstances given to me I have no alternative but to record unfortunately that she took her own life.

“But I would add that she took her own life while suffering from a depressive illness.”