Panorama – A Prescription for Murder.

This week the BBC aired a Panorama documentary titled ‘A Prescription for Murder’ which has stirred some much-needed debate on the mind-altering effects of SSRIs. The very-astute presenter Shelley Jofre is known for tackling ground-breaking medical-related issues, including ‘Who’s Paying Your Doctor‘ and ‘The Secrets of Seroxat‘. (Due to the circumstances surrounding my son Shane’s death, I make a brief appearance in this documentary. )

As expected, the documentary caused a huge furore, with many defending the antidepressants drugs they take ‘that don’t cause them to become murderers’, accusing Panorama of being irresponsible and increasing the stigma of mental illness. Indeed, psychiatrists came out in their droves with their usual defense of psychotropic drugs, with seemingly no concerns whatsoever of adverse effects – or of their profession’s incestuous relationship with the pharmaceutical industry. The possible stigmatization of the people who suffer from serious and well-documented adverse effects of these prescribed drugs never entered the debate.

Anyway, watch the documentary and see what you think. I will say what I have always said – My lovely son would still be alive if he hadn’t gone to the doctor, whose fateful decision to prescribe citalopram for heartache proved fatal. 17 days after being prescribed the drug, following a series of red-flags that the drug was causing havoc, Shane was dead.

Citalopram is an SSRI antidepressant, sold under the brand names of Cipramil in Europe and Celexa in the U.S.

Sertraline, the SSRI that James Holmes was prescribed, is sold under the brand names of Lustral in Europe and Zoloft in the U.S. It was interesting to hear Delnora Duprey speaking on the programme; In 2001, three weeks after he was prescribed sertraline, Delnora’s grandson Christopher Pittman shot and killed both of his paternal grandparents. Then there was David Carmichael, whose account of his time on Paroxetine (Seroxat/Paxil), leading to the death of his young son, is equally harrowing.

Since their inception and without exception, all the SSRI drugs have been implicated in suicides and extreme violence, including homicide. With drug-company reports of ‘self-harm and harm to others’ and regulatory warnings of suicidality, violence, mania, akathisia, worsening depression, severe withdrawal, long-term sexual dysfunction, birth defects, depersonalization, etc., the stance that these drugs are safe for all is no longer tenable.

For more information, see the available research here, and documentation by AntiDepAware and SSRI Stories.

Gareth O’Callaghan on Citalopram.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Inquest of Jake McGill Lynch (age 14).

Jake's Inquest

Today I attended the inquest of Jake McGill Lynch, which concluded with the Coroner returning an open verdict. Firstly, amid all the legal argument, there was an infinitely more important factor; Jake..

In 2012 Jake was diagnosed with aspergers syndrome; he was just that ‘little bit different’ ye see. He was a little too intelligent; too good; too kind; too perfect to be perceived as a ‘normal’ disruptive adolescent. I often wonder why psychiatry gets to define what is ‘normal’, considering the lack of any scientific tests to determine otherwise. Are we not all individuals with traits that others would see as abnormal? Are our strange and weird traits not what makes us likable, or even unlikable? Sure, Jake liked routine and things to be in order, a place for everything and everything in its place – not a bad trait I’d say, but nowadays it’s ‘diagnosable’. This extraordinarily intelligent young man was diagnosed, labeled forever, for being just that little too perfect.

Jake was an articulate, handsome young man. He had an online girlfriend, loved to play with his Lego and like ‘normal’ 14 year olds, spent hours on his beloved Xbox. He had joined a gun club with his mam and idolized his big brother and little dog Charlie (equally). He loved his native language and was a fluent Irish speaker.

Jake was primarily a happy camper with few problems, apart from feeling a little anxious on stressful occasions. He was attending a counsellor to help with his feelings of anxiety. When the counsellor decided that Jake didn’t need any more sessions as he was “the happiest she had ever seen him”, she referred him to a psychiatrist. His mam thought that this referral was in order to sign Jake off. Inexplicably, instead of signing Jake off, the psychiatrist prescribed Jake an SSRI Fluoxetine (aka Prozac), to ‘help with his exams’. Neither his mam or dad were given a patient information leaflet (PIL) or any information on side effects – suicidality or otherwise. Therefore, they were not told that SSRIs, including Prozac, doubled the risk of suicide.

Jake's Parents.
Jake’s Parents.

Jake’s medication was doubled after a week, without seeing the prescribing psychiatrist. He became increasingly restless and had a meltdown in school which was totally out of character. 46 days after his prescription for Prozac, Jake’s parents found him on the floor of his bedroom – he had shot himself in the head with his legally held rifle. He was rushed to hospital but declared dead a short time later.

The psychiatrist had previously testified that she prescribed Jake with Prozac ‘to help with his exams’ because he had had ‘a meltdown’ while doing an Irish exam. This off label prescribing is truly shocking, but what is worse is the fact that Jake’s ‘meltdown’ occurred 5 days AFTER he was prescribed Prozac, not before. Why would a doctor get this so wrong? Is covering their own backsides more important than revealing the true circumstances surrounding the death of a 14 year old child? Do Jake’s parents not deserve to be presented with all the facts, not a cover-up? The HSE’s barrister spends a lot of time in the Coroner’s Court – he’s obviously very good at what he does. Personally I think an apology would be far cheaper. Jake, the 14 year old child in the middle of all this, seemed to get overlooked in copious legal argument.
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The Irish drug regulator, HPRA, states that ‘Prozac is not for use in children and adolescents under 18’ here. The HPRA further states that if Prozac is prescribed off-label to a child over 8 (Sweet Jesus) with ‘moderate to severe major depressive disorder’, that it should be offered only in combination with psychological therapy. JAKE DID NOT HAVE DEPRESSION! In 2005 the Committee on Human Medicinal Products, CHMP, advised that SSRIs ‘should not be used in children and adolescents except within their approved indications – not usually depression – because of the risk of suicide-related behaviour and hostility’. If prescribed off-label, the CHMP recommends that patients should ‘be monitored carefully for the appearance of suicidal behaviour, self-harm or hostility, particularly at the beginning of treatment’. Why then was Jake’s prescription for 10mgs of Prozac doubled the following week, without even seeing the psychiatrist? I would not call that careful monitoring.
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What was particularly grueling for the family, was the 13 appearances in the Coroner’s Court, mainly for legal arguments over whether the family had a right to call an expert witness (David Healy). Not surprisingly the HSE barrister was vehemently opposed to David Healy taking the stand, stating that if he was allowed to be the family’s ‘expert witness’, they (the HSE) had an ‘expert witness’ who would say the opposite. I’m sure they had! The coroner refused the family’s request, referring to the limitations of the Coroner’s Act 1962 and the case of Eastern Health Board v Farrell, but said he’d have no objection to the family having an expert to ‘advise’ them on the day. By this stage Dr Healy was in the US, so Declan Gilsenan (retired assistant state-pathologist) came to the rescue and stepped in to advise Jake’s family. He has publicly stated “Based on my experience of doing postmortems on people where anti-depressants have been started fairly recently I would have concerns about the link to suicide”.
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It is of particular significance, that in May 2012 Dr Gilsenan attended Leinster House with Dr Healy, warning that these drugs were causing many deaths and asking for an investigation to be initiated. Nothing was done – NINE months later Jake was given a prescription for Prozac and the cycle continued.
leinster-house
Leinster House-9 months before Jake was prescribed Prozac
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What was awful today, apart from hearing the circumstances of Jake’s death, was looking into the faces of his grieving parents. That familiar look of unbearable pain etched on their faces, the unbelievable loss of their son who had so much to give – all totally avoidable. Another Irish boy lost through psychiatric drugs and another doctor being permitted to recollect ‘facts’ that just don’t add up; another mom and dad left bewildered and lost; another year, another death and still our Ministers avert their eyes and do nothing. Shame on them and the Irish Government.
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The coroner, having heard arguments for the rights and wrongs of prescribing Prozac in children, said that it was “beyond his capabilities to adjudicate on Fluoxetine” but could not ‘beyond reasonable doubt’ say that Jake intended to take his own life. He then rejected a suicide verdict and returned an open verdict.
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Dia leat Jake. Ní dhéanaimid dearmad ort go deo. 
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The last word must go to Jake. It clarifies exactly what his family have been fighting for. In an e-mail the night before his death, he said (verbatim).. “The ‘anti-anxiety’ stuff is actually an anti depressant which they didn’t tell me. Probably doesn’t make much of a difference, but I feel like I’m drugged to the point that it suppresses everything bad until it suddenly spills out.”
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Westminster Exposé

WestminsterSo myself and the poor long-suffering husband are just back from London, having attended a talk in the House of Commons given by Professor David Healy; ‘Antidepressants and The Politics of Health‘.

The meeting was chaired by MP Jim Dobbins who has previously aired concerns about the pharmaceutical industry and its close involvement within academia, such as the case with Professor David Nuttcase Nutt here. I don’t really have an issue with Professsor Nutt, other than with his false declaration to the Nation (on BBC radio) that ‘it’s impossible to kill yourself with an overdose of SSRI antidepressants‘. Dr Ciara Kelly said the same thing here on Irish radio. Very dangerous propaganda!

I challenged Prof Nutt on his statement (via Twitter) where he changed his story slightly and said ‘ALMOST impossibly’. Tell that to all the people who have died by an SSRI overdose of these ‘safe’ drugs Prof Nutt! Brian at ‘AntiDepAware‘ has a list of some SSRI victims here; Karen Gloster (2005), Barbara BerryDeborah Owens (2006), Rhian Evans (2007), Rodney Harrop (2008), Philip Bromley (2009), Belinda KellyMichael MillerNatalie CashinSusan Mealing (2010), Patrick Carroll (2011), Malcolm AverissRobert Lennon (2012) Donna ChaseMark Cain (2003), Christine ByrneDianne Pickersgill (2008) Dale Pashley (2007), Brian Elder (2010), Afsheen Khan (2011)

Anyway, I’m rambling off the point again this morning. Suffice to say,  as is usual, our trip did not always go as planned. We decided, as we were going to London for this talk, to bring the kids with us and maybe go to Legoland the following day. We had plenty of time as the flight was an early one and the talk wasn’t on until 2pm in Westminster. The Ryanair plane sounded decidedly dodgy, as if it was running on dirty fuel (haha, Tony will tell you I have a good mechanical ear) and unsurprisingly the pilot decided that we would have to change planes. This left us two hours behind schedule so the pressure was on, the kids were happily oblivious but the odds at arriving on time were stacked against us. In stepped my brother-in-law in his superman underpants in order to save the day and meet us in London Bridge. He took the kids to my sisters in Kent (where we were staying with 3 cousins, all girls and under the age of 3). This left us plenty of time to head to Westminster for the talk. Back on track.

There was nothing I could do about the frizzy hair at that stage but I thought I’d better change out of the tracksuit bottoms. I decided I would have to change into my ‘Westminster’ clothes in the toilet on the train. Yep, that sounds like a good idea you think? Thanks, I thought so too. The toilet doors were of the circular kind which we have here in Ireland too. There was a nice man sitting outside the toilet when I went in, who smiled at me and said hello; the English are so polite aren’t they? So I took the boots and tracksuit bottoms off and was standing in my underwear (thank God for small mercies) when the train jolted and I leaned backwards, for balance you understand. I leaned on the open-door button, which promptly left me standing in my knickers exposing myself to the poor man sitting outside. Frantic pressing on the buttons failed to close the doors for a lifetime of seconds, until the doors finally closed on the man’s shocked expression. I debated whether I could stay in the toilets until the man either got off or died from old age, whichever came first, but eventually braved the situation and departed from the toilet where I grinned at him in a stupid fashion. He couldn’t look me in the face and glanced quickly out the window. Oh well, nobody was arrested and Tony’s well used to my little accidents/incidences.

So having laughed our heads off all the way to Westminster, we finally made it with a half an hour to spare. After the talk was over, we retired to another room where a question and answer session took place. Jim Dobbins actually voiced what we all knew all along, that the pharmaceutical industry has the Government over a barrel and if the Govt were to sanction ‘industry’, they would threaten to take their business elsewhere, hence GSK et al having control in the UK. This is no doubt the case in Ireland where industries influence is palpable everywhere. If pharma can have such a huge influence over the UK Government, what chance do we have over here in our small country with a population of 4.5 million citizens and with a proven history of unscrupulously corrupt Ministers? You would have to wonder why Kathleen Lynch and James Reilly have done nothing about SSRI-induced deaths.

LegolandDavid Healy’s talk was brilliant as always. We also had the pleasure of meeting the lovely Brian of AntiDepAware and his equally gorgeous wife. We met with Bobby Fidd which is always a pleasure but who missed the chat afterwards having commandeered my poor husband to go outside for a smoke, and who subsequently both got lost.

The 3 gorgeous girlies under the age of 3 were hilarious, funny and little dotes. I don’t know how any household survives them, but I actually miss them already!

PS. The LegoLand experience was amazing and went without any major incident thankfully. All children accounted for, happy and alive, which is more than I can say for my eldest son’s involvement with Lundbeck pharmaceuticals and some uninformed Irish doctors.

Bob Fiddaman’s account of the meeting can be read here, while Brian’s can be read here.

Panorama Expose on Citalopram use in Pregnancy.

Unhappy pill

Next week BBC’s Panorama team are tackling the issue of antidepressant use in pregnancy. The programme will be broadcast on Mon 1st july, entitled ‘The Truth About Pills and Pregnancy‘.

According to the UK Independent “The programme will broadcast an interview with Anna Wilson, whose son David spent the first five weeks of his life in hospital. A 20-week scan had shown that David had a heart defect and would need surgery immediately after being born. Anna had been taking the prescription drug Citalopram to treat her anxiety four years before her pregnancy began, and was told that she was safe to continue whilst pregnant. The show will feature interviews with Prof Pilling, who will say that GP prescription guidelines are about to be updated to take into account evidence suggesting a link with SSRIs and heart defects.”

A manufacturer contacted by the BBC denies any link to major foetal malformations (no prizes for guessing Lundbeck here).

Panorama spoke to eight mothers who had babies born with serious heart defects after taking a commonly used SSRI (selective serotonin reuptake inhibitors) antidepressant while pregnant.

An article on BBC News stated “Lundbeck, the manufacturer of Citalopram, said a recent review of scientific literature concluded that the drug ‘does not appear to be associated with an increased risk of major foetal malformations’.”

It seems that Lundbeck are lying again or there is a serious lack of communication between the various medicines regulators and the pharmaceutical industry. Below is an adverse reaction report logged with the Irish Medicines Board involving a baby born with a Cleft Lip, associated with the mother’s use of Citalopram.

IMB 1

What about the following, also reported as Citalopram induced? This particular report concerns the intrauterine death of an unborn baby due to ‘Citalopram exposure during pregnancy’.

IMB 3

Then there was our meeting in Copenhagen with the two Lundbeck goons. We asked if Citalopram/Escitalopram was a teratogen. Their answers (or non-answers) may surprise you…

Leonie                       Right, will I go on because there’s no point, we’re stuck at that one?  Anyway.  Do you think that it’s advisable to virtually bathe foetuses in Serotonin given it is now accepted this family of drugs are firmly associated with birth defects?

Dr. Madsen               Virtually bathe?

Leonie                       Foetuses in Serotonin – pregnancy.

Tony                         Pregnant women.

Dr. Madsen               I don’t know what you mean by virtually bathe

Leonie                       I’m talking about anti-depressants are known to cause birth defects.  If you think so, would it not be better if women of child-bearing age were cautioned against, perhaps even contra-indicated from using this drug?  Citalopram or Escitalopram?

Dr. Madsen               Em, I think in…..

Leonie                       Your views?

Dr. Madsen               In pregnancy?

Leonie                       Yeah

Dr. Madsen               Em, I think em, physicians need to double their efforts to make sure that there is a correct risk versus eh, benefit eh, assessment of the em, of any action.

Leonie                       Is Citalopram and Escitalopram a teratogen?

Dr. Madsen               Em, meaning, what, what, what do you mean?

Leonie                       Can it cause harm to foetuses? Unborn babies.

Dr. Madsen               Em, obviously, in order to have our compounds approved we have done em, a large number of pre-clinical trials em, and we are constantly monitoring and the eh, while the recommendation I believe throughout, is to be, be extra cautious when administering any eh, medications to pregnant women…

Leonie                       Can it cause harm?….. to unborn babies?

Dr. Madsen               Anything can cause harm, can cause harm in any dose

Leonie                       So yes it can.

Dr. Madsen               depending on dose

Leonie                       Yep

Em, why if it can cause harm, is this not clearly, clearly stated on the packaging and information leaflet?

Mr. Schroll                Do you talk about the patient leaflet or do you talk about the SPC, the label that the Doctors use in order to prescribe the medication?

Leonie                       I’m talking about a pregnant woman that goes down and gets it in the chemist.  Is it on the patient information leaflet?

Mr. Schroll                In the patient leaflet it says you have to talk to your Doctor….

Leonie                       And what does it say in the Doctor’s leaflet?

Mr. Schroll                That he has to be extra cautious.  I think that if you go to the… to, to the Irish home page, I believe it is like that, it’s like that in Denmark and elsewhere.  If you go to the medicines agency authorities

Leonie                       So,

Mr. Schroll                the medicines agency authorities you can see what is in the checks that the Doctors and that is up to them to decide…..

Leonie                       So you are passing the buck back to the Doctor again.

Mr. Schroll                I think when it’s prescription medication, yes.  If it was eh, eh,

Leonie                       And will they be told that it can harm their unborn baby?

Mr. Schroll                Sorry?

Leonie                       Will the pregnant woman be told that the drug can, can harm her unborn baby?

Mr. Schroll                It would be part of the discussion to talk about the risks and the benefits and that would be up to the Doctor.

Leonie                       It would be up to the Doctor to tell them that the drug can harm their unborn baby?

Mr. Schroll                Eh, now, you’re talking…..

Leonie                       It’s not up to Lundbeck, no?  It’s up to the Doctor to tell the woman that the drug can harm their unborn baby?

Mr. Schroll                To be cautious, yes, yes.

The Irish word ‘amadáin’ springs to mind. I could think of a few English ones too but think I’d better refrain. The Panorama programme should be excellent viewing as usual, particularly with Shelley Jofre as reporter. She did the previous expose concerning GSK and Seroxat suicides. I can see her putting Lundbeck in their place.

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Lundbeck Meeting here.

IMB adverse reaction reports.

MHRA (UK) adverse reaction reports.

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.

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?

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