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IONA Hypocrisy?

Patricia Casey

My attention was drawn recently to an Irish Catholic article involving Professor Patricia Casey, well known Irish psychiatrist and IONA Institute patron (conservative Catholic advocacy group). The article ‘Simplistic therapy approach to suicide criticised in new study’ was published in the ‘Irish Catholic’ and centers on a study published in the Irish Journal of Psychological Medicine. The study Psychiatric and psycho-social characteristics of suicide completers: a comprehensive evaluation of psychiatric case records and postmortem findings is based on toxicology tests done post mortem and expresses the opinion that people dying by suicide were not adhering to their treatment (drug regime). The journal itself is the official journal of the ‘College of Psychiatry of Ireland’ – the same college which I have previously shown to engage in some dubious practices. While sending an ‘internal’ college e-mail to its members (regarding my son’s death where an antidepressant was implicated), it also forwarded the same literature to the drug company in question. While I have queried the ethicality of the latter with the college of psychiatry, no satisfactory answers have ever been forthcoming.

Leaving aside my possible subjectivity on the college’s questionable ethics, the article itself raises other relevant issues. Toxicology results post mortem are notoriously unreliable (Drummer et al 2004) and should not, as yet, be relied upon to conclude drug concentrations before death. I personally know of mothers who have lost their sons to antidepressant-induced deaths where the antidepressant escaped detection in toxicology tests. Two of these mothers vehemently objected and insisted on a re-test – in both cases the drug was eventually detected, once on the second time and once on the third time.

Issues:

Firstly, as the basis of the study relies on toxicology results, the reliability of toxicology tests post mortem was not addressed in the study.

Secondly, even if these toxicology tests were 100% reliable, it raises other important questions – how is it that 1/3 of the people who died by suicide were taking their medication? Were the drugs at best ineffective or at worst a causal factor in these deaths? It is noteworthy that the suicidality warnings included in antidepressant PILs (patient information leaflets), were put there, not by any well-meaning intentions of the drug industry, but by order of the FDA (American Drug Regulator) and EMA (European Medicines Agency) following lengthy investigations.

Lastly, again in the case of the toxicology being 100% effective, how many of the victims were in withdrawal from these highly toxic drugs? Treatment-induced (and withdrawal-induced) suicide has been discussed in another study (Healy et al 2006). This possibility has led regulatory authorities to warn doctors about the risk of suicide in the early stages of treatment, at times of changing dosage, and during the withdrawal phase of treatment. Was ‘withdrawal’ a simple oversight on behalf of the original study authors?

It seems to me that the Irish Catholic and the IONA institute have bigger fish to fry – treatment of the living for example. Considering the current abortion debate raging in Ireland, it strikes me as strange that the pro-life IONA patrons have not addressed the issue of the widespread treatment with antidepressants in pregnancy. Speaking last year on the problem of assessing suicidal pregnant women, Professor Casey said “Who will offer her the first-line treatments (antidepressants and/or cognitive therapy) she so desperate needs?” That antidepressants save lives is not evidence based(Healy 2006) and problematic in pregnancy according to Adam Urato (personal communication, June 29, 2015), expert in Obstetrics & Gynecology and Assistant Professor at Tufts University School of Medicine. He stated –

“The antidepressants freely cross over the placenta and into the developing fetus (baby) throughout the pregnancy. They have significant harmful effects for moms and babies including miscarriage, birth defects, preterm birth, preeclampsia, newborn complications, and long-term neurobehavioral problems. These chemical compounds—what we call antidepressants—are made in chemical factories and they go from these factories, into the pregnant moms, and then into the developing babies (fetuses). Nowadays, with 5 to 10% of all pregnancies being exposed to these drugs, what we are basically witnessing is a large scale human experiment. The track record of what happens when we expose developing babies to foreign chemical compounds is not good.  Chemicals have consequences for developing babies.”

Rather than focusing on dead people, the IONA Institute need to address treatment-induced fetal harm or it could be left wide open to accusations of hypocrisy. Suffer little children – a thorough investigation by the ‘Irish Catholic’ might be a good place to start.

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Drummer O, Forrest ARW, Goldberger B, Karch SB, International Toxicology Advisory Group. Forensic science in the dock: Postmortem measurements of drug concentration in blood have little meaning. BMJ : British Medical Journal. 2004;329(7467):636-637

Healy D, Herxheimer A, Menkes DB. Antidepressants and Violence: Problems at the Interface of Medicine and Law. PLoS Medicine. 2006;3(9):e372.

Healy D, The antidepressant tale: figures signifying nothing? 

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Superheroes at ‘Wicklow Glass and Glazing’..

Dec 2013 053Well Maria Bradshaw has finally landed in Ireland.

Following the death of her lovely son Toran, Maria set up Casper NZ. Statistics have shown that in groups associated with Casper – a reduction of suicide by 20%. It seems inexplicable to me, that despite the billions spent on psychiatric drugs in this country, the suicide rate here is abominable. At the very least, the drugs are not working. At worst, the doubling of ‘suicide and violence’ which accompany psychiatric drugs, particularly SSRIs, are making the suicide rate much much worse.

Anyway, there she was, at Dublin airport, all possessions in 2 suitcases, persuaded by a mad Irish woman to move half way across the world to tackle Ireland’s suicide ‘problem’, accompanied only by Toran’s ashes, when disaster struck – some airline or other had manhandled Toran’s beautiful ‘ashes’ container and broken 3 glass panels. So there’s my lovely friend, alone on the other side of the planet with her most precious possession in tatters, jet-lagged and on the verge of an Irish/Kiwi meltdown.

Averting a meltdown.

Never fear, the lovely Supermen of ‘Wicklow Glass and Glazing’ came to the rescue. After a frazzled conversation, undignified it has to be said, with a couple of hugs and copious litres of tears, Toran stayed overnight in Wicklow, safe in the gentle hands of Stephen and Mark. Toran’s beautiful ornate container was ready the next day, more beautiful than when it went in. These lovely men would not accept any remuneration for their very intricate and extremely delicate assignment. Who said chivalry is dead? Superheroes, in the guise of Stephen and Mark, although with underpants thankfully under their trousers, came to Maria and Toran’s rescue.

Well done to the lads in Wicklow Glass and Glazing!! Phone (0404) 68382 We remain forever in your debt.

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.

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

Ah Yes; The Lundbeck Salute.

Lundbeck two finger saluteI have always said that I never get angry, but I think I may have to revise that statement. You’d think by the following conversation, that I had lost my purse or something equally trivial, but hey, what’s a son to Lundbeck pharmaceuticals?

Sept 20 2013

Causality Assessment.

RE; My son’s death (Shane Clancy)

To whom it concerns,

It has come to my attention that the CIOMS report which I have received for my son’s death is unfactual. The box marked ‘did event reappear after reintroduction’, is inexplicably blank. As you can see from my son’s medical records which I have attached for your attention, there is clearly a challenge, dechallenge and rechallenge period. The significance of my son’s suicide attempt shortly after his consumption of Citalopram and his completed suicide shortly after rechallenge surely did not go unnoticed by your pharmacovigilance department?
As this seems to be an oversight on Lundbeck’s part, can you rectify this important issue and get back to me and the Irish Medicines Board with another assessment. As I’m sure that deceased children are of huge importance to Lundbeck, this matter is surely one of utmost importance in order to prevent future fatalities.
Regards,
Leonie Fennell
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Reply Sept 25 2013

Dear Ms Fennell,

I refer to your query below concerning the CIOMS report for your son’s case. The CIOMS form was completed in compliance with pharmacovigilance legislation which requires a revision of the form on the receipt of relevant new information. There is no requirement for a revision of the CIOMS form, as the case is considered up-to-date by the Irish Medicines Board.

Yours sincerely,
Medical Department,

Lundbeck (Ireland) Ltd

Newspaper and internet articles, Our story., Random

Wicklow Casper Conference

PresentationWell, I did it. I survived the conference with Maria, I didn’t run out the side door and she didn’t have to slap me; well not too hard anyway. Maria was fabulous and I couldn’t have asked for a more experienced ally.

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She was able to give people a real feel for her son Toran, along with an abundance of science behind drug-induced deaths. The stories we heard on Saturday were tragic and very avoidable, but hopefully we can inform the future generation and stop the madness that SSRIs are inducing. 

Maria is the CEO of Casper NZ. New statistics have shown that in the groups which Casper has helped, there has been a 20% reduction in deaths by suicide. For young people that is a stunning reversal, because in the previous year there had been a 45% increase in 15-19 year olds taking their own lives. That has never been done in Ireland and we need to take notice. Despite all the suicide awareness groups, pharma funded and otherwise, the suicide rate in this country is huge. Maria has been asked to speak in other countries including Dubai, The Cook Islands, Australia and the US. I have no doubt she is making a difference; can we possibly ignore these results or will we just keep over-prescribing the unhappy pills which double the risk of suicide and violence?

PS. Thank you so much to everyone who made a huge effort to attend, from all over the country and indeed from across the water. I am humbled! Video to follow once my son Jake gets his act together and posts to Youtube.

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Let’s Talk About Suicide.

Flier

The above talk will include evidence and experience, both from myself and Maria Bradshaw, CEO of  Casper New Zealand. There may be other speakers or there might not, we’re winging it a bit at the moment. Anyway, everyone is welcome and I can assure you, we will try not to disappoint.

What I should have informed Maria is that the last time I did any public speaking I was about ten. My mother thought it was a good idea to send me to elocution lessons (should have got a refund). The elocution teacher, Miss Meredith, decided to put us in a Feis Ceoil (Festival of Music) where I was to recite ‘The Grandfather Clock‘ to a humongous room full of strangers. The first line came into my head, then zilch, nothing, nada, a blank empty head was left where my brain had once been. The prompter, whose prompting was getting louder and louder, might as well have been speaking double dutch, and to add to my humiliation I had to be escorted off the stage as my feet had mysteriously cemented into the highly polished wooden stage.

So whether you’re coming to see if I’ve improved or whether you’re coming to listen to Maria’s expert testimony, you’re all very welcome.

Newspaper and internet articles, Random

Why would anyone defend the use of Lariam?

Sgt. Robert BalesRTE’s Prime-time (Irish National Broadcaster) tackled the issue of Lariam-induced suicides within the Irish army on May 23rd. The programme can be viewed here.

For those who are not aware of Lariam (aka Mefloquine), it is a highly controversial anti-malaria drug used within the defense forces when deployed overseas. The drug can cause many serious adverse effects and numerous families have blamed it for their loved one’s suicide. Interestingly, it comes 5th in the PLOS ONE ‘Prescription Drugs associated with violence’ study (after Champix and Seroxat). The US army stopped the use of Lariam following numerous suicides and severe psychiatric reactions associated with its use. Tragically, for all concerned, this drug has been implicated in the massacre of 17 Afghan citizens including children by Sgt. Robert Bales (pictured) on March 11, 2012. His wife said “I have no idea what happened, but he would not – he loves children. He would not do that.

A few weeks after the Prime-time programme (which included grieving families and their harrowing testimonies), I was disappointed to see the Minister for Defence, Alan Shatter, defending Lariam in the media. He defended the use of the drug, disputing its links to suicide and said “There is no evidence in any of the coroners’ inquests linking any deaths to Lariam.” He seemed to have completely undermined the Prime-time programme and it made no sense to me. Why would he do that?

Sorry but I have no answers to Minister Shatter’s involvement but I do have a very recent warning (8th July 2013) from Roche Pharmaceuticals which the Minister might find embarrassing. The link can be found here but Minister Shatter might find the excerpt below interesting.

Lariam

Minister Shatter said of the nine cases of lariam suicides” “given the limited period of time during which Lariam remains in the bloodstream, according to our expert advice, it is extremely unlikely that the product could have been a contributory factor in practically all of these cases”. Irish Times June 19th. The following excerpt may help him a little bit with that one:

Lariam 1

Roche, who originally marketed Lariam, is no stranger to controversy, having also invented the notorious acne drug Accutane. This drug is also widely linked to suicide and following numerous lawsuits in 2009 Roche pulled the drug from the US market. The Irish Medicine’s Board still allow it though despite a high profile court case involving a courageous Irish father here. Roche’s corruption and intimidation tactics were subsequently captured in Doug Bremner’s ‘Before You Take That Pill’.

What I do find interesting is why Roche came out with the warning now. Was it pressure from the Prime-time documentary? Was it pressure from the pharma-funded Irish Medicine’s Board? I doubt it! But one thing is for sure, it was not out of the goodness of Roche’s pharma heart.

Lariam 2

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Army reviews notorious drug after Afghan massacre

PLOS ONE ‘Prescription Drugs associated with violence’ 

US Army curbs Lariam

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

When is a suicide not a suicide?

@AntiDepAware

This blog was written by Brian today. His blog ‘AntiDepAware‘ is such a revelation. His knowledge on prescription drug-induced deaths, coupled with brilliant investigational skills, surpasses no-one that I’m aware of.

It may come as no surprise that most of the victims in this particular blog were on Citalopram. Despite drug companies admitting that antidepressants (SSRIs in particular) can cause a person to commit suicide, Coroners seem to be lagging way behind in informing themselves. Have a read for yourselves:

When is a suicide not a suicide?

Robert Keywood was married and had two daughters, lived in Kent, and worked for Kimberley-Clark as director of human resources.

A few weeks before his death, he had travelled to Poland and America on business and was having trouble sleeping. He went to see his GP, and was prescribed sleeping tablets and antidepressants.

One Friday last November, Mr Keywood drove to the Pentagon shopping centre in Chatham, where he took his own life by jumping from the top of the multi-storey car park (right). A note left on the passenger seat of his car read: “You’re better off without me, love Bob.”Multi story

Ann, his wife of almost 30 years, told the inquest her husband had acted “agitated” and “out of character” on a number of occasions before he died.

CoronerDeputy assistant coroner Alison Summers (left) said, “One gleans some insight into a particular person’s life and it’s clear to me this was very out of character,” before recording a verdict of suicide.

To give a verdict of suicide, a coroner needs to be certain that the person intended to kill himself or herself. Often, the existence of a written note is regarded as evidence of intent. In this case, Mr Keywood had written just seven words on a piece of paper left in his car.

In a case where medication could well be the cause, however, it is surely relevant to ask the question: “Would the person have killed him/herself if he/she had not been taking medication?” In this case, like so many before it, Mr Keywood had no recorded history of depression, and only began to act agitated and out of character after having been prescribed medication. From the newspaper report, it would appear probable that an adverse reaction to antidepressants was responsible for Mr Keyword’s death. Therefore, unless there are circumstances that have gone unreported, suicide may not be the correct verdict in this case.

Like Mr Keywood, Trina Clinton, a 54-year-old housewife from Redditch, took her life by falling from a multi-storey car park in March 2005. Worcestershire Coroner Victor Round originally recorded a verdict of suicide but told the court that a blood test revealed the prescribed antidepressant Citalopram in Mrs Clinton’s blood.

After Mrs Clinton’s sister-in-law said that the antidepressant “must have been a contributory factor”, Mr Round changed the verdict to “suicide while under medication”. He then modified his verdict again to record an open verdict.

In the same month, Carwyn Lewisa 38-year-old air steward from Carmarthen, was found dead in a bath full of water with a travel case full of books on top of him. He had been suffering from depression for some time.

But the coroner said he could not record a verdict of suicide because of the possible side-effects of the antidepressant drugs that Mr Lewis had been taking. He recorded an open verdict.

Ian Fox, a 65-year-old retired postal worker from Edgware, died in July 2008 after throwing himself in front of a train at Finchley Road Tube station.

He had been prescribed the antidepressant Citalopram for just one month before taking his life and he had expressed a wish to come off it, complaining of confusion and anxiety.

At his inquest, Mr Fox’s wife blamed her husband’s sudden death on the medication, saying that her husband’s action was completely out of character. She described how, until he began taking Citalopram, he had only been suffering from mild depression, brought on by retirement from his job and a foot injury.

Coroner Dr Andrew Reid recorded a narrative verdict in which he accepted that Mr Fox had jumped in front of the train, but added: “I’m satisfied he did so while the balance of his mind was disturbed while suffering the adverse effects of Citalopram.”

Brian PalmerIn September 2011, self-employed electrician Brian Palmer (left), 63, from Littlehampton, visited his GP as a consequence of financial worries. He was prescribed Fluoxetine (Prozac) and Zopiclone. A few days later, Mr Palmer shot himself.

At the inquest, Mr Palmer’s widow Jennifer told the inquest that days after Mr Palmer began taking the drugs, his mental health deteriorated. She said: “I noticed a change in him almost straight after taking the pills. I asked to see the box in the days before but he said he couldn’t find it. I found it a few days after his death and it listed all the changes I had seen in him. My heart just stopped. I didn’t go down there with him, when he picked up the prescription – I wish I had. We have had to learn the hard way. I can’t bear to think of any other families going through this kind of trauma.”

Coroner Penelope Schofield recorded a narrative verdict, in which she concluded that Mr Palmer took his own life following the prescription of antidepressant pills.

In each of the four cases above, the deaths have been linked to the victims’ reactions to antidepressant medication. Yet two of the cases resulted in open verdicts, while in the other two, narrative verdicts were recorded.

My database also contains cases where coroners have turned a deaf ear to evidence pertaining to reaction to antidepressants. This was particularly noticeable in inquests into the Bridgend hangings.

At the inquest of Christopher Ward, for example, a police officer provided the information that 29 year-old Mr Ward “had been prescribed Citalopram for depression.” Even so, Coroner Peter Maddox declared that: “There was a lack of anything in the system that would have altered his judgement, you would expect him to understand what he was doing and the consequences,” said Mr Maddox. “I can’t ignore the circumstances in which he was found, the toxicology results which suggests he was in control of his faculties.” Mr Maddox recorded a verdict of suicide, thus completely ignoring the possibility that Citalopram may have “altered his judgement”.

Lana WilliamsIn the case of 20 year-old mother Lana Williams (right), her fiancé said she had seemed “in good spirits” when he had left the house for work on the morning of her death. A police officer reported that “although Miss Williams had suffered post-natal depression, for which she was still taking medication, there was no other history of mental health problems.” After hearing the evidence, “Coroner Peter Maddox said he thought an appropriate verdict was that Lana Williams took her own life.”

It has been proposed that there should be a separate verdict for those who have taken their lives while under the influence of prescribed medication. This would be a verdict of “Iatrogenic Suicide”, the word iatrogenesis being defined as an inadvertent adverse effect or complication resulting from medical treatment or advice. This would be supported by those who are concerned that suicide figures are underestimated due to the number of self-inflicted deaths registered as open or narrative verdicts.

On the other hand, Dr David Healy writes that: “If someone jumps to their death from a 10th floor balcony under the influence of LSD, unless there is clear evidence beforehand that this was what was planned, an open verdict would be more appropriate than a suicide verdict.”

SSRIs are capable of causing similarly tragic outcomes, and bereaved families who recognised that their loved one’s death was caused by a reaction to medication would be disappointed to receive a verdict of suicide in such cases.

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

Brian’s Beachy Head Stories

Beachy HeadThis post was recently written by Brian at AntiDepAware. Here he argues the idiocy of experienced Coroners who should know better. The post involves Beachy Head inquests which are largely presided over by Coroner Craze and Deputy Pratt (and no I didn’t make that up).
Incidentally, while looking for a picture of Coroner Craze I realized that he was the same Coroner who decided that author Elspeth Thompson died by suicide. At the time of her death she had also been recently prescribed antidepressants. When will Coroners grasp the fact that a drug-induced suicide is not suicide? Ireland has a similar ‘hotspot’ in the Cliffs of Moher. Here consultant psychiatrist Dr Bhamjee states that the ‘suicide’ issue needs to be tackled, although considering his stance on NewsTalk last week, he wont be blaming the mind altering drugs! Now there’s a surprise!
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Beachy Head Stories

Posted on April 18, 2013 by 

Beachy Head is a chalk headland in Southern England, close to the town of Eastbourne in the county of East Sussex. The cliff there is the highest chalk sea cliff in Britain, rising to 162 metres above sea level. Its height has also made it one of the most notorious suicide spots in the world.

There are an estimated 20 deaths a year at Beachy Head. The Beachy Head Chaplaincy Team conducts regular day and evening patrols of the area inSamaritans Call-box attempts to locate and stop potential jumpers. Workers at the pub and taxi drivers are also on the look-out for people contemplating suicide, and there are posted signs with the telephone number of Samaritans urging potential jumpers to call them.

During the past 10 years, the majority of inquests relating to these deaths have been carried out either by Alan Craze, coroner for East Sussex, or by his Deputy, Joanna Pratt. Remarkably, not many of the inquest reports to be found in the newspapers of East Sussex mention either toxicology findings, or the medical history of the victims. It would seem fair to assume that these tend not to be brought up at the inquests themselves – at least, not instigated by the coroner.

Nevertheless, here are just a few of those stories.

In November 2003, Mr Craze presided over the inquest of Oliver Carter, an ex-soldier from East Sussex who drove his car off Beachy Head after breaking up with his girlfriend. Mr Carter had been discharged from the Army the previous year, when he was diagnosed as having a depressive illness. He had been placed on the antidepressant Citalopram. His brother Toby said: “I saw him six hours before his death. It was the best I had seen him for a good long while that night.” Mr Craze delivered a verdict of suicide, without considering why Mr Carter’s mood had changed so drastically.

Days before his death in July 2008, Giles Parker had been prescribed antidepressants, following months of declining such treatment. Three days later he turned up at 6am at the hospital in Eastbourne saying he had taken an overdose of around 30 tablets the night before. He was seen by a doctor, and a series of tests were taken. He told staff he did not have suicidal thoughts and left the hospital. The inquest heard that a couple were walking on Beachy Head later that morning at around 10.15am when a vehicle that Mr Parker was driving sped by on a nearby track. A witness statement said, “He ran around the back of the vehicle, towards the cliff edge and dived off.” A post-mortem showed he had died of multiple injuries.

Mr Parker’s mother said she had no doubt he had taken his own life because he could no longer live with a mental illness. She, along with Mr Parker’s sisters, questioned why the team at the hospital on the day did not have access to his previous mental health records and why, if someone came into hospital having said they had taken an overdose, they would be considered not suicidal. A consultant at the A&E department said that Mr Parker was deemed a low risk and therefore the hospital could not stop him from leaving the premises. He told the inquest that the team did not have access to patients’ mental health records because of legal reasons. Had Mr Parker been seen by the psychiatric liaison team they could have accessed any such records.

Coroner Alan Craze said, “I find myself on so many occasions saying ‘if only’. If only Mr Parker had chosen to stay or there was something medically wrong this might have been different but the fact is he didn’t.” Recording a verdict of suicide he called Mr Parker’s death an ‘awful tragedy’ and added, “I can’t see that anybody linked to this tragedy could have taken different action.” Yet Mr Craze himself could have taken a different action. By 2008 he must have been aware how volatile antidepressants can be at the beginning of uptake. Nevertheless, he failed to let Mr Parker’s family know about the significance of the medication that had, in all probability, led him to the hospital, and from there to the cliff.

Medical student Matthew Campsall was spotted at Beachy Head by a coastguard who said he had seen a man who was pacing up and down over the fence line. He was then seen to walk to the cliff edge and disappear. Matthew, who had in fact driven all the way from Leicestershire, a distance of approximately 300 km, to take his life, had previously spent a few days in a psychiatric unit after presenting bizarre behaviour while in A&E.

His care co-ordinator said, “I think that he felt he had been working a lot, doing lots of odd hours, no sleeping pattern on top of revising for finals, he found he was under a lot of stress.” She added that he was making jokes the last time she saw him, a fortnight before his death. A psychiatrist added that Matthew had been relatively frank in meetings. Responding to these comments, Coroner Alan Craze said, “This is a rare case, even with hindsight there’s nothing to indicate to me as a lay-man or to you as a professional that he was at risk of taking his own life.”

He recorded a verdict of suicide while the balance of the mind was disturbed. Matthew’s parents gave an interview to the Sunday Mercury that revealed more of his story: “When his girlfriend left him, he had mild depression but literally just mild depression. He was prescribed Prozac, which we didn’t know about and were unhappy about, but he seemed to be recovered and had seen a counsellor. The moment you mention those things people start thinking there is more to this. But if you had seen him in the weeks before this – he went on holiday to Yorkshire and with his aunt to Bournemouth. “The only thing we can think is the failure on the course, but on the other hand 35 people failed this year. As far as we know six or seven of his friends had failed, so he was going to go back with them to retake it. But you don’t know what’s happening behind the eyes. We don’t understand why he did it.’’

Perhaps by now Matthew’s parents know more about the propensity of Prozac to induce suicidal thoughts. What is certain is that they were not given that information at Matthew’s inquest.

joanna_pratt

Mr Craze’s deputy, Joanna Pratt (above) appears just as adept at ignoring evidence concerning the effect of antidepressants. This can be seen in the inquest of Jason Edwards. The 40-year-old father-of-two had been prescribed antidepressants in November 2009 after suffering from sleep problems following a bad back. Paula Harding, his partner of 22 years and the mother of his children, said, “He wanted a short-term fix to enable him to get a few nights’ sleep so he could go up to London to further his business. “When he came back with anti-depressants I was surprised because he said he only wanted something to help him sleep. “The anxiety was down to getting his business moving. It was just frustration.”

Ms Harding said Mr Edwards changed after he started taking the medication. “Overnight he seemed to change,” she said. “He was restless and agitated. He said he felt like there was adrenaline sawing around his body.” Ms Harding said her husband had gone from being confident and easy-going to paranoid since he started taking the medication. She said, “I said, ‘you have got to go back, you need to get off this’. It was just not right.” Ms Harding always wanted her partner to get off the medication and she researched the drugs and found psychosis and paranoia were recognised side-effects.

There was a time when Mr Edwards stopped taking the medication for a short period and Ms Harding said his mood and behaviour settled. Mr Edwards had many appointments with his GP, was referred to the community mental health team in Littlehampton and tried meditation and hypnotherapy. He experienced ups and downs and admitted that he had suicidal thoughts when filling out a depression questionnaire at his doctor’s surgery. At that point, his GP changed his medication to an anti-depressant which he said was less dangerous in overdose. Presumably this would be an SSRI, which is particularly risky upon starting or changing dosage. Despite continuing his job and taking their daughter to school, Mr Edwards’ mental state worsened and on March 19 he sent a goodbye text message to his brother from the top of Beachy Head. His body was recovered from the foot of the cliffs by coastguard teams the next day.

After hearing all this first-hand evidence, Miss Pratt simply recorded a verdict of suicide.

The most recent name in my inquest database is Sally Ann Vye, a redundant shoe shop manager who, like Matthew, also made the 300 km journey from Leicestershire. Last June she travelled by bus to London, and then took another bus to Eastbourne. She was rescued on the edge of the cliffs by members of the local chaplaincy team, and taken back to Leicestershire. Twelve days later, she repeated the journey, but this time there was  nobody to stop her achieving her goal. She was on antidepressants.

http://antidepaware.co.uk/

http://antidepaware.co.uk/what-the-coroners-say-part-1-2003/

http://antidepaware.co.uk/what-the-coroners-say-part-2-2004-2005/

http://antidepaware.co.uk/what-the-coroners-say-part-3-2006-2008/

Twitt
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Newspaper and internet articles, psychiatry

Sundance Diagnostics, a genetic test pre-suicide

Sundance Diagnostics<- Click on the picture to go to the Sundance website.

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Did you know that there could soon be a test which will enable doctors to establish whether a person will react badly to antidepressants? An American company, Sundance Diagnostics, is in the early stages of developing a Genetic test for Prescription Drug Side Effects. This test, if successful, will establish whether a person is at risk of Suicide and Violence before (not after) being prescribed an antidepressant.

This from their website:

“Sundance Diagnostics is working to develop the world’s first genetic safety tests to predict a patient’s risk of antidepressant-induced suicidal thinking or behavior. There is a strong need to make pharmaceutical drugs safer for patients—especially when those drugs have serious side effects and are being sold to millions of people. Sundance is using the most advanced genetic technologies to develop its safety tests to predict a patient’s risk. The goal is to save lives, improve treatment, increase patient confidence in treatment, and reduce the cost of treatment.”

CEO Kim Bechthold, referring to the fact that over 90% of school shooters were on psychiatric drugs, stated “The importance of genetic tests to curb the risk of suicide and risk of acts of violence has been heightened as governments and communities search for effective ways to halt tragic mass shootings.”

Maria has written a great article on the MIA website about this. Unbelievably, she mentioned that she was offered a blood test to assess any risk for her cat pre-operation but not a test for her 17 year-old son Toran who died by a Fluoxetine/Prozac induced suicide. I could argue forever that a ‘drug-induced suicide’ is not suicide but that’s for another day. In her article Maria debated whether this test would in fact give the impression that antidepressants actually work for some people and she didn’t want to give people false hope. She answers that one perfectly, as usual. My thoughts on that one slightly differ with others. If you or anyone else is on an antidepressant and feel that the drug is helping, whether it’s the placebo/smartie effect or not, why fix what’s not broken? It’s when the drugs don’t work and cause awful adverse-effects such as suicide and homicide, that I do have a big problem. Informed consent, which you don’t get in Ireland, is my problem. If a person is pre-warned of the possible adverse-effects as recommended by the Irish Human Rights Commission, at least that person will have some chance of survival. In Ireland, people do not get that chance. Considering that this test is being developed in America at huge expense and, if successful, will be used worldwide, what will Ireland’s excuse be? That there is no point ordering a test which will solve a problem that doesn’t exist?

What surprised me most was the comments under Maria’s article, where some people opined that this test might actually make things worse. I hadn’t actually thought about that, and while there are some valid and understandably differing opinions, if this test is successful, in my opinion the pros will definitely outweigh the cons. Or in psychiatric language, in this case (unlike with antidepressants), the benefits will definitely outweigh the risks!

Maria’s Article.

Sundance Press Release 3-11-13 A (3)

I, being a natural cynic, had a few questions which I needed to be clarified. I put them to Kim and her scientific advisor, Peter Tolias, Ph.D,…

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I’ve been enquiring about suicide tests and read a lot about the STAR*D trial. What happened to the hints of a Pharmacogenetic marker from the STAR*D study that you initially referred to?

Dear Leonie,

This is Peter: The STAR*D study itself was the largest and most comprehensive study ever performed that studied drug-induced suicide risk, however, the technology that was available to be used at the time to examine markers only allowed them to study a small fraction of the human genome.  In spite of this, several new markers were identified that could ultimately be useful as a component of a broader genetic test.  These STAR*D markers, plus additional markers we hope to be discovered by Sundance, need to be confirmed in an independent study before a test is ready for the clinic.  Sundance intends to initiate a clinical trial for confirmation just as soon as the sequencing study is completed.

Your press release mentioned Whole Genome Screening (WGS) being an advance on Genome Wide Association Screening (GWAS). Will WGS really tell more than GWAS would?

This is Peter; Absolutely, because whole genome sequencing means identifying the complete sequence of a patient’s genome rather than a fraction of a percent identified by GWAS.  (10 million compared to 3 billion base pairs in the haploid genome (or 6 billion nucleotides), roughly 300 times the information)

How soon do you intend to have this genetic testing ready for distribution, months, years, decades?

Leonie, this is Kim again.  The sequencing portion of our work and the confirmatory study can take from 12 months to 18 months.  Sometimes a study actually has to be redone, resulting in more time.   If the sequencing is successful,  and if all else goes well, we could have a laboratory-developed test for physicians in 18 months in the U.S.  If we seek FDA approval, it will require at least another year.  FDA approval is not required in the United States however. For approval in Ireland, we will submit our initial confirmatory study results.  If the authorities require the type of studies that are required for FDA approval, it will take additional time.