Professional Suicide

March, 2, 2012 | 13 Comments


  1. Just after this was posted, my attention was drawn to an uncritical editorial in the Lancet, praising the research of R Gibbons.

    This editorial ignores the extensive criticism of this research in multiple places (see Coincidence a fine thing – for a critique) and elsewhere:

    This Lancet comment is matched by an editorial from Fiona Godlee in the BMJ last week casting doubt on Irving Kirch’s findings
    “This evidence counters widely publicised claims made in a meta-analysis, published in PLoS Medicine in 2008, that they had little or no effect except in people with the most severe depression. Such claims may well have dissuaded
    patients and some clinicians from considering or continuing antidepressants. It’s good to see them countered here”.

    So doctors waiting for the guillotine to fall can comfort themselves with the friendly faces of Richard Horton and Fiona Godlee knitting.

  2. Dr. Healy, why is it that in in most of the Gibbons et al. papers Dr. J. John Mann is listed as the last author? My understanding is that in academia, being listed as last author in a scientific paper is significant. Is this true?

    Dr. Mann appears s to have a close relationship with the pharmaceutical industry re clinical trials of psychiatric drugs. How can we then trust the objectivity of anything written by Gibbons et al. where Mann is a co-author?

    ie. CMAJ February 3, 2009 vol. 180 no. 3

    J. John Mann holds a research grant from GlaxoSmithKline for a positron emission tomography study of amyloid protein levels in the brains of patients with Alzheimer disease and mild cognitive impairment. He also holds a research grant from Novartis for a positron emission tomography study of mGluR5 receptors in depression.

    Your help in understanding this is appreciated.

    Neil Carlin
    Oakville, ON

    • I don’t put a great deal of store by conflict of interest – I think we are all biased. The progress of science depends not on purity of motive but access to the data and the ability of a wide range of people with mixed backgrounds and motives to scrutinize the data. The major problem is we don’t have access to the data. A second problem as recent posts have tried to point out is our blind faith in controlled trials especially trials done in patients with an illness. Pfizer, whom John Mann has also consulted for, had no problem detecting the agitating and aggression inducing effects of Zoloft when given to healthy volunteers – see Mystery in Leeds. Having made all these points, I have to say John Mann is one of the few people in recent years who have been prepared to engage with me in public debate on the issues

  3. Great article. I have always remembered a tutor I had when training to be an RMN, who stated that most people suffering from depression will get better within about 6 years………without medication. Hopefully, that could be reduced by some quality, timely therapeutic intervention not involving medication. ( I have no idea where he got his figures from I’m afraid) The trouble is that we ( society) want a quicker “fix” and therefore Anti-depressants have become the norm. I have often wondered if a placebo would have worked just as well and be far less dangerous!

    • The mean time to recovery in melancholia/psychotic depression before the availability of antidepressants and other treatments was of the order of 5-6 months. See Harris, M., et al., The incidence and prevalence of admissions for melancholia in two cohorts (1875–1924 and 1995–2005), J. Affect. Disord. (2011), doi:10.1016/j.jad.2011.06.015

  4. Dr. Healy , when you stated:

    “The American Psychiatric Association statement should have read: ‘The American Psychiatric Association believes that Psychiatrists save lives.””

    you encapsulated the problem for U.S. psychiatrists and, by extension, psychiatrists all over the world. Psychiatry professional organizations have sold psychiatrists’ birthright of providing medical care for a mess of pottage from pharmaceutical companies.

    The APA can’t claim psychiatrists save lives (if only this were true) because for 20 years it’s worked to promote psychiatric drugs as invariably safe, no-brainer prescriptions.

    Why go to a psychiatrist rather than a GP for psychiatric care? To make a case for a value-add for themselves, psychiatrists would have to demonstrate they provide safer and more effective treatment than non-psychiatric doctors, nurses, or physician assistants. Which is to say, they’d have to point out adverse effects and health dangers of psychiatric drug prescription and inaccuracy of diagnosis as provided by others.

    Unfortunately, psychiatry can’t make that case. Most psychiatrists act as no-brainer drug distributors, no better than GPs, and psychiatry professional organizations are, indeed, driving psychiatry clinicians out of business.

    One wonders why any psychiatrist who wants to truly practice medicine and help patients continues to pay dues to the APA. All should sign the DSM-5 petition at and withhold dues in protest.

  5. Anything on record of placebo causing the ‘electric-like zaps’ associated with SSRi discontinuation [withdrawal]?

    I know suicide attempts have been reported on placebo but I’ve not come across any reports of the zaps. Then again, my access to clinical trial results is restricted.

  6. The DSM-5 petition has a video that explains a lot but psychiatrists don’t want to get involved.

    I don’t know but it seems to me that even the psychiatrists that are fighting all of this are having difficulty in uniting and spreading the word.
    You work alone, the others work alone, have sites, are at Facebook and only those who are aware of what is happening comment.
    What is the use of preaching for the converted?
    Many patients and serious people, like Charles Medawar, gave up fighting.
    I’m one of them. I have a blog but I stop publishing like I did in the first two years.
    Now I’m dedicated to this blog.
    The Phase 4 of clinical trials is not being done and the words of those who took these drugs is considered as anecdote evidence and we are put in disbelief by the pharmaceutical industry astroturfers that is everywhere.
    The clinical experience is not reported as a source of data. How can it be that the suffering of the patients is not relevant?
    I never saw any psychiatrist claiming that one, two or zero of their patients committed suicide or an homicide because of drug-induced violent behavior.
    Quoting SSRI stories, even though Rosie is doing a great job, is not enough since it can’t be used as evidence and psychiatrists working for the Big Pharma say that they laugh when visit this site.
    Charles Medawar database is closed and I remember the numerous people telling their struggle with withdrawal.

    This is sad and… blah blah blah…

    • You’ve outlined one of the reasons for The arguments often work for Pharma because they appear to have data and others just have anecdotes. The data offers a focus for people who may have very disparate opinions. On the other side there has been no data for people to unite around and critics have tended to fall out over nuances of meaning – as you hint. will offer data rather than individual points of view and this hopefully will make a difference.

  7. My friend who lost her daighter to Celexa tried to bring the information revealed in these articles to the attention of her physician, who refused to acknowledge that it might be valid, and insists that antidepressants are helpful. Jeannie, who died, was an anolmaly in her view. There is enormous resistance by doctors who have invested years believing in these drugs to understanding the lessons that dispassionate analysis of the evidence reveals.

  8. I did a post about one of my suicide attempts when I was tapering Effexor.
    For 18 months I tapered 225 mg of Effexor. It was hell. In the end of the process I discovered that I could not function without Effexor any more.
    I’ve been on the drug for too long.
    For three months I was not able to function… but this is another story.
    I take 150 mg now. I wish I knew that the last dose, 37,5 mg, would be harder to withdraw.

    If I knew that I would have taken 37,5 mg for a long period of time. Months or even years before withdrawing it.

    But what I want to share is that real suicide ideation is very different from the drug-induced. This is my story:

    “I said that I had suicidal ideation while tapering Effexor. What I didn’t say is that I’ve tried to kill myself twice. I thought about it on a wide scale of degrees. Four times it was very hard to cope with it and for two times I’ve tried.
    I’ll tell you about one of these times.
    I was in a normal day, tapering Effexor. All of a sudden, an idea was planted in my brain: “-I have to kill myself.” Just like that. Unexpectedly, no reason for it, I was happy and then this idea appeared.
    You don’t think about anything else. You only think that you have to kill yourself. I wrote some notes for four people, and was thinking at the back of my mind: “-This is withdrawal, this is withdrawal, this is withdrawal…; call your therapist, call a friend, do something!”
    Strangely enough you don’t call anybody. You do not care. All you have to do is… kill yourself.
    I have a dog. So I could not do anything at home for I could not harm her or make something that could kill her, like gas – my second attempt was with gas -, and you keep on wandering how are you going to do it without making any fuss and avoiding the scandal of being found dead in your place. Good, at least there’s room to think about a dignified exit!
    I had many samples of psychiatric drugs, drugs that I tried, and, at the forth pill had to stop… I had an arsenal of psychiatric drugs of many kinds.
    Therefore, I took them all and put them in two bottles of Depakote – by that time it was sold in bottles not in blister. “-It’s withdrawal, it’s withdrawal, it’s withdrawal… do something; call someone; call your therapist, please!” “-Nope! I have to kill myself.”
    I’ve phoned a hotel and ask for a bedroom. I’ve dressed myself with care and took a big bag pretending to be coming from a near town. I have put some clothes in this bag and a bottle of Jack Daniels to have the pills, Rohypnol was in the cocktail which is very helpful and was once used by the site Exit . They used to sell a packed for those who wanted to do euthanasia and I’ve discovered that one of the three items was Rohypnol. They are back now but with another proposal.
    “-It’s withdrawal, it’s withdrawal, it’s withdrawal… do something; call someone; call your therapist, please!” “-Nope! I have to kill myself.”
    It was 9 pm. I went away from my building, took a cab, and told the driver to go to the hotel. He left me there.
    When I was in front of the hotel, I felt thirsty and did not want to appear as if I was out of my mind. I went to a place and asked for a bottle of water.
    I thought that the man could not hear me. By miracle, he gave me the bottle of water. I took it and, miracle, I’ve paid for this and he smiled at me. He smiled at me!
    So people could see me! “-It’s withdrawal, it’s withdrawal, it’s withdrawal… do something; call someone; call your therapist, please…
    Isn’t it good!
    I’m alive! I started walking. I’ve walked, walked, walked, and started to sweat.
    Nice feeling! I was sweating and feeling all my body, my legs, my arms, my head, my hands, my toes…
    “-It’s withdrawal, it’s withdrawal, it’s withdrawal…”
    What am I doing here? Why will I kill myself? I don’t want to kill myself.
    My dog is home! She must be feeling sad. I have to go back home to see her and call my friends and family.”

    “I want to thank Charles Medawar, SocialAudit. There was a man on his site whose nick was “Anon”. He helped everybody and one of the things I’ve remembered was he saying that we should never become a statistics and if we killed ourselves “they” were winning another time.
    He said other valuable things that was on my mind beside the “-It’s withdrawal…”
    Fortunately I don’t remember anymore and I’m glad to be able to talk about it without crying and now I am feeling that it’s in the past.
    The only thing I fear is that even spending 19 months tapering Efexor when I reached the end of the process I felt so bad that I had to go back to the drug.
    I’ll talk about it later.
    If I miss I pill I have nightmares. I fear missing the amount of dose and feel it again.
    You can see that it’s very easy to kill me if someone has the intention.
    I also lost my freedom because I cannot make a trip or go anywhere without Effexor in my purse.””


    The whole post is here:

    BE SAFE!

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