Even Docs get killed by Akathisia

September, 11, 2018 | 27 Comments

Comments

  1. Johanna,

    Thank you for challenging the lack of reference to AKATHISIA in considering “doctor-suicide”.

    We are not taught to recognise, or to understand prescription drug-induced akathisia in our undergraduate or post-graduate medical training.

    This is a shameful omission in medical education.

    We are only likely to begin to understand just how lethal, and how life-destroying this common and very serious adverse drug reaction is, when one of our family has had akathisia misdiagnosed as “Serious Mental Illness”.

    In response to a current headline in a G.P. magazine: —

    “TOP G.P. ISSUES MENTAL HEALTH WARNING AS 400 DOCTORS DIE BY SUICIDE”.

    I wrote the following comment:

    “Several classes of prescription drugs cause akathisia which is the common denominator underlying medication induced suicide”.

    “The increasing and overwhelming agitation, writhing restlessness, and emotional blunting which are the dominant features of SSRI/SNRI induced akathisia are vulnerable to misdiagnosis as worsening or “emergent serious mental illness/illnesses”.

    “The prevalence of clinically significant akathisia in those taking these drugs has been reported as 20%”.

    “We are told that these drugs are used (apparently?) prophylactically in some doctors where adverse professional circumstances have caused vulnerability to depression”.
    (R.S.M. Podcast).

    “As far as I am aware, no meticulous drug history, record of changes of (akathisia inducing) psychotropic medication, dose increase, decrease, or additional psychotropic drug augmentation is routinely made available as a component of the Inquest Reports on our colleagues who have died by alleged suicide”.

    “Surely a greater awareness of akathisia, the risk of misdiagnosis, and the associated risk of induced suicidality justifies detailed, unbiased, objective investigation”.

    “If denial, and unwillingness to address the most serious ADR of SSRIs and SNRIs
    predominates, how can it be known whether or not these tragic deaths in our colleagues are being mis-classified as “suicide”?”

    “The life-long devastation of their families becoming even more unbearable as a result of a potentially incorrect verdict”.

    Clearly my concern applies to all other families whose loved ones may have been lost as a result of the widespread prescriber ignorance of this common and unbearable “medication”
    adverse reaction.

    Did they all really “die by suicide”?

  2. Crime Scenes..?

    Join The Club…That’s when I got pissed and I couldn’t shut up..

    “So how did I get involved in these crime scenes? Why am I so obsessed with doctor suicides? Three reasons. 1) I was a suicidal physician in 2004. I thought I was the only one. Maybe I was just too sensitive and idealistic. I have a personal stake in this issue. I feel it to my core. 2) Eight years later, I discovered doctor suicide is quite literally a hidden epidemic! It came as an absolute shock that so many of my colleagues were dying by suicide. 3) What created my relentless 24/7 obsession was the discovery that these suicides were being covered up—by my very own profession! That’s when I got pissed and I couldn’t shut up.

    http://www.idealmedicalcare.org/33-orthopaedic-surgeon-suicides-how-to-prevent-34/

    This is incredibly persuasive and pervasive talk…from Dr. Wible…if I was a doctor I could feel very sorry for myself..

    We don’t have a Dr. Wible in the UK, yet, but, it runs along the lines of Doctor Creep which we have noticed starting here when patients are more or less accused to causing doctors’ suicides by complaining.

    “Doctors choose suicide to end their pain (not because they want to die). Suicide is preventable if we stop the secrecy, stigma, and punishment. In absence of support, doctors make impulsive decisions to end their pain permanently. I asked several male physicians who survived their suicides, “How long after you decided to kill yourself did you take action—overdose on pills or pull the trigger?” The answer: 3 to 5 minutes.”

    “Ignoring doctor suicides leads to more doctor suicides. Let’s not wait until the last few minutes of a doctor’s life when heroic interventions are required.”

    3 to 5 minutes is key to Akathisia.

    It comes out of nowhere
    It comes out of somewhere
    It is ruthless
    It takes no prisoners

    “Doctors sometimes suffer because of patients’ need to place them on a pedestal. They are idealised as quasi-divine healers, without the same vulnerabilities or disabilities as the rest of us. Doctors who are asked to treat other doctors find it difficult as well. Many feel slightly embarrassed when seeing colleagues. They find it hard to accept that a doctor could have two personae – a strong, powerful medic on the one hand and a frightened and sick individual on the other.”

    https://www.theguardian.com/commentisfree/2018/jun/06/doctors-mental-health-problems-taboo

    https://www.telegraph.co.uk/news/2018/09/03/complaints-against-doctors-pushing-suicide-rates-leading-medic/

    A frightened and sick individual
    Akathisia came out of nowhere
    It came out of somewhere
    It is ruthless
    It takes no prisoners
    The Patient
    A frightened and sick individual

    A heroic intervention, Johanna.

  3. When do we begin to forget that as social animals we like and must communicate with each other. If those in desperate emotional need cannot open up and talk and yes be listened to and not dismissed as some person with a disease then maybe their would be less of us dying.

    Talking to friends and relatives and other professionals who don’t so readily reach for the prescription pad seems so much the better solution when do people stop listening to those who experience emotional turmoil. Dismissed is disengaged and desraught. If we choose to leave emotionally distressed people out of our sites and dismiss them with prescriptions then this world’s whole population is at risk.

    This is the social disease not the so called mental illness.

  4. This one was personal for me – and not just because I have been in Dr. Shaffer’s shoes, more-or-less. But also because he was an orthopedic surgeon. And I can imagine how he felt when told he would have to be “on meds for life,” because I know what he sees around him. I see far too much of it in workers’ comp these days.

    Patients go from the Back Clinic to the Pain Management Clinic (getting hooked on opioids and benzos) and from there to the Psych Clinic (where they get god-only-knows what else, and often pronounced bipolar to boot). Within a year or two their lives are in ruins—if they’re alive at all. There are so many ways to die: suicide, diabetes, seizures, accidental poly-drug overdose, even bowel impactions. I suspect a lot of doctors must say to each other quietly: If I ever get like that, just shoot me, OK? Just get it over with.

    “Anxiety” and trouble sleeping are probably the top mental-health problems among MDs. So I also suspect there are a LOT of benzo-dependent doctors in the USA, given their expanding use in the last ten years and the ignorance of addiction and withdrawal issues. Some may struggle with worsened anxiety and other impairments, while others feel pretty good until they try to stop. Not sure which group poor Ben Shaffer was in, but not surprised his doctors had no clue about benzo withdrawal. And he was a top surgeon, so you know he was consulting the Very Best Doctors! That’s not always a blessing …

  5. The very sad thing about all of this is that doctors are turning to the very drugs that are harming their patients any life that is lost to suicide is one to many when I high profile doctor takes his own life because he is suffering the effects of the very drug that is designed to help and is labelled with a mental illness it must be hard to do you job without being judge by your fellow workers , but the thing for me is everyday men women children are sadly taking there own lives because these doctors dismiss the harm that is happening in front of their very eyes and are told by these doctors that it is all to do with a underlying condition when it’s clear it’s drug induced anxiety depression akathisia so the patient is medicated further leading to suicide as they are not believed and it’s the only way out

    It’s a shame that patients are not treated with the same sort of respect as doctors I have first hand experience of what this is like I am currently of my medication for 19 months I have been living in a hell ever since my doctor withdrew me cold turkey I visit the doctor frequent and tell him that I have felt suicidal everyday but I am told it’s my original symptoms the ones I didn’t have before meds but I am called a liar but when I die at the hands of suicide no reporter will make a case about about me and how we need to protect me and others as we are not high profiled enough to worry about

    With the amount of doctors now loosing their lives to suicide surely the medical profession should realise the harm that the drugs are doing is also costing lives of the patients that they are supposed to be helping why are we not honouring all those lost souls that reported to their doctors how they felt only to be misdiagnosed or disbelieved

  6. Really moved by your response, Johanna. There is also something I find especially disrespectful about how Dr. Wible spoke about his death. At least when we are alive and we are told what’s happening to us isn’t, we can try to defend ourselves (often with little success). Dr. Shaffer didn’t get the opportunity to refute her characterization of of him and what went wrong.

  7. “He was told he would need medication for the rest of his life.”
    My 20 year old daughter was subject to this same prognosis the day before her suicide. After just over 3 years on various up, down and off doses of Citalopram she was told that she could need medication for the rest of her life. I have presumed since 2007 that GPs really knew that here were risks attached to antidepressants but prescribed them anyway to anyone as a get well quick fix. It seems doctors are just as ignorant of the horrendous consequences as my 20 yr old daughter and I were back in 2007. Maybe now more questions will be asked- and answered.

  8. Can you imagine the outrage and pain I feel reading the excerpt below? We phoned repeatedly my family member’s doctor. We respected HIPAA and all that but left important information that was never considered in your “medical complex” or whatever derogatory phrase you’re all making about your own profession. He needed the multiple surgeries that led him to your benzo and neurontin cocktail but you literally killed him – he died within three years of your insane circus. Our family begged for you to help him and there was a single note in his chart, “concern family member call.” From loving family man in a productive career loved by 400 funeral attendees (how many will remember you, seriously) to a shell of a closet addict (we never even knew – he was too ashamed to tell us oxy?) with a newly minted upped dose prescription taken as prescribed (and dated to the day doses all locked up in a safebox), before collapsing. When I hear physicians hiding behind a un-fact-checked ridiculous pharmaceutical claim about chronic pain not becomeing addicted – I am outraged at your denial of complicity for “just” taking orders from a subordinate (pharmacy lunatics) in the profession and two, for having zero common sense that any 8th grader would be expected to have. Each and every one of you who benefitted from Purdue or any other $circus, please donate that money back for cleaning up this epidemic and please become ACTIVE and get Sackler’s to treat for contrition and decency, and repeatedly treat, instead of $gain from the new formulation release of bupro. Trust is BROKEN, people. And the “you” is all of you – incuding me as a sibling who is sorting out the guilt for not walking into your office and demanding your precious protected special high-horse doc time…time I will never have with my only sibling and time his children and grandchildren will never have, either. You can so callously spout off your problems here without taking action to protect the vulnerable patients who depend on you. What protected privileged psychopaths you have become. I suppose in teh end all I’ll hear is that docs are victims of narcissistic parents or whatever and I ought be kinder…or more numb.
    EXCEPT
    Patients go from the Back Clinic to the Pain Management Clinic (getting hooked on opioids and benzos) and from there to the Psych Clinic (where they get god-only-knows what else, and often pronounced bipolar to boot). Within a year or two their lives are in ruins—if they’re alive at all. There are so many ways to die: suicide, diabetes, seizures, accidental poly-drug overdose, even bowel impactions. I suspect a lot of doctors must say to each other quietly: If I ever get like that, just shoot me, OK? Just get it over with.

  9. Dear Sorting it Out,

    I share your outrage. We all do. What happened to your brother was a crime. What I was trying to say, as a patient and a paralegal helping injured workers, is that I am sick and tired of seeing people perish in a criminal system like that. I have lost some clients who were real good people, but your pain on losing your brother is more than I can fathom. If there was something about how I expressed my outrage that struck you as callous, I’m so sorry.

    This blog, and the RxISK.org blog that Dr Healy co-founded, are part of a struggle to PUT AN END to that criminal system. Most of us are NOT doctors — I’m not — and many of us have lost loved ones to mindless and heartless drugging by the medical system. I hope you will come back, take a look around, and see we are all in much the same boat.

    I do feel sad about Ben Shaffer’s death, but I sure don’t value his life more than anyone else’s. Here’s the irony, though: Doctors are taught to tell the rest of us that being on psych meds for life is a great option, and we just have to get past the “stigma.” But if someone gives them the same advice, it’s all too easy to see how they might think their lives are over. They know that the real-life outcome is usually not good. To put it mildly.

  10. Johanna, I admire the measured way that you build up to the crescendo in your ‘open letter’. You add fact upon fact so that the reader is in total agreement with you – and then, slap, you knock them out, right there, with the ‘elephant in the room’. Brilliant! I guess you have the makings of a ‘who done it’ novel, such is your brilliance in the creation of suspense coupled with a fantastic sting in the tail when least expected!
    However, as we all agree, this is TRULY SERIOUS STUFF. The fact that doctors are now caught in the ‘spider’s web’ is, on one level, heart breaking. On the other hand, doctors are human too – if so many of us ‘ordinary’ folk need these medications then, surely, it should not surprise us that doctors too ‘need ‘them. I guess the real question to ask is how many of us DO REALLY need them? Even if they were miracle cures – how many REALLY cannot cope with life? My feeling is that the answer would be ‘very few’. The problem therefore lies once these drugs are introduced.
    We should have seen this coming I guess. We live our lives non-stop these days. Burnout is surely a condition where ‘rest’ helps things to return to normal. Is there time these days to take time out to recover? Hardly – take time out and you could well find out that someone else has stepped into your shoes at work! We live on borrowed money – another reason to keep going at our health’s expense. Eventually, something has to give – often it’s our mental wellbeing that suffers.
    Waiting in the wings is the answer to all our woes – a pill or six that promise to lift all our ills and help us to rise again to our full potential. A promise too far – its acceptance our downfall. The mess created being beyond comprehension. Withdrawal from them is almost an impossibility. Doctors will declare ‘ you need these for life’, pity they don’t add that coming off them is even worse than being on them. Seroquel (Quetiapine to us in the UK) was one of the drugs you named Johanna. We have watched Shane reducing his intake of this drug for the last 3 years – parts of that journey have been absolutely horrific even at the slow rate that he is withdrawing.
    I really hope that this letter of yours shakes matters up so that the horrors of akathisia and all other horrors linked to these drugs are accepted as THE TRUTH at long last.

  11. 2 minutes ..

    SusanShafferSolovay
    @SusanSolovay
    ·
    11 Sep

    I am Ben’s sister. You hit the nail on the head with this

    https://twitter.com/SusanSolovay/status/1039510095212638208

    So you wanna be a doctor to “help people.” You paid big bucks for med school.Now your life sucks. It’s not your fault. You need 3 skill sets to be a happy doctor. Med school provides only one—the technical skills. No human skills. No business skills. The truth is: Med school trains you to be a factory worker. You choose your assembly line. Wanna do treadmill OB? How ‘bout rat-race pediatrics?

    https://www.youtube.com/channel/UC1CcEjwpGjbw_bX_MkQ3jvA

    How to be a happy doctor –

    (in less than 2 minutes) ..

  12. All doctors were taught in med school, but most seem to have forgotten, that combining an antipsychotic and an antidepressant, like “PROZAC and SEROQUEL,” is unwise because it can result in anticholinergic toxidrome. The central symptoms of which are, “memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.” Such symptoms could make a person want to kill himself. I do agree, however, that taking away all hope of recovery by lying to a person claiming they have a “lifelong, incurable, genetic mental illness” is downright evil, especially since none of the DSM disorders are even valid or reliable diseases. My condolences to his loved ones.

  13. Hi,

    Just a quick response: Please, when speaking about taken-as-prescribed benzodiazepines, do not utilize language that mislabels these people “addicts” or “addicted” when what they actually suffer from is iatrogenic prescribed physical dependence. These people are harmed enough — inaccurate language just harms them again. Also, it just perpetuates the problem, giving others taking (or considering taking) benzodiazepines a false sense of security because they falsely believe that they have to abuse the medication to become “addicted.” In other words, they do not understand that there is a very real risk just by way of taking the medication exactly as prescribed by their healthcare provider. Lastly, addiction terminology wrongly implies that the problem is with the user, as opposed to being inherent to the drug class, and were that true, why would anything need to change?

    • I do get the point Nicole, and I agree that people suffering when they try to withdraw from doctor prescribed drugs should NOT be referred to as “addicts.” But as someone who has been there, I feel strongly that the drugs themselves should be labeled as Addictive. The reason? Many doctors use the soothing language of “dependence” to argue that there is nothing wrong with being “dependent.” After all, diabetics are “dependent” on insulin, they say! If you are an honest patient, you can never be “addicted.”

      It is often the prescriber who “reassures” us that we are not “addicted” who is doing the most harm. Especially because s/he is blinding us to the reasons for our steadily declining health, and persuading us that we “need” these drugs to feel normal — because of our underlying disorder, not because of addiction. This becomes a trap that keeps patients mired in utter misery for years, while sincerely believing that the drug is the only thing making life bearable.

      I have seen this happen with patients placed on OxyContin and other opioids after an injury. The process of escalating tolerance and withdrawal they suffer from is exactly the same as with heroin, because it’s essentially the same substance. (That’s not to demonize heroin, which is used medically in several countries for the same purposes as Oxy.) They are utterly blameless for their own condition — they would not dream of ignoring doctor’s orders — they have never sought a thrill or a high — but they are chronically “dope sick” in the exact same way as the person who began by using the drug recreationally.

      So yeah, I feel that drugs like benzos, amphetamines and opioids should be labeled as Addictive. And it wouldn’t be a bad idea if other drugs like anti-depressants and antipsychotics were labeled that way, even though they almost never cause euphoria, and people don’t typically crave higher and higher doses. It would simply be informed consent.

      And by the way, it might prompt us to be less judgmental towards people caught in this trap who began with the innocent pursuit of pleasure. Like us, they had no bloody idea what they were getting into.

  14. Thank you!!! Well said! Another disabled guy who lost a career due to benzodiazepines and antidepressants after years finally half way off the final medication I was prescribed that literally dismantled my life. Just thank you! I too was told I would be on for life by top doctors at Mayo and other “specialists!” They were the poison that made me 100 times sicker than little anxiety that started the ball rolling!

  15. I am a doctor. I am also a doctor who was actually prosecuted like a criminal by the California Medical Board. Why was I prosecuted? Someone published that I had PTSD into the National Practitioners Data Bank.

    Now some may find it strange that a doctor could be prosecuted based on PTSD. But it did indeed happen. I have a transcript to prove it.

    Regarding the ADA, I explained to the medical board they were acting in violation of the Act. They didnt care.

    Regarding shaming me as a doctor, what did the California Medical Board do to me? They took away my license. This put me out of business. My wife divorced me. And I became unemployable.

    All because someone said I have PTSD.

    And this is how medical boards deal with doctors who have diagnostic codes leaked.

    By the way, I never dealt with any actual members of a medical board. When I was on trial, there were no members of the medical board in the room. Only a cop, a prosecutor and a man in a cape pretending to be a judge. It took them less than one hour to delete 4 years of college, 4 years of medical school, 5 years of residency and 13 years practice.

    And what is most galling of all, I was never able to find a lawyer to stick up for me.

    For the people who wonder why a doctor might want to commit suicide, imagine having everything you worked your life for taken from you by prosecutors and judges and medical boards who dont even bother to show up for your trial.

  16. I’m writing this comment to help real doctors by acknowledging their suffering.

    Many physicians got A+-for all the tests while studying and have put in the same effort working their real jobs in hospitals. However they couldn’t prevent errors while working. yet they most probably remember the patients full name, illness and what went wrong during the operation.

    Their colleagues don’t talk about it, so the physician is excluded from dialogs and/or discussions about his failures. The hospitals don’t want court-cases that penalizes them with enormous money-payments. These well-performing doctors carry a burden throughout time even when nobody is allowed to say sorry because that would state admission of guilt.

    In psychiatry there’s no such ‘remorse’ among the ranks even when it’s quite apparent that the medication(s) they prescribed triggered their patients to end their lives because of the chemical imbalance the medications where causing. There is no penalty that punishes these ‘fake’ doctors when they mis-diagnose and thus mis-medicate. Even worse, these psychiatrists often say that they would make the same decisions again.

    I’m however commenting to reach out to the ‘real’ doctors and offer you/them a little solace by explaining that ‘errors-mistakes-failures’ are part of your profession and you never had a chance of doing your job for years and years without making mistakes. It happens to all of us no matter how hard we push ourselves to prevent making mistakes. I want to let you know that even when no-one speaks about your (honorable) suffering in silence, there are many who understand you and hope & pray you’ll forgive yourself because ‘we’ already have done so….

    Salutations
    Alain

  17. Thank you Johanna Ryan.

    I am appalled at the simplistic, reductionist manner, the intentional errors and omissions that Wible presents in her bid to continue to obscure facts she has a legal obligation to know about the death, disability and addiction caused by psych drugs. It is impossible to respect the disinformation, thus harm she perpetuates. Its about time someone called Wible out on this.

    In the spirit of full legal informed consent – the right for the whole truth, a TED talk on what is being omitted must be presented as a challenge to the omitted facts. If Wible (et al) honestly cared about what is killing, not just her own cohorts, but everyone being labeled as “mentally ill” who these distressed drs are “treating” with the same drugs, she would not be presenting such a one sided account of the facts.

  18. To err is human, but apology has gone out the window, apparently. I have known doctors and nondoctors alike who seem afraid to apologize and will avoid this at all costs. Doctors can avoid malpractice lawsuits if they apologize sincerely to the patients (or families) that they harmed.

    Most people have been harmed by a doctor at least one time. Often, the results of this harm are temporary or inconsequential. Sometimes, a doctor’s action, or failure to act, results in deep harm. The patient is left bewildered and confused when the doctor, instead or reaching out and apologizing, instead, kicks the patient out of his practice, does not communicate, refuses any future medical care, badmouths the patient, and even retaliates, in attempt to discredit the patient by diagnosis, drugging, or psychiatric imprisonment.

    This is the wrong way to go. It doesn’t avoid a lawsuit. Instead, patients get angry and take to social media because they have nowhere else to vent their frustration. Those that can afford an attorney might sue.

    I really believe doctors are human. If they have erred, they need to communicate with the patient and apologize. They also need to make a sincere effort not to repeat the same mistake with other patients. If they are not capable of apology, if they’re incapable of admitting mistakes and learning from them, then they should not be doctors.

    Julie Greene

  19. I don’t see any evidence that Dr. Wible recognized withdrawal symptoms or the possibility Dr. Shaffer experienced kindling from treatment with additional drugs.

    Physicians need to recognize withdrawal symptoms and realize they need treatment far different than run-of-the-mill random psychiatric prescriptions with arbitrary dosages — or they risk creating far worse adverse reactions.

    Withdrawal symptoms cannot be treated as relapse or emergence of a new psychiatric disorder! They indicate a nervous system that’s wobbling from drug injury. Clobbering it with additional drugs often makes it worse.

  20. Apology is a pathetic substitute for accurate timely diagnosis, which dr’s are largely incapable of doing. It takes on average 7 years to get an accurate dx and in the meantime everyone is at risk of an “all in your head” conversion disorder that discredits them, follows them for life and protects the dr from a very rare law suit, if and when the underlying root cause of the presenting symptoms is discovered.
    It is very clear that medical mimics and psychiatric pretenders are prevalent, but little to nothing can be done after a person is already tarred and feathered as a “mental patient” for life.
    Depression, anxiety, mania, psychosis etc are symptoms can occur naturally from
    1) common occurrences such as lack of sleep, dehydration, vitamin deficiencies and prolonged stress, poor gut health and lifestyle choices,
    2) more than 100 bona fide (vrs imaginary) biological diseases, including Thyroid, brain injury and Lyme,
    3) and over 500 Allopathic drugs (misnomered “medication”) and street drugs
    To err is human, is a sad weak excuse that does not remotely address the extent of the problem. Toxic Allopathic drugs that by definition and design cure nothing, mask important symptoms and create inflammation and trigger disease in the body are the 4th.Dr’s are the 3rd leading cause of death in the US, to say nothing of the disability and addiction they cause behind only heart disease and cancer. Because Allopathic drugs also cause cancer and heart disease (including psych drugs) dr’s are in fact the leading cause of death in the US. To call that err is willful blindness and sheer ignorance excuse making. Dr’s can keep their fake apologies which are nothing more than injury to insult to most of their victims.

  21. I hope you all are not giving up on the big issues and need for awareness is the key. I have been following the issues and I hope you see the truth and the facts for what they are. Social media has educated me and I hope you fight for your profession and the life of the ones lost. Pamela wible is not in the real problem for the right reasons. She is profiting and marketing from the pain and headlines. I am not even a doctor and was marked as a result of the care I didn’t get. U have followed and became a conserned patient and advocate for the medical field and the issues spoken here.

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