RCPsych President responds to newspaper coverage on antidepressants
24 April 2023
Dr Adrian James, President of the Royal College of Psychiatrists, has written to national newspapers responding to recent articles erroneously linking antidepressants to suicide. Here is the full text of the letter.
“I was disappointed to read your article, which has potential to unjustifiably worry readers who are taking anti-depressant medication or know someone who is.
“The study cited in your article found some individuals who died by suicide were taking antidepressants at the time. This is mere association. It does not demonstrate a causal link. It is a fundamental principle of science that correlation does not equate to causation. To suggest otherwise is simply wrong.
“The overwhelming body of medical evidence tells us antidepressants help to reduce the symptoms of and improve the quality of life for adults with moderate and severe depression, as well as anxiety and other mental illnesses.
“While antidepressants can control symptoms, they do not necessarily treat the underlying cause of the depression or eradicate it. For this reason, antidepressants are recommended to be prescribed alongside talking therapies for treatment of depression.
“Ultimately, the choice of treatment should always be a shared decision between patient and doctor, based on clinical need, medical evidence and the preferences of the patient.”
Dr Adrian James
President of the Royal College of Psychiatrists
For further information, please contact:
Email: press@rcpsych.ac.uk Twitter: @rcpsych
Out-of-hours contact number: 07860 755896
Response to Dr James
Dr Adrian James
President of the Royal College of Psychiatrists
April 25, 2023.
RCPsych President responds to newspaper coverage on antidepressants
Dear Dr James
Your press release risks harming patients and their families more than the article you criticize.
John Read, the author of the paper underpinning the media coverage took care to get the wording right. He notes that in the case of suicides in people taking antidepressants, the antidepressants were clearly not working. He does not say caused the suicide. The press, equally, are not wrong to link antidepressants to suicide.
I reviewed the paper by John Read for Ethical Human Psychology and Psychiatry. I noted the care taken not to go beyond the data and how this was likely to mislead doctors, and the public. I offered Don Marks, the journal editor, an option to publish my review alongside the Read article, which might better inform readers. He accepted. I attach the companion piece to the Read article here.
I imagine you are not aware of the points laid out. If you are aware and have done nothing, I am shocked. In brief, at inquests, doctors do not claim an antidepressant caused a suicide primarily because the doctors are advised by Defense Unions not to blame the drug. This is a business matter. Rather than support a doctor to help a family at a time of great distress, and support him to advance public safety, Defense Unions seek to avoid further costs.
In Samuel Morgan’s case, whose citalopram-induced suicide is Scenario 2 in the paper, the doctor was advised by his Defense Union not to talk to me. He remained silent at the inquest. When a concerned coroner made a Regulation 28 Report, MHRA responded that the doctor had not implicated the drug and therefore they could do nothing.
This is the reason a paper on inquests appears to only produce correlations. Unfortunately, the system is literally a stitch up. It should be your job and the job of the President of the Royal College of General Practitioners to know about and do something about this.
The evidence that antidepressants can cause suicide is unequivocal. I am copying Tania and Ian Morgan, Samuel’s parents, in on this letter. I invite you to tell them, there is no evidence that citalopram killed their son.
You mislead when you say antidepressants treat moderate to severe depression. Older tricyclics can indeed treat melancholia, which comes with a high risk of suicide. Most people, however, will think you are referring to SSRI and related antidepressants. There is no evidence that these drugs are of benefit in moderate to severe depression or that they reduce the risk of suicide in those treated with them.
This is not to say these drugs cannot be of benefit, but the public need an honest appraisal of their role and potential hazards. I can see a role for you and the College to ensure the use of these hazardous drugs is made as safe as possible; you should not be increasing, as you are now, along with the Defense Unions, the chances of a family ending up bereaved as a result of a treatment induced suicide.
In talks on these issues, I commonly use a press release by the American Psychiatric Association from 2004 who were lobbying hard against warnings on antidepressants. Their press release stated that:
The American Psychiatric Association believes that Antidepressants save lives.
I tell listeners that this is a suicide note. If the drugs work wonderfully well and are free of hazards, doctors will be out of business. The APA should have said:
The American Psychiatric Association believes that Psychiatrists save lives.
If you join forces with RCGP, you might say Doctors save lives.
From now on, I will include your press release alongside APA’s as an example of a professional suicide note.
I am also copying Dan Johnson from Alberta into this letter. Dan faces an inquest on his 15 year old son Dexter, whose suicide was induced by Prozac. Dan drew my attention to your press release, worried that your press release would work against him and Dexter.
I am also copying in Yoko Motohama and Vincent Schmitt from France, whose 16 year old son Romain’s suicide was caused by paroxetine. Romain’s case is Scenario 1 in the attached article.
Both sets of parents are trying to raise the profile of a very real and horrific hazard, in order that other parents do not have to go through what they have been through.
I can only hope your press release will illustrate to the public what they and the Morgans are up against.
I regard this letter as open, and will post it online.
Yours sincerely
David Healy MD FRCPsych
Ian and Tania Morgan, Dan Johnson, Yoko Motohama, Vincent Schmitt, John Read, Don Marks.
Footnote
This post follows up on last weeks post – Will Medical Insurers Stop Killing People. The article sent to Adrian James was linked in there.
The Daily Mail and Daily Telegraph articles to which Dr James was responding are linked here.
“Something completely casual” …
Royal College of Psychiatrists’ Suicide Note
THIS should cause an avalanche of disgust, all the more so because Adrian James, has rarely ventured in to this can of worms during his Presidency. Unlike Professor Sir Simon Wessely and Wendy Burn CBE who have been more than vocal in preceding years.
There was a time when Wessely was hardly ‘off the sofa’ spouting forth his views on antidepressants backed up by his wife, Clare Gerada. Wendy Burn is still a constant, pitching-up here and there, looking ridiculous; the letter to The Times newspaper, a case in point.
https://holeousia.com/2018/05/01/rsm-health-matters-podcast-episode-1-antidepressants/
SW: Like most psychiatrists I don’t have the same experience with antidepressants that GPs do. Most depression is treated in this country by GPs and not psychiatrists. I think that Clare is basically right. And there is several points one can make on that. The first is that we all agree that the number of antidepressants being prescribed has been increasing, so up to 66 million this year in the UK, and in the USA has gone up by 30 million over a ten year period. Now if there was even a small association with either suicide or homicide with that scale of increase, you couldn’t, even a really small association, you couldn’t help but see it in suicide rates and homicide rates which are pretty tightly measured. And we haven’t seen. So I think some people have extrapolating from the side effects, that Clare has been talking about, agitation, restlessness etc and then making a very big jump into that is sometimes seen in people who have committed suicide or indeed committed homicide, that is the kind of things they may report before hand, but there is a huge gap in-between., and its a big leap there. The second point to make is the issue of addiction. Addiction is pretty well described and most of the population know what addiction is. But antidepressants are not active in the classic sense of addiction. You can’t sell them out on the street. There is no market for antidepressants. You don’t get a high from taking them, that’s one of the problems actually it takes weeks for them to have their effect. You don’t crave for them. You don’t do behaviours that go with people who are addicted to heroin, cocaine, and indeed benzodiazepines or opioids that are prescribed by doctors. So I think addiction isn’t the right issue to talk about. I think it is true, I think it is a fair point that withdrawal symptoms probably have been underestimated, they can be confused with relapse of the illness, which certainly happens as well. But overall, antidepressants save lives. Most people successfully come off them without difficulty. I think probably we have overlooked those who do have difficulty, and I also think we really don’t do much for them, that’s absolutely true. When I was President of the College we did support more funding for helplines for those who have problems with withdrawal and prescribed drugs. I think that is a perfectly reasonable thing to do.
“Unfortunately, the system is literally a stitch up.”
Dan faces an inquest on his 15 year old son Dexter, whose suicide was induced by Prozac.
recovery&renewal Retweeted
Dan Johnson
@DanJohnsonAB
·
9h
Replying to @DrEvgenyLegedin
He is correct, that sentence does not demonstrate a causal link. The data demonstrate a causal link, which is further apparent in the experiences of thousands of people prescribed SSRI. (One interesting example story is by Dr. Setsuo Ide, Ide Paediatrics; MRIC article.)
I found it, Dan. It is very good and thoughtful
https://www.mricg.info/single-post/considering-over-30-000-suicides-in-japan
” I had no fear of death, no sense of reality at all, and felt that death was right there and that it was something completely casual.”
If the ‘Cult’ of the Royal College of Psychiatrists could grasp this, and make the leap
“So I think some people have extrapolating from the side effects, that Clare has been talking about, agitation, restlessness etc and then making a very big jump into that is sometimes seen in people who have committed suicide or indeed committed homicide, that is the kind of things they may report before hand, but there is a huge gap in-between., and its a big leap there.”
” I had no fear of death, no sense of reality at all, and felt that death was right there and that it was something completely casual.”
No matter the violent means; “death was right there” …
There is something quite obvious about the whole concept of both psychiatry and psych meds. If the claim is that psych meds improve the quality of life, why are psychiatrists so compulsively irresponsible that they are not improving the quality of life? Secondly, psychiatry fails because it claims to be able to resolve every single issue for every single person, and is not qualified to do any of that. So the claim is that the person is ill, and the psychiatrist, who has to be everything to everybody, or claim they are, take the money, and attack anyone who knows its all a lie and says so, fails in one way or another.
Suffer the (little) Children – to the point of suicide . At the hands of those who ‘care’ for them .
This massive article is published in the BMJ – coincidentally? the same time as the article and D H letter came out.
‘Studies are lacking’ if they are why are they experimenting on children without informed consent and evidence.
Maybe a letter from those who have lost loved ones would add to Jennifer’s ‘state of the art ‘ ( I resist adding a letter in front of ‘art’) ‘research’ and the ‘selected seminal papers’ they used.
The space given to this article is unusually long by the way So this is just a snippet
Suicide in young people: screening, risk assessment, and intervention
BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2022-070630 (Published 24 April 2023)
Cite this as: BMJ 2023;381:e070630
Correspondence to: J L Hughes jennifer.hughes@nationwidechildrens.org
Abstract
Articles that were within the scope of the outlined manuscript were deemed to have topical relevance; articles that reflected best practices based on existing guidelines were deemed to be clinically relevant. (But left out the most important evidence)
Epidemiology
Suicide in young people is a global public health threat. (ie Scandal perpetrated by psychs and their cohorts)
Suicide methods
children are presenting more frequently to emergency departments for self-harm.8
(‘presenting’ Not how most of us would describe it. There’s Not one word of sorrow expressed in this whole article.)
No group is left out – except those who could include the most relevant evidence.
Race/ethnicity
Sexual minority status and so on
Interventions
Pharmacological interventions ‘ a decline in antidepressant treatment’ !!
No RCTs of drug therapy specifically targeting suicide risk in young people have been completed.58 The 2004 black box warning that selective serotonin reuptake inhibitors might increase suicidal thinking and behavior resulted in a decline in antidepressant treatment in young people.136 Recommendations for young people treated with selective serotonin reuptake inhibitors for indicated conditions, such as depression and anxiety, include increased monitoring by the prescribing physician during initiation, titration, and discontinuation of these drugs, ideally with the addition of cognitive behavioral therapy.137 Subsequent expanded examination of pediatric antidepressant trial data showed a statistically significant, but small, risk difference of 0.7% for suicidal ideation or suicide attempt comparing drug with placebo.138 Data from more recent pediatric antidepressant trials have not shown differences between drug and placebo, perhaps because newer studies have included suicide specific measures rather than adverse event reporting alone.139
Because treatment with lithium has shown anti-suicidal effects in adults, additional research is needed in young people.140 Observational data from a longitudinal study of children and adolescents with bipolar disorder found that people taking lithium reported half as many suicide attempts and significantly less aggression than those managed with other mood stabilizing agents.141 Treatment with clozapine has also been associated with decreased risk of suicide in adults with psychotic disorders,142 but comparable studies in young people are lacking. Recently, ketamine has shown promise in adults and trials are ongoing in young people. Other somatic treatments that have been applied to suicide risk in young people with little in the way of controlled trials include electroconvulsive therapy and transcranial magnetic stimulation treatments such as theta burst stimulation.
Selecting interventions
Important elements in selecting interventions for young people at risk for suicide include the clinician’s experience and understanding of the existing knowledge . (No doubt the corrupt influence of pharma, regulators and colleges is ‘beyond the scope ‘of their publication. )
Evening David
It appears astonishing, somebody like Dr James appears to be ignorant of the devastating impact this medication can have. This is what we and so many like us are up against. We are faceless, as UB40 wrote on another subject, in essence ” A statistic, a reminder of a world that doesn’t care”. As you know from your work, there is a total lack of understanding. I have thanked you before and do so again for the continual energy you give this. It encourages us to continue, until there is change.
Ian
Ian
I wish ignorance was the real factor here. The College and MHRA and others cannot at this stage be ignorant of the problems these drugs can cause. There appears to me a certain degree of willfulness to what they are doing.
It would be great if you could write to Adrian James and let us know if you get a reply and if you do what he says.
David
I have read much of your stuff, I still find you ‘ too conservative ‘ in some areas.
But here you hit the point I think.
These & Assoc ‘acts’ are committed in full denial of science, rationality, or subjective testimonies.
That implies only one conclusion.!
It does not take Sherlock Holmes to solve the simple case !!
I have and will let you know of any response
Great
I wonder what readers would bet on a reply
And what reply they would bet on
David
Excoriating. And justly so.
Of course, the Royal College of Psychiatry is a protectionist trade association. But doesn’t responsibility for human life demand something more ethically cautious than marketing puffery?
How does this warm bath of misleading tosh stack up beside the urgent patient safety agenda driven by DH for years? Beside the NICE guidance:
Suicidal behaviour and antidepressant therapy.
‘The use of antidepressants has been linked with suicidal thoughts and behaviour; children, young adults, and patients with a history of suicidal behaviour are at risk’.
One of my own children was prescribed citalopram. After a couple of days, he said, ‘These things make me feel like shit. I literally want to kill myself’. Naively, I thought this was a figure of speech. We decided to bin the pills anyway. What if he hadn’t been at home? Or a person who shared his emotions?
Deepest sympathies to all those parents who have not been so lucky. Thinking of you, Dan Johnson and, especially, of Dexter.
Thank you, DH, for your remorseless integrity.
Like Harriet Vogt, I want to add heartfelt thanks for David Healy for his relentless integrity. I cannot think of any other professional in this field who has demonstrated anything like David’s sapere aude.
The Royal College of Psychiatrists seems to be doing its best to be a real world exemplar of the fictional ‘NEON Preservation Society’. This should worry us all.
https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/pe01651-prescribed-drug-dependence-and-withdrawal/realistic-prescribing/the-neon-yellow-preservation-society/
aye Peter
Gardener and Artist
Several years ago, with the help of Marion Brown and Beverley Thorpe, I made this film and shared it with the Royal College of Psychiatrists and Professor Sir Louis Appleby, National Lead on Suicide Prevention. RCPsych and Sir Appleby chose not to reply:
A TIMELINE of missed opportunities, in particular the potential role of prescribed medications as risk factors for suicide: https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/pe01651-prescribed-drug-dependence-and-withdrawal/a-timeline-of-missed-opportunities/
Psychiatry, dependent on its authority, is finding withdrawal seriously difficult:
https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/pe01651-prescribed-drug-dependence-and-withdrawal/the-royal-college-of-psychiatrists-prescribed-harm/psychiatry-dependent-on-its-authority-is-finding-withdrawal-seriously-difficult/
In October 2019, Professor Wendy Burn, President of the Royal College of Psychiatrists [2017-2020] openly stated: “Despite what some people think, most clinicians in the UK are not influenced by the pharmaceutical industry”.
Unfortunately the President of the Royal College of Psychiatrists provided no evidence to support this statement.
https://holeousia.com/2023/04/19/is-there-evidence-to-support-this-statement/
The key word in this statement is “influence”.
For over a decade I have been a grassroots campaigner for transparency regarding payments by industry to academics and doctors. I raised a petition to the Scottish Parliament in relation to this. On hole ousia I have openly shared as much available evidence as I can.
I worked as an NHS psychiatrist for 25 years and my experience was that the majority of my colleagues did not work, in any way, for the pharmaceutical industry. However, my research for a Sunshine Act, revealed that, in terms of influence on prescribing, the pharmaceutical industry relies on a group of academics and doctors [and sometimes allied professionals such as pharmacists]. This group has been described as “Key Opinion Leaders”, and perhaps more accurately as “Paid Opinion Leaders”. My experience as an NHS doctor was that my colleagues were generally unaware that they were being educated [for mandatory Continuing Medical Education] by influential professionals who have received payments from the Pharmaceutical Industry. It is my understanding that, generally speaking, the pharmaceutical industry spends more of its revenue on marketing than it does on research and innovation. This fact, I would suggest, is evidence in itself.
President Burn’s reassurance reminded me of an exchange on the influence of the pharmaceutical industry between her predecessor, Professor Simon Wessely [President of the Royal College of Psychiatrists 2014-2017] and Dr Ben Goldacre [author of Bad Science and Bad Pharma]. Dr Goldacre concluded this exchange: “I’m very concerned about the reputational consequences for the profession of casual false reassurance on these issues”.
Fundamentally ‘Floored’ …
BOB FIDDAMAN
@Fiddaman
·
23h
Your leader, basically, published a professional suicide note.
Dare he respond to @DrDavidHealy?
Wendy Burn CBE (She/her) Retweeted
Royal College of Psychiatrists
@rcpsych
·
Apr 24
‘The overwhelming body of medical evidence tells us antidepressants help to reduce the symptoms of and improve the quality of life for adults with moderate and severe depression’ says RCPsych President @DrAdrianJames in response to recent media coverage.
https://twitter.com/rcpsych/status/1650512523861319680
On the 25th February 2018 the following letter was published in the Times. It was written by Professor David Baldwin, Chair of the Psychopharmacology Committee, and Professor Wendy Burn, the President of the Royal College of Psychiatrists:
Today, 28th February 2018, the following open letter was sent by Professor John Read on behalf of a number of co-authors:
https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/pe01651-prescribed-drug-dependence-and-withdrawal/the-royal-college-of-psychiatrists-prescribed-harm/a-letter-in-the-times/
Professor Wendy Burn: “Oh my Goodness, this sparked a furore. There was radio interest, there was tv interest, I got massively trolled on social media. I wasn’t expecting any of this. Formal complaints were made about me to the College and to the GMC. A group of Scientologists wrote to the GMC about me saying that I ought to be, em struck off. So there was quite, em, em, quite a lot went on. So I was surprised. I was taken aback. I thought it was a fairly, em, bland letter just quoting, em, NICE guidelines. I was really surprised. Eh, so I thought I would look into it a bit more.”
https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/pe01651-prescribed-drug-dependence-and-withdrawal/the-royal-college-of-psychiatrists-prescribed-harm/antidepressant-withdrawal-why-has-it-been-ignored-for-so-long/
They don’t seem to learn much from their ‘Em, bland’ – ‘Howlers’ …
Response to President of Royal College of Psychiatrists:
“Your press release risks harming patients and their families more than the article you criticise” —
Indeed it does. It also causes anger and contempt. My family has now endured 12 years of watching the pain, injuries, suffering and comprehensively destroyed life of our enchanting adult child who was inappropriately coerced by a locum GP into taking an SSRI against her personal judgement. This was prescribed for normal pre-exam stress aggravated by the normal stress of starting a new temporary job.
Despite being a long experienced physician, I had never heard the word AKATHISIA with its inner turmoil, overwhelming agitation and writhing restlessness. She had no adverse event warning and consent is therefore questionable.
Misdiagnosis of this common and life threatening ADR was followed by serial medical kidnapping and incarceration; with multiple enforced akathisia inducing drugs. A generalised psychotropic malignant syndrome was not recognised, and a cascade of diagnostic- incompetence-and-incontinence-based psychotropic poly-pharmacy resulted in multiple systemic injuries. As her parents move towards the later years of their lives we live in dread of what will happen to her when she no longer has our love, support and protection.
“Grieving for the loss of a child is not a process, it is lifetime weight upon the soul”.
We are lucky that our loved one still is with us, but the loved one who was taken from us never returned. The pre-drugging, wonderful adult child has been profoundly changed forever as result of SSRI toxicity denial.
Above, we have above two documents written by doctors. One is based on a unique, dedicated, lifetime, scientific and legal, international experience. Its objective is improved patient care and safety.
The press statement is perceived only as reflex, guild protecting propaganda. I can find no ‘evidence-based’ commitment to patient safety.
“There is no need for propaganda to be rich in intellectual content”. Joseph Goebbels.
Thank you D.H. for your courage, and for your commitment to patient safety.
Suicide in young people: screening, risk assessment, and intervention
BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2022-070630 (Published 24 April 2023)
Cite this as: BMJ 2023;381:e070630
Correspondence to: J L Hughes jennifer.hughes@nationwidechildrens.org
Abstract
snippet from her publication in thebmj
‘Important elements in selecting interventions for young people at risk for suicide include the clinician’s experience and understanding of the existing knowledge’
.Would it be an idea for those with first hand knowledge to write to Jennifer Hughes in order to fill in the massive gaps in her own knowledge and understanding or as David says the wilful ignoring rather than ignorance of the truth?
or maybe submit a rapid response to their article in thebmj ?
Thankfully there are some who won’t be silenced
just published in thebmj
In their comprehensive article (6425 words) about suicide prevention in young people (1), Hughes et al. mention some risk factors, e.g. “Living in a home with firearms is associated with a threefold to fourfold increased risk of suicide.” They do not mention treatment with depression drugs even though this is an important risk factor, as acknowledged in package inserts for depression drugs.
Later, under “Pharmacological interventions,” Hughes et al. say that selective serotonin reuptake inhibitors might increase suicidal thinking and behavior” referring to the 2004 black box warning, but they do recommend against using these drugs for young people with depression or anxiety. They recommend “increased monitoring by the prescribing physician during initiation, titration, and discontinuation of these drugs.” We know that this doesn’t work, just like it doesn’t work to warn against the firearms in people’s homes. Many children on depression drugs have killed themselves shortly after their parents thought they were totally okay (2).
Hughes et al. say that the trial data “showed a statistically significant, but small, risk difference of 0.7% for suicidal ideation or suicide attempt comparing drug with placebo.” However, they immediately downplay this fact in the next sentence: “Data from more recent pediatric antidepressant trials have not shown differences between drug and placebo, perhaps because newer studies have included suicide specific measures rather than adverse event reporting alone.”
The review they use to downplay the suicide risk is a poor one (3). Particularly when studying rare events, it is very bad methodology to lose statistical power by including only “recent” trials and not all trials in a systematic review. Furthermore, five of the seven included trials were conducted by the drug industry, and the review only included published trial reports, even though we know that the industry has omitted many suicide attempts and suicides in their published trial reports (2,4-6).
David Healy and I used the clinical study reports Eli Lilly had submitted to the drug regulators for our restoration of the two pivotal trials of fluoxetine that led to approval of this drug for depression in children and adolescents (6). We found that suicide attempts on fluoxetine were not only missing in the publications but even in the clinical study reports. Adverse events definitely predisposing to violence against self or others leading to discontinuation occurred in 11 patients on fluoxetine and in only 3 on placebo (out of a total of 157 vs 158 patients). We also found that fluoxetine doesn’t work. The efficacy outcomes were biased in favour of fluoxetine by differential dropouts and missing data. But even so, the efficacy on the Children’s Depression Rating Scale-Revised was only 4% of the baseline score, which is not clinically relevant and patient ratings did not find fluoxetine effective.
My research group has furthermore found that, compared to placebo, depression drugs double the occurrence of FDA defined precursor events for suicide and violence in healthy adult volunteers (7); they increase aggression in children and adolescents 2-3 times (8); and they increase the risk of suicide and violence by 4-5 times in middle-aged women with stress urinary incontinence, judged by FDA defined precursor events (9).
A review of suicide prevention in young people should say the obvious: Depression drugs should not be used at all. Indeed not for anyone, as they also seem to double the risk of suicide in adults (10,11) while their clinical effect is lower than what is clinically relevant (2).
1 Hughes JL, Horowitz LM, Ackerman JP, Adrian MC, Campo JV, Bridge JA et al. Suicide in young people: screening, risk assessment, and intervention BMJ 2023;381:e070630.
2 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.
3 Ignaszewski MJ, Waslick B. Update on randomized placebo-controlled trials in the past decade for treatment of major depressive disorder in child and adolescent patients: a systematic review. J Child Adolesc Psychopharmacol 2018;28:668-75.
4 Healy D. Let them eat Prozac. New York: New York University Press; 2004.
5 Le Noury J, Nardo JM, Healy D, Jureidini J, Raven M, Tufanaru C, AbiJaoude E. Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. BMJ 2015;351:h4320.
6 Gøtzsche PC, Healy D. Restoring the two pivotal fluoxetine trials in children and adolescents with depression. Int J Risk Saf Med 2022;33:385-408.
7 Bielefeldt AØ, Danborg PB, Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109:381-92.
8 Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 2016;352:i65.
9 Maund E, Guski LS, Gøtzsche PC. Considering benefits and harms of duloxetine for treatment of stress urinary incontinence: a meta-analysis of clinical study reports. CMAJ 2017;189:E194-203.
10 Hengartner MP, Plöderl M. Newer-generation antidepressants and suicide risk in randomized controlled trials: a re-analysis of the FDA database. Psychother Psychosom 2019;88:247-8.
11 Hengartner MP, Plöderl M. Reply to the Letter to the Editor: “Newer Generation Antidepressants and Suicide Risk: Thoughts on Hengartner and Plöderl’s Re-Analysis.” Psychother Psychosom 2019;88:373-4.
Competing interests: No competing interests
26 April 2023
Peter C Gøtzsche
Director
Institute for Scientific Freedom, Copenhagen
@PGtzsche1
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I worked as an NHS psychiatrist for 25 years. There are vanishingly few long-term studies on the use of psychiatric drugs beyond 8 -12 weeks.
“well documented that the drug companies underreport seriously the harms of antidepressants related to suicide and violence, either by simply omitting them from the reports, by calling them something else or by committing scientific misconduct.”
Antidepressants associated with increased risk of suicidal thoughts in healthy adults
Results of a systematic review suggest that antidepressants increase the risk of events that can lead to suicide and violence in adults with no sign of a mental disorder.
https://pharmaceutical-journal.com/article/news/antidepressants-associated-with-increased-risk-of-suicidal-thoughts-in-healthy-adults
Healthy adults who are taking certain antidepressants have a higher risk of suicidal thoughts and violent behaviour, according to the results of a systematic review.
The research suggests that selective serotonin and serotonin-norepinephrine reuptake inhibitors may increase the risk of events that can lead to suicide or violent behaviour in adults with no sign of a mental illness.
“While it is now generally accepted that antidepressants increase the risk of suicide and violence in children and adolescents (although many psychiatrists still deny this), most people believe that these drugs are not dangerous for adults. This is a potentially lethal misconception,” warn the researchers, based at the Nordic Cochrane Centre and the University of Copenhagen in Denmark.
Writing in the Journal of the Royal Society of Medicine
[1], the team says: “We found that antidepressants double the risk of suicidality and violence, and it is particularly interesting that the volunteers in the studies we reviewed were healthy adults with no signs of a mental disorder.”
The researchers say their results suggest that it is likely that antidepressants increase the number of suicides in people of all ages and warn that their risk calculation may be an underestimate because they were unable to access data from 2 of the 13 relevant trials identified.
The findings are based on the results of 13 double-blind, placebo-controlled trials involving the following antidepressants: citalopram, escitalopram, fluoxetine, paroxetine, sertraline or venlafaxine.
The researchers say that the analysis reveals that treatment of adult healthy volunteers with antidepressants doubled their risk of harms related to suicidality and violence, including psychotic events and mood disturbances (odds ratio 1.85; 95% confidence interval [CI] 1.11–3.08; P=0.02, I2=18%). The number needed to treat to harm one healthy person was 16 (95% CI 8–100; Mantel-Haenszel risk difference 0.06).
The researchers point out the difficulty in obtaining full data about adverse events with these drugs: “There can be little doubt that we underestimated the harms of antidepressants… it [is] well documented that the drug companies underreport seriously the harms of antidepressants related to suicide and violence, either by simply omitting them from the reports, by calling them something else or by committing scientific misconduct.”
They highlight the case of a healthy 19-year-old student who volunteered in a trial of duloxetine (Cymbalta; Eli Lilly) to help pay her college tuition and later hanged herself in a laboratory run by Eli Lilly.
“It turned out that missing in the FDA’s files was any record of the college student and at least four other volunteers known to have committed suicide, and Lilly admitted that it had never made public at least two of those deaths,” the researchers say.
A spokeswoman for the company says: “Lilly reported all known incidents of suicide in our duloxetine program to the FDA, either as a part of our submission for marketing approval or regular safety monitoring reports. A death during a clinical trial is investigated by both Lilly and the FDA. Lilly remains committed to Cymbalta and its safety and benefits.”
References
[1] Andreas Ø, Bielefeldt A, Ø, Danborg PB et al. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109(10):381–392. doi: 10.1177/0141076816666805
Last updated 12 February 2021 16:56
Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers
Andreas Ø Bielefeldt, Pia B Danborg, and Peter C Gøtzsche
https://journals.sagepub.com/doi/10.1177/0141076816666805
Participants
Double-blind, placebo-controlled trials in adult healthy volunteers that reported on suicidality or violence or precursor events to suicidality or violence.
Results
A total of 5787 publications were screened and 130 trials fulfilled our inclusion criteria. The trials were generally uninformative; 97 trials did not report the randomisation method, 75 trials did not report any discontinuations and 63 trials did not report any adverse events or lack thereof. Eleven of the 130 published trials and two of 29 clinical study reports we received from the regulatory agencies presented data for our meta-analysis. Treatment of adult healthy volunteers with antidepressants doubled their risk of harms related to suicidality and violence, odds ratio 1.85 (95% confidence interval 1.11 to 3.08, p = 0.02, I2 = 18%). The number needed to treat to harm one healthy person was 16 (95% confidence interval 8 to 100; Mantel-Haenszel risk difference 0.06).
There can be little doubt that we underestimated the harms of antidepressants, as we only had access to the published articles for 11 of our 13 trials.
Conclusions
Antidepressants double the occurrence of events in adult healthy volunteers that can lead to suicide and violence.
One of these studiesA17 was mentioned by David Healy7 who had spoken with the study investigator, Ian Hindmarch. It was a crossover trial of the interaction between sertraline and diazepam that was terminated due to unexpected adverse events after only four days, before the first phase had been completed and before any of the volunteers had received diazepam. All five volunteers in the sertraline group became agitated and four of them anxious, while one of seven volunteers in the placebo group became aggressive, agitated and anxious. The study was never published.
Limitations
There can be little doubt that we underestimated the harms of antidepressants. For 11 of our 13 trials, we only had access to the published article, and it well documented that the drug companies underreport seriously the harms of antidepressants related to suicide and violence, either by simply omitting them from the reports, by calling them something else or by committing scientific misconduct.2–5,7,10,27 In trials of duloxetine and sertraline, for example, only 33 of 45 cases of suicidal ideation, attempt or injury listed in a trial register were also mentioned in the published reports.2
Psychiatrists believe that the suicide risk with antidepressants is only increased till age 24, but this misconception builds on seriously flawed trial data that the FDA has published.12 Several meta-analysts have pointed out just how unreliable the trials are.5,10,28,29 A 2005 meta-analysis conducted by independent researchers of the published trials included 87,650 patients of all ages and found twice as many suicide attempts on drug than on placebo (odds ratio 2.28, 95% CI 1.14 to 4.55).28 They also found out that many suicide attempts must have been missing; some of the investigators responded that there were suicide attempts they had not reported in their trials, while others replied that they did not even look for them.
Further, events occurring shortly after active treatment was stopped were not counted. Another 2005 meta-analysis conducted by independent researchers used UK drug regulator data and included 40,826 patients; they found a non-significant doubling in suicides or self-harm events when events occurring later than 24 hours after the randomised phase was over were included (relative risk 2.14, 95% confidence interval 0.96 to 4.75, our calculation).29 These researchers also noted that the companies had underreported the suicide risk in their trials, and they found that non-fatal self-harm and suicidality were seriously underreported compared to the reported suicides.
Even the FDA’s 2006 meta-analysis of 100,000 patients in 372 placebo-controlled trials12,30 is seriously flawed. Based on trials that were included in FDA’s analysis, one of us has estimated that there are likely to have been 15 times more suicides on antidepressant drugs than reported by the FDA.10 Two important reasons for the underreporting of suicides are that the FDA trusted the data the companies sent to them and that they only included events up to 24 hours after the randomised phase was over.
Read the whole thing
Deviating slightly – Important Announcements…
New warning over controversial acne drug Roaccutane linked to dozens of suicides: NHS doctors are told to ‘fully discuss’ brutal mental health side effects with all patients
https://www.dailymail.co.uk/health/article-12016603/New-warning-controversial-acne-drug-Roaccutane-linked-suicides.html
A controversial acne drug linked to dozens of suicides will come with a host of new warnings, health chiefs announced today.
Doctors must now ‘fully discuss’ the risks isotretinoin could pose to patients’ mental and sexual health before handing out supplies.
Two prescribers must also sign off on giving the drug, branded as Roaccutane in the UK, to under-18s under the medical watchdog’s new safety measures.
And anyone taking it will be urged to tell their family and friends, so that they can check up on them
Eighty-two suicides linked to the potent drug — which can be given to kids as young as 12 — have been recorded in Britain.
This includes Annabel Wright, who was just 15 when she died by suicide in May 2019 whose parents pushed for a ban on prescribing the drug to anyone under the age of 21.
Taking the drug can also trigger sexual dysfunction such as problems getting an erection and vaginal dryness even after people stop taking it.
The Medicines and Healthcare products Regulatory Agency (MHRA), which polices the safety of drugs, promised a review into isotretinoin.
This three-year-probe carried out by a splinter Government agency, concluded the benefits of the ‘extremely effective’ drug still outweigh the risks.
However, extra measures are needed to improve safety, watchdogs said.
Patients should also undergo mental health and sexual function assessments before starting the medication and be regularly monitored for any signs of deterioration as they continue to take it.
Information included in Roaccutane packets will also be updated to include further details about the risks of psychiatric and sexual disorders.
These disorders can include depression and anxiety, as well as erectile dysfunction and decreased libido, vaginal dryness, and difficulty climaxing.
It will also explain that there have been reports of lasting sexual dysfunction even after ceasing to take the medication.
Experts also advised the creation of a new risk form patients should sign to confirm they understand the risks of taking isotretinoin.
Parents and former patients have previously called for an outright ban on giving the drug to under-18s due to the mental health risks.
But the review ‘did not find enough evidence of an increased risk of adverse effects in young people compared to other age groups’.
And they added that withholding the drug from teens with severe acne could harm them in the long term.
‘Delaying treatment for severe acne in younger patients could increase the possibility of long-term scarring, which may cause significant psychological harm,’ they wrote.
‘So it was felt the evidence available didn’t support restricting the use of isotretinoin in young people.’
The drug, dished out in the UK since the 1980s, works by stopping the glands near the surface of the skin producing oil that creates spots.
Experts from the Commission on Human Medicines, which carried out the review on behalf of the MHRA, recommended a new study to determine the potential effects for young people of taking Roaccutane.
The MHRA said that while medics do not need to take any immediate action while the new recommendations are implemented, they are asked to ‘fully discuss’ the risks of isotretinoin with their patients.
Dr Alison Cave, the MHRA’s chief safety officer, added: ‘No medicine is completely free of risk and the conclusion of the independent Commission on Human Medicines is that on balance the benefits of isotretinoin for severe acne continue to outweigh the risks.’
‘But action should be taken to make sure patients are better aware of them, that they are carefully monitored throughout treatment, and that for patients under the age of 18 there is additional scrutiny on isotretinoin prescribing.
‘We are grateful for the continued involvement of patients, their families, and other stakeholders whose experiences and stories were vital in informing this patient-focused expert review and in developing its recommendations.’
Almost 53,000 isotretinoin prescriptions were dished out by GPs in England in 2022, according to NHS data.
Data from the MHRA’s Yellow Card scheme, which collects voluntary reports on suspected adverse reactions to drugs in the UK, recorded 82 suicides among people taking isotretinoin since 1983.
An additional 62 suicide attempts were reported, seven incidences of suicidal behaviour, 153 incidences of suicidal thoughts, and 22 examples of self-harm.
There are also 133 reports of patients suffering sexual dysfunctions from the medication.
Some suspect that the suicide risk and the sexual dysfunction could be linked as young people struggle to form relationships.
Yellow Card reports do not necessarily mean the drug linked to an event was responsible in all cases, as it could just be a coincidence.
However, the Yellow Card system figures are thought to be an underestimate, particularly given the shame people suffering from sexual problems may feel.
The acne drug that can steal young men’s virility: Tens of thousands are prescribed Roaccutane for their skin. But now there’s disturbing evidence of an embarrassing side-effect for men like Ed that can last for years — and leave them suicidal
Ed Henthorn has experienced devastating side-effects of acne drug Roaccutane
Active ingredient is isotretinoin which works by cutting amount of oil in the skin
But it can also cause anxiety and panic attacks, plus depression and even suicide
Evidence suggests it may also be responsible for permanent sexual dysfunction
https://www.dailymail.co.uk/health/article-6431453/Thousands-prescribed-Roaccutane-theres-disturbing-evidence-leave-men-suicidal.html
As David Healy, a professor of psychiatry at Bangor University, who is studying the impact of isotretinoin, explains: ‘Erectile dysfunction is psychologically devastating to young men and, without doubt, does lead to suicide.’
The review was ‘a whitewash’, says Heather Roberts, an author and illustrator from Bromyard in Herefordshire, whose 32-year-old son, Olly, killed himself in 2012 — he’d been prescribed the drug when he was 21 and lived with chronic anxiety for the next 11 years.
Heather and other parents feel their views about the risks were ignored.
“On my insistence, he went to a dermatologist and was also put on Roaccutane.”
I know how Roaccutane can change lives after suffering the mental anguish of bad acne, writes Dr MAX PEMBERTON
Dr Max discusses that a government medical watchdog has concluded the benefits of Roaccutane outweigh the risks
https://www.dailymail.co.uk/femail/article-12031135/Dr-MAX-PEMBERTON-knows-Roaccutane-changes-lives-suffering-mental-anguish-bad-acne.html
While it’s true that some people remain convinced that isotretinoin can lead to serious mental health problems and even suicide, most studies have failed to find a direct link.
What is known, however, is that debilitating skin conditions, such as acne, are linked to increased rates of depression and can drive people to kill themselves.
Which means that the drug is being given to a group of people who are at increased risk of mental health problems anyway.
It may be that because Roaccutane is given to those with the severest forms of acne, it’s the skin condition, rather than the drug, which is responsible for their mental health issues.
———-
Jab ‘fatigue’ is being blamed for the slowest ever start to the latest Covid vaccine drive. What a contrast to just a few years ago when people were desperate to get a jab.
It will be a tragedy if new variants, like Arcturus, are able to take hold simply because we become complacent.
Might as well toss this in, for good measure…
Focusing on the MHRA in Annie’s comments. Cheryl Grainger in UK Column takes a special interest in their shenanigans although concentrating on vaccines here, (not SSRI’s)
Taking On The MHRA—Part 1
by
CHERYL GRAINGER Cheryl Grainger
Cheryl Grainger BSc is a self-employed Training Consultant who has serviced pharmaceutical companies for over 35 years.
UK Column
The UK Column is an independent multimedia news website supported by its members.
Saturday, 22nd April 2023
I have been a member of the audience listening to the bimonthly Medicines and Healthcare products Regulatory Agency (MHRA) board meetings for some time. The MHRA’s directors are a self-congratulatory bunch who seem to believe that their many conflicts of interest are not of any concern, that the public’s trust in them has grown by leaps and bounds,
Taking On The MHRA—Part 1
by
CHERYL GRAINGER
Saturday, 22nd April 2023’I have already stated that Coroners have certified 59 deaths as being due to Covid vaccination. So the MHRA patently does not assess many cases—but what about the other 2,300 fatalities? With fewer than 10% of serious adverse effects getting reported, this could amount to 23,000 British fatalities that no-one is investigating’.
‘Lack of trust of the MHRA develops because of its duplicitous and disingenuous behaviour, demonstrated at its board meetings and appearances on other platforms.’
I believe that the MHRA has demonstrated malfeasance in public office.
Taking on the MHRA—Part 2
by
CHERYL GRAINGER
Saturday, 29th April 2023
Part 1 of this article is here. (On UK Column-Health)
The CEO of the UK Government’s Medicines and Healthcare products Regulatory Agency (MHRA), Dame June M. Raine, gave a recorded lecture at the All-Wales Therapeutics and Toxicology Centre at the All-Wales Medicines Strategy Group’s Twentieth Anniversary Conference. The lecture was entitled Making Medicines Safer—the Nicola Wheatley Memorial Lecture. Nicola Wheatley was a toxicology expert who died in tragic circumstances, and this was a lecture given in her memory.
The lecture can be watched here. Dame June Raine made a few notable statements at the start of the 36-minute lecture, which I will highlight in note form below:
Re: Suicide in young people: screening, risk assessment, and intervention
Re: Suicide in young people: screening, risk assessment, and intervention John V Campo, Jeffrey A Bridge, et al. 381:doi 10.1136/bmj-2022-070630
Dear Editor (rapid response)
It is worrying that the risk of suicide is down played in the article. People need to know that there is evidence that it is a proven fact. It has been highlighted in publications for many years by now.
I find it totally bizarre that children or anybody can still be prescribed drugs which carry a warning of such potential dangerous consequences, There is no way of calculating what exactly the risk would be for any individual. Surely they should be banned? It is reminiscent of the current situation whereby tobacco is being promoted in countries with least protections afforded to citizens with the least knowledge or where no alternatives are being offered. The often mentioned alternatives to antidepressants in the Western world are not being made available to those who suffer most from causes of depression.
Competing interests: No competing intere
‘For example, more than half the deaths and suicides occurring in trials of psychiatric drugs were not reported in published trial reports.7’
RCT’s are discussed here but without criticism of RCT’s themselves
CONSORT Harms 2022 statement, explanation, and elaboration: updated guideline for the reporting of harms in randomised trials
BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2022-073725 (Published 24 April 2023)
Cite this as: BMJ 2023;381:e073725
Talking of ethics, on 25 April the Illegal Migration Bill passed through the UK House of Commons.
Who do you think commented –
“The Bill is not compatible with the fundamental medical principle of doing no harm and we therefore consider it to be unethical.”?
https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2023/04/26/illegal-migration-bill-'unethical'-says-rcpsych-president-dr-adrian-james
Along with my wife Sian [a GP] this letter has just been published in the BJGP:
Letters to BJGP: Learning from experience
British Journal of General Practice 2023; 73 (730): 204. DOI:
https://doi.org/10.3399/bjgp23X732657
https://bjgp.org/content/73/730/204.1
It is welcome to see this advice on withdrawing from SSRI drugs published.1 I congratulate the authors and the BJGP. The Royal College of Psychiatrists (RCPsych), 4 years ago, published a position statement on antidepressants and depression,2 so I had expected similar advice to be published in the equivalent journal for psychiatry. This has not yet happened.
The BJGP article states that ‘Inaccurate guidance on antidepressant withdrawal has resulted in many patients experiencing distressing, debilitating symptoms’ and in ‘Take-home messages’ [Box1] that ‘GPs should educate patients on withdrawal’. Box 1 reminded me of when I was training in psychiatry. At this time, a 5-year-long ‘Campaign’ was underway to ‘Defeat Depression’. I recall the ‘key messages’, for example, in the article ‘Lay people’s attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch ’, which stated unequivocally ‘Patients should be informed clearly when antidepressants are first prescribed that discontinuing treatment in due course will not be a problem.’3
In 2023, across the UK, 1 in 6 adults are now taking an antidepressant. Such mass prescribing is well beyond the 1 in 20 prevalence on which the Defeat Depression Campaign was based. Vanessa Cameron, Chief Executive Officer for RCPsych for nearly 4 decades, offered the following candid reflection on her retirement in 2016: ‘After the Defeat Depression Campaign we produced guidance that said we wouldn’t use Pharma for any public education activities.’4
The Cumberlege report First Do No Harm5 (July 2020) acknowledged mistakes made in the adoption of new medical interventions and made a number of recommendations to prevent future iatrogenic harm to patients. To my knowledge, the RCPsych has made no public comment on any of the recommendations made in the Cumberlege Report. We all need to acknowledge the consequences of failing to learn lessons from our and patients’ experience, otherwise history will repeat itself.
Warms the cockles of your heart…
https://twitter.com/benzosarebad/status/1651664672108474394
For anyone who hasn’t seen this, I think you will get a lot out of it.
We’re Overdosed
There’s a growing number who object to the widespread use of the ‘chemical cosh’ to treat people with mental difficulties. But psychiatrists and the pharma companies would argue that depression and ADHD are real conditions for which drugs work.
Which side is right?
SPEAKERS FOR THE MOTION
Darian Leader
Psychoanalyst and author
Will Self
Novelist, broadcaster and literary critic
AGAINST THE MOTION
Dr Declan Doogan
Former Head of Worldwide Development, Pfizer Inc
Sir Simon Wessely
President of the Royal College of Psychiatrists
https://www.intelligencesquared.com/events/psychiatrists-and-the-pharmaceutical-industry-are-to-blame-for-the-current-epidemic-of-mental-disorders/
The Pfizer guy “come off it”; Wessely on his “soapbox”
Will to Wessely “I see a man doing a little comic turn, that’s what I see”
Simon’s wife Clare jumps in…
Will and taking Seroxat…
Will takes ‘pot-shots’ at Simon…hilarious..
Bear all this in mind, when Pfizer and Wessely think they are calling the shots…
Professor Louis Appleby leads the National Suicide Prevention Strategy for England and runs the Centre for Mental Health and Safety at the University of Manchester. This was my experience of meeting Prof Appleby in Edinburgh, 20 June 2022:
As I was standing outside the International Congress I spotted Professor Louis Appleby walking up towards the Conference Centre door. As he got to the entrance, I said “hello” and pointing to my placard asked “do you support Cumberlege?” He looked at me quizzically, and responded with physical gestures that I did not understand. So I asked him again. He replied “and who are you?” I replied “I am Dr Peter Gordon”. A few seconds later, but it seemed like longer, he said “Oh, gosh! You’re the one that writes”. His tone of voice was dismissive. As he went through the revolving door, I could see that he was throwing his arms up into the air, as if in despair.
https://holeousia.com/2022/06/23/elusive/
Aye weel, the pen is mightier than the sword.
I wonder would the Ukrainians agree?
D
Without SSRIs I wouldn’t be alive today.
You make an important point, Jeff. For some patients, SSRIs stimulate positive changes in mood. But for a Royal College to imply in a public press release that this is their sole action, is wrecklessly irresponsible, contrary to the guidance – and dismissive of the suicidal experiences/behaviours of other patients. Of course, we only have the testimonies of survivors:
“On the 28th, 29th, and 30th of December 2012, I took one 10 mg tablet of Paxil every morning. I stopped taking it three days after my son, a pharmacology student, warned me about the dangers of SSRIs. Although I had only been taking it for three days, I was haunted by a suicidal thoughts like ‘the elation that death is a comfort’.
I was in a daze for a few days. I took it for only three days, but I thought about death a lot for some reason. It was a strange experience: “If I put a string on the handle of a chest of drawers, I could die, and my wife would have to die with me.” I had no fear of death, no sense of reality at all, and felt that death was right there and that it was something completely casual.”
Dr Setsuo Ide
‘It’s difficult sometimes finding the words to express how cornered you often feel in withdrawal. You can’t run away from it, you can’t hide from it, you can only endure it until you can’t anymore. I’d liken iatrogenic suicide to being caught in a snare.’
@DuthieAlyne
I can see why Dan was so taken with Dr Setsuo Ide
https://twitter.com/DanJohnsonAB/status/1653036826675003393
” I had no fear of death, no sense of reality at all, and felt that death was right there and that it was something completely casual.”
For Dexter, a “fake impulse” from a “fake drug” – it was totally unsuitable for him
This side of things best explains how to deal with the loss to those left behind whose confusion and despair enables them to get a handle on it
Wendy Dolin, Kim Witczak, Kristina Kaiser, Leonie Fennell; these amazing women, out of many more, totally knew what lay behind and have become a powerful force
‘The ridiculousness of the life we are left with never ceases to shock me.
https://www.independent.ie/irish-news/i-believe-antidepressants-drove-my-son-to-kill/31221119.html
“The complete failure of the duty to inform and the duty to warn by health care professionals denied us the chance to save his life, and I apologize to my family for not having been able to guess what was being done to us.”
Dear Dan,
In a million years, you would not have known what Fluoxetine was doing to Dexter; the ‘duties’ however
https://amazingdexterjohnson.com/
You have written exceptional accounts
“Dexter’s action to take his life was a spur-of-the-moment delirious act. Something made him fragile for a moment, and took away the inhibition.”
Once you know, you know…
recovery&renewal
@recover2renew
·
3h
Oooph…
Carmine still flogging a dead horse…
https://twitter.com/recover2renew/status/1652634801659162624
Oooph… Two
https://twitter.com/recover2renew/status/1652679747443347463
Ooooph… Three
The Greatest Illustrated Stories There Ever Was…
https://www.billiamjames.com/tag/dr-david-healy/
My Portrait of Sir Andrew Witty, CEO of Glaxo Smith Kline (GSK), as Frankenstein. for Dr David Healy’s post, Brand Fascism, which tells the story how pharmaceutical marketing seems to be perverting, or limiting, the power of medical science, because it places the interests of corporate investors, before the health of their customers.
“The 100,000 people who work for GSK are just like you, right? I’m sure everybody who reads the BMJ has friends who work for drug companies. They’re normal people… Many of them are doctors”. Sir Andrew Witty
As a production for the digital magazine Inspire The Mind the latest podcast in the At Back of Your Mind Series was titled: Serotonin: What is its role in treating depression?
https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/pe01651-prescribed-drug-dependence-and-withdrawal/realistic-prescribing/serotonin-what-is-its-role-in-treating-depression/
I would be interested in anybody’s thoughts on this podcast that features Prof Carmine Pariante.
INSPIRE THE MIND: “Our in-depth editorial process allows for a collaborative approach between the writer and the editor. We maintain the author’s unique writing style through the process, and review all articles before they are published. The publication is overseen by scientists and clinicians, ensuring that the information put out is not only of significant interest to the public, but also factually accurate.” https://www.inspirethemind.org/
My apologies for another comment. This post relates to the podcast that I mentioned in my previous comment:
Medicine remains a conflicted as ever: https://holeousia.com/2023/05/03/89393/
No apologies needed – your’s has been a saga that has shed a lot of light on the state of modern psychiatry
D
“typical scientific playbook.”
Perhaps the most essential read, aside from the study itself, is the BMJ’s feature examining the study’s history. The article is deeply reported, sad, riveting, and damning. It condemns not just the company and the original study but an entire ecosystem of researchers, journals, and universities that have resisted the sort of correction the BMJ paper seems to offer. The most chilling part is that even though GlaxoSmithKline has been found to have acted questionably again and again in its promotion of Paxil, many of the institutions and researchers involved in the study and subsequent promotion of the product have remained unapologetic and are silent or unresponsive to efforts to have the original paper retracted or the record otherwise corrected.
https://www.theatlantic.com/health/archive/2015/09/paxil-safety-bmj-depression-suicide/406105/
One night in 2002, a couple years after that photo was taken, Sara woke in the night thinking she’d heard a bump in her kitchen. When she went to investigate, she found her 25-year-old daughter on the kitchen floor in a pool of blood. Next to Cecily on the floor was a large and bloody chef’s knife. In her chest were two knife wounds. One was shallow; the other was fatally deep.
Sara has always thought that her daughter was killed that night by an antidepressant called Paxil. Cecily, a bright, generally cheerful Stanford graduate, had been taking Paxil for two weeks. Five months before, she had become moderately depressed, and, as Sara would recall it, entered a psychiatric system newly enamored of chemical models of depression and chemical solutions. In search of the drug that would work well, doctors had put her on one after another that worked badly. Of these, Sara says, Paxil was the worst. It made Cecily more and more agitated, increasingly unlike herself. Finally she ended it in what Bostock has called a death “completely unexpected, out of character and violent.”
recovery&renewal Retweeted
Steve Moskal Wear masks,its VIRAL LOAD dose
@Samoskal
“The University of East London study reviewed media reports on nearly 8,000 coroners’ inquests and found that antidepressants were linked to 2,718 cases of hanging and 933 overdose deaths. …also … associated with another 979 suicides caused by…” #biorisks #brainhealth #stem
Dan Johnson
@DanJohnsonAB
https://www.digitaljournal.com/pr/news/ampifire/new-study-links-suicides-to-antidepressants-reinforcing-fda-s-black-box-warning
@ReadReadj
The negligent hate to be exposed.
BOB FIDDAMAN
@Fiddaman
·
4h
He’s wrong…again. 80% of suicides in Paxil clinical trials were over the age of 30. There were also 40 suicide attempts during the Paxil clinical trials. Black is handing out dangerous, misleading information to the general public.
https://twitter.com/Fiddaman/status/1653698586964533248
Missing the mark
https://twitter.com/ChrisGovernale/status/1653551489980465152
and to finish up
Verily along with the wind
https://longcovidadvocacy.substack.com/p/the-wessely-wizard-of-oz?r=1s0n2a&utm_campaign=post&utm_medium=web
“Why does Simon Wessely, arch-psychiatrist have this power, this control? Is he hiding kryptonite in his Teflon coat pocket or is it a lot of bells & whistles behind the green curtain?”
https://philevents.org/event/show/110021
I actually got a reply from Paul Lodge – they seem to be taking seriously the serious side effects from psych drugs and the gaslighting/abuse/lies in records of patients.
But what are they going to do about it – only 11 people out of 14,000 came forward here:
https://www.emhii.org.uk/announcements/
Even if they are forced to they will lie, they need the hard copy medical records as well as patients and family, partner, friend experience.
Just for the record Sertaline and Citalopram almost killed me and no one is going to tell me otherwise – the horrific experience it was clear as night and day.
Hello Chris No surprises here…..
1 of 1
INQUEST News ⚖️ on challenging state violence & justice campaigns
Spam
INQUEST communications@inquest.org.uk via gmail.mcsv.net
May 4, 2023, 9:41 AM (1 day ago)
to me
MENTAL HEALTH
Last week, we published a new report highlighting the persistent challenges bereaved families are facing following the death of their loved one in mental health services.
The report, written in consultation with 14 families, shows that families face numerous hurdles during investigations and inquests into their loved ones’ deaths, and the processes are not delivering the change required. They are instead shrouded in delay, secrecy and animosity towards families, who simply wanted active participation and a truthful account of what caused their relatives’ deaths.
Speaking anonymously to INQUEST, one bereaved family member said: “The death wounded me, dealing with mental health services has broken me. Everything is a fight when you have the least fight in you. Nothing can bring your child back. All we can do is help them ensure it doesn’t happen again.”
Bereaved families, alongside INQUEST, have been campaigning for a statutory public inquiry into mental health deaths in Essex.
A parliamentary debate earlier this year heard about the impact of the limited legal powers of the current inquiry. Out of the 14,000 NHS staff contacted for evidence, only 11 have come forward. This followed a public statement by the chair of the inquiry, Geraldine Strathdee, stating that the inquiry was not fit for purpose.
Chris Nota, a teenager with autism, was under the care of the trust when he died in 2020 after falling from a height in Southend. An inquest found that multiple significant failures by the trust contributed to his death.
We saw several other critical inquest conclusions into the deaths of young people with autism including Stefan Kluibenschadl and Leo Toze, highlighting the urgent need for appropriate child-centred, autism-focused mental health support.
A critical governance report found catastrophic leadership failures following the deaths of three young women in the care of Tees, Esk and Wear Valley NHS Trust.
It follows the publication of three damning independent investigation reports into the deaths of Christie Harnett, Emily Moore, 18, and their friend Nadia Sharif, 17. The trust is now being prosecuted by the Care Quality Commission (CQC).
We also saw how repeated multi-agency failures led to the deaths of vulnerable young people including Ben Nelson-Roux and Samuel Howes.
Ben Nelson-Roux, 16, died at an adult homeless hostel in 2020. Ben had ADHD and was later recognised as a child victim of criminal exploitation. His parents spoke to ITV News about how Ben was failed and their pleas for help ignored.
Samuel Howes, 17, died after jumping in front of a train in Croydon on 2 September 2020, just one month before his 18th birthday. The inquest found a series of failures by various agencies, including police, mental health and social services, possibly contributed to his death by suicide.
His mother Suzanne has been sharing resources and insights into life after loss in her blog. She also spoke to the BBC about how her concerns were repeatedly ignored by authorities.
I often wonder how many of the families know what akathisia is.
I am not sure if this was widely shared, but I watched it at the time and I think it drew an important distinction
Episode 5 of “Know Risks”: What is Akathisia? Just Call It Delirium with Dr. David Healy
https://www.youtube.com/watch?v=95n_c3iLwdg
293 views • 21 Sept 2022
Heather and Lee are joined again by Dr. David Healy. We discuss akathisia — what it is, who it affects, and what to watch for, as well as a range of consequences for this treatment-induced harm.
Maybe Akathisia has a problem on it’s hands. It has been misrepresented in some circles ie called Akathisia when not appropriate.
It is a difficult word to digest.
Perhaps we should think on this and digest Delirium as a cause of suicide, homicide and violence.
We have got used to Akathasia, but perhaps, if you listen to David, we should go some way to adopting Delirium as a doctor friendly term, who if they don’t know what that means are severely impaired…
The trouble is neuroleptics and or benzodiazepines are used to treat it and am sure the patient is going to get a schizophrenia lable in front of a psychiatrist, not delirium.
Did you know high dose pyridoxal 5′-phosphate can stop akathisia. Twice I’ve stopped it in the last two years with 100mg going up from 25mg over the time of three hours. It gave me a 3 day thumbing headache each time, but the akathisia was gone.
Chris
This comment about B6 is interesting. Are you sure it made a difference – akathisia comes and goes in waves – so not impossible for it to ease off after taking B6 especially if you were distracted by a bad headache. How quickly did the relief come on and how long did the relief last?
David
The wave gathers in intensity, it is strong, formidable.
The wave gives a hint of impending doom.
The mind does not recognise the signal
The mind goes along with it.
The mind is being deceived.
The mind is shrunk in to a corner.
The mind doesn’t translate.
This is the danger point.
This is when the person jumps in front of train, jumps from a tall building, stabs themselves, kills their children and/or others, hangs themselves.
The point of no return.
Suicide implies the person knows what they are doing.
SSRI induced death is not a suicide.
It is a drug induced state of death being a result of delirium.
Dexter died of delirium, in a spur-of-the-moment impulse, as his dad says.
Akathisia is relentless agitation; Dexter wasn’t agitated, he calmly and methodically put a gun to himself, almost as if it didn’t matter. This is delirium.
They go hand-in-hand.
Almost a chicken-and-egg.
Get the Akathisia and hop-up-and-down.
Get the delirium and snuff-out your life and rationality completely.
Akathisia can lead to aggressive murder of oneself or others, but delirium can bring on an unjustifiable demise of oneself.
she is ‘monstered’ in the comments section of the DM, as this ‘story’ played itself out…
Reddinton said the defense has appointed a national expert on parents who kill their children and Dr. Phillip Resnick, a psychiatry professor at Case Western Reserve University, and psychologist Paul Zeizel to look at Lindsay’s mental health.
improperly prescribed multiple medications for anxiety mood disorder and psychosis.
Doctors at the hospital decided to take her off Seroquel – a drug used to treat schizophrenia and depression.
She was then given Trazodone, another anti-depressant, and Ativan, a branded version of Lorazepam, according to her attorney.
an astonishing combination of 13 different drugs to help her cope.
https://www.dailymail.co.uk/news/article-12048809/Mom-killed-three-children-jumping-roof-permanently-paralyzed-waist.html
Setting the Marilyn Lemak story, what are her chances…
https://rxisk.org/marilyn-lemaks-trial-and-punishment/
Trial and Punishment…
Reading that it was sickening and brought back memories having been subject to all three of those drugs – pure evil. Did you do a comment ?
No, Chris.
I have no desire to be set upon, by a ‘Pack’.
I have three cuttings to hand. On July 25, 2011, I wrote a letter published in the DM, it was along the lines of ‘where is the evidence?’ The next day, a woman replied. Her letter had a massive, huge-font, headline, along the lines of ‘I am infuriated by Annie and her opinion, and she was. The next day, another letter, ‘The point Annie was making’ which totally missed the points I was making…
Packs of doctors coming at you is one thing, packs of DM readers coming at you, quite another…
“This comment about B6 is interesting. Are you sure it made a difference – akathisia comes and goes in waves – so not impossible for it to ease off after taking B6 especially if you were distracted by a bad headache. How quickly did the relief come on and how long did the relief last”
I was not on any drugs at the time so it was tardive, it was definately Akathisia and I was terrified but determined not to take any benzodiazepine or sleeping tablets. I knew that p5p is a co factor in GABA synthesis and thankfully I already had p5p and determined to take a large dose. The relief came one within one hour of hitting 100mg, this was about 18 months ago and I continue to take a small dose between 5 and 12mg most days there has been no hint of it coming back since then. I had also read this and knew not being on any neuroleptics or any other akathisia inducing drug it would probably work much better and it did. It made a total difference.
https://pubmed.ncbi.nlm.nih.gov/15554771/
“Akathisia is relentless agitation; Dexter wasn’t agitated, he calmly and methodically put a gun to himself, almost as if it didn’t matter. This is delirium.”
Have you had akathisia Annie – both can happen at the same time. My view is the delirium is drug induced toxic psychosis either at the same time as akathisia or following it due to the drugs heaped up the victim. Also you are not necessarily agitated with akathisia all the time but the suicide ideation is overwhelming. I never had the urge to harm anyone else.
Mix in Akathisia with Emotional Blunting and Delirium-psychosis and you might have a recipe for disaster…
https://www.madinamerica.com/2023/05/ssris-lindsay-clancy-and-me/
“ I immediately thought about Dr. David Healy’s biomedical model to explain how SSRIs cause akathisia, emotional blunting, and delirium-psychosis, which can lead to suicide, violence, and homicide.”
Lessons from SSRIStories #3: How do SSRIs cause violence and suicide?
November 5, 2015 | 9 Comments
by Julie Wood
https://rxisk.org/lessons-from-ssristories-3-of-5-how-do-ssris-cause-violence-and-suicide/
It is one thing to see that taking SSRI medications can cause violence in some people, but quite another to make sense of it. In his blog, “Prescription-Only Violence”, Feb 18, 2013, David Healy identifies the three mechanisms through which these drugs can cause a person to do violent things:
“The antidepressants now come with black box warnings of suicide and in some jurisdictions such as Canada they come with warnings of violence also. Exactly the same mechanisms that lead to suicides lead to violence. In one case you have violence directed inward, and in the other directed outwards. These mechanisms are akathisia, emotional blunting and psychosis.”
It is important to recognize that there is overlap and interaction among these mechanisms in most people. Emotional blunting affects most people and akathisia is also fairly common. Psychosis occurs less frequently but it is not rare. It is very possible for a person to be affected by one or two or all three of these effects.
Mechanism #1 – akathisia
Mechanism #2 – emotional blunting
Mechanism #3: delirium-psychosis
‘There you go’, from Julie…
Tomorrow there is a program about anxiety on BBC R4 4pm. Be interesting to see if they have a clue on glutamate/GABA. My view is the dysregulation starts through stress and trauma made worse by alcohol and benzodiazepines and benzo like drugs.
recovery&renewal Retweeted
Dan Johnson
@DanJohnsonAB
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He was given this useless and dangerous medication without my knowledge, but even when we are informed, they downplay the risk. I’m glad to see the truth coming out, but it was known for decades x
https://brownstone.org/articles/prozac-unsafe-ineffective-for-young-people/
Chris van Tulleken came to Bangor recently
https://davidhealy.org/the-greatest-failure-in-what-used-to-be-called-medicin
We’d had a long conversation beforehand where it was made clear to him that effectively every article on all of the antidepressant trials in children who are depressed – all 30 of them, involved over 10,000 children – are ghostwritten and the data is accessible in none.
This conversation was removed in the final edit. It should have gone with the ghostwritten article being handed over.
“He was given evidence showing that none of the drugs worked. In the trials done on Prozac, it didn’t work either. But MHRA here and FDA gave it a license and this license for Prozac is driving a lot of the sales. And in the programme you’re left with the impression from two other doctors interviewed that Prozac did work. Girls are dying because bureaucrats are not willing to admit they made a mistake.
In trying to explain why Sertraline is also used extensively, he turned to Andrea Cipriani who said it may be because it works so well for adults that prescribing has leaked over. This is baloney. The published evidence for sertraline might be one thing but its known that once you get anywhere near the raw data this is the least effective drug for any age group.”
“This peep of protest was snuffed out.” …
10.40 in
Diane Spaulding interviewed by Christine Dolan – vax injured gaslit as having anxiety saw a psychiatrist prescribed a AD and benzodiazepine. “Progressively started getting worse after medicine. Brusing all over her body, benzo calmed her down so she could research, joined Facebook group got off psych drugs found improvement on Ivermectin.
https://tv.gab.com/watch?v=640d4c980cbc39f7ccfe770d
20.45 – we’re all being given the same anxiety diagnosis