What’s going on Here?

August, 8, 2017 | 57 Comments


  1. Words that will Haunt ..

    “Anyone using Seroxat or Zyban should not worry…

    Posted in Expert Reactions

    GlaxoSmithKline concedes drug fraud charges

    Posted in Expert Reactions on July 3rd, 2012.

    Pharmaceutical giant GlaxoSmithKline today announced it will plead guilty to marketing drugs for unapproved uses and failing to report safety data.


    “but continue to take their medicine. If you have any questions please speak to your healthcare professional.”

    Our aim is to promote accurate, evidence-based reporting on science and technology by helping the media work more closely with the scientific community.


    Our aim is to promote accurate, evidence-based reporting on science and technology by helping the media work more closely with the scientific community.

    A F does not have a strategic philosophy in his bones and the words of F could almost have come out of my doctors mouth ..

    why might it be that you (who obviously otherwise have the highest intelligence), are so willing to go propagate the one sided extremes emphasizing the potential for bad complications from meds

    Don’t worry ..

  2. Having read this blog post, I now understand why many patients who find SSRIs ( for example) beneficial take such a high and mighty attitude towards those less fortunate than themselves. In my opinion, it is NOT your views that may push patients away from these drugs but rather the outrageous way that some people in authority wrongly criticise your views and exaggerate the likelihood that patients are put at risk by listening to, or being frightened by, programmes such as Panorama.
    It is high time that ALL worked together, professionals and patients alike, to get to the root of the problems around the use of these drugs. The title of the Panorama programme had a QUESTION MARK after it – did that fact slip their notice or did they just not want to see it? As for saying that yours are one-sided views – did they not notice that you said that you DO USE Sertraline? If you were ‘totally one-sided’ then you would be calling for a ban of this group of drugs surely? Not once have I heard you say anything which could be misunderstood nor that would encourage anyone to stop their medications. I do not know of the work of any of the ‘professionals’ copied in here – but what I DO know is that if they knew your work, as we do, they would soon see that you work with COMPASSION in every case. Being a compassionate person prevents you from causing harm to ANY patient – that covers ALL patients, not merely those who have had their lives ruined through no fault of their own.
    Patients are not fools, they deserve to be listened to. If we fail to accept the seriousness of the possibility of reactions to these drugs then I feel we have an even bigger problem on our hands. If these actions are not ‘chemically induced’ then we must believe that the human race is in dire straits – more and more turning to murder or suicide year upon year. Why, then, is this happening – if it isn’t for the fact that we are fast becoming a race that cannot live with our own emotions? Swallowing a pill is not the answer to our ills – listening and caring about the wellbeing of each other is a far better bet. We need the luckiest patients, as well as the general public, to understand the importance of having full knowledge of these medications that so many of us are swallowing every day. False, or blinkered knowledge has had its day – now is the time for truth and an acceptance of the whole picture, for all our sakes.

  3. The drugs aren’t perfect but they’re better than nothing–best prescribed without patients knowing the medicine might backfire–if we focus on all that can go wrong before we even begin, treatment is likely to fail due to anxiety and expectation of trouble. Some may not even dare to begin! Best to keep them in the dark, expecting only improvement. If there are still problems or an increase in problems, well, patients have problems. Who’s to say a problem is due to the medication. And these are truly vulnerable people who need medication–their illnesses prove it. The drugs aren’t perfect. They cannot overcome everything. But it’s all we have. (Talk to your doctor to find out if you’re vulnerable, and if you’re not, we’ll get you there).

    • What do you say to a parent that loses their child due to induce suicide from those meds? Oh well shit happens better that one is sacrificed to save the rest! No wonder we have lost our way with an attitude like yours, here’s hoping your not a professional. How stupid am I of course you are a professional.

      • Ann, that was lazy writing on my part. I should have clarified these are things I’ve been told by professionals or heard professionals say to others. They do seem to think some of us are expendable, Alan Francis included, apparently. Sorry my comment was upsetting. The reality is quite upsetting.

    • I assume Laurie is being sarcastic here, in case anyone thinks she’s serious. Laurie can correct me if I’m wrong.

  4. ..the wave of the future ~

    New Analysis of Paxil Data: Were Adverse Events Downplayed?

    Fresh look at infamous Study 329 raises questions about pharma transparency


    ~Allen Frances, MD, a longtime critic of financial conflicts of interest in psychiatry, called the re-analysis a “breakthrough” that demonstrates the “value of having all records available to outside groups. It gives us the opportunity to correct selective reporting of data. It should be the wave of the future.”

    ~Allen Frances names and shames the power players but not himself~

    ~And there is a good deal of prima facie evidence linking psychiatric drugs, not just to “nuisance” crimes, but also to mass murders.~

    ~Given all this, it’s a little late in the day for Dr. Frances to be re-inventing himself as the voice of psychiatric moderation and restraint.~



  5. When I saw a legal aid psychiatrist and (I was asked to see a few) I told him about the side effects I had experienced and a previous expert I had seen on SSRIS and that I had asked my Solicitors to send a copy of that medical report onto him. Well considering I was in a very large private hospital in London with god knows how many computers he replied to me. “I cant retrieve the emails as I only have my phone on me, I will have look later on.

    I was not stupid I knew he could access those emails from my Solicitor quite easily but he chose not to in front of me. So I continued to tell him about the medication and how it had affected me, I told him about all the side effects I had been suffering from and he verbally agreed with me that I had been affected by them and would make a note of it in his report.

    Well several days later I got a copy of his report and he blamed me and did not mention one side effect from the medication, not one side effect was mentioned that I had told him about??????

    This man was a Professional Psychiatrist not telling the full truth in a legal medical report he had been paid to do. I was so Livid, angry and upset and could not believe he was ignoring what I was telling him. I refused to use this report in court and demanded I used my original expert again.

    Why are forensic psychiatrist lying or omitting from their report what the patient is telling them, that is not right at all.

    It left me feeling the Psychiatric Profession is corrupt to the core.

    I know myself people are helped by them and I have no desire to wish that being taken away from any of them but I would like the Psychiatric Profession to at least listen and acknowledge me and how they had harmed and destroyed my life.

    We all know all drugs have positive effects in some and negative effects in others but when I suffered the negatives and landed up in the criminal justice system not one Psychiatrist willingly comes forward and agrees you were harmed.

    I left me feeling there is corruption going on in the Psychiatric Profession.

    • Anne-Marie, I totally agree with your view of forensic psychiatrists – they simply see whatever it is that the prosecution wants them to see, in my opinion. In Shane’s case, the forensic psychiatrist’s report stated that the whole incident was down to alcohol. “It was a bank holiday weekend and he’d been out enjoying himself” was, basically, his take on matters. He’d been out, yes; he’d had a drink, yes – not recommended to mix both BUT no mention had been made by the GP of any danger of doing so. That, I believe needs to change. Anyone prescribed these type of drugs MUST be made aware of the dangers of mixing them with alcohol. Had Shane not had a drink that evening, then what happened to him that night would have had to be seen in a different light.
      Neither the said psychiatrist nor any other saw Shane later that night/early morning therefore. to my mind, could not safely say ‘it was the alcohol alone’.
      Those who DID see him reported an ‘extreme calmness’ immediately following the incident and his solicitor stated ‘perfectly sober when interviewed a couple of hours later’. We didn’t see him, therefore could not comment. However, we DID see two further incidents of his fuming rage – when alcohol was NOT present – during the further two months that he remained on the SSRI.
      Like you Anne-Marie, Shane had never been in any sort of trouble previous to these incidents. This rage, accompanied by other less serious weird behaviours came with the first SSRI tablet and left with the last Seroxat tablet(allowing time for that last one to leave his system). Still, the majority seem to dismiss this possibility of a link – had they witnessed the events they would certainly not remain as blind to the possibilities, I can vouch for that!
      I feel that all this talk of needing to ‘dumb down’ reports of possible side effects is an insult to those among us who have been injured by these drugs. No-one should be ignored when they tell their side of the battle for a fair hearing and neither should professionals who are willing to support, with certainty, be doubted to such a degree. We are all allowed to have our own opinion but one side should not be allowed to dominate, or silence, the other.

      • Alcohol increases Serotonin, SSRIS increase Serotonin, the two together increasing serotonin causes increased side effects like Mania, Akathisia e.t.c. SSRIS can also cause intense cravings for alcohol for a sub group population. The only way to stop this vicious cycle is to come off the SSRI.

        Not only should there be warnings of this combination but there should also be warnings that SSRIS are contraindicated in a certain sub group population. Dr’s should be alert and on the lookout for alcohol drinking behaviours in people taking SSRIS.

        Forensic Psychiatrist’s should also be looking out for these problems instead of ignoring and denying them.

        Whats the point in Psychiatrists if you have to do their job for them?

  6. Here’s my two’pennorth:

    In the interests of honesty (not ‘transparency’, a debased term these days) I haven’t seen the Panorama programme – yet. It’s recorded and I’ll watch it in due course when I can. But my reaction the following day to the eruption of accusations in the media that it was going to cause everyone to stop taking their antidepressants and kill themselves, or suffer appalling harm – or that seriously ill people would be so shocked at the prospect of turning into a mass murderer that they would refuse to take the medication they urgently needed was – oh Christ. It’s backfired. All the programme has done is throw petrol onto a debate which has become so polarized it is now utterly impossible to initiate respectful acknowledgement of the harm/benefit problem.

    That was before I knew that the media reaction had been initiated in advance by a load of big knobs (or, nobs) in psychiatry – most of whom hadn’t seen the programme either. First rule in criticism: it is essential to have seen/heard/read the thing you are slagging off. If you haven’t, you haven’t a leg to stand on and just look silly. Older people here will remember Mrs Whitehouse – arbiter of public morals – who was (in) famous for never having actually seen what she was seeking to have banned ‘in the public interest’. Most people thought she was batty.

    I haven’t seen the programme so cannot – and wouldn’t – give my reaction yet. However, I met a neighbour the day after it had been screened. She is younger than me, has taken antidepressants for several years after an appalling breakdown. She might, as it were, be called Lord Denning’s average ‘woman on the Clapham omnibus’ – i.e reasonable, not especially expert on medication. She asked me if I’d seen ‘that Panorama thing last night?’ I said no – but had she? I assumed my Louis Theroux method of just listening to what she said, which was as follows:

    She thought the prisoner looked so dreadfully sad and bewildered. She believed he had no idea why or how he’d gone berserk with a gun.

    She didn’t really know which ‘expert’ to believe: it could well have been the illness, which was getting worse and turned his awful private thoughts into action.

    However, she was impressed with the other expert (actually she said ‘the old one’ – sorry David) who thought the drug had triggered the murders – caused him to actually go wild with a gun…and, interestingly, she thought the fact that he’d knocked off the sertraline a few days before had played a role.

    She couldn’t really make up her mind but had no problem believing that the drug had played a critical role. The one thing she didn’t say AT ANY POINT was – that she intended to stop taking her ADs as a consequence of seeing the programme. She, like most people on meds, has much more intelligence and common sense than to take such a step on the basis of a TV programme. To suggest otherwise is frankly patronising.

    Part of the reason I have to psych myself up to watch is because it will be distressing. I have absolutely no problem believing that antidepressants can cause inexplicable violence: between 1998 and 2003 I embarked on an astonishing and determined struggle to kill myself. The urge to self destruct led me to harm myself in a way that I cannot now understand – it is impossible to re-create the frame of mind I was in. (apart from the overdoses, one near-fatal hanging and cutting, I once tried to prise my eyeball out…which gives you a notion of just how bizarre the urges were.). At the time I was taking a cocktail of ADs, spiced up with antipsychotics and the rest. It was a recklessness combined with a total disregard for consequences and unbearable inner turmoil. Plus the peculiar, deranged thoughts. So, I have no problem believing that such drugs can cause people to behave in astonishingly damaging ways.

    What makes me sad and distressed is that every shrink and nurse involved in my care stood by and watched a previously completely ordinary, well -behaved person go berserk – without apparently considering the possibility that the drugs might be playing a role. It seems that is still the case – I find it extraordinary that we are still in the situation where no professional will concede that drugs can do terrible harm – and that getting a handle on how often that happens is impossible because of the stupid, vituperative reaction of the psychiatric establishment, every time people like Professor Healy tries to look at the problem.

    I think the vast majority of people don’t go berserk. But we don’t know. I also think that we need better ways of using medication to help people like me, in terrible despair. Seems to me, it is pretty obvious, pretty quickly whether an antidepressant is making someone feel better. If it’s making them feel worse – and behave oddly – then the medical establishment needs to wise up. Otherwise – you all have blood on your hands. Don’t you?

    As for suggesting that Professor Healy should know better because he is intelligent – I’m intelligent too. If anyone said that to me, I’d point out that it therefore might be wise to take note of what I say – before I smacked them on the nose.

    • Sally, this is brilliant. I have been thinking we should find someone to write a commentary on this program and the hysterical reaction of official psychiatry.

      Working title was “Notes of a Vulnerable Patient.” I think you’ve written it!

      PS: There was one other expert interviewed who agreed that Holmes’ rampage was likely triggered by the SSRI’s — Prof. Peter Tyrer — your neighbor might have been thinking of him. He is even older than old Prof. Healy (OMG!)

      • Apologies to the (fairly) old Prof Healy. Interestingly my neighbour couldn’t remember any names at all – even the drug – which makes her assessment sort of weirdly more honest and interesting to me. She had no axe to grind, was neither pro or anti meds, except that she’d found her AD helpful because it calmed her down and let her sleep when she was tormented with insomnia.

  7. I had never had a criminal record or been involved with the police in my life before SSRIS. Completely ruined my life hence why I speak out to try to save others from the same persecution.

    Dr Healy is one of many astute Dr’s that can see the effects of the drugs. What is wrong with the rest of the Profession when its only tool to helping patients is “Mind Altering Drugs” and they don’t even look at the effects unless there positive ones.

    Thank god they don’t work in medicine because more patients would die as a result of their ignorance.

    They always said Psychiatry is normally the profession chosen when they have failed medical school. I can see why now they say that.

  8. Doesn’t seem to me that David H feels embattled – maybe collectively bullied is a better description. He is not the one who needs his ‘mind opened’ – others should be opening their mouths about what they know is going on – leaving it to service users to speak out as well as D, with valid accounts -and do nothing – is a disgrace. Not so long ago gay people were chemically castrated by medics , given aversion ‘therapy their ‘battles’ went on for decades – hopefully this one won’t take so long.

  9. When considering “Service” in medicine, Sir William Osler observed:

    “We are here to add what we can to life, not to gather what we can from life”.

    Also: –

    “You are in this profession as a calling, not as a business.
    A calling which exacts from you at every turn self sacrifice, devotion, love and tenderness to your fellow men”.

    After almost half a century of studying and practising medicine I find that the above exchange of e-mails identifies only one writer who has lived and delivered Osler’s ideology.

    The Panorama analysis of this human tragedy was a masterclass in the very highest standards of investigative journalism.

    If there was any possible bias, those of us who have experienced the devastation of life caused by the reality of, and the denial of undeniable psychotropic ADRs may feel that the potential benefit of SSRIs may have been overstated?

    It was also a masterclass in the presentation of a fastidiously developed, truly expert, academic opinion.
    An opinion of utmost integrity, quietly, honourably developed and delivered with appropriate professional humility.

    A vital question of miscarriage of justice was raised.
    A question that throughout the medicalised world, more and more legions of enlightened, highly informed people demand psychiatry finds the integrity to investigate impartially.

    No wonder UK psychiatry’s new minister of propaganda was wheeled out in advance to defend the increasingly embarrassing party line and the embattled, out of touch psychiatry establishment.

    To fight evidence based questioning with pre-emptive marketing sound bites and accusations of “stigma dissemination” is entirely predictable.
    It serves only to further expose the apparently increasing insecurity discomforting the establishment. It discredits medicine.

    The casual labelling for life with unsubstantiated and often misdiagnosed DSM IV / DSMV “diagnoses” is the real cause of stigma.

    How tragic that many of those so labelled, stigmatised and destroyed suffered from unrecognised psychotropic ADRs such as akathisia and SSRI (et al) induced toxic delusions.
    Acute medical emergencies that the “experts” seem incapable of differentiating from a functional psychosis.

  10. It is my belief that those who act from wrong intent do themselves harm.
    From my experience of working with patients under Section and from working in big business too I see the struggle of David Healy and others like him to be one of good intent – I see the harm that he refers to and I wish him well. I also send a well wish to those that do harm to themselves by acting from less than true intent.

  11. None of the participants in the recent e-mail debate on Holmes-the
    Aurora massacre-Panorama-role of antidepressants–have
    compared the issues re antidepressants (“ADs”) with the similar issues
    associated with other psychoactive substances, especially the most
    important such substance: ethyl alcohol.

    That comparison is illuminating.

    The ADs are not the only class of psychoactive substances that
    disinhibit violence. Alcohol is the undisputed king of such
    substances. Alcohol is the substance:

    * most widely used
    * with the longest history
    * most intensively and extensively studied
    * with the strongest evidence for beneficent effects (without
    beneficent effects, people would not dose themselves in such numbers
    and with such regularity), and
    * with the strongest evidence for unleashing violence, not to mention
    many other malign effects.

    It appears to me that in America people who commit alcohol-fueled crimes generally are sentenced with a lesser degree of retribution than cold-blooded (i.e., sober)
    defendants. Sentences for drunken homicide tend toward
    manslaughter or second degree murder rather than first degree murder.
    Drunken murderers, provided they are not African American, tend to get long prison terms or life sentences, not death sentences.

    Do not the same considerations argue for similar treatment of people
    who commit acts of uncharacteristic (for them) violence under the
    influence of ADs, people such as Holmes?

    • Your so right alcohol has so many comparisons with SSRIS.

      Alcohol Makes you happy initially and increases serotonin.

      Alcohol can also make you aggressive and violent.

      Alcohol can make you addicted and crave for more.

      Alcohol’s effects on serotonin are many just like SSRIS. In fact I wouldn’t be surprised if alcohol and SSRIS are related in some way like distant cousins or something.

      They share many similarity’s and I think many answers to the SSRIS may be found in alcohol and and serotonin research.

  12. “Who are SMC? They are linked to Sense about Science. Simon can probably tell you more. My take is the original idea was reasonable – scientists like him were under attack from what might loosely called activists. He probably had much less hostility to cope with than I have had defending ECT. But the idea was to ensure that proper science got a hearing.”

    It looks to me like David has fallen for some of the spin and prejudice promoted by the SMC here.

    SMC’s action surround CFS and the PACE trial are a clear example of how it has adopted the role of a propaganda organisation. The have played a key role in promoting the bigoted view that CFS patients’ concerns about spun research like the PACE trial stem from prejudices against psychiatry or mental health issues, rather than legitimate concerns about how the research was conducted.

    While international media, like the New York Times, has reported on the large number of academics who have now joined with patients to call for the retraction on a key paper from this trial, the UK media has continued to promote the claims made in this paper uncritically, while smearing the patients who helped uncover this serious medical scandal.


    The PACE trial researchers attempted to keep data from their trial hidden by arguing that they were facing a campaign of harassment from hostile activists, but the information tribunal assessing this case found that “activist behaviour was, in our view, grossly exaggerated and the only actual evidence was that an individual at a seminar had heckled Professor Chalder.”

    The minutes of a meeting on ‘harassment’ of CFS researchers held at the SMC, it is recorded that the decided “harassment is most damaging in the form of vexatious FOIs”. The other two examples of harassment provided were “complaints” and “House of Lords debates”.


    If ‘debate’, ‘freedom of infomation requests’ and ‘complaints’ are presented as ‘attacks’ that scientists need to be protected from, it is quite clear that something has gone very seriously wrong with ‘science’.

    It is patients whose lives have been harmed by the spun junk-science promoted by Sir Simon and his colleagues, and they should be apologised to for how their attempts to raise legitimate concerns have been smeared. The idea that Sir Simon had a legitimate need for a propaganda unit like the SMC to protect him is laughable. The family of Alem Matthees, the patient who beat the £250,000 legal team trying to prevent the release of data from PACE, have been collecting messages of support for him as the prolonged ordeal of this battle has led to a serious decline in his health. He was having to deal with attacks on his integrity from a highly paid legal team. He was at th sharp end of the propaganda and prejudice promoted by the SMC. Who was supposed to be protecting him?

  13. What a series of emails.

    I wish so much I knew how to bridge the divide and have people like Allen Frances see my perspective on the risks and harms of SSRIs (and other medications), as well as the damage done by the lack of informed consent. He and others like him can’t hear me. It’s like being invisible. I’ve given up trying to convince. But I haven’t given up figuring out a way forward on these issues.

  14. The over-confident certainty of members of the medical profession is on display in this Panorama program.

    Do these ‘experts’ have humility or doubt? A note to the ‘experts’ – what you think you ‘know’ now, may prove to be otherwise in future, so please keep an open mind. Science is always open to question, or should be… But as David Healy indicates, ‘proper’ science is being stifled – “It has become nasty and risks being fascist.”

    In regards to the Holmes case, consider for example the surety of William Reid, the court psychiatrist who says: “For me as a psychiatrist it was a result of mental illness. I can state with great confidence to myself that it was completely unrelated to the medication. And of course another reason to believe that is that he was, as far as anyone knows, not under the effects of the medication at the time of the shootings.” (At 52:48 in the video.)

    By contrast, David Healy says: “I believe if he hadn’t taken the Sertraline he wouldn’t have murdered anyone.” (At 0.59 in the video.)

    Who knows what after effects the medication might have had in Holmes’ case? The timeline prepared by the reporter Shelley Jofre seems pretty compelling to me that the medication could have been implicated, i.e. “joining the dots of what happened with his medication suggests Sertraline may have played a part. We found no evidence Holmes planned to kill before the anti-depressants, and plenty to show how afterwards his mental state went rapidly downhill. No one joined these dots up at his trial.” (At 53:10 in the video.) Although it was mentioned earlier in the video that “Jurors heard disturbing details of dark thoughts of killing which he’d had since he was a teenager…” (At 9:45 in the video.) This doesn’t negate the possibility that the Sertraline could have tipped him over the edge.

    Is the medical/scientific establishment going to pull the usual ‘correlation is not causation’ excuse to protect the medical product?

    That’s why people have to think very carefully about the risks and benefits before they take a medical intervention, whether that be an SSRI, or another medical product such as a vaccine, because if something goes wrong afterwards, you’re on your own, you’ll have a devil of a time in getting ‘the authorities’ to acknowledge the medical intervention could be at fault.

    You’ll also be up against the ‘machine’ that operates to protect lucrative medical interventions, courtesy of the medical/scientific establishment. And that includes the ‘peer-reviewed literature’ in journals used to support the use of medical interventions, often bought and paid for by the purveyors of these products, with the assistance of their handmaidens in the medical/scientific establishment.

    • David, in your email correspondence with Allen Frances you say you recommend watching the Panorama program, and note “They left out lots”, including “the clips of Bill Reid saying he knew nothing about the drugs and there was no point asking him about the drugs – you’d better get someone else to comment on that”.

      But if Bill Reid “knew nothing about the drugs” how could he state in the Panorama program “with great confidence” to himself, that Holmes’ murderous crime “was completely unrelated to the medication”?

      What’s going on here?

      • E

        Reid’s response is like a lot of doctors, perhaps more American doctors than British, who want either black or white but nothing in between. The latest example of this is the idea that if opioids are good for pain they cannot be causing addiction.

        Its not the Bill Reids of this world that surprise me. I am astonished at how the establishment (the Bishops) tolerate a complete denial of access to the data and frame guidelines based on junk. They seem to me indistinguishable from Pius XII in the 1940s. He ended up just about canonized, with repeated efforts to canonize him since when the Church thinks the fuss might have subsided a bit.


        • David, it seems to me a lot of doctors are masquerading as ‘experts’, over-confidently prescribing SSRIs, vaccines, antibiotics, opioids and other medical products. What is the quality of evidence supporting the use of these products?

          You raise the point about quality of evidence in your email exchange with Allen Frances in regards to inaccessible data and ghostwritten articles. Why aren’t other doctors worried about this too? It seems to me too many are happy to dispense medical products on a routine basis, and naively trusting of pharmaceutical company data.

          For instance I was gobsmacked to hear reporter Shelley Jofre say in the UK alone there were over 40 million SSRI prescriptions last year. (At 14.09 in the video.)

          Peter Tyrer, Emeritus Professor of Community Psychiatry, Imperial College London, says “Even though we have all these negative effects, we’re getting a much more drug orientated society. We are in fact prescribing more of these drugs than we’ve ever prescribed. (At 14.14 in the video.)

          Both doctors and patients are being led to believe there is a magic bullet for every ailment, don’t worry, just pop a pill or injection and it will be all sorted.

          The pharmaceutical industry is grossly over-medicalising our society, and the ‘bishops’ in the medical/scientific establishment are well onboard this gravy train.

          Who will calculate the physical and financial costs for society in the long run?

          • E

            The situation is beyond investigative journalism, almost beyond parody. The people on the email list to me – AF, Sw etc seem to me to be very much in the position of Pius XII in the 1940s being told there are tens of thousands of people losing their lives but who remain quiet – this is what political maturity dictates. I will try and put some thoughts together on this for a near future post


  15. It reduces your credibility when you make such extreme statements and also makes it harder for people like me who are trying to curb medication excess, while encouraging its proper use (against the false claims of extremists who somehow blame all psych problems on meds) ~ Allen Frances

    So good to know that safety advocates are now being labeled “extremists”. What is it with these professionals and their fetish for labeling individuals?

    What is the point Frances is trying to make here, safety advocates should stay quiet and not voice an opinion?

    Goldacre pretty much makes the same claims. It’s almost as if they have become self-appointed know-it-alls on the subject and patient experiences are just ‘anecdotes’ that account for nothing.

    Lest we forget that the Yellow Card reporting system (MHRA) is merely an official anecdotal reporting service and it will always remain that way because the MHRA never follow up with patients who fill in yellow cards. This is how they like it because they can always claim correlation does not equal causation, thereby dismissing serious adverse events.

    Frances is, pretty much, doing the same here. He’s showing his hand.

    Reading between the lines it would appear that he is trying to say that opinion should be stifled unless that opinion fits in with his and Goldacre’s blinkered views.

    The SMC go a step further. They stifle opinions in ‘nip-it-in-the-bud’ fashion. It’s a classic of halting the snowball rolling down the hill. Which, in essence, is what Frances seems to be doing here.


    Bob Fiddaman ~ The “Extremist”

  16. With good predicted monsoons ..

    Allen Frances‏ @AllenFrancesMD 14h14 hours ago

    Allen Frances Retweeted Robert Howard

    I did naively assume this was a private email to David Healy. Embarrassing mistake on my part I won’t make again.

    Peter D. Kramer‏ @PeterDKramer 14h14 hours ago

    Replying to @AllenFrancesMD

    Posting the exchange w/o your permission is unconscionable, but, you know what, you look good in it.

    Allen Frances‏ @AllenFrancesMD 43m43 minutes ago

    Allen Frances Retweeted BOB FIDDAMAN  ?

    Scaremongering is not patient safety. Extreme/unsupported to claim meds caused mass murder Meds overused/have risks but essential for some.

    wendy burn Retweeted

    Stephanie Wilder‏ @Rainriverwilder 2h2 hours ago

    Stephanie Wilder Retweeted ben goldacre

    Some common sense on SSRIs.

    With good predicted monsoons ..


  17. mongered..

    Allen Frances‏ @AllenFrancesMD 19m19 minutes ago

    Allen Frances Retweeted AntiDepAware

    Wrong to be certain meds cause mass murder when so many other factors. Wrong to scare off those whose depression is much riskier than meds.


    AntiDepAware‏ @AntiDepAware 1h1 hour ago

    Replying to @AllenFrancesMD

    Please provide an example of a scare that you consider to have been mongered.

    Fiona French‏ @benzosarebad 1h1 hour ago

    Replying to @AllenFrancesMD

    We need an honest public debate. David Healy / BBC had the balls to make this hugely important documentary. Damaged patients are silenced.

  18. Everyone has responsibility ..

    Allen Frances‏ @AllenFrancesMD 2h2 hours ago

    Allen Frances Retweeted BOB FIDDAMAN  ?

    Meds not all good or all bad. Everyone has responsibility to be balanced about risks/benefits. Extreme voices either direction harm people.

    BOB FIDDAMAN  ?‏ @Fiddaman 2h2 hours ago

    Replying to @AllenFrancesMD

    Are you trying to stifle patient voices, Dr. Frances?

    Kristina K. Gehrki‏ @AkathisiaRx 51m51 minutes ago

    Replying to @AllenFrancesMD

    Ignoring ADRs & doctors’ ethical duty to provide Informed Consent is “not patient safety.” It is worse than “scaremongering.” It is deadly.


  19. Naively assumes ..

    wendy burn Retweeted

    Allen Frances‏ @AllenFrancesMD 21h21 hours ago

    Allen Frances Retweeted Robert Howard

    I did naively assume this was a private email to David Healy. Embarrassing mistake on my part I won’t make again.

    Leonie‏ @leoniefen 1h1 hour ago

    You sent an unsolicited email to @DrDavidHealy & Cc’d @WesselyS, B Carroll, P Summergrad, J Lieberman & Ronald Pies. How is that private?

    The ‘Perfect’ Psychiatrist brought to you by ..

    RC of Psychiatrists‏Verified account @rcpsych 37m37 minutes ago

    An insight into what it’s really like to see a psychiatrist for your mental health.


    What it’s really like to see a psychiatrist for your mental health ..

  20. I am a MD and a forensic medical examiner. I currently pursue a PhD at the University of Denver, USA, researching the relation between violence, psychoactive medication and genes from the Cytochrome P450 system, involved in the metabolism of this medication.
    During my research, I was surprised about the overwhelming and sound scientific evidence that psychoactive medication like antidepressants, antipsychotics and hypnotics can cause violence like suicide and homicide. Let there be no doubt about it!
    If anybody now a day dare to doubt that evidence they are either:
    In denial, (most likely not able to face their responsibility of sending individuals to their death beds and ruining the lives of many more),
    Creators of doubt, as part of a corrupt but ever so profitable system,
    Ignorant or worse.

        • Actually, having just Googled this in more depth, I think I was a little hasty in my excitement about this. It’s not quite as clear cut as it sounds. I do wish we could tell for certain which individuals cannot get benefit from various medications, but I think we are a very long way from understanding this really. I guess collecting anecdotal evidence and offering it up to RxISK in the form of reports, is the safest way to get an unbiased and honest judgement. Even if it has to come from a bereaved parent/sibling/partner/friend, when it’s too late to get it from the person themselves.

    • Selma –
      Keep up the good work.
      There is no doubt about the various classes of drugs that can cause a person to become suicidal/homicidal, or both.
      Having attended the second F.D.A. SSRI hearing in Washington, and listening to the eloquent, heart wrenching stories of the innocent family members who had killed themselves after taking one or another drug in this class, there can be no doubt in my mind about it, nor should there be doubt in any other mind.

      The fact of the matter is that the prescribing doctors making the loudest denials are like the front men for the NRA saying “it’s not guns that kill people, it’s people who kill people”. The motive for both groups of front men is the same.

  21. Sad and painful ..

    Simon Wessely‏ @WesselyS 56m56 minutes ago

    A certain @ClareGerada talking on the sad and painful subject of doctors, mental health and suicide @bmj_latest http://blogs.bmj.com/bmj/2017/08/09/clare-gerada-mental-illness-among-doctors/ …

    Clare Gerada: Mental illness among doctors—it’s time to address systemic problems

    August 9, 2017

    Staff should receive the same compassion they give to their patients


  22. It wasn’t long ago ..

    “After a long saga that included the discovery of video cameras in the bedroom of the company’s China head, GSK apologized in September 2014 and paid a fine of $500 million to the Chinese government for bribing doctors to prescribe the company’s drugs. The following year GSK laid off 110 of its China staffers for alleged ethical violations. “


  23. What is really bugging A F is that he has been outed as attempting to , not so subtly ,scare David into playing down the dangers of SSRs and – horrors – even worse crime – allowing service users in on the scandalous way psychiatrists and GPs are colluding with attempts to deny proof of harm, It is usual to state ‘Confidential’ on a correspondence if that was so important but what is he is trying to imply – that DH and AF are having private correspondence of a nature that cannot be shared? Why is S Wessly only copied in when Wendy Burns is the president of college of psychs? Why has the chair or any member of the colleges psychopharmacology cttee had nothing to say? Also why does the leader (chair?) of the college of GPs have nothing to say? Instead Claire Gerada, wife of Simon W was chosen as the spokesperson for a debate about opiates on Newsnight – she had nothing to say about the current outrage regarding SSRs – maybe Newsnight could try setting up a programme – with other than the usual media savvy spokespersons put up by the colleges – the scandal of the Jimmy Saville cover up by Newsnight and many others in the media is still raw – they could show that ‘lessons have been learned!’ somewhat (maybe not)by exposing what is going on re SSRs

  24. Research Request ..

    The Council for Evidence-based Psychiatry, in collaboration with the University of Roehampton and with the support of Baylissa Frederick of Recovery Road, has launched a survey to gather data on the experiences and provision needs of those who are suffering, or have suffered, from prescribed drug dependence (PDD) and withdrawal.
    The survey is open to all adult volunteers; however we are particularly interested in volunteers from the UK as these responses will help inform our work around the provision of UK services.


    All the data gathered will be used to generate research to inform policy. Data will be ultimately published in both academic and public policy report form. Completion of the questionnaire should take no more than 20 minutes, but could take longer should you desire to answer written questions in depth.


  25. David

    In your exchange you ask an interesting question about the role of SMC so I direct you the biog of Chief Executive, Fiona Fox, on its website.

    “Other than her dedication to the SMC, Fiona was chair of the Department for Business, Innovation and Skills Working Group that published a report on the future of science in the media in January 2010 as part of the UK’s Science and Society strategy. She was also called to give oral evidence to the Leveson Inquiry into press standards in the UK in 2012, and writes regularly on science in the media.”


    This actually points to the Department of Business as a party taking an interest in the portrayal of science in the media handing the job over to a PR lady as a safe pair of hands. Fox, of course, also featured in George Monbiot’s wellknown expose ‘Invasion of the Entryists’


    – and I suppose an interesting question was, who was entering what? This supposedly far left, Marxist group, to which Fox seems to have been affiliated, mostly ended up acting on behalf of the government while displaying a radical front.The Leveson Inquiry is also an interesting issue – who invited her, and why did the reporting of science lie within the Inquiry’s brief which was notionally about invasive, unethical journalism? I was one of a group of people who tried to protest the behaviour of the Sunday Times and the unethical tactics of their journalist, Brian Deer, over “the Wakefield affair” but our submission, was dismissed (the Sunday Times were allowed to veto it as a stakeholder!)


    Meanwhile, Lord Leveson who failed to disclose his role in denying MMR litigants a hearing, went a long way out of his way to condemn Wakefield in his first report. The sub-plot seems to be that in the defence of public science dirty tactics against the public by newspapers are permissable. A lot of this just seems designed to confuse public perceptions, while SMC always has a list of professional reliables to back up its purpose (which basically seems to be social repression).

      • Hi Annie

        The link didn’t work for me. Highlighting institutional issues I would just go into short detail about what we were complaining about.

        – The Sunday Times conducting a fishing expedition
        – The journalist using an alias (blagging)
        – The illegal obtaining of confidential medical and legal documents
        – The failure to disclose that the journalist launched a formal complaint to the GMC while continuing to report the story
        – The support the journalist received from an industry affiliated body
        – That a new wave of hit journalism was launched against Wakefield days after James Murdoch, the newspaper’s proprietor, was appointed to the board of GSK with a brief to defend the group’s reputation

        These are the things SMC, Times Newspapers and Leveson needed to remain firmly under the rug.

  26. Twitter friends ..

    wendy burn Retweeted

    Nikki Cochrane‏ @NikkiLCochrane 2h2 hours ago

    Twitter friends – I’m looking for male psychiatrists with experience in treating patients with PTSD – is this you? please get in touch asap!

    Simon Wessely Retweeted

    Nikki Cochrane‏ @NikkiLCochrane 2h2 hours ago

    Twitter friends – I’m looking for male psychiatrists with experience in treating patients with PTSD – is this you? please get in touch asap!


    Tricky, when you don’t know who they are ..

  27. It’s staggering.

    Allen Frances‏ @AllenFrancesMD 2h2 hours ago

    Most important goal in helping people with severe mental illness is to keep them out of jail

    The cause of violent behaviour was put under the spotlight again following the BBC Panorama documentary broadcast last month.


    The safety of antidepressants has been questioned for years now. With so many violent deaths and suicides linked to antidepressants, public safety is compromised by regulators who claim that benefits outweigh the risks. It’s staggering. Manufacturers and prescribers have been allowed to carry on their activities unabated for too long with no accountability.

    AntiDepAware Retweeted
    S Randolph Kretchmar‏ @MentalHealthLaw 50m50 minutes ago

    Psychiatric spin doctors & shills are busy trying to play down the role of antidepressants in tragedies.

  28. Paxil on the stand ..

    Fulsher told the jury about DeValle’s recent problems with mental issues, and of the recent switch in medication from Zoloft to Paxil.

    “Paxil has numerous side-effects,” Defense Attorney Ted Fulsher said.


    UK fraud office expects decision on GSK, Rolls-Royce cases next year

    LONDON (Reuters) – The UK Serious Fraud Office (SFO) said on Thursday it expects to decide next year whether it will file criminal charges in bribery investigations related to drugs giant GlaxoSmithKline (GSK.L) and aero engine company Rolls-Royce (RR.L).

    The SFO launched an investigation into GSK and its subsidiaries in 2014. Britain’s biggest drugmaker has already been fined a record 3 billion yuan ($452 million) by Chinese authorities for paying bribes to doctors to use its drugs.


    August 10, 2017 / 5:30 PM / 12 minutes ago

  29. It seems to be like an attempt at silencing you Dr Healy. The ‘consensus builders’ have a vested interest in keeping things just as they are (the public in the dark). They don’t like the consensus questioned, or their vested interests tampered with (or undermined) by virtue of the questioning. It’s a very sinister thing when the ‘consensus builders’ decide that they (or their perceived authority on all subject matters that form the consensus) cannot be challenged.

    The Science Media Center is nothing but a front group for a myriad of agendas, and none of these agendas seem to have any scientific or ethical basis. It seems these agendas serve corporate/ideological and individual ego interests over the interests of the wider public and perhaps that’s what the Science Media Center is really about…

    Wrong on so many levels…

    Bob Fiddaman has done a cracking post on it all…

    See here..


    Making Sense About Science Media Centres
    Email ThisBlogThis!Share to TwitterShare to FacebookShare to Pinterest

    I’m worried.

    I feel kind of deflated.

    I’ve been blogging for over 11 years and met with many people, most of whom have lost loved ones to antidepressant induced deaths. I’ve watched blogs come and go, campaigners who had a fire in their bellies slowly fade away because it all can get too much at times.

    Earlier this week I was alerted to a post on David Healy’s popular blog regarding the Science Media Centre. (SMC) I’d never heard of them before so read Healy’s ‘Honey I Shrunk the Shrinks’ with great interest.

    As a writer, and researcher, I rarely take one post at face value, I always research the subject in question. During my research of the SMC, I became more and more concerned that this is something we should all be looking into. To say it’s alarming is an understatement.

    The SMC is, without sounding too alarmist, like something that you would read in a Dan Brown novel. It’s the type of organisation that one sees pop up on their daily news feeds on Facebook, usually accompanied by a link that directs you to websites that also make claims that the earth is flat or man has never walked on the moon, you know the type.

    What’s different about the SMC, however, is they don’t hide what they do, nor do they hide who they are funded by – maybe this is a purposeful act, one of showing the minorities that they have muscle, who knows?

    Without naming all their financial backers (there’s too many, past and present) I’ve picked out some of the ones that are, for me at least, a cause for concern.

    Present funders include:

    Royal Pharmaceutical Society
    Institute of Psychiatry, Psychology & Neuroscience (IoPPN)
    Medicines and Healthcare Products Regulatory Agency (MHRA)
    Merck Sharp & Dohme (MSD) Limited
    Association of the British Pharmaceutical Industry (ABPI)
    British Pharmacological Society
    National Institute for Health and Clinical Excellence (NICE)
    Royal College of Psychiatrists (RCP)
    GlaxoSmithKline (GSK)

    Previous funders include:

    Daily Express
    Eli Lilly & Company
    Institute of Mental Health
    Mental Health Foundation
    Mental Health Research Network
    Mental Health Research Network Cymru
    News International Ltd
    Pfizer Limited
    Scottish Mental Health Research Network
    World Health Organisation (WHO)

    There are many more pharmaceutical companies that are or have funded the SMC. I’ve just focused on those that market and manufacture antidepressants.

    So, who exactly are the SMC?

    They were formed in 2000 after the House of Lords Select Committee on Science and Technology’s third report on “Science and Society.” This report claimed there was a better need for more experts in the field of science to offer expert information in the media.

    So, why should we be worried?

    Well, one doesn’t have to go too far back to see an example of the SMC in action, in fact, we only have to go back a couple of weeks to July 26, 2017, just one day before Panorama’s ‘A Prescription For Murder’ was shown on British TV screens. The eagerly awaited programme was dismissed as ‘scaremongering’ and ‘stigmatizing’ 24 hours before it aired. The MHRA and the RCP (Highlighted above) took to Twitter on the morning of the 26th.

    RCP tweets included:

    #BBCPanorama claims irresponsible and unfounded. Scaremongering title alone shows real stigma people taking #antidepressants face.


    More #antidepressant prescriptions=more people getting help. Not more potential murderers. Don’t stigmatize people needing help #BBCPanorama

    Whereas the MHRA tweeted:

    SSRIs have been used to effectively treat millions of people worldwide & like all medicines, the safety is continually monitored.

    More on the MHRA later.

    All above board and predictable, one would think, until you dig deep into the SMC and what it is they actually do. It all becomes clear when you read their blurb:

    The Science Media Centre’s ultimate goal is to facilitate more scientists to engage with the media. We provide support for scientists to engage with the media when their area hits the headlines, offering expertise of a team with over 10 years’ experience in science media relations. We have an ever expanding database of experts and have strong connections with UK universities, industry, learned societies and scientific institutions.

    The SMC also runs off-the-record brainstorms to discuss how the scientific community can effectively coordinate its media relations on controversial issues within science. Occasionally the SMC will run subject-focused advisory sessions in anticipation of big controversial stories.

    No surprise then that stories appeared in the British media before and after the airing of Panorama. Most, if not all, the articles featured an “expert” who claimed Panorama was stigmatizing and scaremongering. They were also stating that drugs, such as sertraline, which was heavily featured in the programme, do not cause people to go out and commit murder.

    In defence of all these claims I, along with Kristina Gehrki, wrote a blog post entitled ‘Panorama: Prescription For Stigma?’ It proved to be popular and was shared many times on social media, particularly in the first 24 hours.

    Around 8 hours after I went live with my co-written piece, MQ, a mental health website, ran with an eerily similar headline, ‘A prescription for stigma: why evidence matters.’ The article was written by Ed Sykes who, coincidently, is Head of Mental Health and Neuroscience at the Science Media Centre.

    In not supporting Panorama’s efforts to increase awareness Sykes wrote something quite striking:

    The main evidence the programme seemed to be giving us, alongside the case studies, was the result of a Freedom of Information request to the Medicines & Healthcare products Regulatory Authority (MHRA). The MHRA is responsible for many aspects of healthcare, including a Yellow Card system that records all the bad side-effects linked to any drugs. The Panorama team informed us that their investigation had unearthed 28 cases linking antidepressants to murder and 32 to murderous thoughts. The show did point out that these were just reports, not conclusions that the drugs had caused murder. But what they failed to mention was that these reports to the MHRA can be made by anyone. You or I could go on their website right now and make a report, it doesn’t necessarily mean it was a medical professional who reported it or that the report was supported by strong evidence.

    What Sykes, in his efforts to play down the 28 cases linking antidepressants to murder, failed to mention is the follow-up that the MHRA do when they receive a Yellow Card report. It was a question I put to them back in 2015. Their reply was the bog-standard game of semantics they have played with me for the past 11 years or so, further, they asked for payment to release the information. You can see the correspondence here and here.

    Ed Sykes really should have done his homework before throwing out the ‘correlation does not equal causation’ line.

    Before finishing this introduction into the SMC I’d like to congratulate Prof. Sir Mike Rawlins, former Chairman of NICE (highlighted above) who, a month ago, was honoured by the Queen for his services to the safety of medicines, healthcare and innovation.

    Oh, something else. Prof. Sir Mike Rawlins is the current Chairman for the MHRA.

    Something else of interest, Prof. Sir Mike Rawlins sits on the Board of Trustees at, you’ve guessed it, the Science Media Centre.

    Now, who was it that once coined the term ‘revolving door’?

    Bob Fiddaman

  30. Dear Bob,
    I’m afraid the Yellow Card reporting system is not effective. It’s always worth doing, of couse, but there have been reports of roomfuls of these cards being tucked away without trace, although I expect Annie could find the info, (see Dailty Mail 2014). I’m afraid The System is well stacked against honesty, but we will win in the end, never fear.

    A big thank you for all you do. It’s true that some of us flag as we get weary and lose hope, having lost those we loved so dearly. As we wake each day and agonise over our loss, we ask ourselves “Could have we have saved them, could we have done more?” Well, yes, maybe we could, but we hadn’t read your Blog then. It would have empowered us to know that we were not alone. Thank you. We lost one to Seroxat and no one would listen. His suffering was beyond horror. So was ours, fighting for him, with one hand tied behind our back, because of ignorance. Thank you again. You make things at least bearable.

  31. Ho hum.

    The request was partially successful ..

    Yellow Card Reports

    Caron Ryalls made this Freedom of Information request to Medicines and Healthcare products Regulatory Agency







    we now consider ..


  32. I would like to suggest to Allen Francis that he try taking an ssri for three months and then quit it. Allen why don’t you take the one that was pushed on me by uninformed consent and off label it was paroxetine and why don’t you take 40mg .
    I was unable to get off this drug with out an unimaginable fight for my life. The withdrawal was traumatizing and the dark self destructive thoughts that I had to fight and endure daily you just couldn’t imagine. For me there is no doubt whatsoever that James Holmes actions were drug related. His tragic actions were iatrogenic in nature.

    Don’t believe me then YOU take 40mg of paxil for three months and then quit it.
    Then take out a pen and notebook because you will be getting a huge dose of professional development for noone knows a drug like the person who does or did take it.

    If you choose not to take up this invitation then ask yourself why not ? Do you refuse because it is unsafe? Then until you take it you have no voice on this issue.
    Whats more you should be deeply ashamed of the way you got Risperdal on the market. What did the Rothman report say again …oh that’s right now I remember you “subverted scientific integrity.”

  33. Dr Healy,

    Allen Frances, reading his emails I know him so well, yet I have never met him or read his work before. He is the voice, the puppet of every Pharma owned doctor that I have met in Ireland and UK…Deny, Deny and isolate… now you have an inkling to what patients suffer at the hands of Pharma pimped doctors.

    This week a lot of Exposé on the Director General of HSE and their doctors..Tony O’Brien of HSE has called concerned parents of the HPV Vaccine “Emotional Terrorists”..

    I copy here for you some interactions of Radio/Parents which I trust is self-explanatory..R.E.G.R.E.T. Group are on Facebook and Twitter as is J Irwin…also this week on Newstalk George Hook let out his views on HSE corruption…

    The following starts at 39 mins.



    One HSE Doctor has stated that the 450 injured girls in Ireland is just a coincidence..yet the HSE are withholding Merck’s detailed Personal Information Leaflet and replaced it with a HSE printed leaflet, leaving out all the adverse reactions that HPV Vaccine may cause…

    This is, I think, is a comparison to what Allen Frances is saying…yet not saying…yet many of us know the reality!


  34. Poor Dr. Frances. I don’t think he listens with his whole mind engaged, if ever he does converse with someone who went mad on psychiatric drugs. He is mimbling on about multiple factors without realizing that everything is caused by multiple factors, but it doesn’t matter how many factors lead to expressions of what he would call mental illness. Unless one of them is an antidepressant, the outcome of madness is not going to be non-instrumental mass murder ending not with a dive into a waiting getaway car, but usually in death by cop, armed citizen, or suicide.

    An analogy that might serve is that of the sleepwalker. Without being his conscious self, he can nonetheless carry out behaviors without having chosen to as he would have chosen if he were awake. I have a hunch that antidepressants cause our minds to settle into a mode that is neither awake nor asleep. We are not our complete selves, though. Is the frontal lobe turned off? Something is. Sertraline seems to bring some vigor and anger to a quasi conscious state.

    The dreamer-shooter can locate his weapons and find his way to a familiar environment (he knows he is, in a certain sense, blind). He is putting one foot in front of the other, so he proceeds, but he can’t plan a getaway, or much else.

    REM Sleep Behavior disorder was named in 1988, after all. There’s no question that some cases are caused by antidepressants. Yes, “caused.” If they can cause you to act while sleeping, is there any constraint on how you might act?

    I don’t watch violent movies or play violent games. I have not had a dream in which I perpetrate bloody violence on others, except perhaps with a magnificent oration. If I were to act out a dream, I would probably gather up slippers and throw pillows and address them as if they were a pack of autumn-hued puppies, some pleasingly plush, some with the sheen of damask woven in polyester. I have a hunch that the dream lives of Holmes and his ilk take place on bloody battlefields covered in heaps of gruesome corpses.

    If you can dream it, you can do it, they say.

    I hope Dr. F comes to believe that antidepressants, though not sufficient to cause mass murder, probably are necessary. If not them per se, then mind-altering drugs as a group. Texas watchtower shooter: amphetamine. And a shout-out to sleep deprivation for the exceptions.

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