William and Kate: Thinking Fast and Slow

April, 3, 2022 | 6 Comments


  1. If the strangers don’t have a basis for what they are proposing to do, what then?

    “The main positive for us is that Boeing is admitting liability, and not diverting blame onto Ethiopian Airlines or the pilots … we wanted them to hold their hands up.”


    GSK wins legal case over withdrawal effects of paroxetine after 13 years and £9.33m in costs


    Thinking fast and slow –

    Stephen’s Voice – Suicide Prevention

    This was aired 3 days before Stephen lost his battle with #akathisia and died by medication-induced suicide. Absolutely broke my heart to watch this. If only we had seen this at the time. #PrescribedHarmAwareness


    @antideprisks @DrDavidHealy

    “We’re in a dream, we’re in a video game…..

    “no one’s made the connection…

  2. “I had just finished teaching a class on biases in risk assessment, discussing research on how humans tend to err in sizing up risks and making decisions. People give too much weight to rare risks that happen to be top of mind because we’ve just heard a news story about them or we know someone they happened to.

    We’re also prone to omission bias, or higher tolerance for risks arising from inaction than for those arising from affirmative acts. And then there’s hindsight bias — the tendency to see things differently from the rearview mirror, believing past events were more predictable than they really were. My husband pushed the mirror aside and said he’d still make the same decision if he had to do it over. For me, it was hard to look away.”

    Michelle Mello might consider reading the posts and comments on here

    Here is a good link posted here by annie



  3. ‘Maybe we should report it to the Vaccine Adverse Event Reporting System, the database that tracks events possibly related to vaccines, I said. The hospital care team shifted uncomfortably.As a health policy professor who works on vaccination issues, I knew why: Anti-vaccination groups are combing those reports looking for tidbits to support their claims that the vaccines are unsafe. They’re wildly misconstruing the data, leaping to unfounded conclusions about causality — and the Tucker Carlsons of the world are helping them.Still, I worship in the church of data. The report went in.

    M.M. rather witlessly shot herself in the foot by admitting that she initially decided not to report an adverse effect (even when not proven adverse effects should be reported).
    Also by the admission that ;the hospital team shifted unconfortably’. She is an experienced lawyer and reviewer of other’s work – and works on vaccination issues ,surely she should not have suggested ‘maybe’ the serious incidents should be reported’ but insisted with the corroboration of the team . The reason they were wary could be assumed that they have been ‘guided’ not to report and to put off any suggestion by anyone that they may report an (even suspected) adverse effect.
    So how many adverse effects are being covered up by ‘proffessionals is something we won’t know and importantly they will be knowingly as well as unwittingly scewing the data on adverse events used by VAER and the Yellow Crd scheme used to monitor and ‘inform’ all of us with the aim of persuading us to get vaccinated
    To use the anti’vaccination lobby as a reason to hide the truth one way or another is astonishing (not really) coming from a lawer and a person who is still on the reviewers list of a major medical journal. Presumably the editors read her account, possibly advised her what to publish..And Heres hoping the pale and thin son she agreed to vaccinate on the basis of having no safety data will be fine. M M in her article says she worships the church of data – a n oxymorononic claim by someone who doesn’t it seems understand her own decision making is making a leap of faith rather than relying on suspending her judgement until further exploration of the causes. M M gives a thoughtful academic description of decision making but then reveals how an academic theory can be too easily relied on That’s how too many of us get squashed into a box

  4. Strangers in the room…

    hospital employers…

    medical review boards…

    offensive vaccine missionary colleagues…

    media who might write nasty articles about us….

    Did I miss anyone?

  5. louis appleby@ProfLAppleby
    …….We’re Going on a Bear Hunt.

    It appears a poster on the London Underground has got a few psychiatrists baying for its removal. The poster warns of a condition caused by, but not limited to, antidepressants & antipsychotics. Any idea why these shrinks don’t want the public to see this?

    Answers to @rcpsych

    An Ad for Akathisia on a train; a similar train under which Stewart Dolin was killed from Akathisia

    Anthony David

    Has anyone else seen these ads – on the Victoria line today?

    @DrAdrianJames @ProfRobHoward

    Not helpful – should be removed


    Quite a kickback in the ongoing responses –

    Dr Annie Hickox@DrAnnieHickox 21m

    Replying to @EsquireRN@JustAshleyHand 3 others

    Absolutely. It worries me that some are viewing the ad as somehow being ‘informed choice’. It’s not. It is a way of commodifying fear.

    Dear Mrs Doherty

    Thanks for replying. I want to try to answer your questions in the most helpful way, so it makes sense to start with my understanding of the main issue you have raised.

    SSRI antidepressants can cause akathisia. I have seen many patients with akathisia, caused by different drugs, and it is an extremely unpleasant condition that at its most severe can make people feel desperate and suicidal.

    It’s hard to estimate how often it causes suicide or self-harm, partly because what makes people suicidal is often a mixture of problems – it is rarely caused by one thing. However, the risk is sufficiently concerning for us to be cautious at all times, especially when starting or stopping treatment. It’s essential that the doctor who prescribes SSRIs should inform the patient about this risk, as you say, though I do understand that doctors don’t want to put a patient off taking treatment & getting the balanced message of risks and benefits right can be hard.

    On the national suicide prevention strategy, I need to explain a little of the background. When we came to update the strategy a few years ago, the Government wanted as few changes as possible. We were keen to add something about antidepressants after hearing from families who felt strongly about this and we thought it was best done in the section on treatment of depression in primary care which was mainly about the risks of getting no treatment. So we added a line to the key messages of this section, as follows:

    “There are also risks in the early stages of drug treatment when some patients feel more agitated.” (page 27).

    This may not sound a lot but at the time it seemed an important and unusual acknowledgement to appear in a Government strategy. We used “agitated” because it was a document for the general public rather than clinical guidance for doctors – that’s the job of NICE – or information for patients, which is overseen by the regulator, the MHRA. Current NICE guidance says something more specific about the need for careful monitoring in the early period of treatment, especially in younger people, because of suicide risk.

    I’m sorry to hear about the difficulties your step-daughter has faced. If she has had severe akathisia on withdrawal, it’s an important point of safety to withdraw more slowly, to avoid the distress I’ve mentioned. Most people can come off antidepressants if it’s done over the right time period, and that can vary for different people.

    I hope I’ve answered what you were asking about your step-daughter but if I’ve misunderstood please feel able to come back to me. Of course, I’ve “unblocked” you – happy to do this – but being in touch by email is a lot better than twitter.

    With best wishes

    Louis Appleby



    We’re Going on a Bear Hunt …

  6. John Read


    Should you warn about serious mental health issues in a Tube ad?

    Should you warn about serious mental health issues in a Tube ad?

    An ad referring to akathisia, a side-effect of psychiatric drugs, has drawn both criticism and praise from clinicians and patients alike

    By Miranda Levy

    14 April 2022 • 11:00am


    This week, travellers on the London Underground are being treated to a rather different fare than adverts for Jointace dietary supplements or a little known poem by Keats. 

    “Antidepressants and antipsychotics are two classes of psychiatric drugs that can cause akathisia,” warns the ad, white text on black background, in one of those strips you see above the seats. “Akathisia is a rare, drug-induced condition that can cause violence, self-harm, and medication-induced suicide. Knowing the symptoms of akathisia will save lives”.
    Then follows a reference to MISSD.co, the Medication-Induced and Suicide Prevention Foundation, which has paid for 1,000 such ads to run on the tube for the next three weeks, following a campaign in US cities including New York and San Francisco.

    Most people will – mercifully – be unfamiliar with the term akathisia, and its awful manifestations. Akathisia refers to a side-effect, chiefly caused by psychiatric drugs, ranging from a sense of mental unease and anxiety to severe emotional turmoil. The
    Diagnostic and Statistical Manual of Mental Disorders describes it as “restlessness, fidgeting of the legs, rocking, pacing, and the inability to sit or stand still” – and the condition is often accompanied by these physical symptoms. Some sufferers find it so unbearable that they end their lives, or even harm others. 

    Akathisia has historically been linked to the use of antipsychotics for “unsexy” conditions such as schizophrenia: estimates reckon that somewhere between 50 and 80 per cent of people on antipsychotics suffer from akathisia. However, it’s increasingly being linked to antidepressants – in as many as one in five patients who take these drugs.

    That said, according to a spokesperson at the MSSD.co, the British advertising code CAP made changes to the American version of the ad, insisting on the addition of the word “rare” to describe the incidence of akathisia. 

    Anthony David@ProfTonyDavid

    Has anyone else seen these ads – on the Victoria line today? @DrAdrianJames @ProfRobHoward
    Not helpful – should be removed

    Stewart Dolin, the 57-year-old lawyer in whose memory MISSD was set up, took his own life in Chicago in 2010 – six days after starting an SSRI antidepressant. Of course, it’s impossible to prove the direct cause of Dolin’s death, but family and friends noted his extreme distress and agitation immediately after he started taking the drug.

    So the Tube advert in itself was notable, but it immediately kicked off a combative thread on social media. Professor Anthony David, Director of the UCL Institute of Mental Health, tweeted a photo of the ad, tagged some psychiatry colleagues, and commented that it was “not helpful”, and should be taken down. This response prompted tens of messages from those in the “prescribed harm community,” who feel they have suffered as a result of taking psychiatric drugs. 

    “Where is the empathy towards those that suffer from life-threatening akathisia? Akathisia isn’t rare,” tweeted Rose Yesha. “Seldom disclosed as a potential side effect. Akathisia is often misdiagnosed as anxiety. Common sentiment before someone with aka (sic) dies by suicide: ‘My doc doesn’t believe me’”. Many commentators agreed with Yesha; for example, nurse Angela Howard wrote: “May I enquire what your objection is to millions of people being warned about akathisia as being a risk factor for suicide being issued to the general public?”

    On the other side were the doctors who came in defence of their colleagues – for example, @DrMayJay, who wrote: “Not helpful & wholly harmful if somebody suddenly stops their medication after reading this, or doesn’t ask for help for fear of this!”

    The akathisia ad furore is the latest in a series of controversies around psychiatric drugs: their side effects, and withdrawal symptoms, leading to some asking whether they work, or should ever be prescribed at all. Though it does have to be said that many people find antidepressants helpful: life-saving, even.

    In September 2019, the Royal College of Psychiatrists released a statement finally admitting that antidepressants and tranquilisers could have significant side effects, and a May 2021 prestigious Cochrane report on new-generation antidepressants concluded that the drugs only worked “in a small and unimportant way”, warning that suicide‐related thinking and behaviour “may be increased in those taking these medications”.

    “The fact we need to have these posters represents a failing in psychiatry – that doctors aren’t telling people about the side effects of medication,” says John Read, professor of psychology at the University of East London. “A grieving family has to resort to billboards: that says it all. We’ve known about akathisia for 40 years or so, yet doctors are bound by the principle of informed consent – and they aren’t always informing their patients. Some even tell their patients that restlessness is “part of their illness”.

    Is there not a danger, however, that a person on psychiatric medications may see these posters, and stop taking them immediately, leading to withdrawal effects that can be equally, or more dangerous? Wendy Burn is a consultant in old age psychiatry and was president of the Royal College of Psychiatrists from 2017 to 2020. “This poster is not telling people how dangerous it could be to suddenly stop their medications,” she says. “I’m also concerned that it’s displayed on a Tube line: what if someone in distress read this, who was thinking of jumping under a train? Most importantly, if an advert mentions suicide, there really should be a suggestion of where to get help. I have every sympathy with the people behind the advert, but I’m not sure this is the best way to raise awareness.”


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