I haven’t really mentioned the TV3 documentary, apart from my view that Patricia Casey used the exercise to contradict Professor David Healy, pushing a vendetta that she’s harboured since long before my son died. Professor Healy was expecting it so it didn’t come as a surprise, although I don’t think he’d mind me saying that he thought her posthumous diagnosis of my son was unprofessional, unprecedented and a serious abuse of her position. Protecting the drug and pushing instead the ‘psychiatric illness’ came as no surprise either – par for the course within Irish psychiatry.
It’s interesting that Patricia’s colleague, Irish psychiatrist and fellow Lundbeck supporter Ted Dinan, took a complaint to the medical council against doctor Michael Corry for commenting on Shane’s case without ever having met him; will he be doing the same with Patricia? Dr Justin Brophy, another Irish psychiatrist, also took a complaint to the BAI against Dr Corry and RTE following his Late Late Show appearance. They do protest a lot; could they possibly be right or are they just protecting their cash cow?
The debate following the documentary was supposed to be about the possible adverse effects of SSRIs and whether they can, or cannot, cause a person to become suicidal and/or homicidal. The debate, which sadly didn’t answer any questions on the drug issue can be viewed here. One of the panel, Pádraig MacLochlainn, a Sinn Féin TD, (22 mins) said that the experts need to get their facts in order, that the two experts Patricia Casey and David Healy expressed totally opposing views. He further stated that people need clarification on the effects of these drugs. Sensible man!
Now why would the debate not attempt to clarify these issues? David Healy was happy to take part and could have answered any queries put to him, but TV3 decided against it. Surely Patricia Casey would have welcomed the chance to have an open and honest discussion, considering not only does David Healy say that SSRIs including Citalopram can cause sudden death, suicide and homicide, he also says they cause miscarriages, birth defects and an increased rate of abortion due to the disinhibition effect when taking these drugs. Considering her well publicised views on abortion, she couldn’t possibly defend these drugs knowing that they actually increase the abortion rate, could she?
The only way to get any clarification on the effects of prescription drugs is to have a public debate; so why then did this promised debate not go ahead? Is it to do with the revenue that TV3 receive from its numerous pharmaceutical advertisements? Is Vincent Browne afraid to rock the boat and prod the pharma gorilla? It might be worth mentioning that Lundbeck, the inventor of the drug Citalopram, was supposed to take part in this debate but pulled out at the last minute. It might also be worth mentioning that this company has already admitted to reports of ‘self harm and harm to others’ in other countries such as Canada.
If David Healy was to be proved wrong, I’d be quite happy to admit to being misinformed, that Shane was just coincidently on this drug and I’d even apologise to Professor Casey. So how about it Vincent, will you facilitate a debate with the actual experts – or are you afraid to prod this particular gorilla?
Last Friday Maria Bradshaw of Casper and I went to the European Parliament Offices in Dublin to meet with Nessa Childers – ‘The MEP that stands up for honesty and Transparency’.
I should point out that I had reservations about this meeting as we had contacted Ms Childers before (regarding the adverse effects of SSRIs) and were ignored. I had e-mailed her following a speech she made in UCC Cork, where she spoke about the ethical issues dealing with lobbyists, non-dislosure of funding and transparency within interest groups. She stated that she never accepted pharma hospitality and cautioned that the latter groups may unconsciously be adopting the line of thought of their funders. Anyway, Maria had organised the meeting so she dragged me along too, albeit rather reluctantly. I should also point out that while Maria is enormously clever with statistics and mind-numbing facts and despite having an MBA, her sense of direction is shocking and thus the reason I allowed myself to be roped into accompanying her to Dublin City. It might have been more productive to have let her loose on the Irish roads; I believe Galway is beautiful this time of year!
Honesty and transparency were definitely on the agenda, but it seems the honesty and transparency which Maria and I delivered were not quite so welcome. After some initial frostiness due to some Tweets which Nessa took offence to, the meeting was going quite well. That is, until we got around to the reason we were there – Shire Pharmaceuticals, ADHD and Nessa’s participation in the round table Brussels discussion and this ghost written white paper. Michael Fitzgerald from TCD and his wife Frances were mentioned, which subsequently prompted Maria to point out his links to Shire pharmaceuticals. This may, or may not, have been a turning point in the meeting.
Nessa said that she had turned down a second invitation to host a roundtable for shire pharmaceuticals. When I pointed out that what she said in Cork was a total contradiction to putting her name to a ghost written, pharma-funded paper, she said this occured whan she was a new MEP and had no idea what was happening. She also said that it was too late to do anything about it now, but when pushed on that point said she would retract her name from it if she could. At this stage, despite Maria’s best efforts to remain her usual professional self with her inherent ladylike decorum (which I don’t possess), the meeting rapidly went downhill and Nessa stood up and said “we have to go“. That was it, no niceties, no ‘Slán agus beannacht’ for us; she refused to make eye-contact and we were back on Molesworth Street before we could say the words ‘Honesty and Transparency’. After a fit of the giggles, we looked at each other dumbfounded, trying to figure out what actually happened there. It was one of the strangest experiences I have had yet, even for me!
That should have been the end of that, but alas, the experience was to get even weirder. We set off (in the right direction considering I was driving) to our next meeting, which I may tell you about sometime, whan Maria’s mobile rang. It was Nessa’s PA, who said that Nessa thinks we should contact a different MP and that we should be careful what we say and the accusations that we are making. Since when did facts equate to accusations? Strange day; I guess that Nessa can cross us off her Christmas card list! I suppose I should be thankful that last week I wasn’t aware of this other roundtable meeting that she hosted, facilitated by Lundbeck. I wonder what the chances are of us getting another meeting?
Note to self-
(1) Look up dictionary for the words Honesty and Transparency, and
(2) Buy Maria a Sat Nav!
ADHA Expert White Paper: http://www.europeanbraincouncil.org/pdfs/ADHD%20White%20Paper_15Apr13.pdf
Maria’s Blog which caused the problem: https://www.madinamerica.com/2014/02/making-invisible-visible/
John McCarty’s views on the Cork Conference: http://corkindependent.com/20110929/news/medications-can-cause-suicide-S4715.html
John McCarty speaking on 4 year old Rebecca’s death: http://healthimpactnews.com/2012/how-do-these-people-sleep-she-was-4-and-shes-dead-by-psychiatry/
How many Coroners will it take?
In less than a month, two Coroners, one in the UK and one in Ireland, have raised concerns regarding prescription drug-induced suicide. There are many, many Coroners who have raised the same issues over the years and unless something is done, there will be many many more.
Yesterday at the inquest of Susan Poore 65, a UK Coroner Jacqueline Lake raised concerns about the suicide risk associated with antidepressant drugs.
Mrs Poore was prescribed antidepressants a month before she was killed by walking in front of a train. The Coroner voiced her concern that patients were not given enough warning of “possible side-effects of taking these medications in the initial stages”. Mrs Poore’s family said that she was acting ‘out of character’ and that the drugs had changed her personality. Her daughter stated “People think if you take anti-depressants they will make you happier - it’s such a strong drug and can have the opposite effect”.
Coroner 1 – The Coroner said she is writing to the NHS to voice her concern that patients need clearer information on the side-effects of anti-depressant drugs. She said that Mrs Poore’s mental health deteriorated and that patients were not given enough warning of the “possible side-effects of taking these medications in the initial stages”.
Last month the at the inquest of Teresa Mulvany 70, the Coroner again raised concerns about the suicide risk associated with antidepressant drugs. Mrs Mulvaney became suicidal when her medication was changed to a generic version without her knowledge. She was subsequently prescribed more drugs to counteract the effects of the first adverse event. Shortly afterwards she booked into a hotel and took a fatal overdose. Her family described her last few days as being spent in a ‘torturous trance’; her joy was gone.
Coroner 2 - Dr Desmond Moran said that hospitals will have to take note of drugs which come with a suicide risk. He said “If the drug is adding the risk, there has to be a wonder why it’s being prescribed”. He further stated that there should be proper supervision when medications are changed.
My opinion on the TV3 documentary which aired last night is irrelevant at this stage. There is one issue though which I have had from the start and which came up again last night – the Irish College of Psychiatry’s involvement in my son’s inquest. Professor Patricia Casey, who arrived at the courthouse, uninvited I might add with her legal team in tow, said she was asked by the college to represent it at the inquest. The coroner refused her request to testify, having already had his quota of experts in the form of Professor David Healy and Dr Declan Gilsenan.
The jury at my son’s inquest found that the drug Citalopram possibly caused his death and thus rejected a suicide verdict. Professor Casey who had involved herself before, during and after Shane’s inquest, directly afterwards spoke to the Irish media stating that there were “aspects of the evidence which the college took issue with”. While undermining the jury’s verdict, she neglected to disclose her links to Lundbeck, the pharmaceutical company who made the implicated drug, Citalopram. I subsequently discovered, through a FOI request, that an internal college e-mail had been forwarded to Lundbeck pharmaceuticals from the Irish College of Psychiatry regarding this statement.
Four years on, Professor Casey used the TV3 documentary as an exercise to finally contradict Professor David Healy, who testified at Shane’s inquest that the drug had caused Shane’s death. Professor Healy, a psychopharmacologist, scientist and psychiatrist is an expert on psychiatric drugs. Professor Patricia Casey, who is a psychiatrist (not a psychopharmacologist or scientist) chose to contradict Professor Healy stating that the drug was not to blame, instead that it was the ‘psychiatric illness’ that he was suffering from. At one stage she contradicted Professor Healy’s description of delirium, stating that a person suffering from delirium could not possibly drive a car and would probably crash. Whether she read all the inquest testimonies is debatable considering there was one description of the drive home stating that Shane drove erratically and even hit the curb at one stage.
I should probably point out that Professor Casey has corresponded with me before, in the form of a couple of Solicitor’s letters here and here. Shane’s inquest is not the first one involving Lundbeck where Professor Casey had issues. In this inquest of a man aged 62, again with a Lundbeck drug, Professor Casey defended the drug and said - “Scientific research indicates that children under 18 who are prescribed SSRI antidepressants were at increased risk of suicide attempts and suicidal thoughts but people of 30 years and older were not affected similarly”.
Speaking here for Lundbeck she said “The outcome for those who get treatment is very good. It is also important to be aware too that antidepressants are not addictive”. She said “These medicines also help ‘re-wire’ the brain so that thinking processes work better.” Where is the science behind this re-wiring mechanism?
Being married to a barrister and having co-written a legal-medical book ‘Psychiatry and the law’ in conjunction with Ciaren Craven (part of her legal team at Shane’s inquest) she must be aware of the principle of ‘Perception of Bias’. This is where a decision maker must step down, not just if there is bias but even where a perception of bias may occur. Finín O’Brien - ‘The most obvious source of bias is for the decision-maker to have a financial interest in the matter to be decided.’ So should the expert witness have a similar impartiality?
There are two main rules in the perception of bias principle: Nemo iudex in causa sua; no-one should be a judge in his own cause, and audi alteram partem; hear the other side too.
In 2008 the Law Reform Commission provisionally recommended that an expert witness should be obliged to disclose the existence of any pre-existing relationship with a party to a case or “any other potential conflict of interest”. Speaking at a person’s inquest, while simultaneously being paid by the pharmaceutical company implicated in the death, is surely a conflict of interest?
Professor Casey is no stranger to controversy as an expert witness. In this case, the High Court quashed a decision of the Irish Medical Council’s ‘Fitness to Practise Committee’ for rejecting its own expert and instead going with the opinion of Professor Casey – who had instigated the case in the first instance. The High Court quashed findings of professional misconduct against the doctor on the ground that he had not been afforded fair procedure.
In my opinion, the objectivity and impartiality of Professor Casey as an expert witness is questionable, so I’ll take her opinion that my son was suffering with a psychiatric illness with the respect it deserves. On the other hand Professor Healy’s expert report can be viewed here.
On Monday 10th March, TV3 will air a documentary covering the events surrounding the death of my son Shane and his killing of Sebastian Creane.
We decided to participate in this programme because it provided others with the opportunity to hear about the role that SSRI antidepressants played in the tragic deaths of both young men. This is information we wish we had known before Shane’s death and which we believe may prevent other families suffering the pain we all now live with. Vincent Browne and Lisa-Marie Berry (the Producer) assured us that the programme will be well balanced to all concerned and that we will be kept informed of everything. This TV3 Tweet shows the last recording of my son before his death, something I wasn’t aware existed and certainly wasn’t informed of. I was assured that Shane’s friends would be interviewed for the programme. One of his friends was indeed approached by Vincent Brown; he agreed to do it but is still waiting for the call. As the programme, which I haven’t yet seen, airs in 2 days; I have concerns that I should have gone with my initial decision – to leave the other familes to it.
Maybe the documentary will be as objective as promised. Either way, I feel there are some relevant issues which I should clarify before the airing of this programme.
The Late Late Show:
When we were approached to do the Late Late Show some weeks after Shane died, we were absolutely terrified. The initial feeling was to run, stay away from it – I had no idea how to deal with something like that and we were still deeply in shock – we still are. Our over-riding feeling, from the very beginning, has been that if this can happen to Shane it could happen to anyone – people needed to be warned. That was the deciding factor. I informed the other families that we were appearing on the show and assumed they were asked also. We were then told that Sebastian’s family didn’t want us to do it as his month’s mind was on that weekend, so we arranged with RTE to do it the following week instead. I have never felt anything other than thankful to Ryan Tubridy and his team for allowing us (as Shane’s family) to tell our story and also for allowing Dr Michael Corry to inform the public of the dangers that these drugs can pose. It was never our intention to hurt anyone by doing this show. We felt that the only way to stop more tragedies like ours was to make the public aware of the dangers too.
I was happy with how the inquest went. James McGuill and David Healy were great – despite the fact that Shane died from self-inflicted wounds, the jury rejected a suicide verdict. As for Professor Patricia Casey, who attended Shane’s inquest on behalf of of the Irish College of Psychiatry and who directly afterwards spoke to the media of her issues with the evidence – Professor David healy is a psychopharmacologist, scientist and the world-leading expert on the effects of psychiatric medication; Professor Patricia Casey is not. There was no issue. It is my opinion that Professor Casey undermined the inquest process and the jury’s verdict. As a direct consequence of that, the other families involved were led to believe that the process was defective and thus prevented from getting the answers they needed. We fought very hard to get answers following the death of our son; we got those answers. Again, it was never our intention to upset the other families in doing so. At the time I was not aware that the Creane and Hannigan families had met with the Coroner Cahal Louth before Shane’s inquest. It is my opinion, held with respect for both families, that their involvement in my son’s case, along with the involvement of Professor Casey, was inherently wrong.
The jury took on board Professor Healy’s testimony on the role the prescribed drug played that night – the effect it had on my son. They returned the only other option available to them, an open verdict. This is the part which could have helped others – a change in the law to allow a verdict of ‘Iatrogenic Death’ may be more suitable. This is currently being discussed in the Seanad by another bereaved family, also SSRI drug induced. A rider would have been useful, where an investigation into this medication (or all SSRIs) could have been recommended – or at the very least caution advised. The fact is that Coroners have ordered investigations into this drug before. It comes with a black box warning in the US. In Canada the same drug company has warned clinicians of reports of ‘self harm and harm to others’. The inquest could have played a role in informing Irish people of this.
The Role the Drugs Played:
Professor Healy said that what happened that night was caused by Shane taking the prescribed drug Citalopram. I believe if Shane had not been prescribed Citalopram, both young men would still be alive today. One issue that sometimes comes up, usually from psychiatry protecting their medical model, is that I might be doing more harm than good – possibly stopping people from taking drugs which are perfectly suited to them. These drugs are being prescribed to our children without warning that they can cause cause suicide, violence, worsening depression, mania, akathisia, birth defects and sexual dysfunction. People need to be informed – informed consent is the issue here/or lack of; the choice is then theirs to make. I have never advised anyone not to take medication or to stop taking it – I have, if asked, given all the facts, not just the harmless effects. Irish citizens have the right to the same level of protection and informed consent as Americans and Canadians.
What Can The Irish Government Do?
I have been part of a delegation which met with Kathleen Lynch in Leinster House. This included Professor David Healy, Dr Declan Gilsenan and Tim O’Malley. Each one told her of their concerns that these drugs are harming people. Prof Healy told her these drugs are the leading cause of death within the mental health field while Dr Gilsenan told her that his experience as a pathologist led him to believe that the majority of suicide victims had been ‘recently introduced’ to SSRIs. Both Kathleen Lynch and Tim O’Malley acknowledged that these dangerous drugs are widely over-prescribed.
As a country we need to urgently address our high rates of suicide. The Irish government need to start by gathering and publishing data showing how many suicides and homicides were caused by SSRIs. The investigation into the practices at Portlaoise Hospital was initiated after the death of 4 babies. Ireland has had 525 deaths by suicide last year. Preventing further deaths requires understanding the drivers behind them.
Currently those who provide us with data on the role of SSRIs in suicide and homicide have financial links with pharmaceutical companies like Lundbeck, who exert significant influence over psychiatrists, academia and our Government. Patricia Casey, who has up until this documentary rejected any claims that SSRIs can cause suicide and who has attempted to influence and discredit the verdict of the jury at Shane’s Inquest, has received payment from Lundbeck Pharmaceuticals. She is not alone. Many of the most published academics from Irish universities and the Irish government also have financial ties to pharmaceutical companies. Sadly, the Irish College of Psychiatrists and the government are in denial about the issue of prescription drug induced suicide. For this reason, we need a fully independent inquiry into this issue, one which is not influenced by the pharmaceutical industry or conducted by those who have a vested interest in the outcome.
This week (25 Feb) The Sligo Champion reported on the inquest of Teresa Mullaney, age 70. According to the Champion, Teresa was a retired nurse who spent her life looking after others, was dearly loved by all her family and had a heart of gold.
Click on picture to see the Sligo Champion Article.
In February last year Mrs Mullaney had a knee operation. It seems that she was prescribed Venlafaxine which is known here as Effexor, possibly following the surgery. Some time later her mood worsened and she feared that her medication had been changed without her knowledge. When the family checked with the pharmacist, this was indeed found to be the case, that her usual medication had been changed to the generic version. Shortly afterwards Teresa was switched back to the original version of Effexor plus an anti-anxiety pill. Zyprexa (Olanzapine) was added into the mix, despite coming with a black-box warning in the US for the elderly. A short time later Teresa spent 2 weeks in St Columba’s hospital in order to ‘stabilise her prescribed medication’. The family said she became deeply distressed and agitated. Her son described her last few days as being spent in a ‘torturous trance’; her joy was gone.
Both Effexor and Zyprexa come with a US black box warning and both are associated with an increased risk of suicide. The ‘anti-anxiety’ pill most likely does too. Sadly, but not surprisingly, 4 days after leaving St Columba’s hospital, Teresa checked into the Great Southern Hotel and took an overdose, which resulted in her death. The family have raised a number of issues:
1. The total lack of communication between the doctors and the family.
2. Questions need to be asked about generic versions of prescription drugs.
3. The level of ‘care’ Teresa received in her last few months.
4. How could Teresa, who was recently released from hospital, be allowed access to a months supply of medication.
The Coroner, Dr Desmond Moran, said that St Columba’s will have to take note of drugs coming with a suicide risk. He said “If the drug is adding the risk, there has to be a wonder why it’s being prescribed”. He further stated that there should be proper supervision when medications are changed.
The jury at Teresa’s inquest made a number of recommendations, including:
1. That generic drugs should not be prescribed without proper communication and
2. That appropriate supervision should be maintained where medication has been changed, particularly in psychiatric illness cases.
Sadly for Teresa and her family, the Irish Human Rights Commission made similar recommendations following Shane’s death, which if acted upon by the medical profession in this country, would probably have saved her life! Let’s hope that Teresa’s death can influence doctors when prescribing these highly dangerous drugs in others. Condolences to the family of the lovely Teresa.