Did Mike Geldard Assume That Citalopram Was Safe?

Mike Geldard

Michael (Mike) Geldard was 66 and struggling with a knee injury, for which he was prescribed various pain medications, including Codeine, a highly addictive drug. His attempts to withdraw from Codeine left him frustrated and anxious – for this he prescribed the antidepressant Citalopram (along with a benzodiazepine). The day after Mike was prescribed Citalopram, he told his doctor that he was having suicidal thoughts and asked if he could stop taking the drug. Just like my son Shane, he was most-likely told that these feelings will subside after a few days and to keep taking the drug. Nevertheless, 11 days after being prescribed Citalopram, just like Shane, Mike was dead (he had hanged himself in his garage). At his inquest last week, the coroner, Tony Williams, recorded a narrative verdict saying that Mr Geldard had intentionally taken his own life, but reported his death while on Citalopram to the appropriate regulatory boards.

.
Mike’s former wife (Helena) expressed concerns about the effect that Citalopram had on him and asked the coroner whether it was possible he had taken his life while in a drug-induced psychotic state. No answers were forthcoming. Once again, it raises the question – how many families have to raise the issue of Citalopram and other SSRIs before we wake up to the vast numbers of deaths these drugs are causing? Did Mike give his ‘informed consent’ following a thorough discussion of the increased risk of suicide when starting this drug? I doubt it.

Mike, like Shane, probably trusted that the doctor knew best and that Citalopram would help. However, experts state that the first few weeks are an incredibly dangerous time – Shane was on Citalopram for 17 days, mike lasted 11. This family of drug, SSRIs, the ‘newer’ antidepressants, were sold to recent generations as being safer than the older tricyclic antidepressants, particularly in overdose. Designed to specifically target the brain, SSRIs have proved to be psychiatry’s worst folly, causing thousands of deaths worldwide. Age, whatever the drug industry says, is irrelevant when mind-altering SSRIs are attacking our brains and turning decent autonomous beings into people capable of killing themselves (and others).

While the drug industry and some psychiatrists will acknowledge that SSRIs increase the risk of suicide and violence, the regulatory warnings are for under 25s – no older. Tell that to Mike’s children and granddaughters and all the other retirees who have died from an SSRI-induced death. Sadly for Mike, little has changed since a coroner ruled in 2008, that another recent retiree Ian Fox, 65, died while the balance of his mind was disturbed while suffering the adverse effects of Citalopram.

It seems that being over the age of 25 does not protect against the adverse effects of an SSRI’s mind-altering qualities. Many other people of a similar age to Mike, have died as a result of a recent prescription of Citalopram. Here is a few examples-

Julie McGregor, 73, drowned herself 2 weeks after being prescribed Citalopram.

John Rudd, 62, walked in front of a train 3 days after being prescribed Citalopram. The coroner said he had dealt with at least 6 fatalities (in the previous 4 months) where the person had recently started taking Citalopram.

Bridget Raby, 75, used a knife to kill herself a month after being prescribed Citalopram.

Gordon Briggs, 58, hanged himself 3 weeks after being prescribed Citalopram. Family raised concerns over his deterioration on Citalopram.

Sylvia (Margaret) Tisdale, 64, jumped from her bedroom window following a recent prescription for Citalopram. Her friend raised concerns over side-effects of the drug.

Nigel (Bernard) Woodburn, 68, drove into a tree 4 days after being prescribed Citalopram. The coroner said “this is probably the fifth, if not sixth inquest I’ve heard within a period of three years when somebody either just going on to Citalopram or Seroxat, or coming off it, have killed themselves one way or another, totally out of the blue, totally without expectation, without a history of suicidal thoughts in the past.”

Raymond Hague, 73, hanged himself a few weeks after being prescribed Citalopram.

Stephen Leggett, 53, set himself on fire 5 days after Citalopram. Coroner ordered a Government Inquiry into the drug.

Reports courtesy of Database kept by AntiDepAware.

The Pill That Steals Lives

London July 2016

This week myself and Tony abandoned the minors, left them in the care of the (sergeant) majors and took ourselves off to London. With promises of presents and various forms of bribery, they waved us off without a second glance – the deals were struck. With one condition – as long as we were back for Henny-Benny’s 12th birthday on Wednesday, we could do whatever else we liked. The purpose of our trip overseas was to attend a book launch in Waterstones of Kensington – Katinka Blackford Newman’s ‘The Pill That Steals Lives’. Having read excerpts in the Mail and spoken to Katinka over the last year, I was really looking forward to it.

Katinka is a film producer, director and author – she’s also attractive, clever and extremely funny (as are her 2 amazing children). Her book depicts a particularly harrowing year in her life, a year that started with a marriage break-up and a prescription for Escitalopram (Lexapro/Cipralex). She describes, in painful detail, her subsequent spiral into an emotionally-blunted, chronically-fatigued, medicated shell of her former self. Weirdly, as a result of running out of health insurance, she survived to tell this tale. Her autobiographical account of that year is told in a sometimes tragic, yet often humorous way – this book is a stunner. Considering the enormous increases in antidepressant prescribing, for every conceivable ailment (from exam woes to shyness), I hope it is read far and wide.

We had arranged to meet up with our friends before the book launch (Brian, his better half and Bobby Fiddaman). Brian and the Mrs were staying in a very posh hotel, where the concierges wore top hats and tails – we weren’t. A previous fiasco in Denmark led them to choose their own hotel this time – but that’s another story. Nevertheless, the concierge was very friendly and courteous and after equally posh aperitifs, we all travelled together to Waterstones bookshop on Kensington’s High Street.

It was fabulous. We met other Irish friends there too – Stephanie and John Lynch, whose son Jake tragically died from an antidepressant-induced death at age 14. There were people from all corners of the globe, all with similar stories to tell. I was delighted to finally meet David Carmichael, who had travelled from Canada to be there. David strangled his 11-year-old son while in a Seroxat induced psychosis – he’s a very nice man and I would trust him with my life.

Kirk Brandon, a singer and friend of Bobby’s was there too. While having Lunch the following day, Kirk told an equally harrowing story of his time on Seroxat. There are so many stories, from survivors (the lucky ones) but equally from those who didn’t survive, like Shane, Kevin, Jake, Ian, et cetera. The list goes on and on – read the book.

As is the norm for us in London, we had a few hiccups along the way. Thankfully, there was no flashing of ageing bodily parts this time around, certainly not mine anyway (I can’t speak for the others). Although, getting peed on, first by torrential rain and then by Ryanair, wandering aimlessly around London in the middle of the night (due to a raging fire near Clapham Junction) was all par for the course.

Even an impromptu overnight stay in London City Airport, coupled with additional flights costing a further 600 euro, could not dampen our spirits. It was worth every penny, although we did put ourselves in jeopardy of additional bribery – we missed Henny-Benny’s birthday. All is not lost though – he’s busy concocting up a repayment scheme for the trauma of this particularly bad parenting.

The Pill That Steals Lives.

When Science and Anecdote Collide

cropped-hippocrates12.jpg

For decades, declarations by perturbed relatives that a loved-one’s death was iatrogenic (induced by medical treatment), were often dismissed as anecdotal. Accounts imparted by concerned loved-ones were likely to be rejected, albeit often kindly – yet thrust aside as the demented rantings of a grieving loved-one. Placated with persuasive words, relatives often slink away, suitably chastised by the medic’s evidential superior knowledge. The rantings of the grieving widow or mother will be controlled and placated, with the vociferator patronized and often pitied as misinformed dissidents. Thus, relegated to the anecdotal tray, rather than adverse-reaction tray, the iatrogenesis will likely continue, surfacing some time later to harm another. Many feel this practice is particularly pervasive within psychiatry, where protecting the medical model seems paramount over the safeguarding of patients.

The perception of the American ‘shrink’ listening attentively, while the horizontal patient spills his innermost torment, is one that persists today. In reality, this is far from the norm, with the prescribing of psychiatric drugs taking precedence over the tedium of treating a traumatised patient. Drugs that often mask the problem with disinhibition and emotional blunting are seemingly prescribed with wild abandon, yet only the families affected can see the harms done – while medics seem oblivious. When Cochrane Scientists and expert psycho-pharmacologists, are publicly stating that antidepressants and other psychotropic drugs are causing ‘more harm than good’ and many deaths, dismissive medics who continue to recklessly prescribe are walking a fine line between acting irresponsibly and negligently. However, a vast disparity still exists between scientific findings that psychiatric drugs are the third leading cause of death in Europe (and the U.S) and psychiatry’s Key Opinion Leaders (KOLs) declaring these drugs are safe – even declaring that ‘the public should have no concerns about these drugs’. 

When publicly challenged, KOLs usually retaliate with the mantra ‘correlation does not imply causation’. Pushed a bit further, their hackles will rise and they’ll state ‘these people are causing harm, by stopping people from taking life-saving medication’. Yet, even a utilitarian argument that these drugs provide ‘the greatest good for the greatest number’ has been debunked by Peter Gøtzsche (scientist and co-founder of the Cochrane Collaboration). He stated recently, to no small uproar, that these drugs are ‘doing more harm than good’ and that almost all psychotropic drug use could be stopped without deleterious effect (due to withdrawal, discontinuing is not advisable without medical supervision).

However, the problems run deeper than the KOLs defence of psychiatric drugs. An interesting article on MIA (Mad in America) tells the sorry tale of a dad who recently discovered that the American drug regulator (FDA) is ‘hiding reports linking psychiatric drugs to homicides’. It will be interesting to see what happens next within the FDA.

Furthermore, the statement that ‘the public should have no concerns about these drugs’ was made following an inquest in Ireland, where concerns were raised by the deceased’s family about a recent prescription of Sertraline (Zoloft/Lustral). However, as is common practice, the family’s concerns were dismissed. They had no way of knowing that in 1998, the Irish Drug Regulator (HPRA), following reports of Sertraline-induced suicide, had requested that the drug company in question (Pfizer) search its database for similar cases. There were 594 ‘suicide events’ reported from non-clinical sources, of which causality was not investigated. Of the 252 from clinical trial cases, Pfizer’s internal report concluded that 54 were directly related to Sertraline treatment. Interestingly, 11 of the ‘suicide events’ reported (from both sources) came from Ireland, with 2 found causally related to Sertraline. The latter were from ‘confidential’ documents released through court proceedings and provided by Kim Witczak who lost her husband Woody to Sertraline.

Nevertheless, it seems that science may be catching up with the anecdotal evidence, with some interesting studies published recently. Following the Study 329 debacle (as yet unretracted), the latest study by Jureidini et al ‘The citalopram CIT-MD-18 pediatric depression trial: Deconstruction of medical ghostwriting, data mischaracterisation and academic malfeasance’ shows how Forest Labs, through greed and fraudulent practices, actively ignored the prospective likely harms to children. The study concluded:

Deconstruction of court documents revealed that protocol-specified outcome measures showed no statistically significant difference between citalopram and placebo. However, the published article concluded that citalopram was safe and significantly more efficacious than placebo for children and adolescents, with possible adverse effects on patient safety.

Another study by Selma et al ‘The relevance of cytochrome P450 polymorphism in forensic medicine and akathisia-related violence and suicide’ expressed that a genetic predisposition to iatrogenesis can be traced back to pharmacogenetic interactions, namely the inability of some to metabolize prescribed drugs, making ordinarily ‘safe’ drugs, lethal for some. The study concluded:

“CYP450 status is an important factor that differentiates those who can tolerate a drug or combination of drugs from those who might not. Testing for cytochrome P450 identifies those at risk for such adverse drug reactions. As forensic medical and toxicology professionals become aware of the biological causes of these catastrophic side effects, they may bring justice to both perpetrators and to victims of akathisia-related violence. The medicalization of common human distress has resulted in a very large population getting medication that may do more harm than good by causing suicides, homicides and the mental states that lead up to them”.

Perhaps we will just have to wait for the hapless KOL to catch up, not only with the scientific evidence but with collective anecdotal evidence from families. It would seem that underestimating anecdotal evidence is unwise – not least as science often evolves from this very valuable source.

The citalopram CIT-MD-18 pediatric depression trial: Deconstruction of medical ghostwriting, data mischaracterisation and academic malfeasance.

The relevance of cytochrome P450 polymorphism in forensic medicine and akathisia-related violence and suicide

Family calls for more research into anti-depressants

The FDA Is Hiding Reports Linking Psych Drugs to Homicides

GSK and The Miracle Med – The Happy Horny Skinny Pill

Skinny fat pic

An article in Sunday’s Telegraph ‘could antidepressants be ruining your sex life?’ concerned the use of widely-prescribed SSRIs (Selective Serotonin Reuptake Inhibitors) and the associated loss of libido. The article rightly refers to statistics that estimate between 30-70 per cent of SSRI consumers will be affected with some form of sexual dysfunction – despite their much-argued efficacy. According to Peter Gøtzsche, Cochrane scientist, “There isn’t much happiness in the pills. Their most pronounced effect is to cause sexual disturbances…The drugs should therefore have been marketed as a formidable disrupter of your sex life, but that wouldn’t have sold many pills.” 

However, the Telegraph article also conveyed common misconceptions into the psychopharmacological workings of antidepressants. In a nutshell – by increasing the levels of happy neurotransmitter serotonin, this effectively lifts overall mood but as a result of this increased serotonin level, your libido will decrease along with the ability to orgasm. It seems, despite there being no way of quantifying serotonin (at least not when alive), belief in ‘the chemical imbalance myth’ still prevails.

Nevertheless, leaving aside the legend of the chemical imbalance, the article also discusses another ‘libido-friendly’ alternative to SSRIs, GlaxoSmithKline’s Bupropion/Wellbrutin. The author seemingly expounds the virtues of this drug, marketed in the U.S. as Wellbutrin (an antidepressant) and Zyban (an anti-smoking drug) in the U.S. and Europe. Excerpt:

“It seems that instead of dampening desire, Wellbutrin can increase libido and suppress appetite, earning it the nickname of the ‘happy, sexy, skinny pill’.  

Sounds like the perfect pill, if it actually worked. In case anyone was contemplating doing a bit of self-diagnosing and self-medicating via the internet (as the article reports many U.K. women are doing), there are other factors that just might put you off. In fact, some crucial Wellbutrin-related adverse effects were omitted from the article, f0r example, some very serious psychological effects: unusual thoughts and behaviors, increased risk of suicidal behaviour, aggression, delusions, seizures, hallucinations, paranoia, confusion and manic episodes.

In reality, this so-called ‘happy, sexy, skinny pill’ has been plagued with problems. Following significant incidences of seizures, Wellbutrin was taken off the market shortly after its initial approval – but re-introduced a few years later at a lower dose. In 2009, following numerous suicides, the FDA (US Medicine’s Regulator) was so concerned about the psychological effects of Wellbrutin/Zyban in smokers, that they ordered a further black-box warning to be attached. The following year (2010), a study by Moore et al ‘Prescription Drugs Associated with Reports of Violence Towards Others’ found Wellbutrin to be one of the 31 drugs disproportunately associated with violence.

Furthermore, as for being nickednamed the ‘happy, sexy, skinny pill’ there is one main reason for this – money. In fact, GSK actively promoted Wellbutrin as ‘the happy, horny, skinny pill’ and paid handsomely for promoting the drug for unapproved uses. In an action taken by the U.S. justice department, allegations included a myriad of wrongdoings, including that GSK hired PR firms to promote off-label use, paid doctors, organised sham advisory boards, sham ‘independent’ medical education events and provided samples to pediatric psychiatrists for unapproved use in children (despite knowing it increased the risk of suicide in this age group).

On one particular radio show, well-known tv-doc, Drew Pinsky, said it was possible that Wellbrutin could have caused a female caller’s ’60 orgasms a night’ (Sure, you’d be worn out – and I’m not entirely sure why this wouldn’t be conceived as a downright affliction). Anyway, dear Dr Drew never clarified this or mentioned that he was paid, very, very handsomely, for his services to GSK. In the months before the radio show, GSK indirectly paid him $275,000 – a fact not disclosed to the listeners. Thus, an internal GSK report determined that the media campaigns pushing Welbutrin’s ‘happy, horny, skinny’ effects, reached a total audience of 387 million. It would be surprising if anyone hasn’t heard of it, even on ths side of the Atlantic.

In case you need further convincing, in 2012, GSK was fined 3 billion dollars for these illegal and dubious practices, including for the off-label and harmful promotion of Wellbutrin in children and adults. Nevertheless, as the sales for Wellbutrin during that same period, were reportedly $5.9 billion, GSK made a tidy profit. The collateral damage of  harmed kids and unsuspecting consumers went seemingly unnoticed.

So, I would be very careful of that so-called miracle cure – you just might get more than you bargained for. ‘Sickness’ is a very lucrative business and all pharmaceuticals companies are corporate entities, ones that are totally reliant on sickness, not health. GSK just so happens to be bigger than most and one that has shown itself time and again to use greater bullying tactics.

Telegraph Article – Could Antidepressants be Killing your Sex Life?

New York Times – Suicide Warnings for 2 Anti-Smoking Drugs.

Prescription Drugs Associated with Reports of Violence Towards Others, Study.

Justice Department Complaint, courtesy of KHN, here.

New York Times – Glaxo Agrees to pay $3 Billion in Fraud Settlement.

Lundbeck Astroturfing

Lundbeck's Expert Panel, Madrid

There has been much publicity recently on the alcohol industry and their sponsorship of sporting events. I won’t rehash the numerous arguments here but suffice to say, most agree that it’s an unethical alliance. An article by Dr John Scally, TCD (and RCSI) lecturer in Ethics and Theology, expressed the view that there are particular ethical issues involved when accepting sponsorship from the alcohol industry. He stated “No drug has caused more damage to Irish families than alcohol. Of course, the Guinness sponsorship of the hurling championship did not force young people to drink alcohol. Yet it would be naive in the extreme to think that executives of alcohol companies would fork out huge sums of money on sports sponsorship unless there was some boost to their sales in return”. 

To be honest, I’m not really sure what all the fuss is about – there’s no subterfuge, it’s a self-explanatory and transparent relationship. It seems to me that there are far worse examples of industry-funded events, ones that are far from transparent. What of Pharma-funded awareness programmes, companies that just so happen to have a drug that might (or might not) help the same condition they’re creating awareness for? A recent article in Spain’s El País Newspaper (unwittingly) provides an insight into the unethical subterfuge that can often exist behind ‘awareness’ programmes. The article ‘Three-quarters of at-risk drinkers in Spain unaware of dangers of alcohol’ gives a stark warning to Spanish drinkers who ‘consume worrying amounts of booze’. The article comes on the back of a survey done by Danish pharmaceutical company Lundbeck, which was presented by a panel of experts to a symposium in Madrid last week. Following the study on alcohol consumption, the panel of experts called for legislation to regulate alcohol intake, limit access to alcohol and control alcohol-industry advertising. The El País article ends with the line “Each day, the industry spends a million euros promoting alcoholic drinks. This is not ethical.” Okay so far – many would agree that spending a fortune in promoting alcohol products is an unethical practice.

What the article doesn’t say, is that –

  1. Lundbeck, the Pharmaceutical company behind the survey, (coincidentally) manufactures a drug for alcohol dependence, Nalmefene.
  2. Each expert from the panel has many conflicts of interest, including receiving numerous ‘honoraria’ from Lundbeck – all have a vested (and potentially very lucrative) interest in their submissions. Honoraria (plural of honorarium), a confusing word, meaning cash for services rendered.

The Panel of experts –

Julio Bobes, president of Socidrogalcohol, a research organization into alcohol and drug dependence. His conflicts of interest includes receiving honoraria from Lundbeck and being part of the ESENSE 2 Study, a randomized controlled 6-month study of ‘as-needed Nalmefene’, sponsored by Lundbeck.

Antoni Gual, of Barcelona’s Hospital Clinic. His conflicts of interest include- AG has received honoraria, research grants and travel grants from Lundbeck. He wrote numerous Nalmefene papers, including this one he co-wrote with employees of Lundbeck – ‘A randomised, double-blind, placebo-controlled, efficacy study of nalmefene, as-needed use, in patients with alcohol dependence’. Lundbeck was involved in the study design, data collection, data analysis, and interpretation of the data. AG was also on the advisory board of Socidrogalcohol.

José Ángel Arbesú of the Spanish Association of Primary Care Medics. His conflicts of interest include being an advisor to Lundbeck and obtaining Lundbeck funding for research, publications and training. He took part in the following study ‘SEMERGEN positioning for the treatment of alcohol disorders in primary care’ with Julio Bobes and Antoni Gual – a study that recommended Lundbeck’s Nalmefene for reducing alcohol consumption.

Javier Zarco of the Spanish Society for Family and Community Medicine, has consulted and obtained funding for advice, research, publications and training activities from Lundbeck.

In 2014 the college of psychiatrists of Ireland called for a ban on Alcohol advertising and sponsorship; it seems ironic that they do not see the glaringly obvious similarities between the latter and the pharmaceutical industry’s funding of academia and of the very studys that medics rely on for basic education. One wonders why the college would focus on sponsorship by the alcohol industry and ignore their own professions alliance with, and allegiance to, the pharmaceutical industry.

El País Article.

Suffer little children – Irish Psychiatrist v David Healy and The Nordic Cochrane Centre

Suffer little children

Jeez –  here we go again. Yesterday’s BMJ article that found antidepressants double the risk of suicide and aggression in young people, made headlines worldwide. From America, Australia to india, caution was advised when prescribing in this age bracket. Not so in Ireland. The one newspaper article referring to the BMJ article can be found in today’s Irish Examiner here, entitled ‘Drug link to child suicide queried by expert’. So did it warn prescribers of the suicide and aggression risks, advise stricter guidelines or just advise caution when prescribing to children? None of the latter. Instead the Irish Examiner published an article allowing Professor Patricia Casey to question the findings of the Nordic Cochrane Centre.

Coincidentally, Professor Casey was also in the newspapers yesterday, having brought a High Court action against the Irish Times for alleged defamatory comments made by the public online. The anonymous online comments stated that Professor Casey was an unprofessional psychiatrist who was unfit to treat suicidal pregnant women and further, that she misrepresented psychiatric research in order to promote a Catholic agenda. The Times kowtowed apologised and the action was settled between the parties; therefore, no legal precedent was established. Professor Casey’s legal letters are legendary and many, including me, have been on the receiving end. Whatever happened to ‘truth’ and ‘honest opinion’ being defences to defamation?

Furthermore, regarding the comment that Professor Casey is pushing a Catholic agenda. Similar to defending antidepressant use in children, she’s certainly not pushing a Catholic agenda when she says antidepressants can be life-saving in pregnancy, while keeping quiet about the harms SSRIs can cause to the foetus, an issue that she’s well aware of. Another scientist (and psycho-pharmacologist) David Healy, has brought to her attention that these drugs can increase the rate of abortion, miscarriage and birth defects – but Professor Casey chose not to explore the data. May God forgive us all..

As for the BMJ article, far be it for me to contradict Professor Casey, so I asked the scientist at the centre of the study, Peter Gøtzsche, what his thoughts were on her Examiner article. See his detailed reply (in blue) below –

Prof Casey, however, said the jury was still out on the risks and benefits of prescribing the antidepressants, commonly known as SSRIs.

She believed psychiatrists dealing with children and adolescents should decide on a case-by-case basis.

“If a child is depressed and is not responding to evidence based treatment on offer, like talking therapies or some other anti-depressant, the psychiatrist might only then go and prescribe the SSRIs,” she said.

I consider it bad medicine to use antidepressants in children. They don’t work, according to the children themselves when asked in placebo controlled trials, and they double the risk of suicide and treble the risk of aggression.

“I am not a child or adolescent psychiatrist — I deal with adults. But I know from speaking to colleagues that there are differing views on prescribing SSRIs. Some say no, SSRIs should not be prescribed while others say, yes, we should, otherwise there will a greater risk of dying by suicide.”

Psychiatrists who claim that antidepressants protect children from committing suicide should not be allowed to practice; they are too dangerous to have around.

Prof Casey said it was found in the US and in the Netherlands that the suicide rate in children and adolescents increased after members of that group stopped being prescribed SSRIs.

All such studies have been found to be seriously misleading. I explain why in my recent book, Deadly Psychiatry and Organised Denial. The randomised trials provide far more reliable evidence and they show that the suicide risk doubles when children get antidepressants, which is why the drug agencies warn about using these drugs in children.

This was noticed particularly in the Netherlands, where the drugs carry a ‘black box’ warning.

This is not correct. Robert Whitaker writes about this under the heading “The Triumph of Bad Science” (http://www.madinamerica.com/2012/07/the-triumph-of-bad-science/):

Critics quickly pointed out the dishonest science that Gibbons had employed to make this case. He reported that SSRI prescriptions to youth declined by 22% in the U.S. from 2003 to 2005, and that suicide rates in youth rose 14% between 2003 and 2004. But since he had only the suicide rates for the U.S. through 2004, he should have focused on prescribing rates during that same period of time.

In fact, there had only been a very small decrease in the prescribing of SSRIs to youth between 2003 and 2004, when the number of suicides rose. It was between 2004 and 2005 that the there was a significant decrease in the prescribing of SSRIs to youth, and–as the critics noted–once the suicide data for that period became available, it showed that during that time, the number of suicides for persons ages 5 to 24 declined.

In other words, the data showed that as the number of prescriptions to children and youth declined, the number of suicides in this age group declined too. But Gibbons reported that the opposite was true. He did so by matching the increase in suicides in 2003-2004 to the decline in prescribing in 2004-2005. This is not the sort of error a scientist “accidentally makes.” This is the sort of presentation of data one makes when he or she is trying to deliberately tell a story that fits a preconceived end.

In the Netherlands, Dutch academics were incensed with Gibbons and his statistical antics. In the Dutch Drug Bulletin, they noted that the increase in suicides in the Netherlands was so small that it was “not statistically significant.” They described his conclusions as “astonishing” and “misleading,” and stated that Gibbons and his co-authors had been “reckless” to publish such claims.

“Child psychiatrists should not be eliminating SSRIs totally from their armory but using them when other treatments don’t work because there is now clear evidence of an increase in suicide in young people that appears to approximate to the time when the reduction in their prescription occurred,” said Prof Casey.

This is total nonsense. There are no reliable studies that have shown this. And interestingly, when the usage of SSRIs went up in the UK in youth, suicides in youth also went up, but no one has felt compelled to publish a paper about this, as far as I know. Selective reporting is certainly an issue here.

However, the research led a British expert to call for stricter prescribing rules.

Professor of evidence-based psychological therapies at University of Reading, Shirley Reynolds said only specialist child and adolescent psychiatrists should prescribe antidepressant medication to children and young people.

No. No one should prescribe antidepressant medication to children and young people. I consider this a medical error. They don’t work and they are harmful. 

“Obviously these results will make doctors, parents and young people themselves think harder about taking antidepressant medication,” she said.

They need not think hard. They should just say no. This will save many lives.

“But do the results mean that children and young people should never be prescribed antidepressant medication? No.

Yes! It should be forbidden to use these drugs in children and young people. We also need to face the fact that these drugs can cause suicide at any age, and they can also cause homicide.

BMJ – Antidepressants double suicidality and aggression in children and adolescents.

Woman studying and relaxing

I’ve been neglecting my blog recently and must say, I’ve missed it. I find blogging very therapeutic but have had to forego the rantings in order to study for a masters. Whose bright idea was that? While some people find it relaxing to visit the spa, go jogging (requires too much effort) or veg on the couch with the latest ‘Top Gear’ and a Tesco’s bag stuffed with chocolate and jellys (the poor unfortunate husband) – I like nothing more than having a few hours hunched over the computer (blissfully oblivious to the lads running amok in the background), ranting about what occasionally interests or annoys me. The thing about becoming a mature(ish) student is that there are always essays to be submitted. Timely and well-researched masterpieces take time and effort, I’ll have you know! Having finished my first assignment and mastered (kind-of) the intricacies of Endnote (no mean feat), my time is my own for a few days. I’m still not quite over the shock that this quare one from Sallynoggin was accepted into The Royal College of Surgeons. I kept telling the husband that Sallynoggin people are superior beings but he never believed me, although, I keep expecting the professor to barge through the door and say so sorry Ms Fennell, we got the rejected pile of applicants mixed up with the deserving scholars and you’ll just have to go. Anyway, he hasn’t as yet and I have to say, it’s an awesome place.

So considering I’ve left the triathlons to my much fitter sisters and there’s only so many re-runs of Jeremy Clarkson that a person can watch without wanting to harm the Hammond guy – what did I find of interest today? Well now, seen as you asked, this morning a study was published in the British Medical Journal (BMJ) entitled ‘Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports’ (Sharma et al., 2016). The objective of the study was to study serious harms associated with selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs and SNRIs). Now, as I can feel your eyes glazing over (just as mine did), there’s an article in the Telegraph that provides a simplified account of the study findings – an article which incidentally gives a well-deserved mention to my lovely friend Mr AntiDepAware.

Excerpt from the Telegraph article ..

Antidepressants can raise the risk of suicide, the biggest ever review has found, as pharmaceutical companies were accused of failing to report side-effects and even deaths linked to the drugs. An analysis of 70 trials of the most common antidepressants – involving more than 18,000 people – found they doubled the risk of suicide and aggressive behaviour in under 18s. Although a similarly stark link was not seen in adults, the authors said misreporting of trial data could have led to a serious under-estimation of the harms.”

While the study found no increased risk in adults, the Telegraph provides a quote from Professor Peter Gøtzsche, lead author of the study, who said “What I get out of this colossal underreporting of suicides is that SSRIs likely increase suicides in all ages”.

In a related BMJ editorial today, psychiatrist and author Joanna Moncrieff expressed concerns that many adverse events are being misrepresented – Several deaths were misclassified, and more than half the instances of suicide attempts and suicidal ideation were coded as ‘emotional lability’ or ‘worsening of depression’.

There are two hugely important findings in this study.

  1. the safety of Fluoxetine (Prozac), psychiatry’s main drug of choice for children suffering with mental trauma, was widely misrepresented by Lilly.
  2. antidepressants double the risk of suicidality and aggression in children and adolescents.

The study authors recommend – minimal use of antidepressants in children, adolescents, and young adults, as the serious harms seem to be greater, and as their effect seems to be below what is clinically relevant.

Considering Lilly’s consistent hiding of the harms of Fluoxetine and the recent inquests in the Dublin Coroner’s Court where this drug was implicated, access to the data is crucial in order to stop further unnecessary deaths. A mammoth task but not an impossible one, as shown recently by Le Noury et al (with Paroxetine and Study 329). My brain is frying at the thought of it; although a PharmaHealyGotzsche triathlon actually sounds quite fun.

.

Telegraph Article.

SHARMA, T., GUSKI, L. S., FREUND, N. & GØTZSCHE, P. C. 2016. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ, 352.

LE NOURY, J., NARDO, J. M., HEALY, D., JUREIDINI, J., RAVEN, M., TUFANARU, C. & ABI-JAOUDE, E. 2015. Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. BMJ, 351.