This November IFMAD are holding a symposium in Monte Carlo which is sponsored by an unrestricted grant from Lundbeck pharmaceuticals.
IFMAD is an abbreviation for ‘International Forum on Mood and Anxiety Disorders’ – an unfortunate abbreviation it has to be said. Their website is also sponsored by Lundbeck Pharmaceuticals.
According to their ‘Lundbeck sponsored’ website, IFMAD was founded in 2000 by ‘Professor Siegfried Kasper and Professor Stuart Montgomery’ and supported by a scientific committee from around the world.
So what, you may ask? What’s another pharma funded symposium? Why does it matter that the brochure has a huge advert for Lundbeck’s Cipralex/Lexapro? I dunno, you tell me, or maybe you could ask Brennan McCartney? No sorry, he’s dead, just because his doctor relied on the objectivity of the ‘experts’ advice, believed it, and subsequently prescribed Brennan a sample pack of Cipralex. You can read Brennan’s story here.
Irish Professor Timothy (Ted) Dinan is one of IFMADs scientific advisors, Again coincidentally, he is also a faculty member of the Lundbeck Institute here and a Lundbeck ‘Brain Explorer’ advisor, here. In fact Timothy et al also recently concluded a Cipralex study, this time in rodents, here. The first line states ‘Despite the clinical prevalence of the antidepressant escitalopram, over 30% of escitalopram-treated patients fail to respond to treatment’. Fairly objective statement you may think? In my opinion, that’s a very deceptive statement and expert spiel at its best. What it is actually saying is that Escitalopram (aka Cipralex/Lexapro) has clinical prevalence over other brands and that it works in almost 70% of cases.
Similarly, most of IFMAD’s scientific advisors (listed here), have participated in Cipralex studies and all (without exception) concluded positive results. Here’s a couple of examples: Christer Allgulander (Sweden) here, A.C Altamura (Italy) here, Michael Bauer (Germany) here and Naomi Fineberg (UK) here.
Again (Ahem) most likely coincidentally, at least 12 of IFMAD’s scientific advisors are also faculty members of the Lundbeck Institute: Dinan, Altamura, Boyer, Arango, Kennedy, Mendlewicz, Möller, Papadimitriou, Rihmer, Stein, Vieta and Zohar.
Lars Von Knorring (Sweden) is an IFMAD scientific advisor. He lists Anne-Liis Von Knorring (relationship unknown) as one of his top co-authors here. She was the same professor who was accused of covering up the bad results of Lundbeck’s Celexa (same drug, different story) and actively misleading doctors and the public here. Lars also did studies on Citalopram which once again proved positive; one example here.
Maybe I should get a life and forget that my son would be still alive if he didn’t take Citalopram (same drug as Cipralex), prescribed by doctors who believed in the ‘independent’ spiel dished out by ‘independent’ KOP’s (Key Opinion
LiarsLeaders)? NO? You know what I think? I think that IFMAD is a Lundbeck creation, created to propagate the ‘independent’ KOP’s subjective pharma-funded belief in Lundbeck drugs. Yes IFMAD, IAM(VERYEFFING)MAD this lovely November morning! Lundbeck-funded propaganda at its worst.
Monte-Carlo (2002) here.
Monte-Carlo (2003) here.
Vienna (2005) here.
Vienna (2006) here.
Budapest (2007) here.
Vienna (2008) here.
Monaco (2009) here.
Vienna (2010) here.
Budapest (2011) here.
Barcelona (2012) here.
Monte Carlo (2013) here.
There are some very, very tragic cases being publicly played out in Ireland at the moment. Whether the use of medication was a factor or not in these cases has not yet been established, but the following unusual case came up in the Irish courts recently.
On 22nd of July Nurse Greta Dudko (pictured) pleaded not guilty to murder but guilty to the manslaughter of her mother ‘Anna Butautiene’ on Christmas Eve 2010. The jury failed to reach a verdict and a retrial was set for Oct 2014.
Ms Dudko, who is originally from Lithuania, had separated from her husband two weeks before the incident and was living with her mother and young son. Evidence was given of a litany of mitigating circumstances, including assault, both mentally and physically, resulting in the mother being struck twice over the head with a bottle by Ms Dudko. She said “I hit her on the face with the empty bottle twice because I thought she was going to ruin my life and just hated her,” She further stated she had no intention of killing her, “just to shut her up for the evening“.
Despite huge media coverage, only one newspaper reported that she had recently been prescribed medication by her GP, Dr Hassan Albayyari. On 15 December 2010 Dr Hassan prescribed Librium for alcohol withdrawal (9 days before Ms Dudko caused the death of her mother). Librium, a benzodiazepine, can cause, among other things: depression, thoughts of suicide, unusual risk-taking behavior, decreased inhibitions, no fear of danger, confusion, hyperactivity, agitation, hostility and hallucinations. There was further evidence of a prescription for Xanax in September 2010.
On December 22, 2010 (2 days before her mother’s death), she was prescribed Lexapro. Yes, Lundbeck’s Lexapro aka Escitalopram, found by a Brussels court to be the same as Cipramil aka Citalopram, here. Now, it is well established that this drug can cause ‘self harm and harm to others’, which at worst equates to suicide/homicide, so is this a prime example of involuntary intoxication? Dr Hassan said “Lexapro takes a minimum of three weeks to work”`. According to Professor David Healy who is an expert on SSRIs, that is wrong. In his paper entitled ‘Antidepressants for Prescribers‘ he states “This is completely untrue. These drugs produce benefits and harms within hours or days of first taking them. It may take several weeks for a clinical syndrome to lift but this is something quite different. The argument that the drug takes time to work is trotted out as part of the defense against claims that an antidepressant has triggered suicide or violence.”
So is Dr Hassan defending the use of Lexapro in this case? Who knows, but here is a list of some similar cases where antidepressant use was successfully used in an ‘Involuntary Intoxication’ defense, here.
There is also a further paper written on this subject by David Healy et al, entitled ‘Case Histories As Evidence’, here. Sadly, this paper refers to my son Shane (who is SC) and who suffered from involuntary intoxication of prescribed Citalopram. Is Nurse Greta Dudko another Lundbeck victim to add to the growing list, along with her mother?
Next week BBC’s Panorama team are tackling the issue of antidepressant use in pregnancy. The programme will be broadcast on Mon 1st july, entitled ‘The Truth About Pills and Pregnancy‘.
According to the UK Independent “The programme will broadcast an interview with Anna Wilson, whose son David spent the first five weeks of his life in hospital. A 20-week scan had shown that David had a heart defect and would need surgery immediately after being born. Anna had been taking the prescription drug Citalopram to treat her anxiety four years before her pregnancy began, and was told that she was safe to continue whilst pregnant. The show will feature interviews with Prof Pilling, who will say that GP prescription guidelines are about to be updated to take into account evidence suggesting a link with SSRIs and heart defects.”
A manufacturer contacted by the BBC denies any link to major foetal malformations (no prizes for guessing Lundbeck here).
Panorama spoke to eight mothers who had babies born with serious heart defects after taking a commonly used SSRI (selective serotonin reuptake inhibitors) antidepressant while pregnant.
An article on BBC News stated “Lundbeck, the manufacturer of Citalopram, said a recent review of scientific literature concluded that the drug ‘does not appear to be associated with an increased risk of major foetal malformations’.”
It seems that Lundbeck are lying again or there is a serious lack of communication between the various medicines regulators and the pharmaceutical industry. Below is an adverse reaction report logged with the Irish Medicines Board involving a baby born with a Cleft Lip, associated with the mother’s use of Citalopram.
What about the following, also reported as Citalopram induced? This particular report concerns the intrauterine death of an unborn baby due to ‘Citalopram exposure during pregnancy’.
Then there was our meeting in Copenhagen with the two Lundbeck goons. We asked if Citalopram/Escitalopram was a teratogen. Their answers (or non-answers) may surprise you…
Leonie Right, will I go on because there’s no point, we’re stuck at that one? Anyway. Do you think that it’s advisable to virtually bathe foetuses in Serotonin given it is now accepted this family of drugs are firmly associated with birth defects?
Dr. Madsen Virtually bathe?
Leonie Foetuses in Serotonin – pregnancy.
Tony Pregnant women.
Dr. Madsen I don’t know what you mean by virtually bathe
Leonie I’m talking about anti-depressants are known to cause birth defects. If you think so, would it not be better if women of child-bearing age were cautioned against, perhaps even contra-indicated from using this drug? Citalopram or Escitalopram?
Dr. Madsen Em, I think in…..
Leonie Your views?
Dr. Madsen In pregnancy?
Dr. Madsen Em, I think em, physicians need to double their efforts to make sure that there is a correct risk versus eh, benefit eh, assessment of the em, of any action.
Leonie Is Citalopram and Escitalopram a teratogen?
Dr. Madsen Em, meaning, what, what, what do you mean?
Leonie Can it cause harm to foetuses? Unborn babies.
Dr. Madsen Em, obviously, in order to have our compounds approved we have done em, a large number of pre-clinical trials em, and we are constantly monitoring and the eh, while the recommendation I believe throughout, is to be, be extra cautious when administering any eh, medications to pregnant women…
Leonie Can it cause harm?….. to unborn babies?
Dr. Madsen Anything can cause harm, can cause harm in any dose
Leonie So yes it can.
Dr. Madsen depending on dose
Em, why if it can cause harm, is this not clearly, clearly stated on the packaging and information leaflet?
Mr. Schroll Do you talk about the patient leaflet or do you talk about the SPC, the label that the Doctors use in order to prescribe the medication?
Leonie I’m talking about a pregnant woman that goes down and gets it in the chemist. Is it on the patient information leaflet?
Mr. Schroll In the patient leaflet it says you have to talk to your Doctor….
Leonie And what does it say in the Doctor’s leaflet?
Mr. Schroll That he has to be extra cautious. I think that if you go to the… to, to the Irish home page, I believe it is like that, it’s like that in Denmark and elsewhere. If you go to the medicines agency authorities
Mr. Schroll the medicines agency authorities you can see what is in the checks that the Doctors and that is up to them to decide…..
Leonie So you are passing the buck back to the Doctor again.
Mr. Schroll I think when it’s prescription medication, yes. If it was eh, eh,
Leonie And will they be told that it can harm their unborn baby?
Mr. Schroll Sorry?
Leonie Will the pregnant woman be told that the drug can, can harm her unborn baby?
Mr. Schroll It would be part of the discussion to talk about the risks and the benefits and that would be up to the Doctor.
Leonie It would be up to the Doctor to tell them that the drug can harm their unborn baby?
Mr. Schroll Eh, now, you’re talking…..
Leonie It’s not up to Lundbeck, no? It’s up to the Doctor to tell the woman that the drug can harm their unborn baby?
Mr. Schroll To be cautious, yes, yes.
The Irish word ‘amadáin’ springs to mind. I could think of a few English ones too but think I’d better refrain. The Panorama programme should be excellent viewing as usual, particularly with Shelley Jofre as reporter. She did the previous expose concerning GSK and Seroxat suicides. I can see her putting Lundbeck in their place.
Lundbeck Meeting here.
IMB adverse reaction reports.
MHRA (UK) adverse reaction reports.
Meet Larry, 63. Larry underwent a ‘triple bypass’ operation last Christmas, which involved spending 26 days in the Mater hospital, Dublin. Open heart surgery is known to be a very serious procedure; not least because the sternum (which is opened during surgery) can take up to 12 weeks to heal. Cardiologists acknowledge that Heart surgery is life-changing, both physically and emotionally.
Larry was a good guy, the eldest of six. He was relaxed, funny, and easy-going, with a wife whom he knew since they were teenagers. He had 4 children and 7 grandchildren who adored him. Following Larry’s triple bypass, as is common following big operations, he started to feel a little down. He was prescribed an antidepressant Lexapro (Lundbeck’s poison and the same drug Shane was prescribed). He took Lexapro as prescribed for about a week. He told his son that his head felt like it was exploding, that it wasn’t in sync with the rest of him and that he was ‘all over the place’.
Larry went back to the doctor and his medication was changed, this time to a newer antidepressant, Valdoxan (AKA Agomelatine, manufactured by Servier) and the Benzodiazepine Xanax, another potentially dangerous drug. Larry was prescribed this drug despite recent reports that Valdoxan is associated with serious hepatotoxicity (liver damage) and that caution is advised when prescribing for overweight/obese patients. I’m sure Larry wouldn’t mind me saying that he was more like Pavarotti than Rudolf Nureyev. Either way, I’m not quite sure why any medical professional would prescribe this drug considering the doubts surrounding its efficacy and the possible dangerous adverse effects. Warning here.
According to Larry’s family, following the later prescription for Valdoxan and Xanax, he became manic, unable to function; the simplest of tasks became mammoth. He behaved bizzarely, for example: he wouldn’t allow his wife out of his sight, insisted on holding her hand at all times, seemingly afraid to let go. This was totally out of character for the usually easy-going Larry. As usual, this change was put down to the after effects and trauma of this huge operation, not the mind-altering drugs which are prescribed to unsuspecting patients, including Larry.
On 27th Febuary 2013, Larry took a rope into the garage of his old family home and less than the required 12 weeks it took for his sternum to heal, this easy going 63 year-old man was dead.
There are 2,370 suicides and 1,539 Cardiac arrests reported as a drug- reaction (of Xanax) in the RxISK website. Valdoxan (Agomelatine) is not on the RxISK website because it is not approved by the FDA in America. This drug has been called ineffective, potentially dangerous and ‘a dog’ and had 3 (acknowledged) suicides in clinical trials, before it was even approved. For more of Valdoxan’s dodgy trials and other dodgy dealings with this IMB approved drug, retired psychiatrist and scientist ‘1 Boring Old Man’ explains it here.
The Valdoxan patient information leaflet (PIL) has the usual IMB inadequate suicide warning, although directed at under 25s:
A meta-analysis of placebo-controlled clinical trials of antidepressants in adult patients with psychiatric disorders showed an increased risk of suicidal behaviour with antidepressants compared to placebo, in patients less than 25 years old. Close supervision of patients and in particular those at high risk should accompany treatment especially in early treatment and following dose changes. Patients (and caregivers of patients) should be alerted to the need to monitor for any clinical worsening, suicidal behaviour or thoughts and unusual changes in behaviour and to seek medical advice immediately if these symptoms present.
The fact that the so-called psychiatric ‘experts’ in Ireland deny that these drugs can cause suicide, arguably negates the above warning. Even though Larry was aware of Shane’s case and the role that antidepressants played, he, like most people, trusted that the medical professionals knew better.
Antidepressant drugs come with different warnings in Ireland and the US. In the US these drugs come with a black-box warning due to the increased risk of dangerous adverse effects, including suicide. In my opinion, the difference between the Irish Patient Information Leaflet (PIL) and the American PIL is criminal. The failure to warn here is negligent; don’t be another statistic, make an informed decision.
Here’s a quote from an article in the Irish Times in Oct 2009. The article concerns Shane’s case and our ‘allegation’ on RTE that antidepressants can cause suicide and homicide. Justin Brophy, president of the Irish College of Psychiatry, stuck his oar in: Some people believe doctors and the pharmaceutical companies work hand-in-glove to suppress the evidence. Says Dr Brophy: “If there was any implication of concealment of the truth, the IMB would know it. The facts are very open and accessible. No one is trying to conceal anything. . . . To imply [we] are beholden to the pharmaceutical industry is a misrepresentation. We don’t prescribe based on any information from the pharmaceutical industry – we get it from the IMB.” The article (or Justin Brophy) failed to mention that the IMB is almost fully funded by the pharmaceutical industry. Is this the reason for the discrepancies in the PILs Justin?
Interestingly, this picture is from Irish Psychiatry’s Summer 2010 News Bulletin, which also refers to Shane’s case. The picture is of Justin Brophy with fellow Psychiatrist Dermot Walsh. Dr Walsh had this to say in the British Medical Journal (BMJ): “In the context of the current debate on the efficacy of antidepressants the following may be of interest. Ireland’s suicide rate has risen threefold since antidepressants became available with the greatest increase occurring following the introduction of the SSRIs.” Did you not read that Justin?
It is not recommended that anyone should stop taking these drugs without consulting a (good) doctor. The problem is the risk of suicide, violence, mania and worsening depression which can occur upon starting, discontinuing and dosage change (up or down). If required, information on withdrawal can be found here.
(An important message from Brian.)
Antidepressants, irrational behaviour and “out of the blue” suicides – raising awareness among UK police officers
In 2009 my son, who had never been depressed in his life, went to see a doctor over insomnia caused by temporary work-related stress. He was prescribed Citalopram, and within days he had taken his life.
As a consequence I learned of the suicide risk of antidepressants, particularly in the early weeks of uptake or if the dosage is changed up or down.
At the time, I was working as a crime recorder for one of the UK’s 54 Police Forces. Some time after my son’s death, I was asked to consider an incident involving a man who had left his marital home and was living temporarily with his parents. One evening, police officers responded to a call from a member of the public and found the man, who was very agitated, in a position of risk. The officers talked to the man, calmed him down, and returned him to his parents’ home. The following morning two officers from the next shift went to the house in response to a call from the parents: the man had hanged himself in his bedroom during the night. One of the attending officers recorded on the incident log the significant piece of information that the man had been prescribed Citalopram the previous week.
It was apparent that if the officers on the evening shift had been aware of the potential for harm in the man’s medication, they would have been in a position to offer positive support. He could have been informed that his agitated condition potentially had its source in adverse reaction to his prescribed medicine, which could be addressed with proper medical attention. Tragedy could well have been averted. The outcome could have been so different for all concerned, including the police officers who attended. Increased recognition of this risk could only be of benefit.
I decided to approach a senior officer to discuss a strategy to improve awareness of the irrational behaviour that can result from taking antidepressants, particularly in the early stages, or when the dosage is altered.
The officer remarked that he had seen several similar incidents of “out of the blue” suicides, as well as other irrational behaviour such as out-of-character domestic violence, involving Citalopram and other antidepressants. He asked if I would be prepared to give a series of briefings to groups of call-takers. These briefings were to be followed by talking to officers on training days. I did manage a few sessions with call-takers in the following weeks, but new procedures meant that I never got to talk to police officers as intended. Instead I was interviewed for the force’s in-house newspaper.
What I wanted to do next was to raise awareness in the other Police Forces. With this in mind, I wrote individually to each Chief Constable, asking them to provide me with a contact to whom I could send an article for distribution by email to all call-takers and front-line officers. The article concluded in this way:
The police are in a unique position to help. Front-line officers become involved in incidents of suicidal or irrational behaviour and are motivated purely by the need to keep the public safe.
Officers need to understand what these drugs can do to someone. They need to find out whether the person threatening to harm themselves (or others) is on medication, and if they know what it is they have taken. They can then at least try to convince the person that it is the drug that is making them behave like this, that what they are doing is irrational, and that they don’t really have these feelings.
The Police can have an influence on antidepressant-related incidents at three stages:
- When the initial MFH (missing from home) or CFS (concern for safety) call is made, call-takers are already trained to ask if the person is acting out of character and if they are taking medication. Two more questions need to be asked: What are they taking? For how long have they been taking it? Anyone in their first few weeks on antidepressants could then automatically be deemed to be at risk, and a possible immediate response considered. If the person has been on medication for a longer time, ask if the dosage has been changed or stopped recently. The person would also be at risk in this case.
- Knowledge is power: officers, including trained negotiators, attending a person who has placed themselves in a position of risk, need to ask the same questions or use what call-takers have found out to persuade the person that it is the drugs that led them there, not their own character or situation.
- After a sudden death, officers are required to submit a form which provides part of the post-mortem report. They simply need to add any relevant information about antidepressants to this form so that the coroner becomes aware.
In all, 46 out of 54 forces (85%) requested this article. Among the replies I received were a few asking if I had any materials which could be used for training. I therefore put together a training pack, offering this to all the forces. Eventually, 41 forces (75%) requested the pack.
Recently, the Department of Health’s Suicide Prevention Strategy highlighted the number of suicides in custody. As a result, I re-contacted the Police Forces, and suggested that training could be extended to custody staff.
I have since retired from my job with the police. I have no idea how many police officers, call-takers or custody staff have read my article, or have received training, after my input. However, from the feedback I have received, I know that at least a few forces have adopted my materials and, in some cases, have amended their procedures.
I hope I’ve made a difference.
Update 07/Feb/2013 Brian’s new website: AntiDepAware
- Triple Verdict following ‘Citalopram’ Inquest (leoniefennell.wordpress.com)
- Me a cynic? Absolutely! (leoniefennell.wordpress.com)