PROZAC: Worsening Depression & Panic Attacks: England

Paragraph twelve reads: “The next day was a Friday and I started taking
the Prozac extremely reluctantly. The side effects listed on the pack
included headaches, dizziness, diarrhoea, nausea, vomiting, abdominal pains, dry
mouth, loss of appetite, anxiety, sleeplessness, nervousness. If I am
anxious now, I thought, how anxious will I be on Prozac? If I wake at four each
morning now, and toss and turn for many of the hours that follow, will I get
any sleep on Prozac?”

Paragraph fourteen reads: “By Monday I could not move. I felt sick, heavy
as a rock, everything ached, and my head swam. I had the pains and sort of
breathlessness associated with heart attacks and I was, of course, crying.
I rang work to say I had some sort of bug and that I hoped to be right the
next day. Speaking was an effort. It was hard convincing myself that the
advantages to leaving the house and seeing the doctor outweighed those of
staying inside where I wanted, desperately, to be, but I knew I needed to
seek advice. Dr Fahey offered, again, to sign me off work; my response, again,
was an adamant no. I was going into work as soon as I could.”

Paragraph 20 reads: “After the second visit to Dr Fahey everything
changed. She made me realise that whatever self-deceptions I had entered into,
the reality was that I had not been into work for several days, nor was I
currently fit to go in. She signed me off for two weeks and gave me
tranquillisers to moderate the increasingly severe panic attacks. She advised me
strongly to leave London. The idea of being on my own without work for two weeks
was unthinkable, unbearable. Amanda was off to visit our parents in the
country and taking the children with her. My brother-in-law Neil was staying
at home an extra night then would join her there. Amanda’s suggestion was
that I drive to be with Neil and then the following day he would drive us
both to Suffolk to be with the whole family.”

http://www.guardian.co.uk/lifeandstyle/2010/apr/18/depression-and-recovery-c
amilla-nicholls

Woman on the verge
She was a media executive at the top of her game. But a debilitating
midlife crisis forced Camilla Nicholls to hit rock bottom. In a searingly honest
account, she details her nervous breakdown – and her tentative steps back
to recovery

It all started slipping away from me in July 2000. Depression had been
part of my life for a long time, but that summer it ceased to be under
control. It was shortly after a married friend’s party that I had the first
significant “What is the point?” conversation.

Every guest had brought with them a child, or a swelling stomach. Hardly a
conversation was had at head height; we were all dipping and bending or
squatting to catch half a sentence with someone too heavy to stand for long.
There was no chance of eating as little hands pawed at the snacks, and
pregnant women, picking through the non-pasteurised, took precedence around the
table. Sentences were left hanging in the air as parents attended to
toddlers’ or babies’ urgent needs.

My friends will bear testimony that I am very fond of children. But I was
bitter because, aged 39, I had no partner, no prospect of a partner and,
more significantly, no prospect of motherhood. Maybe the party felt harder to
cope with that day because my hopes had just taken a severe knock. I had
been told by an unsentimental doctor’s receptionist that I was
peri-menopausal (ie approaching the menopause) and the possibility of my bearing
children was lodged somewhere between zero and infinitesimal.

The “what is the point?” conversation is the one for friends and family to
look out for as a first clue to depression. This is not the “what is the
point?” response of a child to doing homework or cleaning a bedroom; it is,
rather, “what is the point of my being alive?” For depressives the feeling
is often heightened when the reasons for depression are not obvious to
themselves or, more importantly, to others. This leads to the cajoling (or
worse, hectoring) question: “What have you got to be depressed about – you have
a great job/partner/house/body?”

I come from a small, loving, middle-class family. I was not brought up to
follow a particular religion, although as a child my grandmothers took me,
and my only sister Amanda, to Sunday services at the local church in the
Surrey town where we spent all our youth. What my parents did adhere to with
near religious fervour was the observation of good manners. A framework of
politeness in all situations was my firmest mould. Now, grown up,
approaching a milestone of middle age, it was safe to say on paper I had more than
most: a well-paid, challenging job in the media, to which I was virtually
married, a lovely house without an enormous mortgage, often exciting
relationships, great friends and I remained close to my stable family. And yet by
August 2000 my predominant talent was for crying.

I wish when I had first asked “What is the point?” I had been advised to
seek medical help urgently. I was talking to my friend Amy, who was no
stranger to depression herself, so I may have acted had she done so. Instead,
Amy told me a story of finding love herself, unexpectedly, and how it could
happen to me. She may even have taken the phrase “You often find someone
when you are not looking” for another turn. What I do vividly remember is
putting my feet up against the cool marble side of my fireplace, saying “I just
cannot see the point any more”, and crying.

A strong feeling of sadness about my childlessness had persuaded me to
seek the help of a psychotherapist, Judy, in the autumn of 1999 and I had been
visiting her regularly since. Judy, like the majority of therapists, took
the month of August as holiday, leaving me and a whole host of other therapy
regulars in a limbo land of summer anxiety. I looked to herbal drugs – St
John’s wort and others – to boost my spirits and, as ever, I threw myself
into the full responsibilities of my job.

What I was far from realising was that none of these tactics were enough.
Therapy alone cannot conquer a depressive illness, and neither can herbal
drugs. Making work the focus of your life is certainly not the answer. I
felt under-appreciated in my job, believed that my contribution counted for
nothing. I felt my body had let me down, and that I was useless physically as
well as professionally. The feeling was exacerbated when the last person
with whom I had had a physical relationship (and with whom I was still
involved) took up with someone more than 10 years younger. I found out,
painfully, through a third party. This was when my emotional strength started to
give out.

The crying got worse. At work, tears would inconveniently start to fall
down my face in the middle of writing an email or at the point of making a
phone call. In the past many had taken refuge in my office seeking privacy, a
shoulder, advice, a place to scream, and now the adjustable blinds became
an essential masking tool for my own distress. I frequently took time out to
weep in a neighbouring colleague’s office. She began to beg me to seek
help, but because I was in professional mode, I assured her I was really
working hard in therapy and a day didn’t go by without my taking the St John’s
wort. All would be fine.

Finally, I began to realise that taking pride in hiding the fact that I
was on the emotional skids was not a good end in itself. I rang my GP, Dr
Fahey, a plain-speaking, wise Irish woman. I was brave, then sniffled, then
howled, and she said there would be a prescription for me at the surgery that
night for Prozac. She assured me I could ring if I felt I needed to talk
before our appointment in a week’s time, and then she asked if I wanted time
off work. My response was an emphatic no. “I have to keep going into work.
Work is what I do.”

The next day was a Friday and I started taking the Prozac extremely
reluctantly. The side effects listed on the pack included headaches, dizziness,
diarrhoea, nausea, vomiting, abdominal pains, dry mouth, loss of appetite,
anxiety, sleeplessness, nervousness. If I am anxious now, I thought, how
anxious will I be on Prozac? If I wake at four each morning now, and toss and
turn for many of the hours that follow, will I get any sleep on Prozac?

The first night, I was lucky – friends invited me to stay, friends who
understood. But on Saturday, as I prepared to leave, I began to sink at the
thought of being alone. My friend was pregnant and to make more demands on
her and her partner felt wrong. We stood on her doorstep and she held me
close, hugging me and asking if I would be OK. “Yes,” I lied, then, more
truthfully: “I have to be.” But I cried all weekend.

By Monday I could not move. I felt sick, heavy as a rock, everything
ached, and my head swam. I had the pains and sort of breathlessness associated
with heart attacks and I was, of course, crying. I rang work to say I had
some sort of bug and that I hoped to be right the next day. Speaking was an
effort. It was hard convincing myself that the advantages to leaving the
house and seeing the doctor outweighed those of staying inside where I wanted,
desperately, to be, but I knew I needed to seek advice. Dr Fahey offered,
again, to sign me off work; my response, again, was an adamant no. I was
going into work as soon as I could.

Everyone has different experiences of how they interact with family while
in the grip of a depressive illness: some gain no support, some seek no
support, some have in mind that individual members of their family are largely
or totally responsible for their illness. Despite our lifestyles being
completely different, my sister, Amanda, was the one I could turn to at any
time.

I was struck by an inability to talk to my parents. I simply could not
pick up the phone, or see them. I keenly felt the weight of their love, and
therefore the weight of their disappointment that I was childless,
partnerless. I saw my own confusion and grief reflected back at me. Eventually I
began emailing them messages telling them a little – oh, such a little – of
what I was experiencing. I am sure it was partly a result of the good manners
they themselves had instilled in me that I made this faint but direct
contact. My preferred position was really to remain silent. What child wants to
tell the parents that gave them life that they want it ended?

By the time I returned to Dr Fahey three days later Amanda knew that
something was really wrong. I had told her that I found eating difficult and
that I was afraid to leave the house. I was ringing work each day to say I
still had not improved enough to go in. Mornings are the worst time for
depression and I was piling on the agony by setting myself the unrealistic target
of going to work and then feeling a failure when I was unable to meet it.
Dr Fahey advised that I cancel the regular appointment with Judy, my
therapist, for that week. At first I suspected professional competitiveness
(“I’ll save you” – “No, I’ll save you!”), but she was trying to prevent any
further introspection on my part. I could not see how I was going to get the
few miles across north London that the visit required anyway.

So for three days my sister and Judy coaxed me, by telephone, out of the
house. A 20-yard trip to the newsagent was fine, a trip to M&S was less
successful. I made it to the shop, but halfway round I froze. All that food,
all those people. I loaded up a basket then had to leave it mid-store and
struggle out of the shop to lean against the wall and gasp. I clutched at my
chest, I thought something might rupture.

All this time I kept thinking I would be back at work any minute. That I
had to be back at work. It was essential that people did not know there was
anything wrong. And, really, there was not anything wrong. I was barely
eating, I could barely leave the house, but I was surely fit for work. Surely.

After the second visit to Dr Fahey everything changed. She made me realise
that whatever self-deceptions I had entered into, the reality was that I
had not been into work for several days, nor was I currently fit to go in.
She signed me off for two weeks and gave me tranquillisers to moderate the
increasingly severe panic attacks. She advised me strongly to leave London.
The idea of being on my own without work for two weeks was unthinkable,
unbearable. Amanda was off to visit our parents in the country and taking the
children with her. My brother-in-law Neil was staying at home an extra
night then would join her there. Amanda’s suggestion was that I drive to be
with Neil and then the following day he would drive us both to Suffolk to be
with the whole family.

At their house that evening I crept into my nephew’s room, in his narrow
bunk bed and under his Star Wars duvet. I gasped and sweated through the
night. In the morning, Neil appeared with some tea and suggested we have
breakfast. Fine, I said, yes. Then I realised I might split in two if he left
the room. I gestured that I could do with a hug – and then I started the real
drop to the bottom. It was as if my chest was going to be rent in two.

As Neil pulled gently away I kept up appearances and said I would be down
for breakfast in a minute. I got as far as the bottom of the stairs and
realised I could not breathe, was going to faint, and sat there bleating for
Neil like some injured animal. You need to eat, he asserted. You need some
sugar, something. It had been so long since I had eaten properly my throat
was constricted; my head, heart, lungs felt squeezed. And the panic was
rising: what if I never eat again? What if I have to stay in this state? What
if? What if? I began to hyperventilate. Neil collected me up and calmly set
me on the sofa. He found some dextrose tablets and crammed them into my
mouth, he lifted my feet above my head and he repeated over and over again that
this was the worst, it would get better. But when I could speak I just
begged him tearfully to ring my doctor, to get me to hospital, to put me out
of my misery. To stop everything, to make it stop.

When Neil felt the panic attack had subsided enough he did go to the
phone. He did not ring my doctor, nor the hospital, but Amanda, who got in the
car and came back to be with me. In the following days I frequently asked if
I could be taken to hospital. I wanted, demanded, a lobotomy. I wanted
something to stop the pain, the panic, the screaming, the crying, the
darkness. I wanted some peace.

Amanda and Neil withstood my pleas and I am glad they did. I am not sure I
would have survived hospital. And I could not give up with my niece,
Jessica, and her brother, Alexander, around. “What is actually wrong with you?”
12-year-old Alexander asked repeatedly in the first few days, until my
sister took him to one side and gave him an explanation in her determined and
straightforward way. I was relieved. I did not know how to answer him, I did
not want to scare him and I did not want to lie. But apart from this one
small challenge the children were nothing but help to me. They would appear
in the morning and scramble on or into my bed and tell me what lay ahead
for them that day. And when there is someone so trusting asking you questions
as if your opinion still mattered and telling you stories as if it was
still important to impress you it is hard to plot and plan death, or much
harder anyway.

Amanda brought me breakfast in bed before she left for her teaching job.
Breakfast was a small glass of orange juice placed in the centre of a plate
with toast fingers arranged around the glass to look like a flower or a sun
– something hopeful. I did not feel worthy of such treatment and it would
make me cry. Neil worked from home so I was never alone, and Amanda would
ring me when she got to work, in her break and at lunchtime.

If my illness put a strain on Amanda and Neil’s marriage or their family
life as a whole they did not say. To help the days pass I did my best to
read carefully selected books – nothing with relationships in, nothing about
family love. I met Neil for lunch in the kitchen. I had become, as my mother
was to remark unforgettably, “a vegetable”. Most evenings were spent
inert, watching the family life go on around me. I listened to the children’s
music practice and I made occasional attempts to help with homework. I should
have known that a night of fractions with Jessica was unlikely to be good
for either of us. I had to leave her with her homework book pages rubbed raw
and almost transparent to howl in the bathroom. She clearly felt this was
a topsy-turvy world of role reversal. Wasn’t the child supposed to be in
tears of frustration not the adult?

While the family watched TV I tended to lie behind it as it continued to
induce a state of panic. I tried to hold on to vestiges of my own lifestyle.
Neil recorded The Sopranos for me, but I managed no more than a few
minutes. It did not induce panic, but anguish. Mine was no longer the life of a
sharp, media-savvy woman with sophisticated tastes – after all Amanda had to
gently chivvy me to wash my hair. I found that Alan Titchmarsh and other
toilers on the land and in the kitchen posed no threat. Being so far removed
from my former life made them oddly bearable to view.

Outside scared me. I felt flimsy and exposed. I did not want to be seen or
heard. When Amanda was home I followed her round like a shadow, always
keen to be in the same room, always keen to be held. I ate a little more food
and gained some substance, I had a few more hours’ sleep a night. Armed
with a mobile phone and a huge send off from Neil one day I left the house to
buy a paper. It is several hundred yards to the paper shop from their home,
but it felt like a major adventure, and as I paid for the paper I felt a
surge of spirit, a lightheartedness I had not experienced for some time.

And then my mobile rang. It was one of my friends, and I was able to share
my achievement with her: I had made it to the paper shop on my own. She
was so delighted she asked if I had planted a flag there. It was great. But
the next day I wept over our celebration. How pathetic. I was a 39-year-old
woman, a senior executive at a national newspaper, someone who at the
office made hundreds of decisions a day, a woman with a reputation for being
scary, and the biggest achievement of that week was leaving the house and
handing over loose change to buy the newspaper for which I was still officially
the spokesperson.

When the next visit to Dr Fahey loomed I decided I should venture back to
London a day or so earlier, the logic being that if I could not be on my
own in the house then I should not be going back to work. And going back to
work was my goal, and what I expected my doctor to be helping me to do. It
was a disaster. The appetite which had been coaxed into some sort of life in
the bosom of my sister’s family disappeared. There was no room in the
house that I could settle in. I could not sleep. I used the time to make my
will to plan which friends of mine struggling with infertility I would endow
with financial gifts when I was gone.

Dr Fahey was prepared to give me a very, very limited supply of sleeping
tablets but “not enough to kill yourself with”. I think I smiled at that.
“Do you ever think of killing yourself?” she asked quickly. “I rarely think
of anything else,” was my response. “And how would you feel about seeing a
psychiatrist?” Fine, I said, fine. They would make a home visit. Fine. On
returning home I panicked. Was I going to be sectioned?

I immediately rang my friend Roger who had had a hand in sectioning
someone in the past. His advice was that it takes two to section. If I saw two
through the fish-eye in the door then I should not let them in.

A short time later my doctor rang and told me that there would probably be
two people who would visit me, a psychiatrist and a psychoanalyst. Two? I
started to shake. “Will they take me anywhere?” I asked coyly. “I do not
know,” my doctor replied. “Only if they think it is necessary.” As soon as I
put down the receiver there was an incoming call from Siobhain, a lawyer as
well as a friend, who, alerted by Roger, was offering to come and be in
loco parentis to prevent a sectioning. And then Martin, the psychiatrist,
rang. “I will be with you in half an hour.”

Perhaps I could convince them that I was not mad. The lethargy which
almost permanently overwhelmed me was temporarily thrown off as I set about
making my house look sane. I made piles of paper, I cleaned the tea mugs, I
folded the rug under which I spent most time. Then I had an inspiration.
Recycling. If I put some paper in the recycling bin it would look as if I was
investing in the future.

When Martin arrived on the doorstep he appeared to be on his own. I made
tea for us in a scene straight from a badly acted kitchen drama; the spoons
and china clattered as I tried, unsuccessfully, to keep the shaking under
control. We sat in my living room. I questioned him. “Are you really on your
own?” and “Are you going to take me anywhere?” He stated reassuringly that
there was no one waiting outside.

Things got better after that. He gave a name to what I was suffering – a
serious depressive illness – which at its worst was a killer. He identified
a singular problem and spoke it out loud. “So you feel you are incapable of
doing anything, of being good at your job, of holding down a relationship,
of being a mother, and now you cannot even kill yourself, is that right?”
So right, so right, I could not speak. This was a jam I could not see my
way out of – and I was not at all sure that Martin, or any other well meaning
person, could help me out of it either.

It was months into my illness before any of the professionals ventured to
use the term breakdown. It was several more before I learnt that this was
not a cause to feel ashamed.

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Running Away from Wellbutrin

I regret ever taking one pill of Wellbutrin.”

 

At first, I noticed the nervousness, where I would expect anything to startle me at every moment. When that passed, I was alright for several months.

My grades did not improve, and my friends started to notice my withdrawal from my usual outgoing self. I was becoming more introverted. When I actually became aware of the changes in the way my brain would function, I stopped taking the medication, and did not reveal this information to anyone. Since it is an accumulative medicine, which I was told I would only have to take until the age of 25, I just would hope and still do hope that it would just wear off eventually, and that the normal connections of mood generating neurons would be naturally restored.

To be more descriptive of my individual side-effects, I was feeling everything that I was prior to the medication, but at half the impact. For instance, my personal life with girlfriends and whatnot suffered drastically. I was unable to feel the compassion and love for them as I once did, and it had absolutely nothing to do with anything going wrong in the relationships. It’s with anything. I’ve become rather sullen – constantly, and uncontrollably melancholy at all times.

Every few months, for about one or two hours, I will all of a sudden feel all sorts of old feelings that I haven’t experienced years, or since before I began taking the medication. It comes with no warning or trigger, and fades in a similar fashion. These bursts only happen every few months, and never for more than about two hours at a time. I was so convinced of the negative effects the medication had taken on not only my thought processes, but my ability to feel emotion, that I ran away from home for good.

I wasn’t allowed to live with my mother unless I was taking Wellbutrin, and I am glad that I did what I had to, because I don’t even want to think about how much worse it could’ve been if I had continued on this medication. I don’t know exactly what happened to my brain, but I do know very well that I regret ever taking one pill of Wellbutrin. Maybe it works for some people, but I’m forced to believe that it prevents the brain from producing more effective healing chemicals that can do more than this synthetic misery pill that some parents are so unaware and uneducated of, and to which they will so readily approve their children to be prescribed such a horrible drug. like a lamb to the slaughter.

I’m sorry for my harshness, but I am strongly against all brain altering drugs. “If it ain’t broke, don’t fix it.”

Seordin Anemeros
anemeros@yahoo.com

 

9/5/2002

This is Survivor Story number 12.
Total number of stories in current database is 48

Running Away from Wellbutrin

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4/23/2001 – Matt Miller's Zoloft tragedy featured in UK article

When Depression Turns Deadly:
Can Antidepressants Transform Despair into Suicide?

ANNE McILROY
THE GLOBE AND MAIL
Saturday, April 21, 2001

www.globeandmail.com

When Matt Miller’s family moved to a bigger house in a new neighbourhood in
Kansas City, Mo., the athletic 13-year-old with thick blond hair found that
he couldn’t penetrate the cliques at his new school. He was a nobody, an
outsider.

“He was angry at us, he was angry at the school, his grades suffered. He
wasn’t himself,” said his father, Mark Miller.

The boy’s teachers recommended that he see a psychiatrist, who prescribed
Zoloft, an antidepressant in the same chemical family as Prozac.
The doctor said it would help Matt’s mood, make him feel better about
himself. The boy started taking the pills and seemed to be in good spirits
for a few days.

But then he began showing signs of intense nervousness and agitation. He
couldn’t sit still, his father remembers. He kept kicking people under the
table. His eyes were sunken and he couldn’t sleep, yet he had a restless
energy.

After six days on the drug, on July 28, 1997, Matt hanged himself in his
bedroom closet.

“Suicide always takes you by surprise, but no one could have imagined that
Matt would have done that,” Miller said in an interview. “There was no
previous attempt, no serious threat of it, no note, no premeditation.
“It was a very impulsive act I am convinced was brought about by the
stimulant nature of the drug.”

Miller has launched a lawsuit against Pfizer Inc., which makes Zoloft. He is
one of about 200 people who have sued — so far unsuccessfully — the makers
of Prozac and similar products. The plaintiffs contend that the drugs, known
as selective serotonin reuptake inhibitors, caused their loved ones to kill
themselves and, in some cases, hurt or kill others as well.
One of the few cases to go to trial so far was that of William Forsyth, a
63-year-old wealthy Hawaii businessman who stabbed to death his wife of 37
years and then killed himself in 1993. At the time, he had been taking
Prozac for 11 days for panic attacks.

In 1999, a jury in the civil lawsuit cleared Prozac of liability in the
deaths. Forsyth’s adult children began another suit last year accusing Eli
Lilly and Co., the maker of the drug, of covering up damaging details about
the antidepressant.

Chief among the scientific experts who have given people, including Miller
and Forsyth’s children, reason to believe that a link may exist between
antidepressants and suicide is Dr. David Healy, whom Miller has engaged as
an expert witness in his suit.

Healy is a well-known British psychiatrist who argues that Prozac and
similar drugs may trigger suicide in some patients, and that there should be
warning labels on the products.

To Miller, Healy is a hero, a crusading scientist with the guts and
credibility to challenge the powerful, multinational drug companies in an
era in which many researchers and institutions depend on them for funding.
But discussing the down side of Prozac does not appear to have been a good
career move. Healy’s blunt expression of his views may have cost him a job
at the Centre for Addiction and Mental Health, a teaching hospital
associated with the University of Toronto. The centre had been recruiting
him for months, but last year rescinded his written job offer after he gave
a speech warning that Prozac may trigger suicide in some patients.

Eli Lilly Canada Inc. is a major corporate donor to the centre, but
university and hospital officials say their decision had nothing to do with
wanting to please the drug company or to avoid damaging future fundraising
efforts. They say their reasons are confidential.
Healy says the only explanation he was offered was that his lecture
“solidified” the view that he was not a good fit.

For Eli Lilly’s part, it points out that a U.S. Food and Drug Administration
panel of experts voted six to three against requiring Prozac to carry a
suicide-risk warning label. In September of 1991, the FDA concluded that
there was no credible evidence of a causal link between the use of
antidepressant drugs, including Prozac, and suicides or violent behaviour.
And a paper published in March of 1991 by Jerrold Rosenbaum of Massachusetts
General Hospital found that patients on Prozac were not prone to suicide any
more than patients on other medication.

Eli Lilly said, in a written response to questions from The Globe and Mail:
“There is, to the contrary, published scientific evidence showing that
Prozac and medicines like it actually protect against such behaviour —
reducing aggressive and suicidal thoughts and behaviour.”

When Prozac was introduced in the late 1980s, it was billed as a wonder drug
that could combat depression with far fewer risks than previous medications,
including the danger of an overdose or problems when mixed with alcohol.
Prozac and drugs like it — Zoloft, Paxil and Luvox — were said to help
with emotional limitations such as low self-esteem and fear of rejection.
Prozac was a commercial as well as a medical miracle, sold to an estimated
40 million people worldwide since it hit the market.

The drug boosts levels of the neurotransmitter serotonin, which seems to
improve the mood of patients. But within a few years of Prozac’s launch came
hints that it brought out a dark side in a small fraction of users.
Martin Teicher, a researcher at Harvard University, published an article in
the American Journal of Psychiatry in 1990 that discussed six cases in which
patients became intensely preoccupied with suicide after taking the drug.
Other scientists also found a potential link between Prozac and suicide.

Healy says in one of his published papers that Eli Lilly scientists
collaborated with the FDA on designing an experiment that would measure how
serious the problem was, but they then decided against conducting it.
Instead, in 1991, Eli Lilly published an analysis of data taken from
existing trials. Its conclusion? There was no increase of suicidal thoughts
or suicide among depressed patients taking Prozac.

But Healy says in the paper that data from only about one-eighth of the
patients in the clinical trials were included. No mention was made that some
had been prescribed a sedative that may have alleviated an intense nervous
state that can lead to suicide, which is called akathisia, he says.
The analysis also did not point out that 5 per cent of patients dropped out
of the studies because they were anxious and agitated and may have been
suffering from akathisia, Healy says.

Another document, dated Nov. 13, 1990, shows that company scientists were
pressured by executives to soften physicians’ reports of suicidal thoughts
or suicide attempts, according to Harvard psychiatrist Joseph Glenmullen,
who obtained the document and is author of the book Prozac Backlash.
Additional evidence about the potential risks can be found in the patent for
a second-generation Prozac pill, which Eli Lilly has licensed. The patent
says the new and improved Prozac would decrease side effects including:
“nervousness, anxiety, and insomnia,” as well as “inner restlessness
(akathisia), suicidal thoughts and self-mutilation.”

But at the same time, Eli Lilly says these symptoms are not associated in
any significant way with taking the current version of Prozac.
The new Prozac — which incidentally was co-developed by Teicher, one of the
drug’s early critics — isn’t yet on the market, Last year, Healy published a
study in the journal Primary Care Psychiatry that said two of 20 healthy
volunteers taking an antidepressant in the same family as Prozac reported
feeling suicidal.

But by his calculations, probably 40,000 people have committed suicide while
on Prozac since its launch, above and beyond the number who would have taken
their own lives if their condition had been left untreated.

The German government now requires warning labels, and Britain is
considering them. Canada and the United States do not.
Healy says he is not opposed to Prozac and thinks that it can do a lot of
good. But he says it is unethical and irresponsible not to warn doctors
about the potential dangers, and believes Eli Lilly chose not to do so to
maximize profits.

He says family doctors seem to be increasingly prescribing Prozac and other
antidepressants to children and now to women complaining of severe
premenstrual symptoms, yet patients in North America do not have to be told
about the potential risks.

Eli Lilly and the other drug companies argue that depression, not
antidepressants, are to blame for suicides. Pfizer is trying to have Healy
barred from testifying in the Miller case, questioning his credibility as an
expert witness.

So what are Canadian consumers to think? Jacques Bradwejn, chairman of the
psychiatry department at the University of Ottawa, says he has reviewed the
literature and agrees with the FDA and Eli Lilly that there is no evidence
that Prozac and similar drugs cause more suicides than would have occurred
if patients had not been treated.

But a small number of patients — even as many as 1 per cent — may fall
into a nervous state that could trigger suicide, he said, adding that more
research is needed to better understand the problem.

While Prozac may be overprescribed for patients who are not truly ill,
Bradwejn worries that the message that the Prozac is dangerous will do more
harm than good for those who are moderately to severely depressed.
“If the message is too alarmist, it could have a very negative effect on
Canadians.”

DEPTHS OF DESPAIR

A study by Dr. David Healy found that two of 20 healthy volunteers taking a
selective serotonin reuptake inhibitor in the same family as Prozac reported
suicidal feelings. This is the story of one of those people, a 30-year-old
woman who didn’t know what drug she was taking, as recorded in the study.
“On the Friday she telephoned early in the morning, distressed and tearful
from the previous night. Her conversation was garbled. She described almost
going out and killing herself. . .

“The night previously she had felt complete blackness all around her. . . .
She felt hopeless and alone. It seemed that all she could do was to follow a
thought that had been planted in her brain by some alien force.
“She suddenly decided she should go and throw herself in front of a car,
that this was the only answer. It was as if there was nothing out there
apart from the car. . . . She didn’t think of her partner or child. She was
walking out the door when the phone went. This stopped the tunnel of
suicidal ideation.

“She later became distraught at what she had nearly done and guilty that she
had not thought of her family.”

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