Antipsychotics Tied to Respiratory Failure in At-Risk Patients

Association Between Antipsychotic Agents and Risk of Acute Respiratory Failure in Patients With Chronic Obstructive Pulmonary Disease

Megan Brooks

January 12, 2017

Antipsychotics have been linked to respiratory failure in a dose-dependent manner among patients with chronic obstructive pulmonary disease (COPD), results of a large observational study show.

“Multiple cases about acute respiratory distress or acute respiratory failure [ARF] from the use of antipsychotics have been reported during the past decades. Nevertheless, no population-based studies have been conducted to examine this potential drug safety issue,” study investigator Meng-Ting Wang, PhD, of the National Defense Medical Center in Taipei, Taiwan, told Medscape Medical News.

“Clinicians should exercise caution when prescribing antipsychotics to patients with COPD and avoid high doses if possible,” the investigators write.

The study was published online January 4 in JAMA Psychiatry.

Dose-Dependent Relationship 

The researchers analyzed healthcare claims records in the Taiwan National Health Insurance Database and antipsychotic medication history for 5032 patients with COPD who developed incident and idiopathic ARF (excluding cardiogenic, traumatic, and septic causes).

Using a case-crossover study design, they compared antipsychotic use during the 2 weeks before the ARF event (case period) and an earlier control period 2 to 3 months before the ARF event.

A total of 590 (11.7%) patients with ARF filled at least one antipsychotic prescription during the case period, compared with 443 (8.8%) during the control period. This corresponds to a 1.66-fold (95% confidence interval [CI], 1.34 – 2.05; P < .001) adjusted increased risk for ARF, regardless of antipsychotic class and route of administration.

The risk for ARF with antipsychotic use was dose-dependent, increasing from a 1.52-fold risk for a low defined daily dose (DDD) of 0.25 or less to a 3.74-fold risk for a high DDD of 1 or more.

“Overall, this is the first population-based observational study that reports a dose-dependent acute effect of antipsychotic use on risk of ARF,” said Dr Wang.

The findings, he added, have important implications for the management of COPD patients.

“First, we urge healthcare professionals to be vigilant about the development of ARF in COPD patients receiving antipsychotic treatment, especially during the initial phase of treatment,” he said.

“Second, antipsychotic use in COPD patients needs to be justified, given we noticed a high proportion of off-label use in our population. Third, according to our dose analysis, high daily dose of antipsychotics with more than 1 DDD should be avoided, and the risk should not be overlooked even in patients at a dose as low as a quarter of 1 DDD,” Dr Wang added.

“Fourth, this novel finding of respiratory adverse events from antipsychotics should be considered when weighing benefits against risks of using antipsychotics in COPD patients, but patients are not suggested to discontinue antipsychotics without consulting their physicians. In addition, we advise COPD patients on antipsychotics not to neglect symptoms of breathing difficulty or respiratory abnormalities and should seek medical help as soon as possible,” he added.

Commenting on the findings for Medscape Medical News, Dr Janna Gordon-Elliott, psychiatrist at Weill Cornell Medicine and New York–Presbyterian Hospital in New York City, said the article is “notable because it highlights a risk with antipsychotics that I don’t think is high up on our radar. In reviewing the literature after reviewing this paper, I am struck by how little this risk is talked about,” said Dr Gordon-Elliott, who was not involved in the study.

“This correlational study doesn’t necessarily put the nail in the coffin and can’t prove causation, although they did a really nice job of controlling for a lot of factors, and with this large population sample, they do show that this is more than just a few case reports,” she added.

“What the paper doesn’t tell us is why these COPD patients were on antipsychotics, and that’s probably just beyond the scope of the paper. But antipsychotics are being used off label in a lot of patients, and this paper should really make us think twice about that in patients with lung disease,” Dr Gordon-Elliott said.

The study had no commercial funding. The authors have disclosed no relevant financial relationships.

JAMA Psychiatry. Published online January 4, 2017. Abstract

http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2595040

Amy – Zoloft Survivor

In 2004, I gave birth to my son, Isaac, on Thursday, July 8. I had significant stresses in my life for several years and especially in the months prior to the birth, but throughout it all I remained happy and healthy and calm and patient. One major stress was moving from Georgia to Minnesota when I was about 8 months pregnant. I loved Georgia but dreaded Minnesota, and was being forced to move for my husband Joel’s new job.

Though I had wanted to deliver naturally, I ended up having Pitocin, an epidural, an episiotomy, epinephrine (synthetic adrenaline), and a vacuum extraction. I also had oxygen therapy for most of the end of labor and delivery. (I recently learned that epinephrine leads to mental disturbances. Pitocin and epidurals can cause an abnormal fetal heart rate, and epidurals can cause respiratory issues.) The final contraction for the baby’s delivery had to be induced with an increase in Pitocin. I was so numb in my lower body I couldn’t even feel when I was supposed to be pushing. I had pushed for an hour and 15 minutes before the doctor grew impatient with me and decided to intervene. Nevertheless I was enamored with my new baby and motherhood and nursing.

The nurses were concerned about Isaac’s weight loss early on (I recently learned that the infant’s weight loss is excessive when you have an epidural, which involves a drug derived from cocaine, and babies exposed to IV fluids are more likely to lose a large amount of weight after birth and get jaundice & hypoglycemia). They had taken him to the nursery overnight twice and told me he could go several hours without eating, but then wondered why he was losing weight. They blamed it on my milk not coming in yet. They shoved us out of the hospital at 48 hours postpartum with some formula samples.

The next morning, when he was three days old, Isaac had to go to the ER. A nurse called me at 10 a.m. to ask me how many diapers Isaac had since we brought him home. When I told her he hadn’t had one in almost eight hours, she told me to take him to Children’s to check for dehydration and jaundice. The ER doctor at Children’s said he seemed fine but sent us home with a bottle of formula just in case we needed it. Back at home again, Joel fed it to him (it was way too much for a newborn), and Isaac threw it up projectile style. Then Isaac fell asleep. Later I noticed he looked a little blue on the skin around his mouth and on his hands and feet. I couldn’t wake him.

We called 911. The paramedics couldn’t find any reason for the overly lethargic baby, blue hands, feet and mouth, but recommended we take him back to Children’s.

A few minutes after we walked into the ER, Isaac nearly choked to death. The staff saved him and he was admitted over night. I was scared he might choke again during or following a feeding, or from getting a small object in his mouth. The doctors explained that Isaac would be just fine with eating, and that the 8 ounce bottle (which they had given us earlier) had just been too much for a newborn. Coincidentally, had it not been for the vacuum extraction, Isaac wouldn’t have had high hemoglobin that made him look like he was turning blue, the first signal to me that something was not right. When we returned home my anxiety worsened from somewhat normal to severe. I had a panic attack. I called my OB and he said I might be having a heart attack and need to go to the ER, or it could be a panic attack. I didn’t want to go to the hospital any more so I just tried to rest.

I felt somewhat better the next day but the home health nurse who came out to check on us advised me to start taking drugs for anxiety. She set up an appointment with my OB/GYN.

For days I refused to let others feed him a bottle unless I was there to watch or listen to make sure he didn’t choke. For the most part I was nursing, but occasionally I let someone feed him a bottle because of medical advice that I “get my rest, and let others take care of Isaac” while I took care of myself. But I could not sleep with others feeding him a bottle, and even when he wasn’t eating, I couldn’t sleep out of fear I was going to wake up to a dead baby. I slept a lot of the time with my hand draped into the bassinet on his tummy to feel it move up and down with each breath.

I walked into my OB’s office with my baby, on Wednesday one week after the birth. The nurse at the desk asked if I was here for my 6-week appointment. I said, no, the baby was only six days old. Then, with a look of horror, she said, “Oh, you must be having problems, then.” I nodded. The nurse let me in within a few minutes and took my blood pressure. It was like 149 over 120 or something, way higher than usual.

When I saw the doctor, I began to talk about the stress of the ER visits, the panic attack, my blood pressure, my inability to sleep, etc. He interrupted me after about one minute and said, “What did the nurse you saw at home yesterday tell you?” I replied that she said I had anxiety and needed drugs. He quickly recommended I start taking 50 mg of Zoloft and possibly up my dose. He said that Zoloft is the standard of care for post-partum depression. Then he said, “Or post-partum anxiety in your case, although people don’t recognize that as much as they do PPD.”

The sample package of Zoloft he gave me was labeled for use in PMDD. He said it would take six weeks to work and I might need to stay on it for six months to a year or longer. He said he felt we needed to be aggressive in treating this, and not to stop taking it once I felt better because it was probably going to get worse and maybe even dangerous if I didn’t take the drugs. There was no information label attached to the sample pack.

I asked about having my thyroid checked because my mother-in-law was worried that could be causing my problems. I had been on thyroid medication for years and never needed a dose adjustment, and my doctor knew this. He said that there are no valid post-partum thyroid levels and he didn’t want to test it.

I asked about Zoloft’s safety for nursing and the doctor said it would make my baby happy too. He also prescribed Clonipin in case of more panic attacks, but told me I needed to check with my son’s pediatrician before taking it (I never took the Clonipin because I didn’t have any more panic attacks). He started to leave and told me to call if I had any side effects that bothered me. I asked if I could take the Zoloft right away and if it would help my blood pressure, and he said to go ahead.

Within minutes on Zoloft I began to feel a little less anxious. We walked to Joel’s office (a few blocks) to show off the new baby. I even let some woman at the office hold him. I had a sense that my anxiety had been too strong and that Zoloft was going to make it better.

Within several hours I felt a bit detached from my new baby, my family, and even my own emotions. While earlier that day I was fearful and protective, with a strong need to have my baby in my arms at all times, yet extremely overjoyed with my baby and life all at the same time, within hours I felt like a different person.

Things gradually got worse and I struggled to feel the joy that was mine a few hours before. Sometimes I felt a bit giddy, but I didn’t feel really happy. I could laugh and make jokes and play with the baby, but it was temporary. I couldn’t feel the overwhelming love I had before I took Zoloft. I continued this way until the most unimaginable thing happened.

That Friday, sleep deprived, I sat next to my mom on the couch, trying to nurse a very sleepy baby in the middle of the night. I remember thinking I had lost my love and adoration for my baby because I was too tired to feel anything. I knew that I loved him but I couldn’t feel it the way I had a few days before. I couldn’t understand why I had to be the only one to stay up all the time and never sleep, and my baby, who needed to eat, couldn’t stay awake long enough to get much food.

As I gave up on the feeding and walked past the stairs to our bedroom to lay the baby in his bassinet, I hallucinated – I saw myself standing about half-way down the stairs, throwing the baby down.

I had no history of mental illness. Never could I have imagined I would think such a thought, let alone hallucinate killing my baby. I went to the kitchen with my mom after I put the baby down and started to cry and told her I was afraid I was going to lose my mind and hurt myself or hurt the baby. She said that wouldn’t happen. She hugged me and told me to get some sleep. Upstairs in bed, I still cried for a long time and then told Joel I was afraid I was going to lose it and that I couldn’t sleep. He told me to get some sleep. I can’t remember if I got any sleep that night.

The next morning Joel and I were holding the baby and watching movies in the living room. But I couldn’t stop being afraid. I was convinced that I was on the edge of losing my mind. I felt like I couldn’t hold the baby, and I asked Joel to hold him. He didn’t understand why. I said I couldn’t hold him, or carry him past the stairs in the state of mind I was in. Joel got really freaked out as I told him about what had happened; he said what I was telling him was disturbing. I just wanted help. I told him I didn’t know why it all happened but I was really scared and I was afraid to hold the baby. I just wanted him to take over and maybe calm me down. He suggested I go take a bath and relax. But I couldn’t do that because I was having thoughts of suicide. I was afraid if I went in the bathroom by myself I would certainly find a way to kill myself with a razor or pills. I was so scared I was going to hurt the baby that I wanted to protect him from me by killing myself. But at the same time I knew this was all crazy and I didn’t want to die. I didn’t want to hurt the baby.

We called the help line for our insurance and the nurse recommended I go to an ER right away. Joel asked what they could do for me at the ER and she said they would give me drugs to stop the thoughts and make me feel better.
This seemed to me like a reasonable thing.

At this point my son was nine days old. We went to the ER, where the doctors pretty much ignored me for a while, gave me some disgusting hospital food, and then came in to talk to me. The doctor nonchalantly told me I wasn’t evil and that I just wanted to kill myself because I was feeling guilty about having thoughts of hurting my baby. I asked how long the thoughts would continue and he said, maybe three weeks or even three months. This was unbearable to me. I already felt bad enough, and to imagine having thoughts of harming my baby for even three days, let alone weeks, was too much. I burst into tears for about the 5th time in the ER room. As I waited and waited for another visit from the next in the series of hospital employees, and I tried to sleep, I was so tired I almost instantly passed out, but only to a vision of myself drowning my baby in our bathtub. Every time I closed my eyes to rest I got frightened and opened my eyes again. I could not let myself fall asleep. I was afraid I was going to fall asleep, and my spirit and mind would die, and when I woke up, I would be someone else.

Then a woman came in with a computer and asked me a bunch of questions and entered in my responses. She tried to make Joel leave for the questioning but I wouldn’t allow it. Judging from a report I obtained months later, she distorted the information I was telling her, making things seem even worse than they already were.

Following her computerized “diagnostic” process, she recommended I be admitted to the psychiatric ward so I could “get someone to talk to and get some help.”

I asked if I could be admitted to a room in a non-psychiatric ward where I could have Joel and Isaac stay with me like they did in the maternity ward. She said no. I said that I didn’t want to be admitted if it meant I had to leave my family. She told me that I could go home after 12 hours if I wanted to, that the admission was voluntary unless a doctor decided to keep me there longer.
She had me sign some admission form and then the nurse walked me and Joel up to the psychiatric ward.

I had only to take one look at the inside before I knew I wanted to go home. I started crying to Joel to take me home, but he said he didn’t want to do that because I needed help, and he was afraid for me and the baby. The nurse told me that I should give it a try. But leaving wasn’t an option anyway since I had signed the admission form. Joel left to get me some things I would need and the nurse took me to a room where he asked me a few questions and had me sign some more forms.
He made me agree that I was willing to do anything to help my treatment. Then he took me to my room and left me there. I didn’t like my room, and there was a girl in there trying to sleep so I left and tried to find some place to sit. There weren’t many places to sit except the room, and there was a phone with a line of patients waiting for it, a few nasty, mismatched chairs, some broken shelves with old games, and a small dining area. I went to the nurses’ station and knocked on the glass and asked to talk to my nurse. I told him I wasn’t happy here and wanted to just go home and that I had changed my mind about the voluntary admission. He told me that the doctors would never let me leave this soon anyway and I should just wait for the doctor to see me and start getting my help. I asked when I could see the doctor and he said not until the next day, or maybe Monday.

I said I needed someone to talk to and he wasn’t being helpful and neither were the doctors. I asked how I could get released and he told me I had to sign an intent-to-leave form and wait 12 hours from that time and I could be released unless the doctor decided to place a hold on me for up to 72 hours. I filled out the form and awaited Joel’s arrival with my bag.

What had started out as a voluntary admission quickly became involuntary. Joel arrived and we waited for an answer from the nurse who was already in the process of checking on my release. Soon we were told that the doctor had placed a 72-hour hold on me but that it wouldn’t start until Monday morning (this was Saturday) when he could see me. We couldn’t understand why the doctor wouldn’t release me when he hadn’t met me or talked to me.

Joel stayed with me as long as he could but then left to go to our house and take care of Isaac (my mom had been taking care of him all day). Later that night the nurses came in to give me meds. They brought me my Synthroid, and several additional drugs- I think they were an anti-psychotic, a tranquilizer, and Ambien. But with these new meds came some information sheets. I quickly read the indications and the warnings, and refused to take them. Not only were they unsafe for nursing, they were indicated to treat “schizophrenia and other mental illnesses” and had many dangerous sounding side effects, such as nightmares, suicidal thoughts, etc. This was the first time I had seen a fact sheet like this, since my Zoloft samples from the OB/GYN three days earlier came with no fact sheet or warnings whatsoever. I also got a fact sheet for Zoloft for the first time.

All alone and with no one to talk to, there was nothing I could do but cry or sleep. I did a lot of crying and pumping of my milk for the baby, even one session in the middle of the night, but I also did a lot of sleeping.

The next morning, Sunday, I felt pretty good in comparison to the day before. I felt more rested than I had been since before my baby was born. And I didn’t feel as unstable or frightened as I had the day before. Since I had been taking Zoloft in the mornings, I hadn’t had a dose for over 24 hours. It occurred to me that perhaps Zoloft could be causing my problems.

I phoned Joel and said that I felt a lot better and wanted to talk to the doctor before taking any more Zoloft.

The nurses reported to the doctor that I was refusing to take my meds and the doctor did see me that day. He talked to me for no more than 10 minutes and told me to keep taking my Zoloft. I expressed concern about its side effects but he said to keep taking it anyway, that all my problems were not caused by Zoloft. It was clear the only reason he came to see me was so he could gather the required information for his background report. The only questions he asked me relating to a mental illness were whether I check the locks a lot and whether I have a family history of mental or emotional problems. I told him that I do check locks occasionally, but not repeatedly, but I have to check them because Joel forgets to lock the door (which he still does to this day). I told him that some members of my family had some emotional issues but not severe ones. I answered every biographical question honestly. I couldn’t really understand why it was important for him to know what clubs I was in during high school or whether I had a serious boyfriend as a teen. And why wasn’t he asking me about the events leading up to my prescription for Zoloft?

I tried to get something more from him and asked him if he thought I could have PTSD from witnessing my son nearly die in the ER from choking. But he said “I have no idea.” And he also said “Your son didn’t almost die.” (Later I learned from reading my file that the lady with the computer had written that I was obsessed about my baby and had imagined him turning blue and taken him to the ER twice where nothing was found to be wrong with him). Then when I expressed my desire to leave because I wasn’t getting counseling and I felt the environment was depressing and the nurses were rude and borderline verbally abusive to me and other patients, he said that was just my paranoia.

My mom, Joel, and Isaac came later that day for a visit. I explained what was going on, how I had been ridiculed for requesting sanitary pads after mine had been taken from my bathroom while I slept, and was treated rudely when I asked for access to my Tucks pads, a place to clean my episiotomy, and the chance to talk to the doctor before taking any more meds, and how I had been not allowed to sanitize my breast pump or get anyone to talk with me about my emotional problems. I explained that the doctor spent about seven minutes with me, left, and wanted to leave me there for an indefinite proportion of the maximum 72 hours from Monday.

Joel and mom could not believe the mistreatment and lack of treatment and threatened to call a lawyer or the press, because the doctor (who was on-call) refused to come up to the hospital or even talk to Joel on the phone that day. One of the nurses was in the room along with an OB/GYN consulting doctor as my mom explained several incidences of ridiculous behavior on the part of the staff. The psychiatric nurse and the OB were really shocked at all the staff had done to me.

That night as my family left, I felt my heart being ripped out again because of my desperate need to be with the people who loved me, and to be with my newborn son.

Monday the doctor requested a family meeting. He agreed to release me with several conditions- that I get psychiatric outpatient care, take parenting classes, stay on Zoloft, and get counseling. He said I had post-partum depression with psychotic features and left it up to my mom and husband to protect me and my son.

As I left the hospital, my mom called her friend who was a Ph.D. Clinical Psychologist. She put me on the phone. I told her my new “diagnosis” and she said I might need to try to get up to a more therapeutic dose of 150 mg, and that 50 mg is just a starting dose.

Over the course of a few weeks I sought counseling, psychiatric help, and adjusted my dose of Zoloft up. My mom tried to convince me that Zoloft was possibly the reason for my problems, but I didn’t listen to her. I listened to the doctors who said I was psychotic. But each time I adjusted my dose, the violent thoughts got worse. I was no longer having hallucinations but I was plagued by persistent “bad thoughts” and the feeling that I had little control over myself. I practiced “I’m in control” messages constantly and used a calming down technique that I learned in therapy. My therapist explained to me that I wasn’t like the moms who kill their babies because I wasn’t angry at the baby, I was just afraid I was going to hurt him, and that I always sought help when I felt overwhelmed, so I would be able to do it again if necessary. For months I worked on my goal of being able to take care of my son without supervision from my mom and Joel.

Most people believe co-sleeping is dangerous. I fully believed this at the time, and I feared rolling over on my son, even though my mother encouraged me to co-sleep and nurse exclusively (and even though I remembered sleeping with my own parents and siblings in our family bed). Psychiatrists told me I needed to let others care for Isaac at night and get at least 8 hours of sleep to stay healthy. Joel and my mom would feed Isaac at night while I slept. Joel started to get sleep deprived and my mom had to take over after he had a car accident. My mom would stay up much of the night with Isaac and then all day with me to keep me feeling safe, and when Joel got home from work she would go to bed to rest for her night duty. I had to set up safeguards for myself so I felt I would not leave the room and kill my baby in the night or kill myself while others were asleep. Eventually Isaac moved from our room to the guest room with my mom. She would bring him to me for feedings in the morning, and sit in the recliner and watch me feed him in bed. Throughout the day she was constantly watching me. If she left me alone with the baby for five minutes, I would freak out. Once she was taking a bath, and I yelled to her to hurry up because I was going to put Isaac in his crib and lock myself out of the house. Eventually, she would take her bath as soon as Joel got home, and then go to bed, to rest for her night duty.

My therapist suggested I add another bottle of formula to the regimen each day so I could get more time to myself. She thought I was having a hard time with motherhood because of the demands of breastfeeding. My psychiatrist increased my dose of Zoloft twice and I still didn’t get better – just worse each time the dose went up. She wanted to switch me to anti-psychotics and stop nursing to do this. I considered going along with it but decided against it because I didn’t want to lose time and progress by going through withdrawal and adjusting to new medications. I also did not want to completely stop nursing.

I began to reconsider everything. I started to nurse more. Finally one night when Isaac was about six weeks old I decided to take him to bed because I was more afraid of falling asleep and dropping him from the chair than I was of rolling on him in the bed. I discovered I could co-sleep and breastfeed simultaneously. Since then I get enough sleep, and so does my family.

Around the same time I had my 6-week checkup with my OB. By this time he was willing to test my thyroid. Two days after the appointment, I got a call from him reporting that I had hyperthyroidism and I needed to back off of my Synthroid and see an endocrinologist.
mood disorders Melanie Blocker Sto
I began to understand what was wrong with me. I knew that I could have breast-fed my baby just fine without nurses taking him and making him starve in the newborn nursery, without bottles of formula, and still get all my sleep as I was now getting through co-sleeping. And I also began to see the pattern that had emerged. Repeated interference from medical staff had resulted in a less-than-desirable labor & delivery, emergencies for my son, subsequent panic for me, Zoloft, and subsequent hospitalization. All the while this was aggravated by Synthroid on top of underlying, undetected hyperthyroidism.

My endocrinologist dismissed the notion that Zoloft could be a culprit in my psychosis. But she did attribute the symptoms to my post-partum thyroiditis and also probably thought I was a little bit nuts. She said had she seen me earlier, she could have helped me more by giving me beta blockers. I learned much later that beta blockers can also cause depression, so I’m actually thankful that my OB didn’t refer me earlier, as I may have had to deal with Zoloft and beta blockers at the same time!

Empowered by my new diagnosis and treatment, I began to feel healthier. But the thoughts never went away. I just felt better physically. It really bothered me that I couldn’t get these thoughts out of my head. Despite my growing ability to spend increasing amounts of time alone with my son, I didn’t feel right. I started believing that it was possible that Zoloft had planted some foreign thoughts in my mind.

I began to consider stopping Zoloft. Every doctor I was in contact with didn’t like that idea. Isaac’s pediatrician said that Zoloft just gives people enough energy to kill themselves. She didn’t touch the violence issue. The psychiatrist all but refused to give me withdrawal information until I called her and told her I had already started to cut back and wanted information on how to do so safely.

My mom was planning to go back to Texas, so I had to get better. I withdrew from Zoloft over a few weeks and started to feel more like myself again.

Since I stopped taking Zoloft, I feel normal. I take care of Isaac by myself and stay socially active. I never feel out of control like I did on Zoloft, but the memories of losing my grip on sanity will never go away. Never again will I subject myself to drugs to “heal” my mind.

I am looking forward to a long life. It is something that Zoloft tried to take away from me. But I beat it. I beat the thoughts, the urges, and I regained my hope. As a result of this ordeal I am more confident in my true self and my ability to get through the worst life can offer you.

Amy Philo
Zoloft Survivor

I can’t remember if I stated this before, however when certain comments were added to my most recent youtube video it made me wonder if I was very clear in telling this story of what happened to me. Yes, a lot of people have thyroid problems which lead to prescriptions for drugs. However I do not believe in the slightest that my thyroid had anything to do with the suicidal urges and homicidal urges.

I have since had a second baby. This time I had a home birth with a midwife attending. I did notice that I felt crummy and irritable if I did not eat enough or rest enough (I have since learned why this happens, you lose a ton of blood continuously and it gets worse if you don’t rest because your uterus is literally bleeding until it completely contracts and you stop having post-baby bleeding). Some of the worst advice I ever got in my life all compounded into one giant insurmountable confusion-fest which was only made worse by Zoloft, most of the bad advice started with my OBGYN’s statement to me that I was too fat and breastfeeding is a great time to lose weight / diet, but a lot of it coming from other sources as well. These included the advice to formula feed rather than telling me I could breastfeed while sleeping (if I hadn’t fed Isaac the bottle when he was 3 days old, he never would have nearly choked to death), the anti-cosleeping dogma that is prevalent in our society, and the blatant lies and omissions from psychiatrists and nurses who should have known or told me that there was a possibility that my really bad psychotic symptoms were drug-related.
The panic attack was absolutely legitimate, perhaps I would not have had it if my baby never almost died, or if I wasn’t rapidly coming down from the effects of labor drugs and pain meds. However a panic attack is not in any way similar to what Zoloft does.

Those who doubt that Zoloft can do this, I want you to go pick up a copy of David Healy’s Let Them Eat Prozac. In this book he outlines all the evidence that SSRIs induce violence and suicide. He states that a good example of proof is the dose-dependent relationship between suicidality and SSRIs. Also, a challenge, dechallenge, and rechallenge protocol has been used to demonstrate the effect.

David Healy is critical of SSRIs but he still prescribes them to some patients. If someone who is in one sense an advocate for the drugs can admit in a several hundred page book all the negative things about SSRIs then I do not understand why people insist on disbelieving that.

When I was on Zoloft there was clearly a dose dependent relationship between homicidal urges and Zoloft. Every time the dose went up, the thoughts got worse. I also had terrible withdrawal (not physical pain necessarily but definitely jitters) including worsening homicidal thoughts. At times I would think things like “If I just kill myself and the baby now, this hell will be over and I will never have to deal with this again.”

This is the type of hell that people somehow think is an acceptable side effect. The number of people suffering from this is not insignificant, and in fact at least 60% of patients discontinue SSRIs within a few weeks because they find it unacceptable. How many others are trapped into staying on them by bad advice and delusions given toa them by their doctors, or by insurmountable withdrawal syndrome?

Nothing of the sort of psychological torture I endured on Zoloft has visited me after my second baby. Doctors warned me to not have any more kids because there is supposedly a 90% chance that PPD will return. I am thankful that I did not listen to them, and it saddens me to think of all the babies like Toby who never got to be born because of poisonous lies from the pharma dogma. It’s almost like a form of population control / eugenics!!!!!!

By the way, Isaac is now 3.5 and Toby is 15 months…

Here is mine

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