Anti-depressants prescription to suicide
by Angela Bischoff
I’m a suicide survivor. My soulmate of 17 years, Tooker Gomberg,
committed suicide March 3, 2004. I lost my best friend and the world
lost a warrior.
The pain around suicide is unfathomable and indescribable for those
left behind, but especially for the person driven to take his/her
life. Unless you’ve been there, you just can’t know this darkest
torture of the soul. I saw Tooker’s anguish, one so deep and riveting
that he saw no choice but to end the suffering through death.
What could possibly have driven him to such despair?
The world lost a warrior Tooker Gomberg, internationally renowned for
his environmental, peace and justice activism, gave up the ghost at
age 48. We had an excellent relationship. He had skills and friends.
He was kind, humorous, courageous, a fighter, a leader, and he had
fame and respect around the world. What went wrong?
His first depression hit in 2001 and continued into 2002, following
the Quebec City free trade protests, police clampdown and horrific
mass tear gas poisoning. Tooker was discouraged and exhausted and his
depression zapped the spark out of him for nine months. He tried many
holistic alternatives to pharmaceutical drugs before turning to an
SSRI antidepressant. Nothing seemed to help but, in time, he climbed
out of his despair.
When his second depression hit a year later, unemployed after moving
to a new city, he sought help through counselling and pharmaceutical
drugs, as this was the only option our health care system would pay
for. Psychiatrists and their drugs are covered, but naturopathic
doctors and their medicines are not, nor are cognitive behavioural
therapists, massage therapists or other helpful treatments.
When Tooker’s psychiatrist prescribed the antidepressant Remeron, his
anxiety and agitation went through the roof – clearly an adverse
reaction. However, his psychiatrist didn’t see it as such and instead,
encouraged him to stick with the drug, repeatedly increasing the
dosages to the maximum. Then he prescribed a tranquilizer to counter
the agitation. After just five weeks on the drug, Tooker’s agitation
sent him over the railing of Halifax’s MacDonald Bridge.
He wrote in his suicide note that he was anxious, felt like a zombie
and couldn’t think.
Let’s look at the facts.
Three weeks after Tooker died, the US Food and Drug Administration
(FDA) publicly associated antidepressant drugs with worsened
depression and suicidal ideation. I was dumbfounded and immediately
immersed myself in this field, reading everything I could.
What I learned is that, typically, one in four patients feel worse
when beginning any antidepressant drug and quit it within the first
month. Almost half quit within three months. So while these drugs may
help some people, they are not reliable, not even close.
If only drug companies were straight up about this. But that wouldn’t
be good for sales. On the contrary, doctors are instructed through
industry propaganda to “reduce patient dropout” by “managing” the side
effects and encouraging patients to stick with the program rather than
to listen to their patients’ experiences.
Agitation is a very common side effect of antidepressant drugs,
especially during early stages of treatment or after a change in
dosage (up or down). Extreme agitation is known as akathisia, an
internal unrest or turmoil.
In clinical trials for SSRIs, the most commonly prescribed
antidepressants, this reaction has been recognized and documented
since the early ‘80s. Prozac’s clinical trials, both prior to and
after its launch in 1988, recorded rates of agitation and akathisia of
between five and 25 percent.
Conservatively speaking then, at least one (and as many as five) in 20
patients become agitated on antidepressant drugs – a significant
adverse reaction that doctors should be informed about and patients
warned about. However, generally, they are not informed. Agitation is
a very potent predictor of suicide and violence.
By extrapolating from clinical trial data and multiplying by numbers
of users, Dr. David Healy from the UK claims that one in 500 users of
antidepressant drugs will complete suicide because of the drug. That’s
100,000 tragic and unnecessary deaths among the 40 to 50 million
people on antidepressant drugs worldwide.
Clearly, drug companies have a lot to lose if this information becomes
well understood. And user numbers are growing quickly: there was an 80
percent increase in antidepressant prescriptions in Canada from 1999
to 2004.
In February 2005, Dr. Dean Fergusson of the Ottawa Health Research
Institute and faculty of medicine at the University of Ottawa
published a shocking finding in the British Medical Journal. His
meta-analysis reviewed data on 90,000 patients from some 700 clinical
trials and found that patients were twice as likely to attempt suicide
on antidepressants as on sugar pills.
Huh? Patients are put on antidepressant drugs to lower suicide risk,
not to double it!
Just how effective are antidepressants in relieving symptoms of
depression? Incredibly, there is little evidence that antidepressant
drugs actually produce benefits. We know that they may help some
people in the short term, but over the long term, we find a worsening
of depression or anxiety compared to placebo-treated patients. Too
often, more severe psychiatric symptoms are triggered by the drug
itself, such as drug-induced manic or psychotic attacks, often treated
with more drugs. For everyone helped by a drug treatment, there may be
another harmed.
There is also the disturbing and very real issue of dependence on
antidepressants. When you try to stop taking them, you can suffer an
emotionally distressing withdrawal that includes “crashing” with
depression, fatigue and feelings of hopelessness, which also often
involves painful physical symptoms, such as flu-like symptoms, muscle
cramps and shock-like headaches.
What are the alternatives?
Leaving pharmaceutical drugs aside, there’s much we can do to treat
depression and anxiety, especially of the mild and moderate sort,
where it all starts.
Proper diet, exercise, talk therapy and hobbies keep your mind and
body strong. Spiritual practice, meaningful work and community keep
you connected and centred. But it all comes down to self-awareness and
self-love.
We all need to support those in our life who are suffering, especially
during their crisis periods. Depression is cyclical. It comes and
goes. When people are in the depth of despair, they may not think
rationally. They need you to give them a reality check, to remind them
that they’re worthy of love and life. Get them beyond their valley of
darkness, and when you’re going through your own dark night of the
soul, someone will be there for you, to pull you back from the brink.
It’s better to light a candle than curse the darkness. With
intelligence and integrity, and with the intention of patient safety
rather than profit, we can save lives. With compassion and skill and a
dose of generosity, each of us can reach out to those we love during
their dark times. We must. We’re all connected, and we’re all making a
difference.
Reprinted from Depression Expression: Raising Questions About
Antidepressants, a project of Healthy Mind Body Planet.
Our recommendations to reduce harm by Angela Bischoff
We believe Health Canada should support a public health framework that
reduces the use of psychoactive drugs through health promotion,
rehabilitation and prevention.
Health Canada should actively discourage physicians from prescribing
SSRIs to adolescents and women of childbearing age.
Health Canada should make all clinical trial data available to the
public, including all serious adverse events.
Health Canada should require that clinical trials last long enough to
study long term outcomes, including withdrawal, to reflect the time
period that patients normally take antidepressants.
We call upon Health Canada to immediately issue safety advisories for
all antidepressant drugs, which would include the risks of suicidal
ideation and violence as well as other reactions
We believe that reporting of all
serious adverse reactions to Health
Canada’s adverse drug reaction monitoring program should be mandatory
for all physicians, and promoted and expanded for public use.
All provincial colleges of physicians and surgeons should develop
standard practice guidelines on suicide assessment, to ensure patients
are monitored for suicidal ideation.
The provincial ministries of education, in concert with ministries of
health, should monitor closely the growing trend toward
pharmaceutically sponsored speakers presenting to students about
depression and suicide, talks that frequently conclude with
pro-prescription drug solutions.
We implore the media and the justice system to take note of the
serious, ongoing role of antidepressants in violence and suicide.
We call for Parliamentary hearings on antidepressant drugs to explore
the nature and extent of harm many Canadians have suffered as a result
of their prescription, with the aim of preventing harm.
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