“…My studies of the research literature in this whole area lead me to a very uncomfortable conclusion: the way we currently use psychiatric drugs is causing more harm than good. We should therefore use them much less, for shorter periods of time, and always with a plan for tapering off, to prevent people from being medicated for the rest of their lives….”
Prof. Peter Gøtzsche (The Guardian 2014).
“For years the public has been under the impression or of the opinion that medication is bad and that talking therapy is good, and if we have enough talk therapy there wouldn’t be any need for medication. That simplistic view is wrong,” she said, pointing out that in dealing with severe psychiatric illnesses, “medication is absolutely essential”.
Prof. Patricia Casey (Irish Catholic 2015).
I wasn’t going to comment on this article (from June 2015) by psychiatrist Patricia Casey, because I think that some biological psychiatrists actually delight in upsetting people by putting out misleading information about anti-depressants. I think that some of these high profile psychiatrists seriously think that by publishing blatantly deceptive and illusory pro-anti-depressant articles they have succeeded in striking a blow against people who criticize them. They seem to imagine that they are being clever by twisting facts and pulling the wool over peoples’ eyes. They are certainly not interested in the truth, they are interested in maintaining the status quo, and this status quo mainly consists of protecting the psychiatric profession, and the drugs which validate the profession.
I find this behavior very disturbing…
Patricia Casey’s recent article in ‘The Irish Catholic’ titled: ‘Simplistic therapy approach to suicide criticized in new study’ – is so utterly ridiculous, and so blatantly insulting, not only to those who are critical of psychiatry and psychiatric drugs, but also to those who have been harmed by psychiatric drugs, their families and their friends etc. It’s even more offensive to the families of those who have had to pick up the pieces from SSRI induced suicides. It’s just simply abhorrent to use red herrings, smoke and mirrors, and selective information from specific studies, and then twist these cherry picked anecdotes into conclusions which are dubious, misleading and ultimately harmful.
It might seem to be clever to publish these kinds of articles, in the sense that many lay people are fooled and some are bewildered enough to go along with it, and then psychiatry (and the psychiatrist) feels elevated and validated by their own propaganda, but ultimately this ego-game just hurts sufferers of ‘mental illness’.. the very people which psychiatry is supposed to protect (disturbing? cruel? you betcha). The public at large would automatically trust an opinion from a high profile psychiatrist, they wouldn’t suspect that there could be an agenda.
Casey’s article (which also re-appeared in the Independent) “Two thirds who died by suicide not taking drugs prescribed for them” attempts to correlate dubious ‘facts’ and ‘research’ in order to draw a ‘conclusion’ (and create a sensationalist headline) that anti-depressants are not implicated in suicides because (she says) that two thirds of people who died by suicide are not taking prescribed drugs (it is unclear whether this means ‘not taking’-as in ceased to take- the drugs prescribed for them and it’s also unclear if this means that each individual in this group was never prescribed any drugs ever). To the lay reader, this seems that it would be logical to then assume that if those two thirds of people had taken their ‘prescribed drugs’ then they would have been saved from suicide.
There are many ways to interpret this ‘study’, but Casey (true to form) chooses the one which she imagines to validate psychiatry and psychiatric drugs.
However, what Casey doesn’t draw attention to in her summation, is the other ‘remaining third’ who were taking their prescribed drugs at the time of their suicide. What does this tell us? It tells us that it’s possible that the two thirds could have been in withdrawal from their drugs? (Casey chooses to omit any mention of withdrawal). SSRI withdrawal can cause seriously debilitating effects, suicide is one of them.
I know because I experienced it...
(and so have many many others).
We could interpret the study in the article to indicate that some of these individuals (in the 2/3rds group) could have stopped taking their (SSRI) antidepressants abruptly before their suicide (maybe a few months, days or weeks before- and perhaps that’s why they didn’t turn up on the toxicology reports?)- maybe this factor is significant in attempting to understand at least two out of three of these cases?- and furthermore we could then go on to perceive that despite being prescribed drugs and taking them at the time, the entire group of those found with psychiatric drugs in their toxicology reports (the other third)-did -in fact- commit suicide.
Leonie Fennell (in her excellent dissection of this article) makes some extremely significant points about toxicology reports, she says:
“...Toxicology results post mortem are notoriously unreliable(Drummer et al 2004) and should not, as yet, be relied upon to conclude drug concentrations before death. I personally know of mothers who have lost their sons to antidepressant-induced deaths where the antidepressant escaped detection in toxicology tests. Two of these mothers vehemently objected and insisted on a re-test – in both cases the drug was eventually detected, once on the second time and once on the third time…”
If one third had an anti-depressant in their system at the time of their death by suicide, then surely this indicates that anti-depressants are not very effective for some- isn’t this another way of looking at this study? If these drugs are really ‘anti‘ ‘depressants’ then surely we would expect then for the drugs to prevent suicides? isn’t that what ‘anti‘ indicates? We should expect to find no mention of anti-depressants found in the bodies of suicide victims or indeed we would expect this to be a rare occurrence; an aberration – yet according to Casey, 100% of those notes on an antidepressant in this study still killed themselves. Therefore, the anti-depressants failed 100% of those studied which were on them, as the third is 100% of those who had toxicology showing anti-depressants in their blood at time of death.
What we don’t know is- were the other two thirds prescribed anti-depressants in the weeks, months, or years, before their deaths? and maybe they suddenly tried to stop taking them, and perhaps it was withdrawal which drove them to suicide? Casey addresses none of these issues.
Furthermore, the article does not mention any details about the study, how it was assessed, where it can be accessed, what drugs were these people on, for how long did they take them, when did they stop them? were they experiencing withdrawal, or side effects? etc.
Casey makes no mention of the other factors which lead people to severe depression, and suicidal actions and thoughts. The core of this is usually societal. People aren’t born suicidal or depressed. These things manifest over an individual’s life. If biology is a factor in depression, it is a small factor (and likely a consequence of depression not a biological cause). Suicides come from despair, and what leads up to that despair is usually a series of traumatic events: abuse, bullying, poverty, loss, grief etc.
Casey does not enlighten us to anything about this study and there are no links to the authors’ credentials, their backgrounds etc. We don’t know what the authors’ agenda is (if there is one), we don’t know their possible professional/public or commercial affiliations, biases, conflicts of interests etc.
There is no link to the raw data. There is no discussion of individual cases from the study. There is no mention of comparative literature in which to draw other possible conclusions. We get no insight into this study whatsoever, we just get Casey’s cognitively biased interpretations and conclusions dressed up as a news article. We get her specifically honed pro-drug perspective too. Nonetheless, despite having absolutely no scientific foundation, the article aims to convince the reader of an outlandish conclusion in regards to anti-depressants. Each and every suicide case is immensely complex, just as each and every suicide case with anti-depressants as a factor is also hugely complex. We have complex lives. This study attempts to simplify individual people’s vastly complex lives, and reasons perhaps, for taking theirs, into something akin to studying weather patterns. If only life were as simple and predictable as assuming ‘it will rain in winter, because it usually does’…
It’s pseudo-science at its very best.
This is dangerous.
There is a website called antidepaware which has been documenting hundreds of suicides (people on SSRI’s at the time) for a few years now. Perhaps Casey and the researchers in this study, need to look a little further, and delve a little deeper. One random study (with absolutely no scrutiny of the question of whether these individuals who completed suicide were withdrawing from an anti-depressant at the time and with many flaws) does not prove that anti-depressants are safe. If two thirds had no antidepressants in their system at the time of their suicides, can we assert that perhaps this was because they had tried to withdrawal from their meds, and it was this that plunged them into suicidal ideation?
It’s true that people on SSRI’s commit suicide, as do people not on SSRI’s. People also commit suicide from akathisia, de-realization, and de-personaliztion (all quite common- and terrifying- side effects of SSRI antidepressants which are well known and listed in PIL’s). We could assume that a sizable portion of suicides could leave no trace of an antidepressant in their system because perhaps they are in withdrawal from the drugs? However, perhaps the only way to truly know what effect SSRI’s have in regards to suicidal thoughts etc, would be to ask those who came off SSRI’s because of suicidal side effects etc?
There are hundreds of thousands of us out there- we are not ‘anecdotes’. Our experiences are valid. Psychiatry should be documenting, and studying us.
Where is the study representing SSRI survivors?
Casey also admits that this study is extremely limited. However, despite admitting that the study is very flawed-(in other words we can’t really make concrete conclusions about it) she then goes on to make sweeping statements about the validity of it..
“….the numbers were small, it does cover a limited period, and the study needs to be replicated”, she said it was “highly likely” that similar patterns could be found nationally and internationally”…
However, she kind of slips up -and reveals perhaps -an agenda- which is: to counter the current cultural aversion to medication for the human condition. There has been a huge backlash against psychiatric drugs, and psychiatry in general, these last few years-because the ‘service users’ are beginning to see that the emperor of psychiatry has no clothes…
Casey defends the drugs because the drugs validate her profession…
The risks of these drugs – it seems- don’t really matter to her..
“..We know that generally people don’t adhere to medication”, she said, adding that “the antipathy to medication for mental health problems is a cultural thing”.
Personally I think that Patricia Casey is talking utter nonsense, and I suspect she is well aware of what she is doing. This is an article which defends psychiatric drugs at all costs, despite recent research from people like Bob Whitaker and Peter Gotzsche outlining the clear dangers from psychiatric treatments (particularly long term). It’s an utterly shameful article which does nothing but confuse and miselead the public. It serves no purpose in the ‘mental health’ discourse, apart from upsetting those of us who can see through it, but then again, perhaps that is the purpose? If so- then well done Casey! You’ve scored another point for biological psychiatry, and let patients down, once again.
“…According to Whitaker, research suggests that while people suffering from depression may not have low serotonin levels to begin with, the use of SSRIs reduces the brain’s capacity to produce serotonin on its own, leading to a worsening of symptoms when patients stop taking the drugs…”
What Casey doesn’t explain is why there is antipathy to medication. In my view the antipathy comes from user’s experiences; largely negative experiences involving horror stories from anti-depressants. She doesn’t seem to see either that the discourse is changing. People can read opposing views now, and people can read about the side effects on the internet. Psychiatry can no longer just tell people, ‘it’s all in their head’ because people can inform themselves. Psychiatry no longer has the absolute stranglehold (it once had) upon the mental health ‘discourse’. The internet has democratized the discussion, patients can now express their opinions on ‘treatments’, and their voices are being heard.
In the 80’s and 90’s Casey was Ireland’s virulent anti-abortion pundit. She regularly took to the Irish airwaves to sprout right wing Catholic views; views which belonged (and still belong) to an age of Magdalene laundries, heavy handed Christian brothers, and an era where women were supposed to feel ashamed of their bodies, and in particular, of their pregnant unmarried bodies. Her stance was, and still is, out of kilter with modern Ireland (and the modern world in general). Her views on abortion and gay marriage disturb a lot of people…(including other -more secular- psychiatrists – such as Prof Veronica O’Keane).
O’Keane has taken Casey to task over her conservative views many times- see the quotes below-
“….Professor Patricia Casey’s latest contribution to public debate on the topic of suicide is that young gay men who have suicidal ideation or who attempt to harm themselves will not necessarily go on to kill themselves. She has told us that we should not “conflate” the act of self-harm with the completed act of suicide. Her argument is that, although suicidal behaviour is disproportionately more common in LGBT individuals, that the completed acts of suicide may not be higher..”
“...Does it really help make us a better or more healthy society to calculate whether gay men are over-represented in our suicide statistics? Is it not enough to know that the mental health of our LGBT citizens is suffering because of social discrimination? Psychiatry and medicine are frequently involved in issues related to ill-health, such as poverty, income inequality and discrimination, because these issues affect peoples’ health. Medics can only treat the ailment, but the power to alleviate this ill-health lies with all the citizens of our country. Choosing to vote ‘Yes’ is a vote that will lead to a healthier society for us all….”
In the 00’s she was one of Ireland’s anti- gay marriage equality mouth pieces. She is a current patron of the right wing Catholic- Iona institute (an utlra conservative Catholic lobby group). This much-hated organization was the driving force behind spreading misinformation about gay people, surrogacy, and marriage equality leading up to the recent (and thankfully successful) marriage equality for gay people in Ireland.
During many intense debates in the media, leading up to the vote, Casey was deemed a homophobe on Ireland’s national broadcaster (by gay activist Rory O Neil), and the Irish broadcaster, in panic-mode- subsequently paid out money in order to avoid the wrath of Casey and her ilk.
(Casey threatens to sue almost anyone who dares to criticize her in any way).
And nowadays (as she was also throughout her career also) she is Irish psychiatry’s ‘medication apologist’.
Her track record with studies and interpreting research leaves a lot to be desired…
as does her membership of the despised right wing Catholic ‘think-tank’ The Iona Institute..
Casey has been accused before of misrepresenting studies, notably in the Irish gay marriage referendum debate-
“….It has come to our attention that Prof Patricia Casey has referred to our article in supporting her views on traditional marriage between biological parents being the best environment for a child to be raised in (March 5th).
Prof Casey’s conclusion that the article is one of the “compelling reasons to continue giving marriage between a man and a woman the special support of the State” is not valid based on our findings”….
Casey was also sued for damages due to alleged negligence, from prescribing psychiatric drugs to one of her patients:
“...Rebecca, originally from Malahide in Co Dublin, but now living in Tyrone, was born in April 2001 with a deformed hand, thin lips, problems with balance and other features of Sodium Valproate Syndrome.
She was described in court as a bright, cheerful, attractive girl whose mental capacity is not affected by her condition. She is of above-average intelligence. “I wouldn’t change her for the world,” her mother added.
Through her father, Barry, the eight year old took a legal action against consultant psychiatrist Professor Patricia Casey and consultant obstetrician Dr Mary Holohan over her disabilities, allegedly caused by prescription drugs taken by Mrs McGillin during pregnancy”…
Casey, of course, denied responsibility (but still paid out), and it’s interesting to note also that it is alleged that Casey encouraged the distressed mother to go to England for a termination (Casey denies this) despite the fact that Casey is known in Ireland for her staunchly anti-abortion opinion (Casey is an ultra conservative Irish Catholic).
Traditionally, Catholicism, and the church, was of the view that suicide in itself was a ‘mortal sin’ (and those who killed themselves would be sent to hell). I do not know whether Casey is of this view, but nonetheless, it seems to me that religion perhaps has no business delving into the realm of ‘mental illness’ and suicide? and considering that these ills are typically symptomatic of a stressful (and often quite de-humanizing, brutal and cruel- modern) society, perhaps they are better left in the secular realm?
I won’t publish the article which I am criticizing (you can read it here) because I don’t want to endorse it or promote it and because, personally I believe it’s articles like that which lead to harm of psychiatric patients, the ‘mentally ill’, and the public at large… but anyhow here’s Bob Fiddaman’s take on the whole thing:
And here’s Leonie Fennell’s
Casey has been causing controversy for years -in a recent article on Ciprmail induced suicide, Casey weighs in again, with her usual nonsense.