Tagged: Suicide

Akathisia Induced Impulsivity..


“.. No-one around you knows that you’re going to boil over and explode”..

– Joe Rogan

Welcome to psychiatric drugs..

Welcome to Seroxat…

Welcome to hell..

 

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People Write Into People’s Pharmacy About Paxil/Seroxat Suicide..


“….One person wrote about her son: “He was a 35-year-old young man with everything to live for, good job, happily married, no financial problems. He was experiencing some anxiety and chest pains and saw a doctor, who prescribed Paxil. Three days later, my son committed suicide. Something needs to be done to stop this from happening to others….’’

http://www.journalnow.com/zzstyling/pharmacy/people-s-pharmacy-can-antidepressants-lead-to-suicide/article_227a9814-b1e1-52af-ad03-25ee0c20f223.html

What Did They Prescribe Lil Peep?


“…”I suffer from depression and some days I wake up and I’m like, ‘F***, I wish I didn’t wake up’. That was part of why I moved to California, trying to get away from the place that was doing that to me, and the people I was around.

“I realised it was just myself – it’s a chemical imbalance in my brain,” he added at the time.”

http://www.mirror.co.uk/3am/celebrity-news/lil-peep-autopsy-results-11534849

 

Lil Peep was an American rapper who overdosed on Wednesday night, November 15, at age 21. Prescription drugs such as Xanax were mentioned a lot in his lyrics and his songs contain numerous references to drugs, prescription drugs in particular. It’s sad to see a life cut short at 21, but Lil Peep is representative of the generation who psychiatry has overdosed and over-diagnosed. His death is one of many.

In one article- from Pitch-Fork- Lil Peep mentions that his ‘mental illness’ is all down to a ‘chemical imbalance’. It’s hard to believe that the drug company created- chemical imbalance theory- is still doing the rounds. A tech savvy millennial like Lil Peep would have only needed to do a quick google search to see that the chemical imbalance theory has long been debunked, and even psychiatrists are backing away from it now. Nevertheless, it seems that the the allure of this myth to those looking for a chemical cure to their despair is as potent as ever. This, of course, means tons of business for the drug companies and their psychiatric puppets… and much harm to patients.

It will be interesting to see what psychiatric drugs were prescribed to this talented young man, and in what way did they contribute to deleting his young life and potential.

RIP Lil Peep…

http://people.com/music/lil-peep-dead-possible-xanax-overdose/

 

Based on information [police] were told and evidence that was found in the tour bus, they had evidence of a possible drug overdose, most likely from Xanax,” Sgt. Dugan says, adding that an official cause of death will be released by the medical examiner after toxicology reports. “Based on evidence, there was drug paraphernalia found inside the bus and some narcotics.”

Peter C Gøtzsche : Antidepressants increase the risk of suicide, violence and homicide at all ages


http://www.bmj.com/content/358/bmj.j3697/rr-4
Feature Medicine and the Media

Antidepressants and murder: case not closed

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3697 (Published 02 August 2017) Cite this as: BMJ 2017;358:j3697

Antidepressants increase the risk of suicide, violence and homicide at all ages

The FDA admitted in 2007 that SSRIs can cause madness at all ages and that the drugs are very dangerous; otherwise daily monitoring wouldn’t be needed: “Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt” … “All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants” (1).

Such daily monitoring is, however, a fake fix. People cannot be monitored every minute and many have committed SSRI-induced suicide or homicide within a few hours after everyone thought they were perfectly okay.

As the published trial literature related to suicidality and aggression on antidepressants is unreliable, we looked at 64,381 pages of clinical study reports (70 trials) we got from the European Medicines Agency. We showed for the first time that SSRIs in comparison with placebo increase aggression in children and adolescents, odds ratio 2.79 (95% CI 1.62 to 4.81) (2). This is an important finding considering the many school shootings where the killers were on SSRIs.

In a systematic review of placebo-controlled trials in adult healthy volunteers, we showed that antidepressants double the occurrence of events that the FDA has defined as possible precursors to suicide and violence, odds ratio 1.85 (95% CI 1.11 to 3.08)(3). The number needed to treat to harm one healthy adult person was only 16 (95% CI 8 to 100).

Based on the clinical study reports, we showed that adverse effects that increase the risk of suicide and violence were 4-5 times more common with duloxetine than with placebo in trials in middle-aged women with stress urinary incontinence (4). There were also more women on duloxetine who experienced a core or potential psychotic event, relative risk RR 2.25 (95% CI 1.06 to 4.81). The number needed to harm was only seven. It would have been quite impossible to demonstrate how dangerous duloxetine is, if we had only had access to published research. In accordance with our findings, the FDA has previously announced that women who were treated with duloxetine for incontinence in the open-label extension phase of the clinical studies had 2.6 times more suicide attempts than other women of the same age (5).

Looking at precursor events to suicide and violence is just like looking at prognostic factors for heart disease. We say that increased cholesterol, smoking and inactivity increase the risk of heart attacks and heart deaths and therefore recommend people to do something about it. Psychiatric leaders, however, routinely try to get away with untenable arguments. Many say, for example, that antidepressants can be given safely to children arguing that there were no more suicides in the trials, only more suicidal events, as if there was no relation between the two, although we all know that a suicide starts with suicidal thoughts, followed by preparations and one or more attempts. The same can be said about homicide. It can no longer be doubted that antidepressants are dangerous and can cause suicide and homicide at any age (5-7). It is absurd to use drugs for depression that increase the risk of suicide and homicide when we know that cognitive behavioural therapy can halve the risk of suicide in patients who have been admitted after a suicide attempt (8) and when psychotherapy does not increase the risk of murder.

References

1. FDA. Antidepressant use in children, adolescents, and adults. http://www.fda.gov/drugs/drugsafety/informationbydrugclass/ucm096273.htm.
2. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 2016;352:i65.
3. Bielefeldt AØ, Danborg PB, Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109:381-392.
4. Maund E, Guski LS, Gøtzsche PC. Considering benefits and harms of duloxetine for treatment of stress urinary incontinence: a meta-analysis of clinical study reports. CMAJ 2017;189:E194-203.
5. Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.
6. Healy D. Let them eat Prozac. New York: New York University Press; 2004.
7. Breggin P. Medication madness. New York: St. Martin’s Griffin; 2008.
8. Gøtzsche PC, Gøtzsche PK. Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review. J R Soc Med 2017 (in press).

Competing interests: No competing interests

Psychiatry Has Destroyed Sinead O’ Connor..


 

https://www.facebook.com/profile.php?id=100006731236998

Irish singer, Sinead O’ Connor, has hit the headlines again, with an impassioned and heartbreaking cry for help to her family through an online video. In distressing and harrowing Facebook posts over the last few weeks, Sinead has been crying out for her family to reach out to her. From the videos and messages she has been posting for almost two years now, it is obvious that Sinead is in a very bad state, and has been for at least a decade, but what has her led her to this crisis?

How did one of the most talented, and famous, female singers- in the world- end up alone, isolated, and severely ‘mentally ill’ to the point of suicide, in a motel in the outskirts of New Jersey?

Sinead, now 50, has been ‘under the care’ of psychiatry (that’s if you could call it ‘care’), and under the ‘treatment’ of psychiatric drugs for years, and if her recent video is anything to go by, the effects of this (mis) treatment have utterly destroyed her mental and physical health, her relationships with family and friends, and possibly her career, and her life too.

Sinead is one of milions (globally) destroyed by the polypharmacy medication merry go round of psychiatric drug treatment. Those of us that have been through this system of psychiatric drugging and mis-treatment (and suffered side effects which made our condition worse), know all too well the dire consequences of it. It’s difficult to see, or to understand, the damage been done to you while you are in it. The meds keep you sedated, and suppressed, so much so that you can be completely unaware. Tragically, people like Sinead  end up stuck in the psychiatric system, not realizing that the system itself is damaging them, but so vulnerable that they are helpless to get out of its grip.

Robert Whitaker’s book ‘Anatomy of an epidemic‘ details the results of mass drugging of the population, and the outcomes are not good, in fact they are extremely grim, particularly for those who have been medicated long term…

 

 “…Whitaker has persuaded me that American psychiatry, in collusion with the pharmaceutical industry, may be perpetrating the biggest case of iatrogenesis—harmful medical treatment–in history….” (Scientific American)

 

Leonie Fennell did an excellent post about Sinead and her experiences with psychiatry 4 years ago-

 

“….Here’s a recent clip of Sinead O’Connor speaking on her treatment by an Irish Psychiatrist.

Sinead says that she was misdiagnosed with Bipolar Disorder and subsequently prescribed ‘toxic’ doses of Lamictal (400mgs) and Amitriptyline (200mgs). She describes her psychiatrist as a horrible ‘b’ who did not inform her of the side-effects while on the drugs, or while coming off them.

Dishing out the pills is always the first-line treatment for people that psychiatry see as ‘abnormal’. Sinead O’Connor is perfectly normal by the way, and fabulously outspoken; she didn’t need fixing! Strange that dangerous drugs can be given to a person for years for an ‘illness’ which didn’t exist. Never mind all that comes with that, not least the weight gain, depersonalization, worsening depression and huge expense; would any other profession get away with such sloppy work? Reported adverse effects of these drugs on the RxISK website: Lamictal and Amitriptyline.

The full video can be viewed here….”

 

 



 

In the video above, Sinead seems to be aware that the medications she’s being prescribed are toxic, as she details the various side effects she has had over the years, however it seems that she is stuck in the psychiatric system, without realizing that it is in fact- the psychiatric system that is the problem.

In another article from 2013 she says –

https://truthman30.wordpress.com/2015/12/02/sinead-oconnors-past-psychiatric-drug-use/

 “They are extremely debilitating drugs. Tiring to the extreme. Ironically, extremely depressing. They can cause suicidal or self-harm type thinking. They can mess up your menstrual cycle very badly and cause you to be incapacitated for a week before.

“[They] f**k up your liver, your kidneys, your eyes, your appetite, your entire way of thinking and generally your entire life..”


Sinead will only get better when she gets away from the psychiatric system and the regime of drugging that the psychiatrists subject patients to. The psychiatric survivor movement is now global, and I hope that Sinead doesn’t end up just another casualty of mass psychiatric drugging. I hope she gets off the psych drugs, and then she can start her journey of healing.

If you haven’t heard the song ‘Troy’ from Sinead’s first album – The Lion and The Cobra- you really should, it’s spine-tingling. It’s Sinead at the height of her creative power, only 19 at the time. Compare that with the video from her facebook cry for help -above (30 years later), and bear witness to the damage that over a decade of psychiatric ill- treatment and psychiatric drugging does to an individual.


Should A Proven Felon And Criminal (GSK) Have Any Credibility At All In A Court Of Law?…


Think about it..

Would you trust the word of a convicted felon and fraudster? one that had to pay the department of justice 3 Billion dollars for fraud, bribery and ‘harm to patients’ offenses dating back many years? Would you trust the word of a sociopathic organization like this? It would be absurd to afford GSK any credibility in trustworthiness and truth wouldn’t it?

See Whistle-Blower Greg Thorpe’s hair raising legal complaint about GSK here-

https://truthman30.wordpress.com/2015/08/28/whistleblower-greg-thorpes-7th-ammended-complaint/


 

https://www.law360.com/articles/950287/reed-smith-atty-s-doctor-knew-of-suicide-risk-gsk-says

 

Reed Smith Atty’s Doctor Knew Of Suicide Risk, GSK Says

Law360, New York (August 1, 2017, 10:12 PM EDT) — GlaxoSmithKline pressed an Illinois federal court Monday to undo a $3 million verdict in favor of the widow of a Reed Smith LLP lawyer who committed suicide after taking generic Paxil, saying the prescribing doctor’s knowledge of the risks relieved the drugmaker of responsibility.
Wendy Dolin sued GSK in 2012, two years after her husband Stewart stepped in front of a train in downtown Chicago. Stewart Dolin had struggled with anxiety and depression off and on, and began taking paroxetine just a few days before his death. A jury this spring awarded $2 million for wrongful death and $1 million for pain and suffering in the days before he took his life.

Glaxo’s new brief elaborates on earlier arguments it has made in favor of a new trial, after Wendy Dolin urged against the move in recent weeks. The drugmaker said that the trial testimony of Stewart Dolin’s prescribing doctor revealed that he believed paroxetine could increase Dolin’s suicidality. Via the learned-intermediary doctrine, Glaxo said, that would mean it had washed its hands of the matter.

“Plaintiff fails to identify a single Illinois decision holding that a manufacturer can be held liable for failure to warn” in a suit like this, the company said.

The trial testimony of prescribing doctor Martin Sachman “shows that he was aware of the very risk that mattered to him when deciding to prescribe paroxetine for Mr. Dolin.”

GSK included an excerpt of his questioning where he was asked, “When you reinitiated paroxetine for Mr. Dolin in 2010, you went over with him the fact that he needed to be on the [lookout] for the signs and symptoms of agitation, increased restlessness or insomnia, panic attacks, worsening depression, or suicidal thoughts or behavior after he started the medication?”

Sachman replied, “Right.”

The company pushed back against Wendy Dolin’s claim that the risk Sachman was saying he was aware of was the obvious depression-related suicide risk, not a medication-related risk; Dolin “selectively cites” Sachman’s testimony to reach that conclusion, the drugmaker said, and didn’t try to push back against Sachman’s agreement that he didn’t realize that a 2006 label that warned him properly about what happened to Dolin was later changed before Dolin’s death.

GSK also said its hands were tied because drug regulators would not allow the company to use the specific warning language that it wanted. The label for the drug changed more than once between 2006 and 2010 as the U.S. Food and Drug Administration examined it.

And the company also took issue with a myriad of jury instructions that it says didn’t fully separate out different elements necessary for liability.

According to Wendy Dolin, the doctor testified that when he decided to prescribe the drug he relied on the 2010 Paxil label, which didn’t warn that Paxil could lead to suicidality in adults over 24. The doctor also testified that if GSK had warned of that risk, he wouldn’t have prescribed paroxetine to Dolin in 2010, Wendy Dolin said.

But Dolin says GSK never proposed her desired warning: A short statement that taking Paxil is associated with suicidality in adults over 24. “Since GSK never attempted to insert that simple warning anywhere into the Paxil label, GSK cannot meet its burden of providing ‘clear evidence’ that the FDA would have rejected such a labeling change, especially when the only FDA expert to testify at trial rejected that notion,” Dolin said.

Dolin argued the company had failed to alert drug regulators that research showed increased suicide risk in adults. With a short exception, the potential for suicide in adults was left off, and doctors were left uninformed, the suit said.

The FDA also invited GSK to discuss the inclusion of language specific to adult suicidality in the label at a formal meeting in 2007, but the company didn’t take the agency up on its offer, Dolin said.

Representatives for the parties were not immediately available for comment Tuesday.

Wendy Dolin is represented by R. Brent Wisner, Michael Baum, Bijan Esfandiari and Frances Phares of Baum Hedlund Aristei & Goldman PC, and David Rapoport and Matthew Sims of Rapoport Law Offices PC.

GSK is represented by Andrew Bayman, Todd Davis, Ursula Henninger and Heather Howard of King & Spalding LLP and Alan Gilbert and Anders Wick of Dentons.

The case is Dolin v. SmithKline Beecham Corp. et al., case number 1:12-cv-06403, in the U.S. District Court for the Northern District of Illinois.

–Additional reporting by Emily Field. Editing by Brian Baresch.

What Did They Prescribe Chester Bennington?


Petrusich-Chester-Bennington-1

 

http://www.eonline.com/news/868229/the-dark-side-of-linkin-park-s-chester-bennington-alcoholism-and-depression-inspired-and-plagued-singer-shadowing-his-massive-success

 

“…Meeting his second wife helped pull him out of a period of “absolute self-destruction,” he told Bullz-Eye.com in 2009 while promoting Out of Ashes. “I don’t know when to stop when I’m in that mode. I’ll go through a gallon of Jack Daniels and down some antidepressants in one night and keep on going. I just hated my life at one point. I loved my band, career and friends, but when I got home from tour, I couldn’t deal with stuff. I would just begin drinking.”

 

RIP Chester..

 

https://www.theguardian.com/music/2017/jul/21/chester-bennington-obituary

Chester Bennington obituary

Vocalist with the band Linkin Park whose sound was emblematic of the nu-metal genre

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Linkin Park’s Chester Bennington dies aged 41

The death of Chester Bennington, vocalist with the rap and nu-metal band Linkin Park, at the age of 41, curtails a brilliantly successful career that brought a string of awards and multimillion-selling albums and singles. Linkin Park enjoyed enormous and immediate acclaim with their debut album Hybrid Theory (2000), released on Warner Bros after the band had been rejected by several labels. The combination of Mike Shinoda’s rapping and Bennington’s soaring, impassioned singing became the band’s instant focal point, with the group’s metallic thunder enhanced by edgy electronic treatments. Their sound became emblematic of the nu-metal genre, alongside like-minded artists such as Korn and Limp Bizkit.

Hybrid Theory sold nearly 5m copies in its first year and to date has sold more than 20m, and reached No 2 on the US chart and No 4 in the UK. The singles Crawling, One Step Closer and In the End became radio favourites, receiving heavy airplay on MTV, and in 2002 Crawling won a Grammy for best hard rock performance. The album Reanimation (2002) comprised remixes of Hybrid Theory songs plus additional material, and was another international multimillion-seller.

When the band released Meteora in 2003, following intensive touring in the US, including dates with their own multi-artist Projekt Revolution tour, it shot to the top of the US and UK album charts and spawned a fresh batch of hit singles, including Somewhere I Belong, Breaking the Habit and Numb, the last of these an anthem of Bennington’s disconnection from the world. The album went on to sell more than 10m copies. In 2004, Linkin Park teamed up with Jay-Z on the EP Collision Course, mixing rap with metal; the track Numb/Encore, splicing together the band’s Numb with Jay-Z’s Encore, went to 20 on the US singles chart and 14 in the UK. In 2005 it won a Grammy for best rap/sung collaboration.

But while his music provided a cathartic outlet, Bennington had experienced an assortment of emotional and drug-related issues since childhood. He was a close friend of Chris Cornell, the lead singer of Soundgarden, who killed himself in May, and wrote a heartfelt posthumous letter to Cornell. Bennington was found dead at his home in California on what would have been Cornell’s 53rd birthday.

Bennington was born in Phoenix, Arizona. His mother, Susan Elaine Johnson, was a nurse, and his father, Lee Russell Bennington, a police detective who often worked on child abuse cases. They divorced when he was 11, after which his father gained custody of Chester. He had two older sisters and an older half-brother, Brian. Since his father often worked double shifts, Chester frequently found himself at home alone. He fell into a pattern of drug and alcohol abuse, and, he once told Metal Hammer magazine, “dropped so much acid I’m surprised I can still speak. I’d smoke a bunch of crack, do a bit of meth and just sit there and freak out. Then I’d smoke opium to come down.”

His emotional state was further affected by the fact that he suffered sexual abuse by an older friend between the ages of seven and 13. “It destroyed my self-confidence,” he told Kerrang! in 2008. “Like most people, I was too afraid to say anything. I didn’t want people to think that I was gay or that I was lying.” He was also bullied at school.

He found some respite in drawing and songwriting, and was a fan of Depeche Mode and Stone Temple Pilots. At 17 he moved in with his mother, and worked at Burger King while attempting to become a musician. His first group, Sean Dowdell and His Friends?, made a three-track cassette in 1993, after which Bennington and Dowdell formed the alternative-rock band Grey Daze, who released three albums during the 1990s.

Bennington married Samantha Olit in 1996, quit Grey Daze in 1998 and moved to Los Angeles to further his musical career. He auditioned for a band called Xero, and when he was hired as vocalist he completed the original line-up of what then became Linkin Park (a pun on Lincoln Park in Santa Monica), alongside Shinoda, Brad Delson, Dave Farrell, Rob Bourdon and Joe Hahn.

In 2005 Bennington put together a side project, Dead By Sunrise, featuring musicians from Orgy and the Street Drum Corps and comprising songs he considered “darker and moodier than anything I’d come up with for the band”. In 2009 they released their only album, Out of Ashes, which scraped into the US Top 30.

Linkin Park returned in 2007 with the album Minutes to Midnight, co-produced with Rick Rubin and marking a deliberate step towards a more mainstream rock sound. This delivered the big hit singles What I’ve Done, Bleed It Out and Shadow of the Day, which all scored heavily in the American alt and rock charts. New Divide, from the soundtrack compilation album Transformers – Revenge of the Fallen (2009), gave them another major hit. Their subsequent albums, A Thousand Suns (2010) and Living Things (2012), saw sales falling way below their earlier peaks, but they still delivered big hit singles including The Catalyst, Waiting for the End and the anthemic Burn It Down.

In 2013 Bennington joined Stone Temple Pilots after they fired the vocalist Scott Weiland, and, after recording the EP High Rise, stayed with them until 2015. “I got to create and perform with one of the greatest rock bands of our generation, that had so much influence on me growing up,” he said afterwards. He was back with Linkin Park for The Hunting Party (2014), on which they tacked back towards a heavier rock sound. One More Light (2017) was, by comparison with the group’s original sound, virtually a pop record. “It’s a great record, we love it,” insisted Bennington to hostile critics, and the album shot to the top of the US Billboard chart.

Bennington had tackled his addiction issues with some success, admitting falling off the wagon in 2005 when he divorced, but getting clean again in 2006 when he married Talinda Bentley, a schoolteacher and former model. In the run-up to the release of One More Light, he seemed optimistic and positive, saying that he had shaken off the depression he had felt two years earlier. “I know exactly who I am, I know exactly what I’m made of and I’m totally happy with it,” he said.

He is survived by Talinda and their children, Tyler Lee, Lily and Lila; by a son, Draven Sebastian, from his first marriage; and by two sons, Jaime and Isaiah, from a relationship with Elka Brand.

Chester Charles Bennington, singer and songwriter, born 20 March 1976; died 20 July 2017

 

13 Ways That GSK Hid The Seroxat/Paxil Suicide Signal…


Seroxat/Paxil/Aropax (Paroxetine) : The Anti-Depressant that makes you want to kill yourself!..

 


https://davidhealy.org/change-in-chicago-whose-problem/

Change in Chicago: Whose Problem?

May, 24, 2017 | Reply

Stewart Dolin’s Doctor Says (about Paxil) : ““I don’t trust the labeling,” he said. “I don’t trust the company, to be honest.”…


And why would he?

Why would anybody trust GSK? Would you trust a felon?

The Dolin trial opened a can of worms about Paxil/Seroxat, suicidality and akathisia which GSK would rather remained tightly in the can. It’s too late now though, the worms are already out…

See Dr. David Healy’s excellent new post about wider implications of the Stewart Dolin Paxil induced suicide trial.


“……The regulatory history of Paxil and the other SSRI’s was almost Byzantine.   For years they carried no warnings of a risk for suicide.  In 2004, after thousands of troubling reports, a Black Box warning was finally issued for children and adolescents.  A number of medical experts felt the warning should apply with equal urgency to adults.

However, in 2007, the FDA decided on a uniform warning for all antidepressants, old and new.  This was the “24 and under” label attached to both brand-name and generic Paxil in 2010.  This suited GSK just fine.  The FDA invited the company to discuss whether additional warnings were needed for Paxil, but GSK never took them up on it.

More importantly, it never fully shared with the FDA—and still less with doctors in the community—what it knew about the real risks of its product.  In fact, GSK had known since 1989 that its drug could trigger akathisia, an agonizing combination of physical restlessness and emotional turmoil that could lead to suicide.  The risk applied to both teenagers and adults; at least twenty suicides had occurred in patients on Paxil in clinical trials, the majority of them in people over age thirty…..”


https://davidhealy.org/change-in-chicago-dr-welby-on-the-witness-stand/

Change in Chicago:  Dr. Welby on the Witness Stand

May, 15, 2017 | 8 Comments

Editorial Note: This is part three in the Change in Chicago series covering the Dolin trial and its implications.  Like part 1 it is written by  Johanna Ryan – The Dolin Verdict and Playing Go

By twenty-first century American standards, Stu Dolin’s medical care was close to ideal.  That’s a hard idea to swallow, given what happened to him in the end, but it’s true.  The real paradox is why it wasn’t enough to save him – and how his doctor became a victim as well.

In June 2010, while taking a generic version of the antidepressant Paxil, Dolin jumped in front of an oncoming subway train in downtown Chicago.  His family was convinced that the medication had caused his suicide.  Last month, a federal jury agreed.  They found GlaxoSmithKline (GSK) liable for Dolin’s death, and awarded $3 million to his widow Wendy – two million for her own loss, and one million for Stu Dolin’s own suffering in his last week of life.

Few people succeed in suing the drug company when a loved one dies from the effects of his medication.  It’s far more common to sue the prescribing doctor.  Plenty of lawyers are willing to take on a malpractice insurer with limited loyalty to the doctor, and a lively interest in a reasonable settlement.  To face off against a multinational corporation with an unlimited war chest, which will fight like hell for the reputation of its product, is something else entirely.

An even bigger barrier is something called the Learned Intermediary Doctrine.  Under American law, drug companies have no obligation to level with you, the patient, about the potential hazards of the drug.  Their only obligation is to tell your doctor about those risks.  He or she is then expected to function as a “learned intermediary” – a sort of educated bodyguard who will tell you what you need to know, in language you can understand, and see to it that no harm comes to you.   The drug’s official label (that enormous, technical document folded up and stuffed into the drug package) is written with your doctor, not you, in mind.

But what if that official label does not tell the whole truth about the drug’s hazards?  That was the situation faced by Martin Sachman, M.D., Stu Dolin’s family doctor, who became a key witness in the Dolin lawsuit.

Marcus Welby M.D. – the old-school family doctor

That’s not Martin Sachman in the picture at the top of today’s blog – it’s Robert Young in the title role of Marcus Welby, M.D., the popular prime-time TV drama from the 1970’s.  To most of us, Dr. Welby represents the family doctor we wish we could have – the one our parents had in the good old days.  He was a settled presence in the neighborhood; he’d known you and your family for years.  You could go to him for advice on just about anything, and you tended to trust what he told you.

For Dolin, Marty Sachman was that kind of doctor.  Since about 2005, Sachman has had what’s known as a “concierge” practice.  For an annual fee of about $2,000 (over and above their usual insurance costs), patients can get something close to a Marcus Welby level of care from a doctor of this type.  They can be reached on weekends, may even make house calls from time to time, and you’re almost never limited to a ten-minute appointment.

Sachman had been Stu Dolin’s doctor for at least ten years. He was also a close personal friend.  (That’s unusual enough these days that attorneys rushed to assure the jury there was nothing “unethical” about it.  A generation or two ago it was fairly common, especially in small towns.)   Often, faced with a difficult medical decision, there’s one question we really want to ask the doctor: Would you give the same advice to a loved one or a best friend, if they were in my shoes?  Mostly, we don’t have the nerve to ask.  Stu Dolin was lucky enough to know the answer would be yes.

A Job For A General Practitioner

Most family doctors take that Learned Intermediary business fairly seriously.  It’s one reason why they refrain from handling “specialty” drugs for complex or serious conditions, which may require expert management.  Chemotherapy for cancer; biologic drugs for Crohn’s disease, MS and other autoimmune disorders – those are best left to specialists.

When he began practicing medicine in the 1980’s, Sachman explained, antidepressants were in that category.  The older ones were more problematic, with more side effects, and were reserved for people with relatively severe symptoms.  Rather than try to treat such patients  himself, he’d refer them to a psychiatrist.

This changed when Paxil, Prozac and the other SSRI drugs came out in the early 1990’s.  They were depicted as being safe enough to be handled by general practitioners, and a reasonable option for patients whose troubles didn’t warrant seeing a psychiatrist.  By the mid-2000’s, this had become the first-line option for dealing with both depression and anxiety.

As Dr. Sachman saw it, if a patient had mild to moderate depression in response to some trouble or stress in his life that was a “reactive” depression for which he could prescribe SSRI’s.  If they had serious problems with sleep and appetite, a slowed-down or unusually agitated appearance, and an inability to function in daily life, that was true “clinical depression,” and they should see a psychiatrist.

Dr. Sachman knew Stu Dolin well, and the anxiety he complained of in June 2010 did not alarm him.  Stu was just going through “one of his stress periods, on account of his work responsibilities.  He seemed to be getting through it like he did the other times.”  Dr. Sachman’s diagnosis was situational anxiety.  A drug like Paxil could help people get through a rough period like this.  The condition was fairly benign—and like the overwhelming majority of his colleagues, he considered Paxil to be a fairly benign drug.

A “Warning Label” that failed to warn

By 2010, the official label for Paxil gave physicians no reason to doubt that assessment – at least for adult patients.  It warned that any antidepressant could trigger agitation and suicidal impulses in children and youth up to the age of 24.  However, it also stated that “short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24,” and showed lowered suicidality in those over 65.

The warning added two more crucial sentences:

“Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.   Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality or unusual changes in behavior.”

As psychiatrist Joseph Glenmullen told the jury, this label effectively blinded doctors to the risks faced by adults:  “What this tells me as a practicing psychiatrist is that if I’m treating a 57-year-old patient, and I put them on Paxil, Paxil couldn’t make them worse.  Paxil couldn’t make them suicidal.”  If they did feel worse, said Glenmullen, “it would be, and it says explicitly, their depression or other underlying psychiatric condition.”

Worst of all, he said, “if the patient gets worse and it might be the drug, what do you do?  You take them off the drug to see.  If they get worse and it couldn’t be the drug but it’s the depression, what do you do?  You increase the drug, which is going to worsen the risk.  So it’s very dangerous.”

The regulatory history of Paxil and the other SSRI’s was almost Byzantine.   For years they carried no warnings of a risk for suicide.  In 2004, after thousands of troubling reports, a Black Box warning was finally issued for children and adolescents.  A number of medical experts felt the warning should apply with equal urgency to adults.

However, in 2007, the FDA decided on a uniform warning for all antidepressants, old and new.  This was the “24 and under” label attached to both brand-name and generic Paxil in 2010.  This suited GSK just fine.  The FDA invited the company to discuss whether additional warnings were needed for Paxil, but GSK never took them up on it.

More importantly, it never fully shared with the FDA—and still less with doctors in the community—what it knew about the real risks of its product.  In fact, GSK had known since 1989 that its drug could trigger akathisia, an agonizing combination of physical restlessness and emotional turmoil that could lead to suicide.  The risk applied to both teenagers and adults; at least twenty suicides had occurred in patients on Paxil in clinical trials, the majority of them in people over age thirty.

A Doctor Taken Hostage

Thanks to GSK, that information never reached Marty Sachman.  If it had, he testified, he would never have prescribed Paxil for Stu Dolin.  There were plenty of other options—other drugs, and non-drug strategies – for treating situational anxiety.  Because of the warning label, he said, he had never prescribed Paxil to a patient under 25; the benefits didn’t seem worth the risk.  He had a few adult patients who seemed to do well on Paxil; if they had been on it for several years and wanted to continue, he would refill it.  However, in the seven years since Stu Dolin’s death he had not written a single new Paxil script:  “I don’t trust the labeling,” he said.  “I don’t trust the company, to be honest.”

Marty Sachman’s anguish—and his sense of betrayal—was apparent to everyone in the courtroom.  Physicians like himself, he said, “rely on truth and honesty from pharmaceutical companies, and to falsify information or hold back information is totally criminal. How can we treat people effectively and safely if we can’t depend on that?”  They couldn’t.  Instead, he had prescribed a drug, and a patient had died.  That alone would have been traumatic for any honest doctor; that the patient was his best friend made it devastating.  It was not like being a Learned Intermediary; it was more like being a hostage.

So what about the average Joe?

Dr. Sachman never got the chance for a follow-up visit with Stu Dolin; within six days of starting Paxil, he was dead.  If he had, it’s just possible he could have spotted his longtime patient’s real problem. Maybe even stopped the Paxil.  We’ll never know.

In 2010, the year Stu Dolin died, doctors wrote 259 million antidepressant prescriptions.  For most patients, who don’t have access to anyone remotely resembling Dr. Welby, the situation is even scarier.  They may get a script for an SSRI in a ten-minute encounter with an overworked stranger, based on a checklist left in the waiting room so that every patient can be “screened” for depression.  The potential number of doctors taken hostage – and patients tossed overboard – is hard to imagine.

I have to think genial old Marcus Welby, M.D. wouldn’t stand for it.  What about us?

Chris Cornell’s Wife Issues Statement, Blames Anxiety Medicine for Suicide


Interesting article about the death of Soundgarden lead singer, Chris Cornell. I loved Soundgarden when I was a teenager. RIP Chris,

http://www.rollingstone.com/music/news/chris-cornells-wife-issues-statement-w483179

 

Statement, Blames Anxiety Medicine for Suicide

“When we spoke after the show, I noticed he was slurring his words,” Vicky Cornell says. “He was different”

Vicky Cornell, the wife of Soundgarden singer Chris Cornell, issued a statement Friday morning where she remembered her late husband, who died Thursday morning at the age of 52, and speculated whether his suicide was the result of taking too much of his anxiety medication.

“Chris’s death is a loss that escapes words and has created an emptiness in my heart that will never be filled. As everyone who knew him commented, Chris was a devoted father and husband. He was my best friend,” Vicky wrote.

“His world revolved around his family first and, of course, his music second. He flew home for Mother’s Day to spend time with our family. He flew out mid-day Wednesday, the day of the show, after spending time with the children. When we spoke before the show, we discussed plans for a vacation over Memorial Day and other things we wanted to do.”

However, following Soundgarden’s concert Wednesday night, Vicky noticed a change in her husband’s demeanor when they talked on the phone after the show.

“When we spoke after the show, I noticed he was slurring his words; he was different. When he told me he may have taken an extra Ativan or two, I contacted security and asked that they check on him,” she continued. “What happened is inexplicable and I am hopeful that further medical reports will provide additional details. I know that he loved our children and he would not hurt them by intentionally taking his own life.”

An attorney for the Cornell family, Kirk Pasich, reiterated Vicky’s belief that an extra dosage of Ativan, an anxiety medication often employed by recovering addicts, altered Chris Cornell’s mental faculties after the Detroit show. Pasich added that the Cornell family is “disturbed at inferences that Chris knowingly and intentionally took his life.”

“Without the results of toxicology tests, we do not know what was going on with Chris — or if any substances contributed to his demise,” Pasich said. “Chris, a recovering addict, had a prescription for Ativan and may have taken more Ativan than recommended dosages. The family believes that if Chris took his life, he did not know what he was doing, and that drugs or other substances may have affected his actions.”

Pasich added that side effects of Ativan include “paranoid or suicidal thoughts, slurred speech and impaired judgment”; Vicky Cornell noted her husband’s slurred speech following the Detroit concert in her statement.

She added, “The outpouring of love and support from his fans, friends and family means so much more to us than anyone can know. Thank you for that, and for understanding how difficult this is for us.”

Hours after Cornell’s death at a Detroit hotel, a medical examiner’s report confirmed that the singer had died by suicide.

Chris Cornell, lead singer for Soundgarden, has died at age 52. Watch here.