Over the last decade David Healy.org and RxISK.org have both featured a series of posts about SSRIs and alcoholism and about Anne Marie Kelly.
There has been Out of my Mind Driven to Drink and related posts, Petra’s Story and Every Drink Spiked on DavidHealy as well as Driven to Drink: Antidepressants and Craving for Alcohol, Prescription Drugs Spiking your Cocktail, and Did My Doctor make me a Substance Abuser as well as Caught in the Firing Line on RxISK. And in particular see When is a Drug Guilty.
The person who put this on the radar for us was Anne-Marie, whose case – New Onset Alcohol Dependence linked to treatment with SSRIs – was written up in the International Journal of Risk and Safety in Medicine.
Anne Marie’s name should have been first on the authorship line of this paper. She did all the work. To this day I’m astonished that having dropped out of school early and with no background in research or psychopharmacology, she taught me who has a PhD in the psychopharmacology of the serotonin system things I didn’t know about that system – and she continues to educate me. Her drive also led to the phrase Motivation is worth more than Expertise.
The two Driven to Drink posts have had over 400 comments making them the most commented on posts linked to RxISK. These comments and reports to RxISK that followed these posts laid the basis for a RxISK article detailing Ninety-three cases of Alcohol Dependence following SSRI Treatment.
The cases outlined in this 93-case article pretty well nailed a phenomena that is now widely accepted and risks landing doctors in trouble if they don’t know about it.
Many people linked to RxISK or SSRI Stories or who read RxISK posts or have ever dipped into SSRI Stories when they hear about mass shootings figure wonder what psychotropic drug the shooter was on. Many are on drugs – but where the media once reported this, they simply now refer to a person’s mental illness – that might have been non-existent till they began a drug.
Some of us also though when hearing about public figures who have had terrible things happen to them, which are openly linked to their alcohol problem, also wonder about the drug they were likely on and wonder if they are going to get a fair hearing in court or from the public.
A Decade Later
A week ago, the Canadian Medical Association Journal published another Case of a lady who developed a significant alcohol problem on an citalopram. I was fortunate to have my name on the authorship line – although it should have been Anne Marie. Severe Alcohol Use Disorder following initiation of SSRI Therapy.
This was a learning example published to coincide with an even more important paper – Guideline for the Clinical Management of High Risk Drinking and Alcohol Use Disorder.
The guideline makes some pretty strong recommendations against initiating treatment with a serotonin reuptake inhibiting drug in someone with an alcohol problem and the need to monitor apparently recent onset escalation in alcohol intake following SSRI therapy. Both the article and the Guidelines make a case that is completely consistent with what Anne Marie put on our radar over a decade ago.
Evan Wood, the first author on the Guideline, has also been talking recently of a wider psychotropic drug induced substance abuse problem – leading to cocaine, opioid and other drugs of abuse. Could SSRIs have contributed to the recent opioid epidemic?
The Guideline points to other guidelines aimed at reducing alcohol use during pregnancy but does not point to the evidence that SSRI use in pregnancy has been linked to a 10-fold increase in Fetal Alcohol Syndrome in infants. 
Guidelines can be tricky. This one leans toward saying don’t use SSRIs to treat the depression that can often be seen in people with excessive alcohol use. This can seem clear enough except the doctor facing a patient who is anxious, with panic attacks, may argue later when things have gone badly wrong – but the patient wasn’t depressed and I wasn’t treating depression so this was not my fault.
The same happens with the warnings for suicide. The doctor says I wasn’t giving this drug to treat a depression.
Unless warnings and Guidelines state clearly that even an absolutely normal, healthy volunteer can become suicidal or start drinking to excess on these drugs – that the drug can cause the problem without any contribution from the condition – they risk misleading some people. In this case SSRIs can make completely normal people start drinking. And equally, there may be people with an alcohol use disorder that could be helped with an SSRI. The key thing is a warning so the person knows they are starting a poison and may be poisoned rather than starting a sacrament. Someone also needs to monitor the person who starts treatment to ensure nothing is going wrong as sometime the person on the pill can miss what is happening to them.
A Remaining Mystery
Anne Marie’s case alerted us to a another problem that features in some of the posts above – some people going on SSRI and related antidepressants can end up with raised blood alcohol levels compared with what they would normally have when not on treatment.
For a decade, we’ve been searching for an answer for this mystery. Several leads have been chased without getting any nearer an explanation.
At least 5 convincing cases of this problem leading to criminal entanglements have come RxISK’s way. These have been supported by evidence from blood alcohol tests done under police supervision on and off the SSRI. This is solid evidence – but courts and the public like to know how this could come about rather than just that it can come about.
We desperately need leads on this so any suggestions readers have would be great to get.
Anne Marie Comment
Mulling over this post and the comments that came in, Anne Marie added a comment to the next Empathy for Drug Induced Injuries that is too important to leave as a comment on a different post.
I was reading this post and it made me think of how all my research started.
I was in the courtroom and lost my case and was devastated. I was so angry I asked the barrister why they didn’t believe me. He said it’s not that they don’t believe you it’s that you have to prove it. I asked how do I do that? He mumbled something on the lines of scientific research. I looked at him in disbelief as I didn’t think it was possible to be able to achieve this myself.
I went home exhausted, beaten and felt defeated. I spent weeks feeling irritable and angry because I felt cheated. My life had been destroyed by the tablets and no one could see it or cared. I couldn’t let it go. All I kept thinking in my mind is what the barrister said, “you have to prove it scientifically”.
That’s when I started researching. I felt driven to do it even though I didn’t know how to or want to I knew I had to do it. Thank God for the internet otherwise I would never had been able to do it. The more I researched and learnt the easier it got. I started to realise the answers are there it’s just like a jigsaw that needs the right parts putting together to prove it was the tablets.
I was driven by wanting to show the judge the proof. I wanted the judge to repair the damage done to me. For my life to just be normal again. I just wanted my pre tablet clean record life back again. It had caused me so much unfair damage.
It was coming across Dr Healy and Rxisk that then made me realise there was something far more important to be done and that was to help prevent it happening to all the other people across the world too. In fact I didn’t realise I was entering a new chapter in my journey and how it was a very important one too.
You are so right when you say it is team work that is so important and it’s that that makes it all possible to find the answers we are all looking for.
October 16
As it happens on October 16, the same day the Canadian Guidelines were published, the UK published a Draft Guideline for Alcohol Treatment – that anyone can comment on up to December 8..
Its a strange choice of words. Unlike the Canadians, they are not referring to the management of alcohol use disorder – which would include possible triggers to the alcoholism – like an SSRI. Its all about how to treat the acute withdrawal state and then what drugs to use to avoid cravings – acamprosate, naltrexone and baclofen.
But it does have this very very small paragraph buried deep in the middle which you’d miss unless you were lucky
10.5.5 Drugs that should not be used for relapse prevention
Antidepressant medication
Many people seeking help for alcohol use disorders have already been prescribed antidepressant medication. This may be appropriate if you are clear that the purpose of the prescription is to treat a pre-existing or concurrent depressive disorder, but there is no role for antidepressant medication specifically to treat an alcohol use disorder. You should not prescribe antidepressant drugs (including selective serotonin reuptake inhibitors) with the purpose of preventing relapse in alcohol use disorders.
Somewhat Crazy?
This is a vast document – tens of thousands of words. It focusses heavily on psychotherapy input which is of debatable value – especially in the light of a shortage of folk to deliver the therapy in proportion to the numbers of people with alcohol use disorders.
Nowhere are therapists alerted to the fact that all their efforts might be a waste of time if the person is on an SSRI.
There is a lot of talk about alcoholics not coming for treatment because of stigma, but nowhere are AA or similar groups warned that SSRIs can cause alcoholism and that they too are quite likely to badly stigmatise people by incorrectly telling them that their hunch that their antidepressant might be making things worse is typical alcoholic thinking.
The overall thrust of the document almost seems to be dealing with a new kind of ‘alcoholism’ – one that has featured in media coverage recently – well-placed women who crash a car and kill someone under the influence of alcohol – a Desperate Housewives scenario. These women are highly likely to be ashamed and the surprising emphasis on stigma and a lot else about it suggests the guidance is being drafted with this kind of case in mind. A feminization of alcohol use disorders.
Quite regularly when you dig into these media stories, there is an antidepressant involved – without which there likely wouldn’t be an alcohol use disorder. But none of these women are likely to be given any hint of this. That they should not be ashamed, they should be angry. The shame lies with companies and guideline makers who dare not raise the topic of what might be happening. There now dear, don’t bother your pretty little head about this, let us, the experts, sort you out – and leave you in the dark.
There is a lot about pregnancy but no women or obstetricians are alerted to the data indicating a 10 fold increase in the rate of alcohol use disorders in women taking SSRIs.
There are realms and realms of words about things that are unlikely to help much and nothing about a very simple warning that might make a substantial difference.
The BBC covered the Canadian Guidance very favourably. CBC in Canada has also covered the Canadian Guidance in a manner they could not possibly cover the current UK Draft Guidance – as there is no clear take home message in the UK version comparable to what you find in the Canadian version. Nothing for a journalist to get their teeth into.
All major British newspapers today (Nov 8) report that British women are now the greatest binge drinkers in the world. They are also the largest consumers of SSRIs in the developed world (barring Iceland).
This is a developing story. In March of this year, the National Institute on Alcohol Abuse and Alcoholism in the US reported that College women in the US were now binge drinking more than men. This is a group whose SSRI use has grown rapidly in the last decade.
Anne-Marie says
Finally!
Thank you to Rxisk and all those who have contributed to this, if it wasn’t for you we would never had gotten this far.
I think about all the people who have died and been injured by this side affect from Suicide, RTAs, Murder being Incarcerated, losing their Jobs, Home, Broken Marriages, Children being taken into Care. The list goes on and on but at least now finally people in the future can be saved from these devastating consequences by simply having a warning for drs and patients to look out for that SSRIs can cause or worsen alcohol cravings and consumption and to look out for this or to avoid altogether.
The huge difference a simple warning can do to someone’s life can be life saving for them.
Thank you for finally listening to us.
Dr. David Healy says
I regularly get asked by people what can they do to help with Visual Snow, PSSD or other issues. I can’t tell them what to do.
I say things happen in respect of PSSD or alcohol and SSRIs because people like you pick them up and make them happen. Its driven by your motivation rather than some expertise you had to begin with. Same with PSSD and other problems.
In all this everyone has different gifts to bring to the table. In the case of alcoholism and SSRIs, it may be connections to a lawyer who does drink driving cases or some connection to a celebrity type person who ends up in a mess and has not idea why but where a drug like an SSRI may have played a part or a media contact who can get a story placed somewhere where it is more likely to get read that just a RxISK blog post or an academic article.
In all this the media as a terrible bias against thinking a drug could have played a part – they much prefer a story about someone’s downfall. They don’t want to deter people from taking these marvellous drugs. The drugs will be much more marvellous if we look after each other while on them.
David
chris says
“Following the sudden and devastating death of my father I became anxious and over a period of a year developed a fear of choking which got worse to the point that I was avoiding food and losing weight. I realized I needed help”
If you could go back in time how would you deal with this terrible situation you were in ?
Anne-Marie says
Mirtazapine helped a lot until I overcame the problem.
Timofey says
Good afternoon. David, you once advised me to try benzotropin in a small dose; this drug is not available in my country. Will atropine work?
Dr. David Healy says
There are lots of other anticholinergic drugs – atropine is possibly too strong.
D
тимофей says
David. In previous articles, you wrote that in benzotropin and bethanechol, in addition to the anticholinergic effect, there is something else that mediates the regeneration of nervous tissue. Since benzotropin is an antagonist, and bethanechol is an agonist. But is this something therapeutic in other anticholinergic drugs? I can get bethanechol online, but even taking 25 mg per day, treatment for six months will be very expensive.
Dr. David Healy says
It now looks like other anticholinergic drugs will work as well. Russia likely also have some interesting options not easily available elsewhere.
D
Тимофей says
Is biperiden ok? His dosage ranges from 1 mg to 16 mg per day. What is the effective dosage to choose?
Dr. David Healy says
If I knew the answers to these questions there wouldn’t be a problem. You’re going to have to do the research which in this case will mean taking it and monitoring any effects closely and letting everyone else know precisely what you did and what the effects if any have been
D
chris says
Yes AD’s and AP’s induce a craving for food usually carbs – I guess alcohol would be in with that and itself induce more drinking by dysregulation of glutamate/GABA. A cycle directly leading to behaviour issues. Olanzapine is probably the worst. At the same time AP’s also cause significant constipation. Think about that – it’s just evil.
Dr. David Healy says
It is still a mystery exactly what is going on with SSRIs and alcohol. In trying to work this out it seems a good idea to think about knock-on effects on dopamine or glutamate or whatever – but I don’t think it is a good idea.
I may be wrong but SSRIs don’t seem to induce generic craving. It can be alcohol and nothing else. In me and not in you. Or a drug of abuse and nothing else. But for others it looks almost more like the SSRI is causing akathisia and alcohol alleviates this – this is not classic craving. Its relief not craving. Life is more comfortable with alcohol on board.
There are other things too such as both SSRIs and alcohol disinhibiting giving someone a high – leaving them feeling amazing – and unaware how badly wrong things are going.
Besides this, it regularly takes someone other than the person affected to spot the problem and try to get them to stop.
We need a lot more really good descriptions from those affected as to what is happening them – what it feels like. The best way to manage each of these states may be quite different. P-5-P may play a part in the akathisia like ones. But until we get a sense of what is happening and the best way to help. I’m inclined to think mentioning glutamate or dopamine is a hindrance not a help – because it gives a false sense that we know what we are dealing with
David
Chris says
Besides this, it regularly takes someone other than the person affected to spot the problem and try to get them to stop.
This is a massive on going problem with members of my family.
Dr. David Healy says
Chris
You are so right on this – families either save us or condemn us. I have a lecture this afternoon which will later feature as a post on davidhealy.org which makes this point also
David
Anne-Marie says
Could SSRIs affect Ghrelin and cause intense alcohol cravings?
http://irp.nih.gov/blog/post/2023/04/hunger-hormone-feeds-alcohol-cravings#:~:text=A%20hormone%20called%20ghrelin%20that,alcohol%20use%20disorder%20(AUD).
I was looking up akathisia and alcohol and it definitely is involved
with SSRIs and alcohol. I then tried to identify where the craving is
coming from and came across ghrelin.
I never considered akathisia at the time because I’d never heard of it
but looking back I did feel very tense, restless and anxious for a
drink on a daily basis.
It’s very hard describing it all because there was so many side
effects so unpicking it all takes a long time. Your in a trance like
state so aren’t aware of it all at the time.
annie says
“Besides this, it regularly takes someone other than the person affected to spot the problem and try to get them to stop.”
Well, my doctor started to get interested in alcohol consumption. I’m not going to drag out the huge box of Seroxat stuff under the bed, but she said something along the lines of ‘I asked her how much she drank’ and then she said ‘I suspect it may be more than one glass of wine’.
This doctor was throwing suggestions out left, right and centre. Anything and everything was thrown out in her written scribes except Seroxat withdrawal. God knows, it was obvious enough as Seroxat jumped in at almost every opportunity. Even when she was obliged to get me off from 40 mg to nil over a year, she carried on with her personal attacks.
Years previously, my partner, at the time, came back from the surgery. He asked me how much I drank, he said, what did you say I asked, I told him to mind his own bloody business, he said. He had gone in for ring-worm from our guinea pigs, and so doctors can ambush airline pilots seemingly at random and out of nowhere.
So all very amusing in our house.
There is no doubt in my mind, that alcohol relieved Seroxat akathisia.
After the ridiculous situation when the doctor told me to drive to the mental hospital because I was enveloped in unrecognised akathisia from cold turkey and did not tell the psychiatrist and did not tell him she had given me three benzos and propanolol either, and I left with suicidal ideation.
At home I was detached and disconnected, divorced from reality.
I remember with extreme clarity most of what happened to me, and I remember having a glass of wine which is what we usually did before dinner. I remember a stark reality of normality from my previously disassociated state of hours previously and we embarked on plans for a weekend away.
This turned out to be a false sense of security.
I had no idea that early the next morning, there were more horrors to come…
So in my case, I was not driven to drink, I found the alcohol soothed away and replenished whatever it was the drug was doing and actually in quite a remarkable way.
chris says
How long did this horrific nightmare go on for and are you off all psych drugs now?
annie says
The above is a synopsis relating to alcohol and this post.
Thanks for asking.
If the doctor and psychiatrist had spent any time at all doing their respective jobs properly, it would not have taken two immense withdrawals one year and then another year for me to come out the other end unscathed. But I was not unscathed, I was put in positions of immense harm and by the end of the second year it became impossible for me to even consider Seroxat or anything else. I almost certainly would not have survived.
It was sheer mental grit on my own behalf in the latter stages. Their absurd and dangerous interferences caused havoc and mayhem and they couldn’t have made a worse job of it doing more damage than could ever have been contemplated. Sometimes, even now, these words ring in my ears ‘I told you not to take those pills’.
The Mayday Calls always went unanswered.
chris says
Are you able to say what kicked it all off.
I’m wondering what can be done to keep people from being lied to about medications – that have done horrific harm – so that they don’t go near a doctor in the first place and end up with iatrogenic harm.
In your situation as it was before the drugs including alcohol is there anything looking back, that would have helped get you to a better place?
annie says
I admire your tenacity as to the hows and whys as to why companies like GSK scored so magnificently with their antidepressant, Seroxat, Paxil, Paroxetine.
Now over ONE MILLION
The number of people aged 18 and older on antidepressants this month reached a staggering 1,020,000 – almost a quarter of Scotland’s adult population.
Dr Jane Morris, chairman of the Royal College of Psychiatrists in Scotland said:
‘There are complex reasons why the rise in antidepressant prescriptions is occurring. However, they are an important treatment option we know to be effective.
Asked in Parliament:
“I cannot be the only one who listened to that question that is really disturbed by the insinuation that antidepressants are not a legitimate treatment for those who require it”
First Minister
Humza Yousaf
How I ended up with a psychiatrist sitting in my sitting room asking me if I was suicidal and then getting all excited about the new wonder drug Seroxat was a mish-mash of a slap-happy doctor with a woman problem, he was not a native Scot shall we say, and this guy dying to try out Seroxat on me.
It was a beautiful morning, the dog and I on the beach, as he motored up to our house
I was so close, so close, to saying his visit wasn’t necessary.
So we got chatting and I told him the story all about the logging company quite close to us on our coastal narrow road. Most of the residents along our little roadway were fed up with gigantic logging lorries chugging along, blotting out the light, crumbling the asphalt.
This man turned out to be a massive bully and when I walked past his lorries with the baby buggy and the dog, would stick his finger in my face, and insult me.
But this wasn’t the problem.
What he did was so vengeful, so full of malice, it was difficult to comprehend what he thought he was doing.
He alerted the police to lay in waiting as my partner left the nearby country hotel.
All very embarrassing and tricky, but by the time the psychiatrist arrived it had pretty much sorted itself out and we were back on track, so to speak.
I don’t know in what innocent little world the psychiatrist lived, but his eyes were wide with fascination. So he prescribed the pill and I took it.
I will never know why I took it.
We were pretty worldly folk having worked and lived all over the world.
I didn’t know what Seroxat was, had barely heard of antidepressants, this was 1999, I think I just got swept up in the guys enthusiasm for this wonder drug. So I guess I thought, as I do about most things, hey, let’s try it……………..
I became one of Seroxat’s worst nightmares, because a whole army figured I was not capable of being saved.
That is the truth of it.
To answer the last bit, it was so lovely on the beach in the sunshine, I should have waved him on.
I was in the best place.
chris says
Thank you very much for that Annie. If only you had known about DH’s work and maybe Peter Breggin, which can also be said for countless others whose interest will be, in some cases too late, in others they will have gone through what yourself, myself and others on here have gone through – utter horrific hell. The issue that you were faced with was nasty but as you say you were getting over it.
There is a major Mark Rothko show on at Fondation Louis Vuitton it’s my view he died of akathisia. As I usually do, have taken it upon myself to contact an arts journalist to say such exhibitions should also be used to bring awareness of this condition and get doctors correctly identify akathisia and stop the medication. I referenced Kendra Campbell and suggest if interested they contact Professor DH. I live in hope.
https://www.listennotes.com/podcasts/the-benzodiazepine/dr-kendra-campbell-getting-jJZdDcbtlvC/
38.20 – “We know that thousands of people commit suicide every year because of akathisia”
“I have seen hundreds probably thousands of times someone get started on a psychiatric medication let’s say an anti-psychotic or something and they have akathisia and the akathisia is not recognised by the person who prescribed that medication or by other prescribers and it is assumed to be a new mental illness right – oh my god they’re so agitated, now they have bi-polar disorder or this and that. Literally they get a new label and they get another medication added. I have seen this in the emergency room, I have seen it so many times”
Dr. David Healy says
Chris
Thanks for mentioning me and referring to my work – but its not mine – its yours and Annie’s and Wendy Dolin’s and others – I listen and learn. This is what RxISK is all about – you guys are the experts – have much greater expertise at this point than a lot of doctors who have become little more than bureaucrats following procedures.
David
chris says
The Art world will not interact with me at all, am pretty sure I’m down as a terrible risk to the general public as a result of what happened to me during akathisia and toxic psychosis in a general hospital 5 years ago now, which was seen as serious mental illness not a result of the polypharmacy which the consultant later lied about – a lie which was proven by the health trusts own documents listing the drugs to be taken at night. David – you have a much better chance, if they ever have such an interest about what is happening to thousands of people the world over.
“After the ridiculous situation when the doctor told me to drive to the mental hospital because I was enveloped in unrecognised akathisia from cold turkey and did not tell the psychiatrist and did not tell him she had given me three benzos and propanolol either, and I left with suicidal ideation.”
Annie how long were you in a psych hospital and in there did matters improve – were you listened to what was the interaction for the wider public. Did they interact with you in a meaningful way from your perspective or were your true – must have been very serious – concerns about what was happening to you ignored ?
Dr. David Healy says
Chris
Can you put together some ideas about this – how you would approach the art world – and on the back of what – the death of someone like Mark Rothko – what do we know about his death?
David
chris says
Feb 25 1970 killed himself by slashing his right wrist and is reported to have taken an overdose of barbiturates. I’ve not read any reports of a suicide note. He was very successful as an artist at the time and has since become even more famous. I’ve seen a docu drama reporting he was taking valium. He is reported to have been an alcoholic.
We would need to see his medical records to establish the medication and any changes in medication upto his death to make serious consideration of akathisia. My view – this would be highly unlikely to happen unless his relatives took a serious interest.
I’ll think some more about approaching the art world but I don’t think it’s possible for me to do it – their world is all about fame and status and it’s a closed culture to anyone else and not just on a money level. But I’ll try to think in a positive way.
annie says
Reputational damage to the extent you describe, Chris, must be a heavy cross to bear.
Just to give you a little flavour, and how we were squeezed out of society, as we knew it, and the doctors, just down the road, displayed an acute lack of compassion which compounded an extremely miserable situation. What was most apparent was the judgement and persecution resulting from their lack of awareness as to how dangerous these drugs can be.
“You must remember how many cups of tea you had this morning” he shouted at me, the admissions person at the mental hospital, a half-hour drive.
I went in on a Friday. The new lady doctor who sent me cold turkey from Seroxat, knew nothing of my personal circumstances, child, dog, at home and who would look after them. After six weeks or so of unbearable withdrawal I had restarted Seroxat myself and this had led to my screaming at her to send me to a hospital.
She immediately picked up the phone, paged the psychiatrist, and made me an admission. That was it, no conversation, no descriptions, nothing at all.
There was no sign of the psychiatrist and I kept asking, where is the psychiatrist.
I was in such a state, I had begged for Diazepam which was given several times a day along with Seroxat.
He came in on the Wednesday.
The Diazepam had a soporific effect.
He sat by my bedside, where I had been all week.
I was desperate to go home.
Seroxat and drugs were not discussed because she had not told him she had taken me off cold turkey and I did not have the wherewithal in the drugged state I was in to talk much at all.
I went home on the Saturday. Nobody gave me Diazepam.
I was driving for about ten minutes when I started to hallucinate about ending my life.
It was the Sunday morning when I had violent episodes leading to a general hospital.
When I saw the psychiatrist some weeks later, I asked him what he had thought when he heard what had happened to me. He looked at me as if he was almost seeing something, but then he said, “I was surprised.”
Then he upped the dose to 40 mg.
He transferred me to a very young psychiatrist who I told about the recent Panorama programme on Seroxat and she said she would talk to the hospital pharmacist about a withdrawal programme.
This year-long reduction programme was sent to my lady doctor.
The psychiatrist who came to my home never knew anything about the lady doctor’s behaviour with drugs.
When I became at peak-point suspicious, was when she rushed in to my sitting room with packets of Fluoxetine as the reduction programme was coming to an end and I was going back in to the state of the previous year. “You need this” she cried.
In the bin they went, three months of torture, no drugs were to be taken by me ever again.
So I got my medical records and lo and behold, the psychiatrist had written a letter to the surgery saying if ever I was to come off Seroxat, I should be given Fluoxetine to help with blood levels.
He wrote this letter around 1999.
It was now 2003.
My life was so wrecked, I moved home and to a new surgery.
By now I was incredulous and so I sent my medical records to the new owner of my previous practice to go through them to try and get a handle as to what had gone on.
“I did notice you weren’t given Fluoxetine” he said, after saying he didn’t notice anything irregular and as I was about to leave, and charged me £99.
The lady doctor wrote on 4th September, 2003
‘She has been seen by (psychiatrist) in the past and he has suggested the use of SSRIs. She has had Seroxat which she discontinued last summer when she was well at his suggestion of Fluoxetine. It does not appear that either of those drugs have made the slightest difference to her and I notice a recent article they are no more efficacious in anxiety than Benzyodiazepines.
Her problems always seem to arise in the summer. One of her other features of her summers her mother comes to stay with her.’
OMG it was my mother who saved my life with her three month nurturing during the two excruciating withdrawals each summer. That had to be one of the most outlandish and despicable statements made by a doctor. My gorgeous mother had been calling her night and day, and if she deigned to turn up she was offhand, quite often rude, dismissive and upsetting.
The Clinical Director at the hospital, in response to my complaint told me it wasn’t the job of a consultant psychiatrist to check up on medications given by a GP.
We lost the GSK court case, I lost out in my attempts of a legal case against the doctor.
All I can say is that fighting the good fight, and spending years and years on possible litigation helped enormously with feelings of being a social outcast. It gave some credence to the matter in hand and although crushingly disappointing to let GSK off the hook, the fact that we got as far as we did and that all litigants stayed the course put some fire behind the drug racket.
chris says
Reading that brought back my own horror memories along the same lines. It’s incredible you are alive – you certainly had akathisia maybe into toxic psychosis, but still had the tenacity to bring a legal case. I got as far as the PHSO but knew I was wasting my time and stopped it.
Yes it’s Anne-Marie’s post and she has clearly been through hell as well and ended up in prison with a criminal record. It’s diffficult to be positive – it’s so unjust.
Dr. David Healy says
Chris
Being angry to the point of being homicidal is appropriate given what happens. But your finding that 5P5 helped your akathisia and likely others and Anne-Marie’s discoveries about SSRIs and alcohol save lives and offer people something constructive – read the comments after her driven to drink posts. Nobody is going to come to a site where people have to wade through repeated bitterness.
Annie has told her story before. I’m not sure there is any easy way to link back to prior comments where this comes up. Perhaps when situations like this develop I should ask her to email you. But this is all work for me, it risks making you and maybe Annie feel shunned which is not what I want. Maybe you need to ask me instead can she email you as you’d like to find out more.
I’m not for one minute trying to invalidate your reactions. I think homicidal rage is appropriate in the circumstances and there is place for it on RxISK – perhaps though in a post if you want to think about writing one/
David
Dr. David Healy says
Chris – Annie
This post was about a triumph – Anne-Marie’s. The comments should primarily be on this. Ideally trying to draw new people in. Working out how to capitalize on this. Perhaps by solving the mystery about why some people’s alcohol levels are higher when they are on an SSRI – solve this and lots of lawyers will be in touch wanting to use it – and will spread the word.
There needs to be good news – you both have contributed good news in other posts – we need an occasional break from looping around the iniquities of the medical system.
We need you to encourage others to do more of what Anne Marie and you have otherwise done.
David
Magnus says
Dear Dr. David Healy,
I admire your and your community work greatly!
Maybe not the place to ask this but I was wondering after listening to many PSYCHMEDS sufferers incl. Dr. Mark Horowitz.
My question:
– Can you notice a pattern of patients first being presribed antidepressants or benzos, then stimulants for lost motivation. Then finally mood stabilizer or even antipsychotics to deal with the side effects of stimulants.
I was prescribed benzos for stomach distress and I took them for 18 years. One year ago I finally quit the benzos (2mg clonazepam) but I was then still on 8 meds. Now I’m down to 2 meds and starting to feel much better.
Thanks for all the great work again!
Magnus
Dr. David Healy says
Magnus
This is increasingly common. Well done for getting off clonazepam – it can be very difficult to stop. Can you send me a more detailed account of what you were on and the sequence in which you were put on them and how you went about stopping clonazepam
David
chris says
So it seems you were involved with this new guidance Anne-Marie and DH. It seems like someone is listening:
https://www.aldergrovestar.com/news/doctors-urged-to-screen-for-alcoholism-before-prescribing-antidepressants-6526512
“New guidance to help family doctors detect and manage high-risk drinking addresses a crucial gap in knowledge among both patients and doctors, say its authors, who warn that a common practice to prescribe antidepressants can actually induce cravings for alcohol.
The advice is comprised of 15 recommendations on early detection of alcohol use disorder, withdrawal management, psychological interventions and community-based programs.”
Your paper got some attention –
New onset alcohol dependence linked to treatment with selective serotonin reuptake inhibitors:
https://pubmed.ncbi.nlm.nih.gov/23796469/
Dead says
What about fungal overgrowth? Drugs like ADs and Isotretinoin both seem to cause problems with the gut and candida infection. Could the alcohol addiction be caused by the auto-brewery syndrome? Carb cravings stated by chris in another comment can also be explained by the same thing. As an extension, could the body and the nerves not healing after discontinuation of the drugs be a result of constant exposure to mycotoxins?
Dr. David Healy says
Thanks for suggesting but this doesn’t really fit the bill for the addiction or the raised alcohol level. I have thought about it and am not writing it off entirely
David
Dead says
Its impossible to deny the connection with the gut. All the drugs that cause pssd like disease like finastride and isotretinoin also cause gut problems. 95 percent of serotonin is made in the gut. How come all these drugs with seemingly no connection other than affecting the gut all cause the same problems. It does not have to be just candida, it could be different microbes for other people, the point is that there is an altered microbiome. It was just an example for the alcohol problem. Fecal transplant could be the cure, there are success stories.
Dr. David Healy says
You’re welcome to think its the gut. But why the gut and not the skin. The gut is part of your skin – its outside not inside you.
There are all sorts of things that help on a once of basis like gluten-free diets, IVIG, perhaps photobiomodulation etc. None of these including fecal transplants work consistently
D