Editorial Note: The last post on Lariam and suicide mentioned an alternate treatment for malaria prophylaxis – doxycycline. Doxycycline is not without its problems. It can cause suicide – Suicide is Painless. It and other tetracycline antibiotics can also cause sexual dysfunction including enduring post-treatment sexual dysfunction – makes you wonder if they also inhibit serotonin reuptake.
I am 33 years old and have had mild acne for 19 years. I have tried topical solutions, which tend to calm things down during treatment. Once stopped, the acne always returns. Feeling quite sensitive about my skin, I went back to see my GP.
She suggested Doxycycline tablets. I had heard that particular tablets for skin problems could make you feel depressed and suicidal. I mentioned this to my doctor, in the hope that she would tell me that the drug she was prescribing would not cause this. She did. I happily took the prescription to the chemist. The pharmacist then dispensed a loading dose of 200mg and a three month supply of 100mg tablets, one to be taken daily.
Things started well…
I began the course feeling hopeful. The tablets did seem to be an effective treatment for the acne, although I noticed a change in how I was feeling. Initially this was not a problem, I felt good. Apart from a nagging headache and some nausea, I felt subtly dis-inhibited; freer in general. I actually found this quite liberating. This lasted for 3 days, at which point I started to notice that my mood was fluctuating quite quickly. I felt great one minute and extremely irritable the next. My tolerance for stress was decreasing rapidly. It would take one comment to switch my mood and I would become withdrawn and feel like screaming to be left alone. I would visit family feeling bright and upbeat but very shortly end up sitting in a completely separate room trying to calm down before making an excuse to leave. It’s only in retrospect that I can see that this was odd behaviour. Outwardly, I think I must have just appeared quieter, duller. Inwardly, I felt frustrated and angry. Although I can be quite sensitive under usual circumstances, this was heightened way beyond this. I did feel that it could have escalated further, had I continued with the medication.
Disconnected, anxious & unhappy
Family members felt the need to speak to me, specifically to ask how I was feeling. Apparently I had been acting ‘oddly’, they used the words ‘withdrawn’ and ‘down’. These descriptions puzzled me as I had felt that I had swung to and fro from happy to angry, but did not have the insight to see that I was feeling low in mood, as they were describing it. Although, under normal circumstances, I would connect the two things together, under the influence of Doxycycline, it seems that I could not make those connections. Looking back, I felt somewhat disconnected from external events and overly concerned, even locked into internal thoughts. These thoughts turned in to viciously negative ruminations, which made me feel anxious and unhappy.
It was after 3 days of the treatment that I began to notice that I was feeling anxious, escalating as the days and treatment went on. I was worrying about things that I would not usually worry about. I felt an increased heart rate; I could feel my heart thumping in my chest when I lay in bed, silly thoughts whirling through my head most of the night. Unsurprisingly, I found it difficult to sleep. Whilst I was searching for a solution to all my perceived problems, an idea literally popped into my head. I felt relief for the moment that I thought I would carry out this idea; to commit suicide, to kill myself. I brushed this aside as a non-solution and carried on being unable to sleep; obsessing over minor issues that just a second ago I had thought were worthy of ending my life over. At this point I could not see that this was absurd.
Making the connection?
I continued taking the Doxycycline, feeling quite pleased with its effect on my skin. Over the next few days I continued to feel anxious almost constantly, the feel good moments had gone. I was thinking more and more of that absurd solution to all of my problems that seemed to just get worse and worse. I would be driving in my car, at any time of day and suddenly think…I could just crash my car. The words repeated themselves in my mind for the remainder of the journey. I was struggling not to give in. By this time I had heard some stories about others taking Doxycycline, with disastrous results that ended in suicide. Even then, I felt like there needed to be some deliberation about stopping the drug; it was working as a treatment for the acne. I felt like I couldn’t quite grasp the reality of the situation, I was somewhat removed. I would like to think that if I was to choose to end my life that I would not try to take other lives with me. Crashing my car would likely cause other injury or fatalities. Looking back, this seems like a very selfish and ‘disconnected’ thought to have.
In the end, I bargained with myself. I would stop taking the tablets to see if I ‘felt’ better. I could always re-start to cure the acne. Even though acne makes me feel sensitive about the way I look, I can’t ever imagine wanting to take the risk of death in the hope that it could be cured. I think this is another example of how I experienced feeling disconnected.
Without doxycycline I felt more like me again
I gradually started to feel more like me as the days without Doxycycline went by. After 2 weeks I felt much better. After the first few days the impulsive suicidal thoughts had stopped, although I continued to feel anxious and ruminate about things. This reduced in intensity over the 2 weeks until I just felt my kind of normal again. A relief!
I did get the sense that the tablets had affected my hormones in some way. I can compare how I felt then to symptoms of PMT and my cycle had been set off course by 11 days. This may sound circumstantial but this is less than rare in my case; it has never happened to me before. These 11 days were days that came after I had stopped the tablets, so at first I did not think it was related. I searched the internet for things that could be the cause; I found quite a few cases implicating Doxycycline in women with the same problem. This strengthened my suspicion that the effect may have been, at least in part, hormonal. The whole experience has deterred me from taking medications in future. It’s frightening to think that a tablet I take for acne can make me want to take my own life. It’s even more frightening that I nearly didn’t make the connection.
The experience wasn’t fatal in my case, but others haven’t been so lucky.
annie says
In, my particular, experience with Paroxetine, I associate myself with the legal cases which have been succeeded in the US.
A force of chemical toxicity so strong that any thoughts of salvation were completely stripped and it was impossible to fight.
To me, it was completely unexpected and I had no thoughts of violence and suicide except when I was trying to get myself home from the hospital whilst experiencing hallucinations about ceasing to exist through the use of my car.
Something happened three days later.
Something occurred in my chronically akathisia ravaged body which somehow transgressed to taking me over to escape this horrendous affliction of chemical induced cessation of my life.
Those who step back is an interesting question.
Not being them, it is difficult to answer.
However, I was so disassociated from myself and in such an alien place that it did not occur to me to tell anyone about it.
I can only suggest that people who held themselves back were may be not swiped in such a ruthless, savage and destructive way with drugs such as Seroxat and may be metabolised it differently thereby giving themselves a chance to survive.
Yolande is a forensic psychiatrist who has put this over quite straightforwardly and I would like to suggest that it could be useful to watch her presentation.
https://truthman30.wordpress.com/2015/04/11/yolande-lucire-psychiatric-drug-dangers/
With thanks to Truthman for this compelling dissertation.
One thought from Maieliv…..so far………….
annie says
If you put toxic chemicals in to your mouth don’t be surprised if they come out the other end
15+ years later…
The only voice I haven’t heard is that of Sir Andrew Witty whose company GSK manufacture Paroxetine and whose company were well aware of Paroxetine’s Law of Diminishing Returns in the US prior to introduction here
http://www.economicshelp.org/microessays/costs/diminishing-returns/
Those who disappeared under the fine line are those who have lost their voices as this graph clearly illustrates…GSK economic decision making has taken precedence over mortality and other figures available on Rxisk.org
Vera says
It is about having a certain level of awareness which means being able to analyse a change that takes place after the introduction of a drug. The ability to make the connection.
Something like: I have never felt like this before, and now that I am taking this drug things are changing. Strangely enough even doctors are incapable of making this connection, and instead of stopping the drug they introduce new ones to combat the side effects.
Has anybody ever thought of the side effects of this increasing COCKTAIL.??
It is quite criminal actually.
No wonder our NHS is creaking under the strain of increasing number of patients.
You hardly hear anybody advocating a healthier way of life.
This country is obsessed by the NHS. It has become an emotive political football. I travel quite a lot and do not find continentals obsessed by a disfunctional health service. They take more responsibility for themselves and are more health educated. It is in their DNA.
I really despair about the general medical IGNORANCE in this country!
Likes lambs to the slaughter they make wonderful guineapigs for the ruthless farmaindustry and which financially prospers on their ignorance.
nicole dailey says
Thank you so much for sharing your story Im so happy you made the connection before it was to late because for my family we didnt .My dad took his life on march 15th 2014 .My dad was on and off doxy for about 7 years .The month before my dad passed he went to the er cause he was having a reaction to his meds they said he was allergic to the doxy so to stop taking it so he did .Well a couple weeks later his doctor told him to take it cause it helped his Prostate but to also take Claritin if he felt a reaction coming on .The week before my dad passed he was very sick and in alot of pain .Also he was Obsessing over things that didnt matter and I noticed he was messing with his hands more and he would do that when he was nervous or anxious .I would say will you stop and he would be like like i cant help it .The day before he was acting shut down and my mom said he has been up at night vomiting so i brushed it off .The day he took his life started normal he went to my daughters game and went and got clams to cook for lunch and dinner .then hours later my world stopped a day that plays over in my head like a broken record my mom called screaming my dad killed him self i dont know why but i hung up on her and got into my car driving about 90mph my parents lived like 5 miles from me i then called my mom back and a cop picked up and said hurry my mom needed me as i pull in my body was numb i jumped out of my car and ran I could hear my moms screams as i hit my yard i see someone laying on the ground with cops around them and my mom is in a ball in the yard still it hasnt hit me i was asking were my dad was but my mom couldnt talk so i ran in the house and couldnt find him so i ran out the back door and toward the cops almost to them a lady cop grabbed me she said dont go up there you dont need to see this and i said were is my dad she said that is your dad for some reason i knew it was him but my mind didnt want to believe it .she then asked me tons of questions and I replied no to every one .My dad wasnt depressed never had a mental disorder was a great dad and grandpa and would never leave us this way .I was so pissed .My mom then told me she was home and at the same time i wish she wasnt but because she was we got to understand he wasnt in the right mind set .She said he had zero emotion to him and that wasnt my dad .There is no way he could have looked my mother in her eyes and not cried as she is begging him not to .She did everything she could to stop her as she was on the phone with 911 he took off up the hill and did it .we then were trying to figure out what happened and we looked up his med and nothing we then googled doxycycline suicide and tons of links came up i wanted to vomit I felt played and so angry .MY dad wasnt the first person and he wont be the last but at least my family has closure to his suicide only because a mother shared her story of her son and we were able to connect the dots .The fda still wont put a waring in the med sheet .How many people have took they lives because of this med and how many are taking it now and have not put to two together .Please spread the word this could happen to anyone .I wouldnt wish this pain on anyone .Also this is a link to another family who lost a great person to this med .https://www.change.org/p/doxycycline-causes-suicide-in-teens
BOC Sciences says
That’s quite horrible. Side effects is one of the problems the modern medication faced with. There should be more standard involved in the weighing of a drug’s effect before they are published.
Lelle says
Thank you so much for sharing!! I have been on tetracycline for over a week now and am feeling exactly the same as you. It was great to read I am not the only one and not just imagining things.
Dr. David Healy says
A senior coroner has demanded action from the Medicines and Healthcare Products Regulatory Agency after a student who had taken an antimalarial drug jumped from a plane to her death.
Alana Cutland, 19, a natural sciences student at Cambridge University, was doing an internship in Madagascar when she had several attacks of paranoia.
She had spoken to her parents and was about to fly home to the UK after cutting her internship short in July 2019 when she travelled in the Cessna light aircraft. She opened one of the plane’s doors and, despite attempts by the pilot and the other passenger to restrain her, leapt from the plane.
An inquest into her death determined that the cause was “traumatic injuries following a fall from a plane” but heard that she had been prescribed doxycycline as an antimalarial drug.
Tom Osborne, senior coroner for Milton Keynes, wrote in his inquest report, “The deceased was prescribed doxycycline as an antimalarial medication for use whilst in Madagascar. It was quite apparent from the evidence that she had a psychotic reaction as a result of taking the drug and yet there is nothing on the drug information leaflet that either highlights or mentions this possibility.
“If she or her parents had been aware of this possible side effect they may have been able to intervene earlier to avoid her death. In my view the information sent out with the drug should be reviewed. In my opinion action should be taken to prevent future deaths and I believe . . . your organisation [has] the power to take such action.”
Doxycycline is a tetracycline antibiotic that can also be used to prevent malaria. The National Institute for Health and Care Excellence website lists anxiety as a rare side effect but doesn’t mention psychotic reactions.
Coroners are under a duty to send reports, known as regulation 28 reports, to individuals or organisations they believe to be in a position to take action if their investigation reveals a risk that other deaths will occur in similar circumstances.
An MHRA spokesperson said it had been granted an extension to the deadline for replying to the coroner’s demand for action “in order to seek independent expert advice.” The spokesperson added, “We are currently reviewing the available evidence on the suspected association between doxycycline and psychotic disorder. This is because psychotic disorders are not currently a recognised side effect of this drug.
“We have informed the coroner that our review is ongoing, and any regulatory action will be communicated to healthcare professionals and patients. Malaria can be a very serious, sometimes fatal, infection. It is important that people travelling to areas that pose a risk of infection receive appropriate antimalarial prophylaxis.
“Doxycycline has been authorised for the prevention of malaria and also for the treatment of bacterial infections and skin disorders such as acne for over 50 years. During that time many millions of people have taken it. The balance of benefits and risks for doxycycline is considered to be positive. Patient safety is our highest priority so, as with all medicines, we keep the product information for doxycycline under review.”