Be these juggling fiends no more believed,
That palter with us in a double sense;
That keep the word of promise to our ear,
And break it to our hope.
A storm blew up just over a week ago with a Lancet article on antidepressant dependence and withdrawal. Based on company studies, this article gave some credence to the idea that antidepressants might cause dependence and withdrawal.
Many struggling with dependence were concerned, however, that a relatively low dependence rate, and lack of serious complications gave a misleading impression of the severity of the problem.
On the other side, the psychiatric side, there was a degree of crowing by a Dr Pariante in the Guardian and others on X claiming the Lancet article laid to rest the idea that antidepressants are addictive.
Fiendishness
There is a juggling fiends aspect to the word addiction – keeping the word of promise to our ear and breaking it to our hope.
As Shelley Jofre, serially impaling Alastair Benbow, then of GSK in a series of Panoramas from 2002 to 2004, when Dr Pariante and others had not been heard of, made clear for most people the word addictive means I can’t stop.
Saying a drug is not addictive in plain language means I will be able to get off it when I want to.
Back then, GSK and other defenders of the faith in companies, colleges and associations were clinging to a specialist definition of the word addiction – meaning that a drug does not have abuse liability. It’s not an opioid in other words. It won’t make people criminals in their efforts to get hold of it. This distinction turns a blind eye to doctors dishing it out liberally
Given recent developments in behavioral psychology, appetitive seems a better word than addictive. It is more precise. It means certain drugs can create an appetite and even after you withdraw from them, which is relatively easy compared to the difficulties some people have attempting to withdraw from SSRIs, the appetite remains and can get you back into trouble.
We’ll have to wait and see if Ozempic comes to the rescue on this point.
Symptoms on Stopping
It seems the faithful vassals (Pariante et al), if that’s the right word, are still clinging to this distinction – in defiance of regulations, common sense and simple humanity.
Long before 2004, struggling with the addiction-dependence-withdrawal issue and not wanting to use any of these words, GSK and other companies resorted to a neologism – Discontinuation Syndromes. This invention was getting a bad name by the time Panorama and Shelley Jofre came along. Flailing in the face of a Jofre chainsaw, Alastair Benbow resorted to Symptoms on Stopping.
The SoS concept has delighted me ever since for obvious reasons.
Almost certainly as well-coached as any juggling or fiendish politician might be for a debate with a serious interviewer, why would a smooth operator like Alastair flail?
The answer is he was the company at that moment and companies are regulated when it comes to making claims. They can’t say things like non-addictive in the way Dr Pariante could. This is not a matter of simple falsities. Companies are not supposed to mislead and drug labels should speak in the language of all lay people and likely many doctors for whom addictive means – you are unable to stop.
Around this time GSK were faced with a lawsuit for a paroxetine label that said it was not ‘habit-forming’. The lawsuit led to a removal of these words.
Judas Goats?
Dr Pariante can say whatever he wants without repercussions. He can say non-addictive, non-habit-forming and even lowered serotonin or chemical imbalance without a problem. If they felt like taking a risk, and the drug was still on patent, GSK could include statements like lowered serotonin or chemical imbalance in the paroxetine label with a reference to a footnote citing Dr Pariante.
The reason is FDA, EMA, MHRA etc do not regulate claims made by academics. They only regulate company claims. And it seems regulators only regulate company claims in glossy adverts but not in adverts in medical journals like Study 329 which claimed paroxetine worked well and was safe, or the many articles written by companies that feature defenders of the faith on their authorship lines. There was nothing in the original Study 329 article showing the highest rates of suicide events in this trial happened in its withdrawal phase.
Company articles aren’t usually viewed as adverts and we all think the academics on the authorship lines are the people who wrote the article. It must be the simple thinking bit that there is a genuine element somewhere in all this – besides a genuine company requirement to make money – that deters FDA etc from taking issue with these claims, even when companies tell them this trial (Study 329) shows our drug didn’t work.
Regulators don’t want to confuse the public. They will even agree with GSK’s proposal not to mention that Study 329 and all other GSK studies in adolescents were negative in the label of the drug and keep quiet about the fact the same was true for Prozac.
Not mentioning is not lying or making a false or at least misleading claim in the way mentioning non-habit-forming or non-addictive would be. Clear? There is a phrase that covers this – being economical with the truth.
Where do Judas Goats fit in? Psychiatric academics and the President of the Royal College of Psychiatrists – see Sex Death and Royal College of Psychiatrists – push or at least happily tolerate the line that the only problems there might be with antidepressants stem from their prescription by primary care doctors. This fits a model they are comfortable with – that partialists like the shrinks are better doctors than generalists.
Generalists and Partialists dissects this thinking. The partialists are often and like to be termed Key Opinion Leaders – KoLs. Judas Goat as illustrated in G and P might be a better term.
Background
Our current set of juggling academic fiends, whether in the US, UK or Europe, may be too young to know much about the background here.
SSRIs were first made to explore what looked likely to be a serenic effect mediated through a normally functioning serotonin system – The Fantasies of Psychopharmacology.
They became antidepressants because of a benzodiazepine crisis in the 1980s – nobody, at least in Britain, was going to believe an anxiolytic, tranquilizer, serenic, was not addictive.
Within 3 years of paroxetine being launched in the UK, there were more reports to the MHRA of dependence on it than there had been in the previous 20 years’ worth of all reports of dependence on all benzodiazepines combined.
Meanwhile years prior to launch, in the mid-1980s GSK ran healthy volunteer (phase 1) trials in young men. Many of these lasted 2 to 3 weeks with symptoms on starting and on stopping recorded. The rates of significant discontinuation symptoms ran at up to 85%. The rates of serious sexual dysfunction on treatment were over 50% with a possible persistence after stopping.
Investigators on GSK treatment trials, like me, were later told not to ask about sex. Companies were able to construct these licensing trials to eliminate this and other features they had learnt from their phase 1 trials. It is these treatment trials that the Lancet article is reporting on.
Severe dizziness was among the most common problems healthy volunteers had on stopping. Anxiety and depression were as common. These findings should clearly colour the interpretation put on any data coming out of treatment trials such as the studies listed in the Lancet.
I have checked with several authors from the Antler study, praised by some of the current academic jugglers, which they claim also helps nail the spectre of addiction. The Antler authors make it clear that in contrast to the way they viewed dizziness, they viewed symptoms of anxiety and depression on stopping as manifestations of the original condition and as indicating a need for ongoing treatment. The healthy volunteer data suggests that anxiety and depression was likely just as indicative of dependence and withdrawal as dizziness.
The problem for the Antler and any juggling academics is that they have not seen these healthy volunteer trials. I have but am not free to share the original documents. I can give document details to anyone who wants to make Freedom of Information requests to GSK. It’s difficult to have a genuine discussion if key evidence is being withheld.
On the rare occasions some of us get access to clinical trials, we find evidence of fraud. But no-one normally gets access to clinical trial paperwork. Clinical confidentiality, companies claim – to their great regret – prevent them from sharing these with Dr Pariante and colleagues. But there is no clinical confidentiality involved in healthy volunteer trials.
Juggling is an art-form and it’s a lot easier sitting in a plush academic office, perhaps with prompts from company emails, than it is while you are actually suffering from the balance, visual, sexual, suicidal or other problems linked to withdrawal – See Balancing our Bodies and Juggling our Selves.
Those who are having real difficulties balancing their bodies and themselves, and struggling with tapers that can last years can be hit from behind by other academics like Dr Young saying – of course there’s some dependence but nothing that a little bit of tapering won’t take care of.
One of the defenders of the faith recently implied they were motivated by a need to save some good drugs. For 25 years in Psychiatric Drugs Explained, I’ve been saying that it’s important to save good drugs. It’s important that what happened the benzos doesn’t happen the SSRIs.
The time to save the SSRIs was 25 years ago by acknowledging their problems and working on managing these rather than shrinking from them and sticking our heads in the sand. There is every chance the SSRIs will get swept away now – by companies.
Companies swept the benzos away, not Heather Ashton or Esther Rantzen. It suits companies for you to think Heather or Esther, but Heather and Esther didn’t go around telling doctors they would be sued for giving benzos – or tricyclic antidepressants that are more effective than SSRIs.
Companies are now tolerating the raising of SSRI problems in a way they weren’t a few years ago. This adds an edge to an old adage – Be not the first to take up the untried nor yet the last to lay the old aside. Company interests to get rid of old and cheap SSRIs have likely pushed the door ajar to talking about SSRI linked sexual problems, and the increasing number of young people seeking Medical Assistance in Dying because of protracted withdrawal. This risks leaving the defenders of the faith looking like the last to lay the old aside.
Peter Scott-Gordon
A weak after Pariante featured. Peter Scott-Gordon, a psychiatrist who suffered badly from SSRI dependence, took up position outside the Edinburgh Conference Hall where this year’s annual meeting of Britain’s Royal College of Psychiatrists took place.
Peter gives an extraordinarily fascinating account of the high and mighty of the College coming up to him at the entrance to the building whom he engaged with. For some reason Hannah Arendt’s Banality of Evil phrase about Nazi Holocaust officials came to mind – see Outside on the Pavement.
See also What is Cumberledge?
Peter and many others (who will be familiar to RxISK readers) have also written to the President of the College, Lade Smith, about Patient Safety.
The Guardian refused to publish their letter What was the Guardian doing giving the Pariante piece such a prominent place and refusing what is for patient safety a far more important initiative? See Challenging My Media to Disclose on dh.org, which grapples with this.
In the near future Consumers or Cyborgs will extend the grappling.
Peter J Scott-Gordon says
David, you belong to a science that used to be.
I could have picked out so much from your post, but for now:
‘Symptoms on Stopping.
Companies are regulated when it comes to making claims . . . they can’t say things like non-addictive in the way Dr Pariante has [in The Guardian] …. Dr Pariante can say whatever he wants without repercussions ….’
Patrick D Hahn says
Antidepressants are addictive according to the dictionary definition of the word, and that’s the only definition we have. There is no category called “addiction” in the DSM.
For drug-company-funded experts to abolish the word addiction from their lexicon and argue from authority that antidepressants are not addictive is the height of mendacity.
chris says
The problem for the Antler and any juggling academics is that they have not seen these healthy volunteer trials. I have but am not free to share the original documents. I can give document details to anyone who wants to make Freedom of Information requests to GSK. It’s difficult to have a genuine discussion if key evidence is being withheld”
Anyone want to make a Freedom of Information request ?
Maybe Dr Peter Scott-Gordon could put the reply details on his banner for next year…
susanne says
Looked up the meaning of Judas Goats I think it’s brilliant with respect to KOLS. Not only do they lead doctors up a path but influence whole populations to become sub kols who are now breeding like rabbits and spreading the message though journalists ‘patient groups’ ‘experts by experience’ Most bought by pharma and co. and treated like their pets. Not with payment – please -but invitations to conferences. voluntary expenses , meetings in nice hotels feeling they are doing something altruistic and decent. As many are but this actually repeats what medics taking freebies from pharma and co .are castigated for but openly still do as the occasional letter which slips into med journals reveals. Try writing to any of them from the womans’ point of view pointing out the means by which women are being corralled into taking vaccines with a huge degree of surveillance and intrusion into their lives For example calls at home from ‘trusted community members’ to ‘ask’ why they are ‘refusing’ (not declining) vaccines and other heavy handed persuaders.
annie says
The influence of paid opinion leaders on the prescribing of antidepressants in the UK
https://holeousia.com/in-the-world/a-sunshine-act-for-scotland/british-psychiatry-marketing-as-education/the-influence-of-paid-opinion-leaders-on-the-prescribing-of-antidepressants-in-the-uk/
British Psychiatry is heavily influenced by opinion leaders who are often paid by industry. These opinion leaders are in positions where they can significantly influence prescribing of psychiatric drugs. Furthermore, this group determinedly shape and form the overall narrative arguing that they are free from “ideology”. Yet, the exact basis of their “joint working” is generally opaque. This may reflect a wish to maintain a position of medical authority that comes from science that is perceived as independent from outside interests.
I have submitted a response titled “The influence of paid opinion leaders (POLs) on the prescribing of antidepressants in the UK – a timeline of some key publications” [taken from the public domain and with all available citations provided].
In October 2018, the Editor-in-Chief of the BMJ, Fiona Godlee said: “We don’t let judges or journalists take money from the people they are judging or reporting on: we shouldn’t let doctors do this either. Paid opinion leaders are a blot on medicine’s integrity, and we should make them a thing of the past.” [4]
However POLs who generally control the narrative in relation to psychiatric drug prescribing continue to be very much of the present.
Peter Scott-Gordon says
Patient safety
From: Peter Scott-Gordon
3:30 PM (21 June 2024)
To: guardian.letters, RCPsych feedback, President of the Royal College of Psychiatrists, Dr Ellie Cannon [c/o Daily Mail]
I write to express concern in relation to the following perspective as published in The Guardian:
https://www.theguardian.com/commentisfree/article/2024/jun/08/antidepressants-addictive-has-been-debunked-psychiatry-depression-withhdrawal-symptoms
This published opinion has the potential to cause considerable avoidable harm.
This published opinion spins what the Lancet meta-analysis carefully says.
Why the Guardian should publish this opinion piece, without fact-checking, should be a matter of concern.
This opinion piece is by a career-long paid opinion leader whose vested interests [paid and otherwise] are multiple.
As a retired NHS psychiatrist I was dismayed to learn that the President of the Royal College of Psychiatrists recommended this Guardian perspective with these words “This is a MUST read” [sic]
Yours sincerely
Dr Peter Scott-Gordon
Harriet Vogt says
This is a remarkable post. A knock out blow to the juggling fiends so careless with people’s lives – like Peter’s, Alyne’s, Charlie’s, Dexter’s. Romain’s, Annie’s, Chris’s – and thousands more trusting innoccents.
One challenge – ‘addiction’, ‘addictive’, or even the more neurologically precise and contemporary ‘appetitive’. I have serious misgivings:
1. These words/concepts imo are indecently judgmental of human beings.
2. They fail to recognise that what drives many so-called ‘addicts’ , ‘addicted’ to opiates, is a
desperate need to avoid withdrawals, as well as desperate lives. They are grappling with dependence just like those struggling to escape antidepressants or benzos.
3. Dependence is a non-judgmental, democratic and symptomatically appropriate construct across the board.
4. People have complicated, individual, emotional and physical relationships with psychotropic drugs – and all drugs for that matter. It’s multi-dimensional. Let us not fall into the conceptual conformity (a useful concept) trap.
5. They imply a helplessness which I think is unhelpful. They also encourage, even in the most open-minded and supportive, a destructive power imbalance in relationships.
6. They enable juggling fiends to manipulate a distinction that does not exists to imply drug safety that does not exist.
7. The implicit and imo unacceptable moral judgementalism is manifest in NHS guidance about ‘drugs of dependence and antidepressants’. Nonsensically, there is an attempt to sanctify antidepressants by describing them as ‘not dependence forming,’ but still capable of causing withdrawal. Ludicrous. Except it’s not funny.
Yes, I’ve observed, though not been the direct recipient of ‘addiction medicine’ – in action – and it offended me. Just as juggling fiends lying about the ‘non addictive, safety’ of atidepressants offends me. And you. And all of us.
Casting a spell. ‘Addiction’, ‘addictive’, ‘appetitive’ – Begone.
Dr. David Healy says
H
The word addiction is too important to lose. We are not going to help people by getting rid of it and part of the harm Pariante and others do by failing to recognize SSRI harms is they also harm people who have opioid problems.
There is no question that people caught in substance abuse and opioid services can also be treated despicably but getting rid of useful words is not the answer to this. Part of the answer lies in making clear that in general Symptoms on Stopping can be much worse with antidepressants and antipsychotics than they are with opioids. Clearly some people can stop SSRIs no problem but so too with opioids and in particular with drugs like clonidine or lofexidine which can make stopping opioids very easy and safe.
The opioid problem which doesn’t apply to antidepressants is that these drugs create an appetite, a craving, for more that persists after stopping. The appetite element to the problem creates the perceptions of depravity linked to opioid use that don’t apply to antidepressants. Everyone breathes easily when a woman in particular says she is taking an SSRI, the way they do if a person with epilepsy tells us they are taking an anticonvulsant and we get nervous if they aren’t. In lots of ways we want awkward people like women to be numbed and quiet but this is a different problem that needs understanding in its own right – not conflating with entirely different problems.
There are all sorts of ways to manage appetite issues besides the methods substance abuse services are constrained to use by political dictates – there are elements of a degraded environment that make the problem worse, there is increasing knowledge about how to manipulate appetites behaviorally (without drugs) that could be brought into play but aren’t. Drugs like Ozempic might shed light on all this – not necessarily in the sense that they would be used to manage appetites but might reinvigorate research into non-drug ways to manage appetites. But none of this will happen if you refuse to distinguish between the types of stopping problems we have with antidepressants that are totally different to the ones opioids generate.
There are cross-overs – in some cases of severe SSRI induced akathisia, for instance, opioids can help.
I think your linguistic proposals are just going to lead to a reinvention of neologisms that will be new but equivalent and offer industry and the juggling fiends more opportunities to exploit and confuse.
Life on earth can’t survive without appetites. Understanding them is important even though unfortunately understanding appetites completely won’t help the antidepressant difficulties this post deals with one bit.
D
D
chris says
My experience is that people going through these horrific experiences are treated as utter trash and as criminals not patients. The akathisia I suffered caused directly by my GP and a number of psychiatrists was seen as severe anxiety and in their view could only be because I had committed some terrible crime. I was just one of many being treated in this way. They don’t give a fuck about words like addiction and they don’t give a fuck about akathisia nor if you die. What I experienced was pure evil and it needs to be exposed and stopped some how.
Sorry to be direct but that is what is going on.
Dr. David Healy says
Chris
Direct is good in this case. What you are saying helps marry some of what Harriet is saying with what I’m saying.
The Challenging My Media or Disclose post puts it a different way – in between the lines. The more direct version is you are a sinner – something you did in a past life was horrendous and you are being punished and who are we to get in the way of God punishing you.
We will tolerate demented elders, people who have the ‘wrong’ colured skin, women etc before we will tolerate you. They are second class citizens but you are outside the pale – a sinner, a blasphemer for not kneeling down in front of the sacraments and telling the Creators how marvellous they are.
The biggest failures in all this come from the Left Wing Media who sanctimoniously go on about Diversity, Equity and Inclusion but who vilify you, from Medics like Pariante who cancel you, and my pet bugbear – the Pope – who mandated vaccines even in the face of people he knows being badly injured.
There is a religious element to all this. We are talking about religion in the sense of keeping the herd together and sacrificing some injured members to the circling hyenas in the interests of keeping the rest of the herd safe. We are not talking religion in the sense of making the stone the builders initially rejected the cornerstone – which is almost a definition of science also.
D
susanne says
Chris it was and still is pure evil nastiness. (We all know that the claim is sweeping and that every health worker is not in this category = but this is not what we are talking about.The connection between mental illness and sin was embodied in the beliefs of more than a few psychs in Wales. Dafydd Huws a one time psychiatrist politician and environmental campaigner made people who consulted him sit in front of a cross which was behind his desk and talk about their ‘failings’ Brian Harris psychiatrist influential member of the church in Wales at the same institution used to ask people to pray with him – and laughably used to say a prayer at the close of meetings with colleagues who sat there stony faced but said nothing. He was found guilty of sexually abusing young men who consulted him. And later tried to be reinstated after being chucked off the medical register. These anecdotes were common for many years around S Wales but covered up pre much used internet days. I was asked by a charity to draw up an ECT information booklet. B Harris was furious and stopped me using the hospital library , His reason was that people would refuse to have it if they saw the information plus the video trainees used to learn from. A long time ago maybe but the perception of people as disposable trash is still part of the psych psyche .. Corruption and cruelty is exposed constantly.
Gwen Adshead is another case, a psychiatrist.therapist another lay preacher who seems to have found redemption after being found guilty of breach of trust. It was long ago but too often the story gets whitewashed by later revised versions of history It is sickening how often this happens
GA tells the revised story in a Church Times article in 2021 Interview: Gwen Adshead, forensic psychiatrist and psychotherapist
by Terence Handley MacMathos MARCH 2021. This comes up on Google and makes her seem saintly. Terence is no investigative journalist. This is very far removed from what was the reality – I could tell a very different story.
chris says
Yeah I looked up that piece on Gwen Adshead just made my eyes roll and wondered what your take on her is – guess you can’t say publically – and if she has views on akathisia causing violence and that her drug perscribing/forcing actions as a psychiatrist may well , as all psychiatrists, have caused a person to be violent especially within the context of her work at Broadmoor.
“I do think about my shortcomings, and regularly acknowledge to myself that my patients and I are more alike than different.”
Harriet Vogt says
Round 2.
Total respect for your perspective as, frankly, a rarity – a psychopharmacologist specialising in drug actions and harms, a doctor who genuinely practises the relationship based medicine you preach. That may be the rub. And Chris’s unforgivable ‘treatment’ may be more of the reality, however you phrase it, regardless of language.
But, from a patient and communications’ perspective, I still baulk at clinical language that has implicit within it – moral judgment (sinner, indulgent…), a theft of personal agency (out of control, weak willed…), power and epistemic injustices – and, of course, the sort of economies with the truth beloved by juggling fiends.
This kind of language is ubiquitous in medicine, especially psychiatry. And I object to it.
One clearly heinous example is – ‘Borderline Personality Disorder’. Its wickedness captured in THAT internal RCPsychiatry email outlining a course on ‘BPD’, when the writer actually described patients so labelled, publicly, as – ‘THORNS IN THE FLESH’.
Judgmentalism also pervades ‘weight management’. Food conceptualised as ‘good ‘ and ‘bad’, sinful and virtuous – articulated so well by Susie Orbach in, ‘Fat is a feminist issue’ (1978). This undermines people trying to lose weight.
I guess Keto (from passing exposure not experience) kind of embodies the democratic mindset and language I’d like to see across medicine – more of a neutral ‘objectified’ system of eating, that doesn’t moralise. Democratic disclosure.
I won’t go on – because I can. I’ve made my protest. You understand it, even if you see it as problematic. Heaven forefend giving the ‘juggling fiends more opportunities to exploit and confuse.’
‘Appetitive’ is definitely more acceptable than ‘addictive’. And I’m fine with that classic ad for cream cakes – ‘Naughty – but nice’.
H/S
Vee says
Hu Man creates problems and then refuses to acknowledge and repair. Semantics are a tool, skill, tactic, strategy – the same words can mean a variety of different things depending on who uses them, the aim, the goal, the intention, the motivation, the agenda, the situation, the topic, the context …. games. The sophisticated, the educated, have become the privileged and entitled. After so many years of study they deserve …. . What if all adjectives such as addiction, addicted were deleted? Why have them at all? For convenience, for conformity, for funding, for grants, for coding, for insurance, for pay cheques … ? This same argument has gone on for decades now. What a waste of intellect.
chris says
I was down for ECT at one horrific low point caused by the maniac who subjected me to polypharmacy. He then wanted to electrocute my akathisia away.
“This is a very short post. I received this message from Ray Flores of Children’s Health Defense. This information is from a press release by attorneys who won this ruling. I believe this ruling is offering some much needed good news that at least in some cases the courts affirm bodily autonomy of the patient. This case was unrelated to vaccines, it is about a medical device. However, it creates much needed precedent.
On the other hand, we must keep in mind that the use of this horrendous medical device (for electroshock “therapy”) was not an EUA use under public health emergency. To my knowledge to date the courts refuse to look at the constitutionality, or basic rights such as bodily autonomy in the EUA scenario, and we need more cases to challenge the federal kill box laws that fund, incentivize and cover up the medical mass murder under pretenses of “pandemic response”.”
I do know DH ran a ECT clinic and am aware of the views others have about it.
Dr. David Healy says
Chris
This is a great comment about an important legal case won by some great lawyers. The case will be worth a post in its own right – pretty soon. The key point is this – everyone about to start any treatment needs genuine information about the risks of treatment. There can be no assumptions that a reasonable person would always consent to this and no assumption the doctor knows best.
This is all before someone starts treatment. What we now need is another victory which enshrines the rights of people with developing harms on treatment – that recognizes the person on the treatment is best placed to decide if they are getting any benefits and if they are or not whether ongoing treatment is worth it given the developing problems that again the person on treatment is best placed to decide on,
My patient with OCD who found Nicotine was better for him than SSRIs is a great example of the need to enshrine what the people who come to someone like me can bring to the table in terms of moving things forward.
The ECT situation is complex. I was in a great position to say – nope you are not suited to ECT – and said it on lots of occasions. In one grim case I remember well the patient and the patient’s doctor insisted on going ahead which they apparently have a right to do. The outcome was not good.
D
susanne says
I think physiological dependence is something the public would and actually do understand but have not been given as an alternative . The symptoms are clearly seen in public and understood not to be psychological – and attract quite a lot of compassion rather than castigation from my observation. There are many instances where words once taken for granted have been made obsolete by campaigning to use alternatives . They give added benefit of educating people about conditions as well as creating greater respect by creating a different way of looking at a condition -which a friend with MS pointed out in a discussion about how things have changed since ‘spastic’ is no longer acceptable .
Peter Scott-Gordon says
Impact Report of the Royal College of Psychiatrists: https://holeousia.com/2024/06/22/impact-report-the-royal-college-of-psychiatrists/
This Royal College of Psychiatrists report has recently been published and can be read in full here. It is a lengthy report. It is also glossy. It is chock full of positives.
The Royal College of Psychiatrists is a professional organisation that has charitable status. This status exempts the College from statutory legislation such as Freedom of Information etc
My father is a retired Bank Manager. Last year he had a stroke and as a result he now needs 24 hour care in a Nursing Home. When I visited him today he asked me to have a look at the 2023 report for the NatWest Retail Bank [where his pension now comes from, though my father’s career was with the Royal Bank of Scotland]. On reading the NatWest Report, lengthy and glossy, my thoughts returned to the Impact Report of the Royal College of Psychiatrists.
Here are a few highlights of the 2023 Impact Report of the Royal College of Psychiatrists. Although these are of course ‘cherry-picked’ by me, the report reveals that the RCPsych cherry tree is laden with ‘fruit’:
Vee says
The Royal College of Psychiatrists is an organisation that is running a profitable business in its own best interests. The impact report is about finances. The language used throughout its website is vague, ambiguous, non-committal and sounds to be self-serving of its members.
Peter Scott-Gordon says
In relation to the use of language in relation to antidepressants and ‘difficulty to stop’, I am with Harriet.
The term I use is ‘physiological dependence’. This is the closest match to my continuing experience
aye Peter
Dr. David Healy says
Physiological dependence is a perfectly reasonable term to use. Part of the problem is companies and lots of the public view the words dependence and withdrawal as indicating addiction. Its also difficult to disentangle this from psychological dependence and drug dependence.
Companies do not include any of these words in the label of the drug precisely because they believe you will view the problem as an addiction – which might be a useful way to view it.
We need a broader recognition that many drugs can be difficult or impossible to get off – and this has nothing to do with abuse liability. Above all we need to require companies and researchers to engage with letting us know about this risk before we start a treatment – it might be a PPI or Ozempic, we need a road map to finding answers to the problems and ultimately we need ways to manage the problem, which we don’t now have.
D
Peter Scott-Gordon says
This Royal College of Psychiatrists report has recently been published and can be read in full here. It is a lengthy report. It is also glossy. It is chock full of positives.
The Royal College of Psychiatrists is a professional organisation that has charitable status. This status exempts the College from statutory legislation such as Freedom of Information etc
My father is a retired Bank Manager. Last year he had a stroke and as a result he now needs 24 hour care in a Nursing Home. When I visited him today he asked me to have a look at the 2023 report for the NatWest Retail Bank [where his pension now comes from, though my father’s career was with the Royal Bank of Scotland]. On skimming through the NatWest Report, lengthy and glossy, my thoughts returned to the Impact Report of the Royal College of Psychiatrists.
Here are a few highlights of the 2023 Impact Report of the Royal College of Psychiatrists. Although these are of course ‘cherry-picked’ by me, the report reveals that the RCPsych cherry tree is laden with ‘fruit’:
https://holeousia.com/2024/06/22/impact-report-the-royal-college-of-psychiatrists/
chris says
https://www.dailymail.co.uk/health/article-13557907/How-patients-denied-mental-health-treatment-stop-harming-killing-doctors-believe-theyre-attention-seekers-simply-making-up.html
Still not getting it.
BPD toxic label or seriously and on goingly affected by prescribed drugs inducing emotional lability into akathisia/tardive akathisia into toxic psychosis and delirium, as well as, a toxic label, you can throw in ‘bi polar’ as well for those going manic after stopping neuroleptics?
David T Healy says
This is a response to Peter – Harriet and Susanne – having slept on the dependence point..
I don’t know enough about Peter’s difficulties to know if physiological dependence is the right word to describe his problem.
This links to a Question people with PSSD often ask – did I cause this by Tapering too fast. The answer is no you didn’t..
Like Tardive Dyskinesia, PSSD and other problems for example Visual Snow Syndrome start on treatment but often become more obvious, or only manifest, or we can only say people for sure have them after they have stopped treatment – so this leads to them being seen as part of the withdrawal spectrum.
Some people coming off antidepressants have what we could say is reasonably called a physiological dependence for which tapering is likely to be relatively successful in smoothing the process.
But there are others like those with PSSD or VSS – both of which many people with ‘antidepressant withdrawal’ have which like TD o are different and not appropriately labeled physiologically dependent.
I’m reluctant to use the term damage but these problems persist, are not caused by tapering too quickly as they were there before starting to taper, and while tapering may be no harm it may not be successful or fully successful – leaving people with some deficits afterwards rather than back to normal.
These cases likely form a significant chunk of what gets called protracted withdrawal. I expect there are a lot more dysfunctions that start on treatment and persist and remain after the drug has been stopped – perhaps clearing more fully years later when some repair mechanisms make a difference.
In due course the work of people like Peter Groot may allow an estimate as to how many people are best viewed as physiologically dependent, along with how many have a persistent problem of some sort with perhaps a grey (hard to call) cohort in the middle.
In the meantime, there are problems telling anyone who has a protracted withdrawal that their condition is best called a physiological dependence – which is a term I once used but have stopped using in the light of PSSD, VSS, PPPD and what I expert are a number of other conditions feeding into this mix
D
Harriet Vogt says
It’s conceptually tricky. I understand that – despite seeming to have slightly high horse opinions.
My logic may be too simple minded. I think it’s maybe what you are saying, dumbed down.
1. Some degree of physiological dependence (or neuroadaption) is a prerequisite for withdrawal. There are also complex psychological factors in play.
2. For some people, like Peter, the nature of that physiological dependence makes withdrawal insufferable. No doubt a lot of individual complexity in here – the drug(s), the person, the duration etc – I couldn’t even pretend to understand. You would. Peter will have the best idea. Are there other neurotoxic injuries involved?
3. Others seem to be able to taper at various rates without lasting problems. These are the success stories that fit the RCPsych guidance/storybook, match an idealised theory of hyperbolicity and absolve doctors and companies of causing lasting harm. Just re-regulate those pesky receptors.
4. Protracted withdrawal Syndrome, PAWS, is rather unacceptably murky because it blurs the distinction between those whose ‘SOS’ may resolve in time, the harmed patient stories psychiatry prefers, and those whose NEUROTOXIC INJURIES may endure for years, or for life – if they don’t end their lives. Of course, the distinction is fluid, since some people will recover from their injuries and might then attribute them to PAWS (you said this, quoted below). I was having an X chat with Alto (Adele) the other day along these lines, and her perspective is that some ‘PSSD’ can fall into this category – she had it herself and sees through a PAWS lens generally – as she would, it’s her work.
5. In your blogs you never subsume specific injuries under PAWS. I think that’s exactly right. If they were buried in a PAWS cluster, as some decent people have suggested they should be to ‘big up’ the seriousness of PAWS, their significance as injuries would be lost.
6. Suspect ‘injuries’ is more appropriate language than ‘damage’, because it’s specific, not without hope, follows the official benzodiazepine line – BIND – and the way neurotoxicologists like Mark Baker talk – DIND https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951833/pdf/170.pdf – and those investigating ototoxic etc. drug effects?
‘Like Tardive Dyskinesia, PSSD and other problems for example Visual Snow Syndrome start on treatment but often become more obvious, or only manifest, or we can only say people for sure have them after they have stopped treatment – so this leads to them being seen as part of the withdrawal spectrum’.
Yes, this is what I was trying to say the other day about PSSD when I went off piste and lost you. It’s not that PSSD, for example, is a separate injury during and after halting the drug- that is when it becomes clear. The sexual, sensual and emotional blunting that resolves in withdrawal is part of PAWS. PSSD isn’t. This needs much tighter definition.
Coda
Understand the clinical value of defining some drugs as ‘appetitive’ – it’s all on the drug – to guide treatment. Still baulk at ‘addictive’ – too much moral baggage/patient blaming – and scope for juggling fiends.
Dr. David Healy says
H
Classic physiological dependence is short. Stopping beta-blockers is the classic example – it lasts 48 to 72 hours. Even cold turkeying off opioids or alcohol is much briefer and shorter than cold turkeying off antidepressants or antipsychotics for some not all people.
With ADs, APs and Benzos – some people have little or no problem, not unlike getting off beta-blockers. Others simply can’t get off, which is not really consistent with physiological dependence.
I think Peter Groots iatrogenic dysregulation is a very useful way to frame the issues. Dysregulation is suitably ambiguous – it can accommodate you and me having very different pictures – while physiological dependence suggests greater uniformity
D
Harriet Vogt says
Just seeing this. A bit late. Party’s over. Tables cleared.
Now understand your professional resistance to ‘physiological dependence’ – if the pharmacological meaning is a process that is relatively simple, brief and, one assumes, painless.
Nothing like the experience of getting off antidepressants for at least one third of patients – once Tony Kendrick and Robin Carhart-Harris had corrected the maths in the ‘Pariante style garbage’.
YES – Iatrogenic Dysregulation – does capture who/what is responsible (not the patient), can embrace boundaryless individual permutations (including injuries, psychological and physical), the lack of medical ‘grip’, the chaos of it all .
Buy that. What I’ve always baulked at is anything that implied to patients that this is going to be universally easy, controlled, predictable, almost mechanical.
Vee says
ADs, APs, PYS KHO ACTIVES, (antibiotics, antibacterials, azoles, corticosteroids) affect the whole body.
Drugs cause sedation or elation.
Drugs cause damage to nerves e.g. tinnitus (8th cranial)
Drugs cause vasoconstriction or vasodilation – and hence peripheral neuropathies. Research (transparent) would show PSSD in light of these findings.
Cascade prescribing for symptoms causes further side effects and adverse effects.
Prescribers appear to be immune to the harms being caused, often under the guise of being viewing the person in front of them as demanding and or difficult and or disturbed
It needs to be acknowledged and accepted and made legitimate, that many common drugs on the market “cause” psychiatric events.
These events, then can be treated in the best interests of everyone.
When will prescribers ever back peddle and become less influenced by Governments, politics and politicians and Big Pharma – ?
annie says
Peter knows best using his term. I say this because having almost succeeded in a ‘life-changing incident’ from Seroxat, he dare not risk coming off Seroxat again. He hates this drug which he has spoken about. He daren’t risk putting his family through it all again.
There is also considerable risk that it could happen again.
I totally appreciate this.
My experience closely tallies with Peters.
But after my ‘incident’, and the psychiatrist having upped the dose to 40mg., I began tapering with liquid over the following year and it was the last few mls. that started the whole withdrawal calamity again.
I took a different approach, knowing that if I restarted Seroxat, it could all happen again. I wanted it completely gone out of my life. So with the help of my mum, who came to stay for another long haul, I rode it out, virtually in bed, with no additional benzos or beta-blockers this time.. It was pretty horrific, again, but eventually it all calmed down. As a second-time, to the first-time, cold-turkey, I had more experience this time round with a bit more fighting spirit.
This is where tapering strips, as a good idea that they are, don’t take you down to minute measures, that the liquid does. And those last few mls can completely throw you back in to the vortex.
However, no suicidal ideation, or thoughts, like that of any kind happened this second time and I felt largely comforted by that.
Peter can speak for himself, but, obviously there is a dependence as if you don’t take it, you, like Peter, are at risk of history repeating itself.
We are ‘physically dependent’ on food to live, air to breathe –
All of us, have significantly different experiences of the whole thing.
Dr. David Healy says
Peter will be able to speak for himself but he doesn’t know best across the board. If he has been unable to stop as you say this suggests the problem is not just physiological dependence but I leave that for him to chew on.
I was once very much of the same view and inclined to think of tardive dyskinesia as physiological dependence – most people with TD or indeed PSSD, PFS etc don’t see their problems in terms of physiological dependence and I don’t either.
We need a hard-headed look at the constellation of problems that fall under Symptoms on Stopping antidepressants and tease out what are almost certainly distinct components. Up till then nobody really knows much.
D
Harriet Vogt says
This research from Jo Moncrieff, John Read and Mark H – you’ll have clocked it – seems like a reasonable start to the teasing out of distinct components into the ‘Discriminatory Antidepressant Withdrawal Symptom Scale’ (DAWSS). I’d like to see it fleshed out with richer patient insight and language. Plenty of material on this site – and Surviving ADs etc.
Something like this could be helpful, distilled into a simple questionnaire for use by both patients and prescribers, with no reasonable or instinctive understanding of how withdrawal differentiates from ‘relapse’. To deliver to the medical machine you have to package material for processing. You’d hope patients and doctors in a true collaborative relationship – how many of those? – would know what was going on.
‘Anxiety and worsened mood were among the most common symptoms following withdrawal, but physical symptoms, including specific symptoms such as dizziness, increased sensitivity, electric shock sensations, muscle symptoms (including cramps and tics), vivid dreams, vertigo, nausea and palpitations newly occurred or worsened in more than 70 % of the sample. 60.7 % of patients reported an increase in suicidality after reducing or stopping antidepressants, whereas only 29.6 % of respondents reported any suicidality in the weeks before starting an antidepressant.
The ten symptoms that showed the highest ‘discrimination index’ (the ratio of increase following withdrawal compared to pre-withdrawal levels) were, in order of magnitude: electric shock sensations, akathisia, dizziness, vomiting, vertigo, nausea, gait and coordination problems, increased sensitivity to light and noise, tinnitus, and psychotic symptoms. The fifteen most discriminatory symptoms that comprise the ‘Discriminatory Antidepressant Withdrawal Symptom Scale’ (DAWSS)’https://www.sciencedirect.com/science/article/pii/S2666915324000519
Many readers have experienced all this – and more.
Imo (not nearly as humble as it should be probably) – enduring Tardive Syndromes, PSSD and PFS are surely more likely to be neurotoxic injuries – than the theoretical effects of messing with receptors? Why wouldn’t the blasted things ‘re-regulate’? This is what, as a layperson, I don’t like about ‘dysregulation’ – the implication that it is reversible, sort of self-adjusting. ‘Iatrogenic Dysfunction’ seems closer to reality. Trying hard not to head down the semantics’ rabbit hole again.…
A sensible paper on Tardive Syndromes I came across years ago, trying to get to grips with neurological injury:
https://discovery.ucl.ac.uk/id/eprint/10102654/3/Bhatia_Tardive%20syndromes_AAM.pdf
chris says
I appreciate this. The fear of going back to that horror is beyond, way beyond most people’s experience who have not been there. I don’t care how anyone wants to call it, you just want away with it, out and done with.
When the reality of tardive akathisia hit me I realised I would always, for the rest of my life be firmly concerned with what I need to do to never ever go back to that horrific state.
David T Healy says
Before posting the last comment, I sent the same point in an email to Peter Groot – one of the creators of Tapering Strips – created in part out of his own experience getting off antidepressants.
His response is fabulous – iatrogenic dysregulation has real possibilities. It brings doctors into the frame as part of the problem is not necessarily the lead cause. Physiological dependence points to an physiological glitch in the person who has problems.
David
As I see it, many of the things we are observing are interconnected phenomena, where cause and effect relations can go both ways. Which is something many people only seem to be able to handle with great difficulty. Too many people think they have found an explanation when they have given something a scientific name.
The example I am struggling with is the protracted withdrawal syndrome or PAWS. My objection to this term is the use of the word ‘withdrawal’, which suggests that even when a person starts having complaints after a successful taper (as I did), that this would still be a form of withdrawal, which, if you think about in terms of (in my case) venlafaxine’s half-life, doesn’t make any sense at all.
It is for this reason that in my presentations I ask myself the question ‘what did I suffer from?’ and gave as possible answers ‘relapse?’, ‘withdrawal?’, or ‘iatrogenic dysregulation or destabilization’?’ I prefer the last term, because it is descriptive and does not imply or suggest a specific cause of a clinically very important phenomenon.
Using words like PAWS leads people to tell with great confidence that there are suffering from PAWS, without having the faintest idea of what this actually is. This is not different from saying ‘I suffer from ADHD or depression or ASS or . . . . and this explains why I behave the way I do’. The reification of things that do not exist, to the great joy of the pharmaceutical industry, who will happily provide expensive solutions for all these ‘conditions’.
If we can agree that we don’t know what are the precise causes of very real problems, it will become much easier to understand what we are in fact talking about, easier to come up with practical solutions (as we have shown), also easier to set up more useful studies than we now have. It is because I think we do not nearly know enough, that I cannot give you concrete answers to the questions you are asking. Because we do not have good data, because we have never investigated things properly, by carefully observing what happens.
I do believe that it is justified to conclude that more gradual tapers help to prevent problems during as well as after tapering. But we do not yet know and cannot yet know for how many people this will be the case and why this is the case. From the many questions I get from people who have difficulties tapering benzo’s like lorazepam I conclude that there are situations where patients as well as their doctors seem to be a complete loss about what to do to change something for the better for the patient. It is my impression that a history of previous (rapid) medication- and dose-changes are an important reason why patients ended up in such a terrible place.
To conclude: I am not able to answer the questions you rightfully ask. If we really want to answer them we should 1) acknowledge uncertainty; 2) deal with this uncertainty by letting patients decide themselves how gradually they wish to taper; 3) carefully observe and analyse what happens to large number of patients.
We have started doing this already. Our hope is that others will follow. Which is not a straightforward thing to hope for. Currently, for investigators the easiest way to get money is to promise to do a randomized study, not by proposing something more useful. If it’s not randomized, you will probably not get what you ask for. We tried, but stopped trying for this reason. As you know better than I do: people have been brainwashed into thinking that randomized studies are the only hammers that should be used.
Bw Peter
Harriet Vogt says
‘Using words like PAWS leads people to tell with great confidence that there are suffering from PAWS, without having the faintest idea of what this actually is. This is not different from saying ‘I suffer from ADHD or depression or ASS or . . . . and this explains why I behave the way I do’. The reification of things that do not exist, to the great joy of the pharmaceutical industry, who will happily provide expensive solutions for all these ‘conditions’.’
This is brilliant. PAWS is dead murky- and exploitable
tim says
Thank you. The term: Iatrogenic Dysregulation would perhaps be most appropriate?
I wish that those responsible for the destruction of our loved one’s life would have the courage to certify her inability to work (due multiple-systems, psychotropic drug induced injuries and sequelae)
as “IATRROGENIC DYSREGULATION”.
My perception is that this is diagnostically honest and accurate, and does not serve primarily to further blame, label and outcast the injured party.
The term: “Iatrogenic Destabilisation” does not achieve this.
The concept of Destabilisation – aka – “UNSTABLE” is vulnerable to medical/diagnostic misuse and stigma. It would surely become shorthand for “Mentally Unstable”.
————————————————————————————————————
This is another outstanding post.
My response to the Pariante Column, precipitately publicised by “The Defenders of The Faith”, (The Great and The Good), was that this had the potential to become a textbook example of
Group-Think based on Confirmation Bias.
Dr. David Healy says
From Peter Groot
For people interested in getting off antidepressants.
Next week on Friday the 28th there will be an IIPDW webinar about Liquids & Tapering Strips: https://liquidsandtaperingstrips.eventbrite.co.uk.
In the first part all sorts of options people have to obtain lower dosages by splitting, cutting, diluting et cetera will be discussed. Judge for yourself how useful you think all these things are for doctors and patients. In the second part, with the title ‘Tapering Strips: A Practical Tool for Personalised and Safe Tapering of Withdrawal-Causing Prescription Drugs’, I will explain the tapering strips, how they work, how they can be used and the evidence we have for them. This will be followed by a Q&A part.
Our approach is pragmatic. What we want to do is to help people now, because this is practically possible, and start quibbling about theoretical explanations later, when we have more data. Data we should get by observing what happens to patients in daily clinical practice, not from performing more RCT’s.
chris says
There is something else that is profoundly important – people who have been released from a psych hell hole run a very real risk of been put on a CTO which will mean a depo of a neuroleptic, so they tell the psych who totally controls their life exactly what they want to hear – that the medication is working well they feel normal and are doing well. For this reason almost everyone will not tell their psych they have started to taper off. They are on their own unless they have a real trusted buddy. So there is no way for them to engage with tapering strips.
Vee says
Psych Hell Hole – institutions, mindsets, practitioners, psychiatry (and psychology) that demeans,
and belittles because they can from positions of power wealth status education opinions “respect experts” and even threats
I have read about one too many stories where tapering is rejected, and or goes unsupported.
What is the root cause and analysis for such professional behaviours? The answers are fairly obvious
Peter J Scott-Gordon says
Everybody’s input is important here. All I know is that I have found stopping Seroxat to be hellish. I agree with David that I do not know what is best across the board.
The language that we used to describe the difficulties in stopping prescribed drugs is important. I wish it was easier to do find clearer language that fits the experience. Clearly there are a range of difficulties.
So I agree with David that “We need a hard-headed look at the constellation of problems that fall under Symptoms on Stopping antidepressants”
aye Peter
Vee says
Treatment – “treated brutally” and then the “hellish” aftermath
The psychologist stated “why would you go on drugs?”
The person in front of them answered “because I trusted the doctor”
The psychologist replied in a most annoyed and harsh tone “why would you do that?”
The person was made to be the problem and also a person with a problem.
Do we not all experience problems?
Twenty plus years later, twenty plus years of denial of drug toxicities in all forms from all sources; institutionalised as a quick and easy free pass off into others’ care;
plus the records and notes that follow everywhere once in the treadmill of mental disease
This is cruelty personified when there are obvious and definitely better ways, albeit they are not via RCTs Big Pharma or huge profits
How to know when observations are facts? Is it possible?
Harriet Vogt says
A fast-moving debate.
‘His response is fabulous – iatrogenic dysregulation has real possibilities. It brings doctors into the frame as part of the problem is not necessarily the lead cause. Physiological dependence points to a physiological glitch in the person who has problems.’
His response IS fabulous. I’m not totally convinced by ‘dysregulation’ – iatrogenic, of course, but dysregulation implies something repairable which an injury may well not be. Does iatrogenic dependence get over the ownership problem?
Johanna says
Thank you Peter Groot for your perspective! The provisional new term “iatrogenic dysregulation has real potentiaI. But I appreciate your skepticism and openness to new information even more. I agree that when we rush to reify our symptoms into a bright shiny new medical term, pharma often turns out to be the only winner.
I also strongly agree with David Healy’s view that the term “addiction” is too valuable to let go of. I know I am in a small minority among affected patients in this view. The benzo survivor groups in particular have passionately opposed any reference to addiction in discussing our plight. WE ARE NOT ADDICTS! they cry. Meaning that we did not take these drugs to get high. We did not even take more than our doctors prescribed. We followed medical advice to the letter, and now we are suffering for our obedience. This is “Dependence, Not Addiction.”
The trouble is that Pharma and the medical establishment are all too happy to use this framework to manipulate us and obscure the truth about their drugs. Dependence, they say, is not necessarily bad. Aren’t people with diabetes “dependent” on insulin? Likewise, the crowds of people languishing at our Pain Management clinics are only “dependent” on opioids because of their underlying chronic pain. Just like “withdrawal” reactions on stopping anti-depressants are simply a recurrence of the underlying chronic depression.
The central Big Lie on which the US opioid disaster was built was the false distinction between Addicts (non-medical users) and Legitimate Patients (those taking opioids as prescribed for chronic pain). Those using the drugs to cope with genuine pain, supposedly, almost never got addicted; that only happened to those “abusing” the drugs to get high. We shouldn’t let our fear of the Bad Addicts lead us to deprive the Good Patients of OxyContin, which can bring them only blessings.
The resulting deluge of over-prescribing took us from a country where opioid addicts were a shrinking cohort of aging “survivors,” to the worst drug crisis in our history, with over 100,000 overdose deaths per year. Yes, you can become addicted by taking opioids for pain. We’ve learned that in every war since 1865 at least. In teaching a generation of doctors to unlearn that simple fact, the drug companies committed a historic crime — and they can do it again.
As someone who has struggled with dependence on alcohol (strictly my choice), antidepressants, and amphetamines (both strictly on doctor’s orders) I think the classic elements of Tolerance and Withdrawal are present in all three. It may feel discouraging or “disempowering” to realize this, but unless you know it you haven’t much chance of finding your way out. Belief in the pure unfettered force of your own “agency,” and a resolve to stop making bad choices, won’t help.
“Addiction” is not a property of a person. It’s a property of the drug. Naming a drug addictive, because you can’t quit even when you badly want to? That doesn’t stigmatize us. Possibly it stigmatizes the drug. More accurately, it calls us to treat it with the caution it deserves.
susanne says
Chris Regarding your comment re Gwen Adshead above If you know anyone who can open the whole article for you you will see that G A is not capable of admitting such damning evidence about akathisia which would have been right in front of her eyes at Broadmoor . Ravenswood and at UCH London where people were treated in ‘a cavalier fashion’ including by the psychotherapy dept.
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
A primetime documentary that points the finger at antidepressant use as key evidence in a mass murder case misses the mark, argues Gwen Adshead
Samuel Johnson observed in 1734 that it was “incident among physicians to mistake subsequence for consequence.” His observation might apply more to journalists; and especially the BBC Panorama programme “A Prescription for Murder,” broadcast on 26 July. The programme’s premise was that a rare side effect of antidepressants may be to induce violent thoughts; and it offered as evidence the case of James Holmes, who in July 2012 went into a cinema in Aurora, Colorado, and shot into the audience, killing 12 people and injuring 56 others. Holmes did not deny his role in the massacre, although at trial he offered a defence of not guilty by reason of insanity, which was not accepted by the jury…..the rest needs a subscription
There are 5 long comments which put her in her place – free to read by David Healy; Peter Gotzche; Elizabeth Price’; Fiona French and Noel Thomas But no comment by G A in defence of her crass article
chris says
Yes James Holmes was on 150mg sertraline had emotional lability into akathisia, stopped cold turkey and went into either toxic psychosis or delirium or both. I know this because it happened to me on sertaline at 50mg which made me very suicidal with in a few hours. A bombardment of drugs from a psychiatrist followed. Fortunately I did not have any homicide ideation nor do I have full memory of what happened after but what I do remember was parts of a horrific feeling of being awake in a nightmare that it was very real and then gaps, being in an ambulance and held down and thrown into a psych cell.
annie says
So bad, Chris, terrible. It is beyond cruel, what these drugs can do and then punished for it.
When you know what happened and nobody will believe you and what they put you through afterwards, after a ‘short burst of charged disorientation’, is terrifying in itself, and then the long haul of accusations and trying to get off, just makes it all considerably worse.
Trouble is, what the drugs are capable of, murder, homicide, and still being alive. What happened to James Holmes is haunting and he didn’t get a fair trial as David has explained so thoroughly, and all those at the top of the profession being so diabolically opposed to expanding their minds to understand the concept in its entirety. Really shameful, from the ‘crème de la crème’ of psychiatry…
After the manic episodes, and I swallowed a whole packet of beta-blockers, and I was then so calm, I remember thinking, omg, is what I have just done against the law.
Homicidal thoughts; what I do remember, during an action-packed period of complete madness, was for the briefest of moments, a split, nano-second, was a vision of someone so precious, I was leaving behind. I remember this vividly as it was the only time I stopped in my tracks outside in the dark by the car.
In the blink of an eye, how things can change and go very badly. It is quite shuddering how badly they can go.
As discussed, in this thread, language matters…..
chris says
‘Hospice Nurse Julie across social media, admitted that ‘death can be messy, and maybe not so pretty.’
what does this sound like…..
‘In the specific instance of ‘terminal agitation’ – which may or may not be disease dependent – ‘people will just be terminally agitated,’ Julie said.
‘They’re pretty confused, there’s no reasoning with them. And they’re trying to get up out of bed all the time or they’re trying to constantly walk around the house.
‘But it’s kind of dangerous cause they can’t really walk or they’re too weak, or we don’t know where they’re going.’
https://www.dailymail.co.uk/femail/article-13577557/hospice-nurse-death-messy-julie-mcfadden.html
chris says
In the responses the only thing I disagree with is this from a FDA reference.
“akathisia (psychomotor restlessness)”
Akathisia is far more as we discuss on here. This has yet to be widely understood. I’m hoping young psychiatrists who have some grit and a conscience can bring this about.
susanne says
This site is intended for health professionals only
PULSE 365 LIVE PCN
Pulse Today
Home News Clinical areas Mental health, pain and addiction GPs could support almost half of patients to quit antidepressants, finds trial
GPs could support almost half of patients to quit antidepressants, finds trial
GPs could support almost half of patients to quit antidepressants, finds trial
Emma Wilkinson
27 June 2024
GPs could support almost half of patients taking long-term antidepressants – who are well and willing to stop – to safely come off the drugs, researchers have claimed.
The study, which was looking at the addition of a phone hotline or internet support to GP review in patients discontinuing antidepressants, found more than 40% safely stopped taking the drugs whichever approach was taken.
Those who could access online support and psychologists by phone had lower rates of depression, fewer withdrawal symptoms, and reported better mental wellbeing but the differences were small.
However, the additional support did tend to reduce calls on health services and therefore may be cost-effective at a population level, they reported.
The researchers from the Universities of Southampton, Hull and Liverpool said the trial of 330 participants across 131 GP practices around the country was the first to show that helping people stop taking antidepressants is possible at scale without providing resource-intensive psychological therapy.
After six months, 41.9% of patients in the control group who had support from their GP had successfully stopped taking the drugs compared with 45.5% of people in the group who also had access to internet or telephone helplines.
All those taking part did not currently have depression or were judged to not be at significant risk of relapse by their GP and wanted to discontinue treatment, the researchers reported in JAMA Network Open Psychiatry. They had been taking antidepressants for more than a year for a first instance of depression or more than two years for recurrence.
Roughly 15% of patients in each arm reported adverse events with one serious adverse reaction in each group, leading the researchers to conclude that discontinuation is safe to attempt in primary care, as long as patients are monitored for relapse and treatment can be quickly restarted.
Lead author Professor Tony Kendrick, professor of primary care at the University of Southampton, said the research showed high numbers of patients withdrawing from the drugs do not need costly intense therapy sessions.
↓
annie says
recovery&renewal@recover2renew31m
Includes bit with Dr Zoe and Tony Kendrick, starts 0.48 mins in
https://player.stv.tv/summary/this-morning
Tony Kendrick tells us he is on This Morning, talking about his Reduce, Study
So he is.
Interviewer has to rush off –
Was she rushing off to find The Helpline –
His choice word ‘Optimism’
Tony Kendrick@tony_kendrick
Some people need to stay on antidepressants because they have a relapse of their depression on trying to come off them – 55% in the placebo controlled ANTLER trial. They are needed for many people, but they don’t know unless they try to come off.
Mark Horowitz reposted
Dr John Read@ReadReadjJun 29
Thanks to @PCGroot and Sarah Jones and @markhoro for an excellent IIPDW webinar yesterday on how to safely come off antidepressants…. tapering strips, liquid formulations etc. Recording will be available at @Institute_PDW
GPs should inform themselves about these methods please
‘Antidepressants unlimited’
https://holeousia.com/2024/07/01/antidepressants-unlimited/
Isn’t keeping Up to Date a Prerequisite…
annie says
recovery&renewal@recover2renew1h
Replying to
@UoSMedia @tony_kendrick and 4 others
Tony says that he is 67 now and retired from clinical practice. He can reflect on his work over several decades. Here is a view ‘from the other side of the bed’ – as widow of a GP from the same era.
https://bjgplife.com/a-50-year-timeline-including-the-1990s-defeat-depression-campaign/
He worked full-time as a GP for a further 25 years. In the early 1990’s he was started on Seroxat for depression, commonly experienced alongside Addison’s Disease. He remained on 20mg Seroxat until after his retirement in 2010, when he was recommended by a psychiatrist to switch to Venlafaxine. This only lasted two months as the side effects were intolerable, and he went back onto Seroxat 20mg which seemed to suit him better. Just a few months later he developed almost complete insomnia, terrors, awful gut issues, severe arthralgia, chronic pain, loss of temperature regulation, paranoia, nightmares, agitation, cognitive issues and altogether felt terribly ill. No-one could seem to fathom what had gone wrong, despite various tests and investigations, adjustments to usual medications and a trial of Melatonin. His notes record an exchange between his GP and endocrinologist where they agree that he is probably ‘somatising’ and ‘just needed stronger antidepressants’. Of course, the Addison’s disease was a significant complication. He was increasingly deeply suicidal and utterly desperate, and acted upon this.
Having now learned of so many unsuspecting souls who have experienced the horrors of medication-induced akathisia, my husband’s ultimately fatal experience following 20 years on Seroxat probably was a form of catastrophic autonomic dysregulation and overwhelmingly intolerable akathisia. He thought he had completely lost his mind.
The ‘other side of the bed’ –
How crass was the advice around late 90s, early 2000s.
Many have a similar time-frame.
It was as if I was in a Kangaroo Court. The onus completely destroyed my private life, heavy-handed, dangerous, and wrong, on so many fronts.
Last week there were two pages of accolades about our new country doctor. He has been awarded the contract for two new surgeries, half an hour, from his own practice. This was the doctor who took over a country practice, in 2006, then upped sticks, in under two years, and left for Canada. The doctor who had got him the practice, left to run it p/t, who lived on an island, who would go on to develop lung cancer, with locums, for three and a half years.
In 2012, he threw a hissy fit on his return to Scotland, when he accused Highland Health Board of basically sabotaging his application for the same new contracts and threatened them with court and damages.
This was on the front page of our newspaper and recorded in minutes of HHB.
Another article appeared, when he staged a meeting in our village hall – your surgery is bankrupt he said.
Anyway, his surgery website is awash with his plans for expansion. He might move to my area, but he has suggested he needs to spend monies upgrading the surgeries. He says he has teams of doctors just waiting to join him but his website requests staff…
Everyone, but everyone, is cock-a-hoop at such a brilliant doctor with such expansive plans.
He rode rough-shod over me after Seroxat and all that. His tone was threatening when I queried my treatment, twice. Once before he left for Canada, and once in a telephone call from Canada.
I may need to make some transfers, of one sort or another; this man follows me about like a bad penny – I reserve judgement on NHS Highland, who must have thought all their dreams have come true, when he, once again, dropped in to their lap. All the hopes, all the promises, just like we had when he dropped himself on us, in 2006.
“ It took the P….. clinic about a year to understand the importance of helping patients understand the system, he said,, and that slowed down growth and acceptance of the practice.
That mistake, he said, was probably a big part of why the practice ended up being closed.
He called the closing of P….. — laying off 14 staff and leaving 4,500 Islanders without a doctor, in addition to taking personal financial losses — the absolute low point of his career. But he said he wishes the province the best of luck in establishing the medical homes, and hopefully cutting doctor waiting lists.”
Time will tell, how his ‘medical model’ will work, as he builds his new empire; with rapid acceptance, starting Aug 1.
Harriet Vogt says
Perhaps the segue for this comment is – multi-cultural juggling.
As I mentioned on DH, searching for authentic prescription drug journalism, I came across an interesting little series, ‘Mindset’, on Al Jazeera, not my normal hunting ground. 7 short investigative pieces exploring approaches to treating ‘mental health’ (I’m sure we’d have less of it without this set of words) across different cultures – Jamaica, Denmark, South Africa. Ukraine, South Korea , Argentina– and Iceland, the one that originally caught my eye, ‘Why are antidepressants so popular in Iceland?’
https://www.aljazeera.com/program/mindset/
So far I’ve only watched two, Iceland and Argentina. A bit of a spoiler alert…
So why is Iceland one of the highest global consumers of antidepressants – (along with Portugal and the UK) – swallowing 157 daily doses per 1000 inhabitants? There are only about 385,000 inhabitants in total. The obvious reason is that in the winter they only have about 4 hours of daylight – not very cheery. One less obvious driver of consumption is cost – a packet of antidepressants costs 7 x less than one hour of psychotherapy. And the major motivation is that , as they say in Iceland, ‘everybody’s on it’, ‘it’s a quick fix’. It’s sort of cultural cocoa.
I checked out suicide rates – a known association with Scandinavian countries and ADs. It’s hard to get any sort of a trend for Iceland since the numbers are so small, annually double figures. Fertility is on a steady slide, down from 2.2 per breeder in 2000 to est 1.85 now – radical comparison, Niger 6.6.
What was interesting, though, was the emergence of a holistic sub-trend to the drugging, evident in Argentina too. For the Icelanders, this involves companionable plunges into the frozen sea – ‘you feel like you’re encased in a block of ice’ (no hyperbole!), ‘very much in the moment’, releasing ‘bottled up feelings’ – followed by the euphoria of group immersion in hot pools. It reflects the viscerality of human existence that recent blogs have focussed on – as distinct from the narrow brain obsession of so much psychotropic marketing and ‘medical’ beliefs.
Argentina, a country riven by political and economic horrors, is full of woe and pills. As well as the highest number of psychologists per captia in the world. But there was also a holistic parallel to Iceland’s icy sea therapy. PSICO-TANGO, No, not some sort of ghastly Latin slasher movie. But a fabulous application of the Tango – where patients are softly blind-folded to enable a focus on their visceral selves, as they dance closely with their partners. It’s gorgeous – I want to do it. The very opposite of numbing our selves senseless with pills.
Worth a watch.
annie says
‘Pills killed my sex drive for ever’: Roy has no libido, pleasureless orgasms and is facing a future without relationships or children – because he took antidepressants without knowing the risks…
By ANNA MOORE FOR YOU MAGAZINE
PUBLISHED: 12:00, 6 July 2024 | UPDATED: 12:11, 6 July 2024
https://www.dailymail.co.uk/home/you/article-13596187/Antidepressants-sex-drive-medication-pills-stopped.html
Roy Whaley was 22 when his GP first offered to prescribe him antidepressants, but he resisted for almost a year.
At the time he was suffering from obsessive-compulsive disorder (OCD). ‘I had this intense anxiety around cleanliness and constantly needed to wash my hands,’ he says. ‘I actually wanted therapy and was put on the waiting list, but it was a long wait.’
After a very bad day when he crashed his car, he decided to give the antidepressants a try. ‘I was having a week where everything seemed to be going wrong,’ says Whaley, now 39 and living in Somerset. He started on the SSRI (selective serotonin reuptake inhibitor) citalopram, and although it made no impact on his OCD, he noticed almost immediately that something else was changing.
‘Before I took it, I was a normal young lad who felt horny all the time,’ he says. ‘Sex was on my mind constantly, and if I saw a naked woman, it would turn me on. Everything worked normally and when I had an orgasm, it was highly pleasurable.
‘When I took citalopram, my sex drive was wiped out. I stopped thinking about sex. If I had an orgasm, it was entirely pleasureless. The only analogy I can think of is when you have a cold and lose your sense of taste. You can still eat chocolate, but you can’t enjoy it. You go through the process, but feel nothing.’
For years, sexual dysfunction was an adverse effect of SSRIs that somehow slipped under the radar. Embarrassment and stigma stopped sufferers from coming forward – and many who did seek help were assured by their doctor that their symptoms were caused by depression and anxiety, not the medication.
This has slowly changed. Sexual dysfunction and the blunting of sexual responses has become a well-documented side effect of several classes of serotonergic antidepressants (antidepressants that act on the neurotransmitter serotonin), including SSRIs. For this reason, they have even been prescribed to help men who are suffering premature ejaculation. The drugs can cause inability to orgasm or pleasureless orgasm, genital numbness and loss of libido.
This can impact both women and men – although it is thought that men, who can also suffer erectile dysfunction as a symptom, might be more likely to report it and discontinue with the medication as a result.
The DJ and mental health campaigner Roman Kemp recently made headlines when he described how SSRIs reduced his libido – although for him, the problem was easily solved by switching to an alternative SSRI which, he says, got him ‘back up and running’.
What’s now emerging is that, for some, sexual dysfunction persists even when they have stopped taking the drug. This is a condition known as post-SSRI sexual dysfunction (PSSD), which was officially recognised by the European Medicines Agency in 2019 and the Canadian government in 2021.
Research has found that PSSD can continue for years, even when mental health is otherwise fine and scores for depression or anxiety are normal. One study found cases of PSSD after just four days of taking the medication; in another, the PSSD had continued for 16 years (at the time of the study).
Research from Israel found that men who had discontinued SSRIs were three times more likely to require medication for erectile dysfunction subsequently than the general population. Last month, a group of scientists in the US joined together to sue the Food and Drug Administration for failing to warn patients of these potential persistent sexual side effects.
Back in November 2007 when Whaley started on citalopram, he knew none of this. ‘To be honest, at first, I wasn’t even too bothered as I knew it was the drug – the effect was so immediate and dramatic that it was obvious. I just thought it would go away when I stopped taking it,’ he says.
Less than a month later, Roy did opt to stop taking it, partly because of this sexual side effect and also because it hadn’t eased his anxiety. About a month after that, his sex drive hadn’t returned to normal, so he went to his GP. ‘He told me that it couldn’t be the drug as it was all out of my system,’ he says. ‘As the months passed, I got more and more worried as nothing seemed to get better.’
Whaley began doing his own research and found people on a few online forums who were experiencing the same thing – today, the PSSD Reddit forum has 13,000 members. ‘I began reading accounts from people who’d had this for five or six years and still hadn’t recovered, and that is when I started to really worry,’ he says.
It was around this point that Whaley finally got to the top of the waiting list to see a psychiatrist for his OCD. When he mentioned his sexual dysfunction at his first appointment, the psychiatrist dismissed it and instead convinced him to try the SSRIs again, which Whaley did for a few weeks before coming off.
‘If my libido was at 15 per cent of normal levels after taking SSRIs the first time, it had dropped to five per cent after the second,’ says Whaley. ‘It has never recovered.’
He has been in three short-lived relationships in the years since. ‘I didn’t tell my first girlfriend about it,’ he says.
‘I just sort of faked it, but the relationship eventually fizzled out.’ His subsequent relationships followed a similar pattern.
‘I did tell one girlfriend,’ he says, ‘but sex is very difficult to fake when you feel completely asexual. It’s almost like being an actor. I’m getting close to 40, my siblings and cousins have all had children and settled into long-term relationships. This has caused me absolute chaos.’
There is now an international support group for sufferers called the PSSD Network (pssdnetwork.org), which has helped Whaley. A year ago, the site had 7,000 monthly visits; now it’s 50,000. ‘I’ve met people on there who describe exactly the same experience,’ says Whaley. ‘There’s a lot of desperation among people on the PSSD Network.’
He is aware there are those who argue that talking about PSSD is irresponsible, as it might frighten off people who need the drugs for their mental health. However, he is adamant that in an era when SSRI prescriptions continue to soar (between 2015 and 2021, antidepressant prescriptions for children aged between five and 12 grew by 40 per cent), we should know the full facts, all the side effects and long-term risks.
There have been several suicides within the PSSD Network, including two last month. ‘Maybe my own case is severe, but I’ve met so many people in my normal life who have said that their sex drive has never been quite what it was since they took antidepressants,’ says Whaley.
This is why he is speaking out now – despite the embarrassment associated with the issue. ‘I feel like it’s my duty to show what can happen,’ he says. ‘I’ve had it so long and it’s not getting any better. I don’t feel I have much to lose.’
susanne says
The whole article is too long to paste here and too impossible to precis Chris There are references to ECT which as you know has been around for a long time but has been included in this New and Emerging treatments review.
State of the Art Review
New and emerging treatments for major depressive disorder
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj-2022-073823 (Published 08 July 2024)
Cite this as: BMJ 2024;386:e073823
Correspondence to: P P Ramanuji p.ramanuj@doctors.org.uk, p.ramanuj@nhs.net
chris says
“These include drugs such as psychedelics, antibiotics, opioid modulators, neuropeptides, and onabotulinumtoxin. Neuromodulatory treatments such as light based therapies”
The above was all I got to copy when I went back it was gone so couldn’t read the rest.
I think there is something to be said for light therapy. You know I’ve noticed in supermarkets they have these very large lightweight LED light box’s with luminous photos which could be voluptuous landscapes . I suspect it could help people who are correctly diagnosed with depression to have such on their living room walls during winter. As for the rest I’m sure you feel as I do.
Also was wondering if you have any insights into this case being as it’s South Wales:
https://www.dailymail.co.uk/news/article-13612159/paranoid-schizophrenic-hospital-kill-hero-church-warden.html
susanne says
Chris I Can’t help with this, sorry. I’m not in S Wales very often these days but remember this reported just on a level of ‘never happens in place like this’ and her mother and family blaming the lack of ‘care’
Strangely I can’t remember any of the usual blaming – s/he had stopped taking her/his medication. That’s all the ‘care’ would have amounted to in most institutions. There is never any investigation as to why people stop taking these drugs. If there was a trustworthy service to help those who decide to at least try to come off them safely ……doubt if it exists in S Wales though
You may have heard of this ?
Preventable Deaths Tracker
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A vigilance platform to learn lessons following inquests
The Preventable Deaths Tracker is the first open database of all published coroners’ PFD reports in England and Wales. It’s a data-driven learning and vigilance platform that includes over 5,000 coroner reports and is updated weekly, providing real-time analytics and bespoke research investigations to prevent future deaths.
The mission of the Preventable Deaths Tracker is to make coronial data usable so that lessons can be learnt to improve public safety. Ultimately, we seek to save lives by reducing preventable deaths.
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Founder Dr Georgia Richards will speak at an upcoming event for the Royal College of Pathologists on 30 July 2024.
Regarding light therapy I know someone who uses them in the Winter for Seasonal Affected Disorder which isn’t though at a level of depression.
chris says
Very interesting – do you know if Dr Georgia Richards is aware of this site I suspect she must be. I just read one of her papers no mention of akathisia but she does realise that more than the usual suspect drugs are involved –
“The poor application of policies and procedures that were repeatedly identified by coroners should be addressed when updating NICE guidance on depression, which will be renewed in 2023 [38,39]. Medicines implicated in these suicides may be emerging evidence of risks associated with these medications. For example, the MHRA are considering if further action is required following concerns raised regarding increased risk of suicide when using ciprofloxacin and quinolones”
tim says
Susanne and Chris,
I recently wrote to Dr. Georgia Richards about my concern: –
‘It appears that on occasion, prescribers and patients may not have a comprehensive awareness of akathisia as a serious adverse drug reaction to SSRI/SNRI/’Atypical antidepressants’ (and other prescription medications’).
I also referred to the published work of Professor David Healy.
I had previously written to her referring to the comprehensive evidence base relating to prescription drug induced AKATHISIA , associated disinhibition and emotional blunting with potentially avoidable suicide.
I received a prompt and professional reply, a copy of a published paper, and joined the Newsletter mailing list.
I do hope that the Preventable Deaths Tracker may be able to address this avoidable cause of death-by-self at some stage.
Surely if prescription drugs, taken as directed, have lead to an ADR induced death; then this may not be accurately recorded as suicide?
Would the cause of death not be ‘Involuntary Intoxication’?
chris says
Also
“There were 734 suicide-related coroner reports, with 100 (14%) reporting a medicine. ”
I think it is way higher than that. The coroner’s reports need to be re evaluated via GP/hospital historical records for drugs stopped and started and when they were last prescribed. Akathisia can kick off months into years after stopping. I well know – it happened to me and well know the experience to know it was not another “bi- polar ” “episode” of mania.
annie says
Something is going on here –
Log-Jam…
Tony Kendrick@tony_kendrickJul 5
Ha ha ha ha ha!
Tony Kendrick@tony_kendrickJul 5
Disgusting excuse for a human being. Good riddance.
Tony Kendrick@tony_kendrick8h
Again you make things up to suit your bias. The study has demonstrated – importantly – that more than 40% of people can stop their antidepressants with GP advice to taper. Costly specialist clinics and tapering strips are not necessary for nearly half the people.
Mark Horowitz@markhoro17h
Replying to @markhoro and @tony_kendrick
Your study has – if I follow correctly – demonstrated that GPs think they are seeing relapse and put people back on the drug…..there are 10,000s of ppl whose GPs thought the same that are now off by tapering slower. Ignoring that is ideological.
Tony Kendrick@tony_kendrickJul 8
It’s good that tapering strips are so helpful. REDUCE suggests they are not needed for nearly half of people on long-term antidepressants who are well. Do you have a financial interest in promoting their use @PCGroot?
Peter Groot@PCGrootJul 1
@tony_kendrick 70% of the participants in our studies (n>2800) were able to taper succesfully when their gps or psychiatrists prescribed #taperingstrips, as explained in
https://www.madinamerica.com/2024/04/tapering-strips-a-practical-tool-for-personalised-and-safe-tapering-of-withdrawal-causing-prescription-drugs/
Me – on the telly…
https://x.com/tony_kendrick
Robert Howard@ProfRobHoward22h
Replying to @AdamLeedale and @ReadReadj
I don’t think I have ever seen AD withdrawal symptoms in my patients, but as I have said, I take people off slowly because of concerns about relapse. The most likely reason that GPs are surprised is that these symptoms are uncommon. They’d quickly learn if they were seen in 50%.
Aye Peter – Something is going on here
https://holeousia.com/2024/07/08/something-is-going-on-here/
The REDUCE trial, finally published last month, established that nearly 60% of those prescribed antidepressants were unable, for whatever reason, to stop them. The REDUCE trial chose not to comment on this. Peer Reviewers supported this omission. The media followed suit.
Something is going on here.
If I was on social media I would ask:
The 1990s Defeat Depression Campaign was based on a prevalence of 1 in 20 having ‘clinical’ depression [based on a ‘consensus’ conclusion of experts]. Why then are nearly 1 in 5 adults prescribed an antidepressant today?
The REDUCE trial does not even begin to address this. This has not stopped the lead author to state: “stop blaming people who need long term treatment to remain well”.
Something is going on here.
annie says
Global leaders in the field of psychiatry have previously told MailOnline that ‘people should think very hard before they go anywhere near them’.
Prozac Nation: Record one in SIX people in England are now on antidepressants, new data shows, with a quarter of the population in some parts of the country taking the drugs
By JOHN ELY DEPUTY HEALTH EDITOR FOR MAILONLINE
PUBLISHED: 11:51, 11 July 2024 | UPDATED: 13:10, 11 July 2024
https://www.dailymail.co.uk/health/article-13623233/One-SIX-people-England-antidepressants-data-shows-quarter-population-country-drug.html
The data also recorded that 11,854 under-15s were also prescribed antidepressants by the NHS.
While the vast majority of these (11,186) were in 10-to-14-year-olds, about 600 five to 10-years-olds and 32 under fours were also prescribed the drugs.
annie says
This Thread is a powerful testimony of Cold Turkey/ADs
https://x.com/HumbleDiscourse/status/1811355100503556569
Not splashed all over the newspapers, not in front of Wessely, Gerada, Burn, Kendrick, Howard, Etc., but something all the invisible folk have gone through. The invisible children, Dexter and Romain, what were they thinking …
People are screaming out for help and it is not coming.
The Suffering in Broad Daylight – starting, changing, stopping – never on earth has the cruelty inflicted been so evident, and the jokey responses –
louis appleby@ProfLApplebyJul 7
A distinguished scientist as Minister for Science. A leading justice reformer as Minister for Prisons.
Experts.
You see where you are led – the Bumping has not stopped.
annie says
Let’s have a good look at Dexter Johnson –
https://x.com/DanJohnsonAB
Dan Johnson@DanJohnsonAB
I wrote a summary regarding our efforts to improve safety for other young people after Dexter’s sudden death, and the results. That post begins “Family, friends, other parents, and teachers have wondered about the results of the complaint I sent”. The decision is listed here.
7:28 PM · Jul 15, 2024
·
4,851 Views
Dan Johnson@DanJohnsonAB
1. Summary of decisions, stated in the letter to me, in short: The CPSBC Review Committee recognizes that fluoxetine is known to increase suicidal ideations in adolescents, and appropriate monitoring is required, but the CPSBC indicates they will take no action.
NO ACTION 1 – 8
https://x.com/DanJohnsonAB/status/1812917082163716221
Dan Johnson@DanJohnsonAB
8. I was informed by an email from CPSBC that Dexter’s treatment and death, and the decisions of the CPSBC, will be excluded from the Public Notifications posts of the CPSBC, at www. cpsbc. ca. There will be no news or public knowledge of the case, errors, or the decisions. End.
https://amazingdexterjohnson.com/
Look at the Detail –
Selective Serotonin Reuptake Inhibitors: science, efficacy, and dangers. Duty to warn.
“Beware of Doctors Bearing Gifts (Especially for Your Children)” Guest Speaker Dr. David Healy. Jan 26, 2023, University of Lethbridge.
Nearly every day I have followed Dan, the pics of Dexter, and have almost developed a passion for grasshoppers, but today, reading all the above, Dan has let us know, the results of all his endeavours.
Dan is very stable, he never gets over emotional, he has carried on, his loss is immensurable. He has done a ton of research, he knows exactly what’s what.
I really hope people will pore over this …..