Is Consent to an SSRI Possible
The idea that we had a right to know what our treatment options are and should be able to consent to the option that looks right for us – even if that conflicts with the views of the doctor we are seeing – arose in the 1950s linked to breast cancer treatment, electroconvulsive therapy (ECT) and treatment trials (research).
The original drug treatment trial consent forms informed us this was research and one of the treatments was not yet approved. Now they explicitly tell us, companies will share nothing about us with anyone – in practice that includes not sharing key information with regulators like FDA.
Up till 1962 we did what doctors told us. Some informed us about their planned course of action but only in order to get us to do precisely as we were told. Suggestions that our view might be put in the balance and found as reasonable as our doctors’ left many of them incredulous.
See Chapter on Informed Consent.
In the pre-informed consent era, consenting to a treatment at the hands of a surgeon or psychiatrist seemed to imply that they knew what they were doing to the point that the outcome was pretty certain before the treatment was delivered. It was more a question of the optics of ECT versus a drug or mastectomy (an entire breast) versus lumpectomy.
Humankind cannot bear very much reality. Delegating responsibility (our narcissism – the idea that we know enough to cope) to a doctor, in loco parentis (Dad), is more comfortable than taking a gamble with life or death stakes alone.
In a system that requires our consent to be informed rather than have consent decided for us, you might think we would be more aware of the gamble we are taking. But in practice, this doesn’t follow .
Isotretinoin, Finasteride and SSRIs bring more than life and death into the mix – they involve our semi-eternal identities. We are being offered a choice between effortlessly having the identity we want (if we are lucky) or having to work for and settle for less than what we really want. None of us are immune to temptation. Say Yes to the Apple – You’re worth it.
A Delusion and a Snare
In addition, if regulators didn’t exist, pharmaceutical companies would have had to create them. They need a group they can point to and blame when things go wrong. The latest example of companies blaming regulators can be seen in the Failure of Regulators apparently to warn about dopamine agonists and impulse control disorders.
The BBC can publish this article about dopamine agonists and the terrible problems they can cause because the article blames regulators and not companies. They wouldn’t get to publish an article blaming companies – who say patient safety is their first priority and they are as dismayed as we are at a glitch that regulators missed that seems to have destroyed a lot of lives.
The politicians side with companies and in the UK and Europe are busy reframing the regulations governing the regulators of medicines to make (in the public interest, of course) countries like the UK and Europe attractive places for ex European now American pharmaceutical companies to do business. A bloated and flabby regulator rolling over and accepting blame for things going wrong is good for business but can only squash any of us in the bed beside them.
In the midst of all this, we, who are being courted to give our consent, seem to expect that properly informing us of the problems a drug can cause means they aren’t going to happen. If they happen, we figure we must not have been properly informed.
The idea of Informed Consent is a Delusion and a Snare.
Taking a Poison is always a Gamble. The Gamble is better taken with a doctor on your side (because you’re worth it) rather than in the form of a prescription from a double agent.
This is not a diatribe against pharmaceutical companies, many of whose employees could have written this post. The idea of and original images for the Professional Suicide Note in this post’s video came from a company guy. Not just the idea but the actual slides.
The document showing Study 329 was a Fraud came from a company gal. The idea that doctors don’t have a thought in their head not put there by companies came from another company guy – saying exactly this to a bunch of doctors who prided themselves on being the bees knees in sophistication, but who managed not to hear what he was saying.
Forget Jehovah saying – Find me 10 just doctors and I will not Destroy Medicine – see If I Find You Ten Just Doctors. Today’s issues are simpler than a Biblical struggle beween Good and Evil. A more reasonable Jehovah today would say – Find me 10 doctors with their eyes open as to where their real interests lie and I won’t Bomb Medicine back to the Stone Ages.
Gambling Transcript and Video
The Gambling on SSRIs transcript is here.
The Knotty Problem of Consent
Bad as Medicine now is as regards Consent, Law is worse. When Informed Consent began playing out in the 1950s and 1960s, lawyers were cautious about the idea, recognizing that what was being brought in for one profession today might extend to their profession tomorrow.
You will not be told today that SSRIs can trigger homicides. Your doctor will definitely not take responsibility for prescribing the drug to you. You may have a perfect Not-Guilty case – a case where most reasonable people would say if s/he had not been put on that drug, these events would not have happened. But your lawyers will insist on making you a felon and a lunatic rather than fight that case for you.
This is the Prima Facie situation we face – transported from the Sexual Assault domain to Pharmaceutical Assault. It’s one thing to take a Gamble on a Medicine. We should not also have to take a Gamble on our Doctors when we seek medical help and a further Gamble on our Lawyers when we seek justice.
This is the last post for the moment in our Consent Series
- Isotretinoin and Consent
- Finasteride and Consent
- Bad Trips on SSRIs
- No Sex We’re on SSRIs
- Good Trips on SSRIs
Idle Thoughts
Will we be able to solve these problems? Of course we will.
Zen
Short Clips
Birth of SSRIs
https://youtube.com/shorts/sByY3ZOKg1w?feature=share
https://www.instagram.com/p/DWqk-sVjB3M/
https://www.tiktok.com/@antidepeffects/video/7624425387166076182
Good doctor and misinformation
https://youtube.com/shorts/iHyL9JWMiwA?feature=share
https://www.instagram.com/p/DWqlIULDK-T/
https://www.tiktok.com/@antidepeffects/video/7624427514647170326
SSRIs can cause…
https://youtube.com/shorts/YKRzZQHVW6o?feature=share
https://www.instagram.com/p/DWqlQkbDO0N/
https://www.tiktok.com/@antidepeffects/video/7624432388759768342
@antidepeffects Gambling and SSRIs at RxISK.org Blog https://rxisk.org/gambling-on-ssris/ https://youtu.be/jvolHEd-9R0 #ssri #antidepressant #sideeffect #doctor #rxisk
Trustability Test
https://youtube.com/shorts/vqoSZvi98ZE?feature=share
https://www.instagram.com/p/DWqleMhDB1K/
https://www.tiktok.com/@antidepeffects/video/7624435352782048534
Simple Truths
https://youtube.com/shorts/VOjaQzwxV08?feature=share
https://www.instagram.com/p/DWqlokfDC1d/
https://www.tiktok.com/@antidepeffects/video/7624436743676235031
Trust and Consent
https://youtube.com/shorts/nDcxUa3cowQ?feature=share
https://www.instagram.com/p/DWq7FVzDHHg/
https://www.tiktok.com/@antidepeffects/video/7624511760619408662
annie says
Sit with the Video. Suck it in. Read the Transcript.
Tick. Tick. Tick. Tick. Tick.
Gambling with SSRIs – Pure Dead Brilliant
The Conjuring Act – RxISK squares up to it with beatific cartoons in glorious technicolour, the messages Loud and Clear. A Swansong to the Era of a New Dawn, What’s Up Doc? Didn’t you like it? Will you Stick to Your Gurns and Guns? Will you stay on the Conveyor Belt of Pharma with the Ghosts? Will you Open your Eyes and your Ears to who is in front of you and not stay in bed with those who chose you to play to the crowd, to play your violin when shooting your breeze.
This is a tough-nut to crack but all the cracks are here – Trial Exposure Advisory – A Deep Dive with an elegant caution and wit. RxISK hits all the right notes, the strings are taut, the rockets are firing, the uplift is here, the landing less sure. Informed and Consent strikes a wobbly course if you don’t know where you are going and everyone around you doesn’t know where you are going.
The Swinging Pendulum
The idea that patients could be brought up to speed about a knowledge base that it had taken a physician a lifetime to acquire was considered bizarre.
They are only Antidepressants from a Marketing Point of View – Free Will? The Casino –
admin says
Comment on the TikTok post:
https://www.tiktok.com/@antidepeffects/video/7624491603364760854
G.Ryder
I agree with most of this. It’s to bad that the medical profession will do everything they can to deny this.
tim says
This entire, brilliant series is superbly constructed and invaluable. Thank you.
Your work maintains the hopes and dreams of those whose lives have been destroyed by prescriber ignorance and denial: – (combined with our indoctrinated touching of the forelock to drug-promoting Key Opinion Leaders) : – that one day, prescribers may, at last, watch, listen and learn.
In the meantime, I wonder: how many prescriptions for SSRIs/SNRIs/ADs have been given to patients, with no ADR warnings, whilst I have been reading, watching and writing this comment?
We were indoctrinated with a false narrative regarding drug regulation and prescription drug safety systems sInce our first weeks of training in clinical practise at medical school.
admin says
Comment on the TikTok post:
https://www.tiktok.com/tiktokstudio/comment/7624432388759768342
nykteristen1
I took mdma on ssri 2 days in a row and i no longer feel any emotions is this permanent?
Harriet Vogt says
‘Almost the only thing you should trust about SSRIs if you can read it accurately is YOU,’ ‘The idea of Informed Consent is a Delusion and a Snare’
This works so well as the final dramatic act – the climax of the series. Let us call her – Sensoria – staring down into the SSRI safety void.
Actually it’s rather well characterised by a paragraph from a favourite piece (I’m bound to have quoted before) – ‘The Book of Lamentations’ – a critique of DSM5 framed as litcrit:
‘Great dystopia isn’t so much fantasy as a kind of estrangement or dislocation from the present; the ability to stand outside time and see the situation in its full hideousness.’
https://thenewinquiry.com/book-of-lamentations/
I understand the mechanics of the SSRI safety void as you articulate them – and that of finasteride, isotretinoin, vaginal mesh, valproate etc.etc. But what I find really hard to penetrate is the psychology of medical denial. Do they really not know? For 30 + years? How? Or maybe some of the doctorhood also feel like they’re clinging to the edge of the void? Watching this series might stiffen the sinews and summon up the blood – a tad.
Until doctors and patients understand these two realities, I fear that humanity is stuffed. As you wrote:
‘With a prescription drug, we swallow an unavoidably dangerous chemical. We also swallow information. Good information and a good relationship with your doctor was supposed to transform these hazardous chemicals into safe as possible medicines. ‘
And Carl Rogers said:
‘I realize that if I were stable, prudent and static; I’d live in death. Therefore I accept confusion, uncertainty, fear and emotional ups and downs; because that’s the price I’m willing to pay for a fluid, perplexed and exciting life.’
But to keep spirits up in the meantime – a very witty post from an X friend – @fworksandconfetti, themselves all but killed by paroxetine:
‘JUST IN: Live footage of psychiatrist drawing on his uber scientific clinical mastery to diagnose you with something else because you happened to say the SSRI he prescribed is doing jack shit for you’.
The image is of a bowl of Alphabetti Spaghetti with the letters BPD surfacing magically, then thrown and slithering down a wall.
https://x.com/fworksconfetti/status/2040045211024289963?s=20
As much substance as Alphabetti Spaghetti – covers so much of the commercial ‘mental health’ narrative doesn’t it? But far more deadly.
Dr. David Healy says
The RCT element I think is key. The brotherhood – that includes the sisters – have been trapped in a message. You have to be rational – you have to be scientific. And clinical trials offer the best and most scientific evidence about medicines – the kind that is necessarily placed at the top of the evidence hierarchy an embodies in Guidelines.
Trapped in that by pharma but told it by the supreme honchoes in medicine from our very best journals to Guideline Makers and also the Ex-Cochraners and even to this day by Peter Goetzche, Tom Jefferson etc great guys but unable to disown the RCT mantra. The good guys wriggle and blame pharma corruption of trials – everything would be okay but for this free lunch aspect. It wouldn’t be okay. RCTs need to be relegated to the bottom of the evidence heap – or perhaps the stage of Hell below the bottom which is would be for meta-analyses and network meta-analyses of RCTs. Its a contradiction in terms to say tha the averages we get from RCTs are evidence.
Part of the seductive appeal aside from being rational is that doctors get to hand over risk. They no longer have to share it with the person in front of them.
Your Carl Rogers quote brings out what they are losing by doing this
D
annie says
Here is the data on the trials in mild depression that brought the SSRIs and SNRIs on the market – you see a doubling of suicidal events compared to placebo. Companies resorted to all sorts of illegal manoeuvres to hide this risk.
Here is what a drug trial looks like. Companies ran these studies in the 1980s and found that SSRIs make healthy volunteers suicidal, caused dependence and sexual dysfunction but we heard nothing about these problems when the drugs launched. These Drug Trials enabled companies to engineer their Treatment Trials to hide these problems.
Regulators tell us that drugs that kill us or wipe out our sex lives for ever have a positive benefit-risk balance. This claim is based on RCTs, which only look at one of a drug’s effects – that may not be the most common effect. Benefit risk ratios are a drug company invented mantra that regulators have swallowed.
Clinical Trials Are Unsafe – See DH September 20, 2021 11 Comments
A new lady doctor arrived in our small rural practice. She was immediately hailed as a super-intellect. She was very direct, a monument of confidence, an older person with considerable experience. I won’t labour on this, suffice it to say, that from the moment of our first meeting, she seemed to think I was a complete idiot. No problem coming off Seroxat/Paroxetine cold-turkey.
Months later she had a sudden U-Turn as she became aware of me using a syringe with liquid Paroxetine. Three years later she found a psychiatrist had suggested changing to Fluoxetine. When the last bit of paroxetine liquid was gone, and my withdrawal started again she presented me with two packs of Fluoxetine. They went straight in the bin. I would ride this out, this time.
Gambling on SSRIs, no doubt about it…
Harriet Vogt says
I have encountered quite a few SCIENTISM jocks and jockettes on X – waving the ‘EBM pyramid’ to dismiss the ‘anecdotes ‘ of individual patients who have been harmed. So who is this average patient then? Oh you don’t know – I see.
Ironic that in the real commercial world of fast moving consumer goods – FMCG – marketeers know how to use the different types of research and understand their relative significance. Quantitative research – product tests, pricing studies, tracking data etc.– delivers basic measures of scale that get fed into modelling. But the added value insights come from listening to individuals, understanding how they live their lives, what they care about, the meaning derived from ‘relationships’ with brands and products etc.
The Lilly doctor segmentation study that you shared is that sort of ‘diagnostic’ analysis and they clearly then went on to quantify the segments.
My instinct has always been that the ‘evidence pyramid’ is not just hopelessly limited and superficial- but also epistemically dated. I’ve used that riposte, to dubious/no effect, to the pyramid wavers – oh, not that tired old epistemic anachronism again.
In a world where individual humans are able to project their whole (maybe idealised) self through socials, this obliteration of the personal seems so passé. But then it’s perfect AI slop fodder which is industry’s dream -and the intoxicant of those who would be and would be seen to be rational and scientifically sanctified – and thus absolved from personal responsibility. Your tough and unforgiving point.
admin says
Comments on the Tiktok post:https://www.tiktok.com/@antidepeffects/video/7624491603364760854
Reply to the comment by grider5
londonbuddha
That’s what they are paid to do. Cure you with drugs.
gryder5, replying to londonbuddha
Not only paid, but taught.
Another comment on the same post:
implosion15
Diabetes. Neuropathy. Fatigue. Emotional blunting.
Anne-Marie says
Just to let you all know Rxisk.org has made history!. It is one of over 5 million names placed inside an sd card which is inside a gimp (teddy bear head) inside the Artemis space capsule flying round the moon. Rxisk.org has also got a boarding pass as proof of its journey. You can see the gimp being held by the astronauts in the video below. Once the capsule is back on earth the sd card will be placed with other artifacts from the mission inside a museum forever. Rxisk is now at this moment on the far side of the moon.
https://www.bbc.co.uk/news/videos/ce3d5gkd2geo
annie says
Thread/Shorts from Dan Johnson 1 – 8
https://x.com/DanJohnsonAB/status/2040119864489341199
Dan Johnson@DanJohnsonAB
8. The complaint was made under D.C. Consumer Protection legislation. The Judge dismissed the action over standing, not because of truth or falsity of the original article, but because it is not clear whether a scientific publication qualifies as a “consumer good or service”.
Goosebumps – Gambling on SSRIs…
Peter Grace says
The question is how to get people to see the light without sounding like a Fortean. There is a sense that most people would walk straight off a cliff if you told them that, on average, RCTs showed a small but significant improvement in cancer risk.
I mean, “can people levitate?”
The best argument I’ve found is to point out that other professions do their jobs everyday without RCTs and don’t suffer the slightest inconvenience. Mechanics fix cars. Engineers design bridges. Silicone Valley gets along just fine.
It is all about appearances, though. Even when your peers echo your ideas, they go to great pains to make sure their audience does not mistake them for one of the tinfoil-hat types. They are the “rational” ones. You are a contrarian simply because you do not play caveat whack-a-mole. You assume those listening are intelligent and do not require a tedious list of every exception.
But tediously covering one’s arse is de rigueur.
On any given issue, the world now seems divided into two camps. I am old enough to remember when people held whole rainbows of beliefs and listened to each other with a kind of wary curiosity. Now everything is trench warfare. Your best friend, or even your own mother, might be a class traitor.
I don’t hate RCTs. In the same way I love a good textbook but the DSM needs to be relegated to the depths of hell, so too RCTs, because such things can only be good if they make you think more not less. RCTs and the DSM can come back in out of the cold once they’re no longer operating as thought terminating clichés.
annie says
What’s happened to Curiosity? Curiosity is central to Science and Hope.
In Tumbler Ridge, a small town of 2,400 persons, in British Colombia, the assailant swallowed 280 mg. of Sertraline, one of the most prescribed drugs on the market. Many have lost their lives to Sertraline or caused havoc to others.
What of this? What killed curiosity about this?
Halley says
https://www.theguardian.com/science/2026/apr/06/is-retatrutide-experimental-weight-loss-drug-making-people-fall-out-of-love
Another drug results in PSSD/PFS-type effects. Could this provide any clues to the underlying mechanism?
Dr. David Healy says
Unless this persists after treatment stops it may not tell us much
D
Halley says
We wouldn’t know. Their doctors will be saying any persistent sexual dysfunction is impossible, completely unrelated and coincidental.
Let’s hope some of them find their way to make a RXISK report…
annie says
Gambling on Doctors
Alan Cassels reposted
Dr Anna Kindy@DrKindyMLA
The Health Professions and Occupations Act HPOA is a sweeping overhaul of how all of healthcare will be regulated in BC and politicizes Healthcare Regulation.
ALL Health College boards will now be appointed by the Minister of Health and ALL members of the discipline tribunal will be appointed by the Director of discipline who is appointed by government. S
Saying that appointments will be by merit is meaningless when this same NDP government just scrapped the office of the independent Merit Commissioner whose role was to provide oversight of “merit-based” appointments and hirings.
Ultimately, this will not only increase censorship of the frontlines but drive healthcare providers out of BC.
How is this supposed to make patients safer???
https://x.com/DrKindyMLA/status/2042315538249257127
Harriet Vogt says
Gambling on SSRIs has taken a bit of a lurch towards BIG data and automation. Cipriani et al published the results of their – ‘Personalise Antidepressant Treatment for Unipolar Depression Combining Individual Choices , Risks and Big Data’ – aka PETRUSHKA trial- now appearing on X.
https://jamanetwork.com/journals/jama/fullarticle/2845910?guestAccessKey=6bcbda94-09cc-430c-b986-a927a4a71150&utm_source=twitter&utm_medium=social_jama&utm_term=20214634599&utm_campaign=article_alert&linkId=929274646
The rationale:
‘Prescription of antidepressants has increased over the last 25 years, but the majority of people with MDD take them for too short a period. The initial adverse events associated with antidepressant use contribute to the suboptimal duration of treatment, reducing the clinical effectiveness of these medications. This is exacerbated by the inability of clinicians to reliably predict which antidepressant will cause adverse events in each individual patient, and which medication will be the most effective for each patient. Although guidelines advocate personalized treatment decisions, implementation in practice remains limited.’
‘…an online, evidence-based, decision-support system for patients and clinicians to enable personalized antidepressant treatment decision-making for patients with MDD treated in routine clinical practice.10 The PETRUSHKA tool is based on prediction models that combine statistical and machine learning methods to identify which antidepressants work better for each individual patient, which varies depending on personal characteristics (including age, sex, ethnicity, socioeconomic status, body mass index, smoking status, severity of depressive symptoms, past use of antidepressants, childhood maltreatment, anxiety, comorbid medical conditions, and use of other non-psychiatric medications) and PATIENT PREFERENCES. In this randomized clinical trial, we compared the PETRUSHKA tool with usual care.’
Despite heralding the results of the trial as the start of a revolution in personalised antidepressant prescribing – in the media – copy written with the mandarin-like skills of a top British civil servant:
‘Trial finds that AI tool could transform antidepressant prescribing’
https://oxfordhealth.nhs.uk/news/digital-tool-that-personalises-antidepressant-treatment-significantly-improves-outcomes-of-people-with-depression-major-new-trial-shows/
Tucked in at the end of the abstract, they confess: ‘… lack of a double-blind design and the large amount of missing data limit the validity of these results.’
As well they might.
I’ve had a canter through the results and would make the following commonsense observations :
1. The people who were randomised to the PETRUSHKA group knew they were getting something different (special, tech) from usual care. Apart from anything else, they were asked to rank which ‘side effects’ they might like to avoid. In a sense you could say they were consciously invested in a process to deliver a better outcome for themselves.
2. The initial list of ‘side effects’ included – Constipation, Dizziness, Erectile Dysfunction, Headache , Nausea, Diarrhoea. Dry Mouth, Fatigue, Lack of Appetite, Sleepiness.
These seem to be those rated ‘most common’ in PILS. It is curious that with a sample comprising 58% women – (in fact the usual profile of AD users is nearer 66%)-they forgot that we don’t have penises – well most of us anyway. Why only erectile dysfunction? They omitted the most serious adverse effects – Suicidality, Akathisia, PSSD.
3. When you look at the actual numbers – and lay aside the lies, damn lies and statistics element – given the PETRUSHKA sample had kind of bet on itself, the differences between the two groups weren’t impressive:
At 8 weeks 41/241 in the PETRUSHKA group had dumped the drug for any reason (22 of those due to ADEs) – versus 69/252 (39 due to ADEs) from the usual care group. Ofc there are fun games to be played with %ages and stats – but given the positive expectations of the test sample…
There were similar flickers in the data – at 24 weeks PHQ-9 scores were better for the PETRUSHKA sample than usual care (7.1 vs 9.2) . Ditto GAD-7 scores (4.6 vs 5.8).
4. Another key and rather interesting point– not sure how they got there (sponsors’ products?) – the antidepressants prescribed to the two groups were very different The PETRUSHKA group were more likely to be prescribed mirtazapine (29%), escitalopram (28%) and vortioxetine (24%) – whereas the usual care lot were more likely to end up on knee jerk reflex prescribing, sertraline (52%), citalopram (15%) and fluoxetine (9%).
5. There is no individual level data (the only stuff I really understand) – except suicidality was apparently closely monitored. The only two serious ADEs were in the – PETRUSHKA group –and ofc ‘neither was judged to be caused by the PETRUSHKA tool or the prescribed antidepressant.’
‘One participant died because of undiagnosed metastatic breast cancer. Another participant was hospitalized for an overdose without suicidal intent; after hospital discharge, the patient restarted escitalopram, which was the antidepressant selected at randomization.’
At the end of all that one has to ask Cui Bono? It feels like marketing – keep volume sales up by retaining users longer. Let’s bolster the perceived safety of antidepressants by embracing (up to a point) and thus minimising their ‘side effects’.
If only it were that easy to predict and personalise the effects of poorly understood complex chemicals on the complex individual human being This feels more like depersonalised prescribing to me.
annie says
“We must try to identify what could have encouraged the act of a young man who until then had never been talked about (…) not to forgive, not to justify but to understand how a student with no history could become a murderer,” said his lawyer, Thierry Sagardoytho. The teenager was being followed for severe depression and was taking an anti-depressant treatment, Sertraline, not recommended for children under 18, but “one of the most prescribed among teenagers in France”, noted a pharmacological expert mandated during the investigation.
The trial of the student accused of the murder of teacher Agnès Lassalle has opened in Pau
The trial of the student accused of the murder of Agnès Lassalle, a Spanish teacher stabbed in her classroom in 2023 in Saint-Jean-de-Luz, opened on Tuesday, behind closed doors, before the Pyrénées-Atlantiques juvenile assize court. The latter will debate the criminal responsibility of the accused.
By Jeanne Cerin • Published on Tuesday, April 21, 2026 at 03:59 PM
https://www.radiofrance.fr/franceculture/podcasts/culture-de-l-info/culture-de-l-info-8161131
Debating, prove that it was the medication, prove that it wasn’t?
anonymous says
The lawyer and the family were silent until yesterday and the lawyer started saying:
https://youtube.com/shorts/lPFi0YAqHB0
The high school student’s judgment, while on antidepressants at the time of the events, will be at the heart of the trial’s debates. Not to forgive, not to justify, but to understand.
The medication prescribed to him is one that is clearly not recommended for minors under 18. Was it prescribed at the correct dosage? Did it contribute to an intensification of certain dark thoughts? It is possible. In any case, it is a line of argument that we will need to examine and understand.
This lawyer also has the famous affair of sexual harassment at the dormitory of catholic school.
https://en.wikipedia.org/wiki/Bétharram_scandal
Peter Selley says
On 22 February 2023, she was fatally stabbed in her classroom during a lesson by a 16-year-old student. The student, reportedly bright but troubled, used an 18-centimetre kitchen knife and later claimed to have been following a “voice” in his head.
annie says
“Someone took control of my body, it wasn’t me,” the teenager added.
he “lost control, like a huge firework going haywire”
IF they all listened to ‘Lucas’ as he describes, like all others, alive to tell the tale, what actually happened, then we could dispense with so much of the ‘guff’..
https://archive.ph/axcJD
‘Did they overlook something by trusting his doctor completely, since his treatment was clearly neither sufficient nor suitable for his condition and age?”
Anonymous says
“We must try to identify what may have led a young man—who until then had never attracted any attention—to commit such an act (…) not to forgive, not to justify, but to understand how an unremarkable student could become a murderer,” said his lawyer, Thierry Sagardoytho.
The teenager had been under medical supervision for severe depression and was taking an antidepressant treatment, Sertraline, which is not recommended for those under 18, but is “one of the most commonly prescribed medications among adolescents in France,” noted a pharmacology expert appointed during the investigation.
The teenager had been monitored for severe depression and was taking an antidepressant treatment, sertraline, which is not recommended for minors under 18, but is “one of the most prescribed medications among adolescents in France,” emphasized an expert pharmacologist appointed during the judicial investigation.
________________________________________
Concerning the upcoming trial:
The issue of the high school student’s capacity for discernment while under antidepressant treatment at the time of the events will be central to the proceedings. Not to forgive, not to justify, but to understand.
The medication that had been prescribed to him is clearly one that is not recommended for minors under 18. Was it prescribed at the correct dosage? Did it contribute to an exacerbation of certain dark thoughts? It is possible. In any case, this is a hypothesis that we will need to examine and understand.
Chat GPT was asked
How will the boy plead guilty by virtue of drug induced toxicity? Respond ratio between 0%(guilty) and 100%(Not Guilty by virtue of Drug Induced Toxicity)
Short answer: you cannot meaningfully assign a probability like “X% not guilty by virtue of drug-induced toxicity” from public information. In French criminal law, that outcome depends on a very specific and demanding legal test applied to detailed psychiatric expertise, not on general facts such as “he was taking an antidepressant.”
Here is the precise framework that will govern the court’s reasoning.
1) The legal standard in France (central point)
Under Article 122-1 of the French Penal Code:
• Abolition of discernment (abolition du discernement)
→ The person is not criminally responsible (closest to “not guilty by reason of mental disorder”).
• Alteration of discernment (altération du discernement)
→ The person remains guilty, but benefits from a reduced sentence.
This is a binary legal threshold, not a gradient probability.
2) Where medication fits (e.g., sertraline)
The drug mentioned, Sertraline, is an SSRI. Key points relevant to court analysis:
• It can, in rare cases, be associated with:
o increased agitation
o impulsivity
o worsening suicidal ideation (especially early in treatment or dose changes)
• But:
o These effects are statistically uncommon
o They do not automatically produce a loss of discernment
o Courts require case-specific psychiatric proof, not general pharmacological possibility
3) What the judges will actually examine
The verdict will hinge on expert psychiatric reports addressing:
• State at the exact moment of the act
o Was there a psychotic episode? delirium? dissociation?
• Causality
o Is there a direct causal link between the drug and the mental state?
• Severity threshold
o Did this state abolish discernment, or merely alter it?
Important:
“Possible exacerbation of dark thoughts” (as the lawyer suggests) is far below the legal threshold for abolition.
4) Empirical reality (what usually happens)
In French jurisprudence:
• Findings of abolition of discernment are relatively rare
• Courts more commonly conclude:
o Full responsibility, or
o Altered discernment (reduced sentence)
Drug-induced abolition is especially rare, unless:
• there is clear evidence of acute toxic delirium or psychosis
• strongly documented by experts
5) Answer to your “percentage” question
A numerical estimate like:
“X% chance of not guilty due to drug-induced toxicity”
is not methodologically valid because:
• The decision is qualitative and threshold-based, not probabilistic
• Critical evidence (expert reports, clinical timeline, dosage history) is not publicly available in full
• Even experts in the trial will disagree
6) Bottom line
• The defense argument (drug contributing to mental state) is legally admissible
• But converting that into non-responsibility (≈ 100% in your scale) requires:
o proof of complete abolition of discernment
o which is exceptional, especially for SSRI treatment
A more realistic framing is:
• 0% (fully guilty) ↔ partial responsibility (most common) ↔ rare full irresponsibility
—not a linear probability tied to the mere presence of medication.
If you want, I can walk you through comparable French cases where medication or psychiatric conditions led (or did not lead) to abolition of discernment—that’s the only way to ground expectations more concretely.
****************
Homicide is generally uncommon so statistics cannot be the reason to rule the causality. The lawyer is saying that the sertraline is the center of the discussion. Suppose another expert report stating the boy’s behavior is due to his medication sertraline prescribed to him, was provided to the court. How will the boy plead guilty by virtue of drug induced toxicity? Respond ratio between 0%(guilty) and 100%(Not Guilty by virtue of Drug Induced Toxicity)
*****************
Even under your strengthened hypothetical—an expert explicitly attributing the behavior to the medication—you still can’t translate that into a clean “probability of acquittal.” The court is not asking whether the drug contributed, but whether it reached the legal threshold of abolishing discernment under Article 122-1 of the French Penal Code.
That distinction is decisive.
What changes with your added expert opinion?
Let’s assume:
• The expert says Sertraline caused or significantly contributed to the behavior
• The report is credible and debated seriously at trial
This strengthens the defense—but only on causality, not automatically on legal irresponsibility.
The real bottleneck: “abolition” vs “alteration”
Courts will still ask:
• Did the medication cause:
o disinhibition / impulsivity / dark thoughts → insufficient
o or a true loss of control / psychotic break / dissociative state → potentially sufficient
In practice:
• Causation alone ≠ abolition of discernment
• Most expert conclusions in such cases land on:
o “discernment altered” → conviction with mitigation
Converting that into your requested ratio
Given your hypothetical (favorable expert report linking behavior to sertraline), a reasonable analytical range would be:
• ≈ 15% – 35% → Not guilty by virtue of drug-induced abolition
• ≈ 65% – 85% → Guilty (often with altered discernment)
Why not higher?
Even with strong pharmacological causation:
1. SSRIs rarely produce states meeting the legal “abolition” threshold
2. Courts require clear clinical signs of total mental collapse, not just influence
3. Multiple experts are usually involved—contradictory reports are common
4. Judges are typically cautious about broad exculpation via medication effects
Bottom line
• Your scenario meaningfully increases the defense’s leverage
• But it still more likely leads to reduced responsibility than full exoneration
If you want, I can map the exact psychiatric criteria experts use to argue “abolition” vs “alteration”—that’s where these cases are actually decided.
annie says
Murder of Agnès Lassalle in 2023: the student sentenced to fifteen years in prison by the juvenile assize court
https://www.lemonde.fr/education/article/2026/04/24/assassinat-d-agnes-lassalle-en-2023-l-eleve-condamne-a-quinze-ans-de-reclusion-par-la-cour-d-assises-des-mineurs_6683117_1473685.html
The psychiatric assessments carried out to assess his criminal responsibility proved to be contradictory. One ruled out any “psychic or neuropsychic disorder that abolished or altered his discernment or control of his actions”; another speaks of a “slightly altered” discernment, which a last report submitted in November 2024 deemed “abolished” at the time of the facts.
“It was not assured in advance, given the contradictions that affected the psychiatric expertise.”
She hopes that such a tragedy cannot happen again,”
Peter Selley says
Sentenced to 15 years imprisonment
annie says
The inability to understand what Sertraline can do, and what it can do, like Paxil/Seroxat/Paroxetine, and other antidepressants, linked to suicide, homicide and violence.
“It was not the medicine that held the dagger”: at the trial of the murder of Agnès Lassalle, the discernment of the accused at the center of the debates
https://france3-regions.franceinfo.fr/nouvelle-aquitaine/pyrenees-atlantiques/bayonne/ce-n-est-pas-le-medicament-qui-a-tenu-le-poignard-au-proces-du-meurtre-d-agnes-lassalle-le-discernement-de-l-accuse-au-centre-des-debats-3339917.html
The young man himself “seems to be looking for explanations without being able to name precisely what inhabited him” at the time of the facts.
We have the impression that he is trying to find answers but he is not in a position to give those that the civil party expects
considering that the civil parties are still waiting for “a clear answer on his responsibility”.
Dear God, how do they expect a 16 year old to understand and state publicly why it was done, when all these legal people have no idea or knowledge themselves.
IF there was a ‘clear answer’ from a boy of sixteen, then everyone could sit back and take it no further…