Editorial Note: This is part 2 of Natalie’s story written by her mother Kristina. The photo shows Natalie aged 18 at her graduation.
Abductor number three: 2010
Natalie’s tardive dysphoria remained undiagnosed, and the counselor recommended that Natalie see her colleague, a psychiatrist. The counselor’s records reflected Natalie’s fears about taking drugs. Natalie shared, “I’m afraid they will change who I really am.” Caught in a Catch 22, Natalie also wanted to get her life back.
Natalie’s dad took her to the new psychiatrist who was aware of Natalie’s adverse reaction to Prozac. The doctor recommended a “different drug.” Again, the doctor provided no informed consent, no Black Box info, and no discussion of risks vs. benefits. Natalie decided to try their new drug, Zoloft, after the therapist and doctor promised to closely monitor for side effects.
Such reassurance disarmed us. How we wish we knew to more thoroughly research Zoloft on our own. Would knowing Zoloft was also a SSRI like Prozac have saved our daughter from more medical violence? This sad reflection causes profound guilt. However, I’ve since met other parents whose children died from SSRI prescripticide. When they did ask about the risks and warnings, their doctors dismissed them as overblown and unnecessary.
Drug-induced mania and akathisia
Natalie sometimes laughed at inappropriate times, had pupils the size of flying saucers, experienced violent nightmares and showed little empathy. My daughter— who never even had a school detention—was soon identified as a behavior problem. Concerned by this new outgoing and fearless Natalie, I talked with the counselor and doctor. The psychiatrist’s records state “Mother wants child off Zoloft” and “Mother thinks Zoloft is causing nightmares.”
Natalie’s therapists apparently believed I was uncomfortable that Natalie was no longer shy. They thought Natalie was doing well. They perceived Natalie as empowered when she was actually suffering from drug-induced mania.
Soon Natalie experienced agitation and anxiety worse than ever before. I saw she cut herself badly and wanted them to look at Natalie’s scars. They did not. It was implied my request for such an examination was an invasion of Natalie’s privacy. I briefly considered taking pictures of Natalie’s cuts when she was asleep to show them instead, but I recognized if Natalie awoke she would be distressed and our trust diminished. I also worried that perhaps the doctor or counselor would report me to child protective services.
Instead of physically examining her patient, the doctor added another potion: Valium. Natalie told me Valium was “the only thing that worked” to decrease her new anxiety. Years later I would learn that during Zoloft drug trials, Pfizer also gave subjects sedatives to mask the symptoms of akathisia. Just as her predecessors had done, Natalie’s doctor increasingly viewed Natalie as an object—a thing to be modified by prescriptions. Seldom was my daughter seen as an individual human being.
Natalie’s good grades dropped dramatically. Her teacher reported a significant difference between Natalie’s behaviors from the first quarter to second. In 2013 we re-read this report. Something tragically relevant stuck out: the teacher observed Natalie would not sit in her chair and often wandered around the room. How could our daughter have gone from being too shy to sharpen her pencil, to being unable to sit in her chair? The answer: akathisia.
Abductor number four: 2010-2013
Armed with research and documentation, we sought another opinion. I provided the doctor with an extensive, typed history. I believed the 100 mg of Zoloft should be stopped and that perhaps it was prescribed at too high a dose. I asked about metabolism and noted Natalie’s petite size (under 5 feet tall and 110 pounds). The psychiatrist retorted dosage has “nothing to do with metabolism.”
We explained Natalie’s adverse reaction to Prozac and offered to provide all medical records. The doctor didn’t want the records, declaring, “I make my own diagnosis.”
Her response surprised me. But instead of running out of the office fast enough to save my teenager’s life, I fooled myself by misinterpreting the doctor’s declaration: I thought she wanted to make an independent, objective assessment before reviewing the records. I was wrong.
After years of being dismissed, derided, blamed and misquoted by doctors, I realized too late that I also suffered an abduction: My motherly instinct was gone. I arrived at the appointment convinced Zoloft was the problem but left undermined and defeated. I could no longer consciously recognize nor trust my judgment. It seems our society has gone from the belief “Mother knows best,” to “Mother knows nothing.” Modern medicine and the pharmaceutical companies have played a key role in creating this shift.
The doctor continued Zoloft and Natalie suffered more years of torture. As the drug increasingly caused faulty cognitive reasoning, memory loss, and destructive, risky behavior, Natalie was blamed for and held responsible for adverse outcomes.
When Natalie was 17, she wanted to stop taking Zoloft. The doctor’s notes reflect we shared this and received no information about tapering. Natalie stopped Zoloft but later asked to refill her prescription. She told friends horrible things happened to her when she tried to stop Zoloft. Natalie believed this was proof of her illness; therefore, she needed Zoloft. She never knew her suffering was drug withdrawal.
My daughter diligently took Zoloft during her last year of life. She was resilient and there were glimmers of her happy spirit. We grew close and repaired much of the damage “therapy” caused our relationship. Natalie started college, enjoyed a part-time job, and socialized with friends. Her college papers reflect Natalie’s optimism about her future.
Double, double toil and trouble
In November 2013, the doctor increased Zoloft from 100 mg to 150 mg. Medical records reflect Natalie shared she felt “overwhelmed.” She told the doctor she worried when she transferred to college in Washington state the following year, she might become suicidal. It is unimaginable the doctor never shared this information. Again, there was no informed consent, no risks vs. benefits, etc. The doctor conducted no tests. No assessments for akathisia, suicidality, OCD, metabolism, depression—nothing. She simply increased the Zoloft.
She also failed to inform Natalie’s caregivers that she directed a Zoloft increase. FDA guidelines state patients should be carefully monitored, and caregivers informed to watch for and report any unusual behavior changes whenever a SSRI dose is changed. The FDA must not believe this is critical, however, as it’s merely a guideline, one the doctor chose not to follow.
We noticed several “unusual changes in behavior” after the 50% Zoloft increase. But left uninformed, we made the connection too late. The last week of Natalie’s life, I noticed she was walking strangely. Her gait had turned into a wide stance-shuffle. I thought maybe it was due to her snow boots and planned to ask. I also saw Natalie, a beautiful girl who cared for her skin, had picked at her face. I asked Natalie if she had a reaction to makeup. Natalie replied, “I know what I have; it’s called…” She flatly muttered some scientific word, explaining, “It’s uncontrollable skin picking.” Natalie believed, as did her doctor, it was just another sign of worsening OCD. She added, “I think I have an unspecified eating disorder.” I told her we would find a support group and a specialist in eating disorders.
Natalie further explained “I felt this way in fifth grade.” (Note: We later connected that it was fifth grade when Natalie was hospitalized for Prozac-induced Serotonin Toxicity and psychosis, but the hospital misdiagnosed her drug toxicity as an “illness.” Natalie was reflecting on her new and returning symptoms, but couldn’t recognize all were adverse drug reactions.)
One week later, Natalie had a scheduled therapy appointment. She was feeling ill, complained of “swollen throat glands” had a fever and headache. She thought she had the flu. Natalie tried to sleep, but had terrible insomnia. She called the doctor to cancel her appointment. The doctor suggested they have telephone therapy instead. During their phone call, Natalie said she had been vomiting, discussed her “increasing OCD symptoms,” and Natalie cried. I later learned the psychiatrist instructed Natalie—without ever seeing her—to start taking 200 mg of Zoloft. Again, no informed consent, no risks vs. benefits, and caregivers left in the dark. Abductor Number Four doubled Zoloft the last 12 weeks of Natalie’s life. The doctor scheduled a follow-up appointment in two weeks. This is not close monitoring.
Two days after taking the maximum Zoloft dose as prescribed, Natalie was dead. She had valiantly raged against the dying light for nearly half her life, but was no match for 200 mg of Zoloft. She died of violent self-sustained injury, but did not die by her own hand: She was chemically tortured, suffered and died at the hands of her doctors. Their negligence was medical violence. As is typical of akathisia-induced death, Natalie, who was born a gentle soul, did not go gently into that good night.
On Natalie’s nightstand was a note of sorts. It read: “I keep coughing up blood. I’m not hungry. It’s time for me to take my meds.” It was next to the nutrition book Natalie read her last night on earth. The book was entitled, “Eat This and Live.”
After Natalie’s death, the doctor stated, “Natalie was not depressed.” She said she increased the Zoloft dose in response to Natalie’s increased obsessions.
Anecdotes are evidence
Sometimes we don’t recognize a story is a story until we reach the end.
Ironically, Natalie and her doctors had several “things” in common. While Natalie developed a lazy eye, they willfully turned a blind eye. Natalie was abducted by her doctors, and her doctors were abducted by pharmaceutical companies. They were not practicing medicine in the traditional sense of the phrase; rather, they were practicing prescribing.
After Natalie died, I turned to Google, searching “Zoloft Kills” and “SSRIs cause suicide.” I quickly found real stories of beautiful people—Woody Witzack, Candace Downing and Stewart Dolin—who also suffered SSRI-induced akathisia and prescripticide. Overwhelmed by the realization that Natalie suffered the same torture, I fell out of my chair. My child was dying right before my eyes in the weeks and days until her final breath. We simply did not know. We were not trained to identify akathisia. Left uninformed about the two Zoloft dose increases, the increased risks and need to report unusual changes, I was unaware Natalie’s change of gait, fever, swollen face, skin picking, agitation, eating problems, etc., were all signs of drug toxicity. If only we had known…
Each psychiatrist who treated Natalie resisted, challenged or denied the concerns about Natalie’s symptoms. Her doctors long ago swallowed the data fed them by the pharmaceutical companies. They endangered Natalie by prescribing SSRIs and abandoned her when she could no longer rally from their actions.
Are the pharmaceutical companies solely responsible? Of course not. The question is: “How do medical schools produce doctors who have no respect for the treatment relationship?”
To stop antidepressant deaths, doctors must develop equal relationships with patients and stop blindly prescribing. Many lives will be saved when “modern” medicine hears and values patients’ anecdotes as evidence. Doing so will reduce serious adverse drug reactions including akathisia.