If you look at the adverse events section of the sertraline – Zoloft – label you will see in small print that sertraline has been linked to psychosis, hallucinations and aggressive reactions. Its there in small print. These links have been there since the mid-1990s.
Vanishingly few doctors understand what is going on here. They see a label saying something like “there have been reports of violence and psychosis on our drug so we are including these here”. They read this as – look at this wonderfully transparent and responsible company who are putting in the label even whacko reports from nutters and scientologists – am I going to believe this? Don’t be ridiculous.
In fact what is going on is Pfizer and other companies have reports that no matter what way they spin it they cannot explain in any other way but that our drug has probably caused this.
From internal Pfizer documents:
“As of 15 March 1994, 13 cases coded… “psychosis” in sertraline treated patients patients were identified… One case was poorly documented and contained insufficient information to be properly evaluated. Four cases could have been related to the underlying disease, two other cases to concomitant medication (unspecified sleeping pill or alprazolam) and one case to a mutiple drug overdose. These eight cases are excluded from further discussion.
“All of the five remaining cases were spontaneously reported to Pfizer. These cases are summarised in the attached table. In three cases, the psychosis either improved or resolved after either discontinuation of sertraline therapy or a decrease in sertraline dosage. In one case the event continued and in one other case the patient died.
“In summary, a review of Pfizer’s early alert safety database identified cases… five of which were sufficiently detailed to evaluate and had no other obvious cause. Therefore it is recommended that “psychosis” be added to the Adverse Reactions section of the sertraline International Product Document (Core Data Sheet)”.
It was the same for aggression, agitation and hallucinations.
In 1952, Parke-Davis were faced with cases of aplastic anemia on Chloromycetin. This was their best-seller. It had made the company the biggest pharmaceutical company in the world – at a time when Pfizer were a minnow in the market.
Faced with this threat, the company created an Anything But the Company Drug playbook. This involved digging deep into the medical records, and circumstances, of the person reporting a problem in order to find the ingrown toenail at the age of two that was possibly the cause of the problem. And of course if something else was possibly the cause – like the unnamed sleeping pill above (better unnamed than named) – then we can’t conclude our drug did it.
Part of the problem for Pfizer – who swallowed up Parke-Davis decades ago – is that in some of their cases the problems cleared up when sertraline was stopped. This evidence of challenge-dechallenge is still the best evidence for cause and effect there is. (RCTs are the gold standard way to hide adverse effects). Parke-Davis were in a handy position with aplastic anemia – the problem doesn’t clear up when you stop the drug. The patient, child, adult, black, white, stays fucked.
Quite aside from any large print saying our drug can cause aggression or psychosis, the adverse reaction sections of the label of over hundred drugs says they can cause psychosis – and this is without checking all the others that say they can cause hallucinations or delusions or paranoid reactions.
The adverse reaction section in heading toward a hundred other drugs say they can cause violence, aggression, hostility or homicidal ideation. Again there may be multiple other terms under which these reactions may be hidden. I have to thank Julie Wood for putting in the leg work to track these references down.
The drugs involved include the skin drug isotretinoin. This comes in tens of different trade names so for it alone there may be close to what might seem like fifty different drugs causing both violence and psychosis.
The other skin drugs recently released Siliq, Taltz, Otezla and others will almost certainly have similar reactions soon – or should do.
Other drugs include a host of antibiotics including the fluoroquinolones and many others, steroids, drugs like Advair (salmeterol) as Singulair – montelukast – and Accolate – zafirlukast – for respiratory problems, most of the retrovirals and other anti-viral drugs, as well as Mefloquine (Lariam) obviously.
The dopamine agonists are on the list. They are for parkinson’s disease – or for just little ol’ restless legs syndrome.
It may be little surprise to find the stimulants on the list but remember these drugs are being given hand over fist to children. Everyone recognizes the link between street amphetamines and violence but somehow once the same drugs are channeled through a prescription pad this recognition seems to be laundered away.
The list includes pretty well all antidepressants, and anticonvulsants and in addition a bunch of antipsychotics. Antipsychotics note causing psychosis and hallucinations and violence. It also includes the choline-esterase inhibitors giving for dementing disorders.
All these cases are interesting because the companies have the chance to in most cases to blame the problem on the disease but there is something about at least some of the cases reported to them that blocks off this easy escape route.
A few lines up, the phrase “or should do” occurs. Many years ago a number of us had a shock seeing a memo from a Forest lawyer telling staff they should never make causal determinations in the case of any reports in to the company of adverse reactions happening on citalopram and escitalopram.
The rough basis for something like this – a strategy first adopted by GSK – is as follows. Even if by all the conventional rules of cause and effect, by the Federal Judicial Manual sanctioned rules which hinge on challenge and dechallenge – not RCTs – there is no way out of assigning causality, we can still claim that unless RCTs have shown drug A causes problem B there is no way for sure to know the drug has caused the problem.
So you dudes who work for Forest or GSK, despite all logic you guys have to refrain from assigning causality until the RCTs proving the point get done. The fact that they will never get done, that it would be unethical to do them, is irrelevant. Come to think of it there are no RCTs of anyone ever dying from Zyklon B – maybe time to rewrite that bit of history.
The above scenario is for real. It is not a nightmare. The first person I heard push it was Ian Hudson, then of GSK, now head of Britains MHRA (FDA). But it may be the case that at least some people in what Iain Chalmers and Ben Goldacre continue to laud as the most ethical outfit in the universe and in other companies have recognized the lunacy of this and are quietly doing something else.
Difficult to know. But it pays to read the small print and maybe translate it for your doctor – or lawyer.
There are unquestionably many people now in jail who possibly should not be because of a drug they were on, dead who should not be because of drugs someone else was on, or who will not get a fair trial because when it comes to the small print vanishingly few people realize what is being said.
Even the Challenge–dechallenge–rechallenge has been spun in such a way that many healthcare professionals believe it’s a return of the illness, particularly if the patient tries this themselves.
PATIENT: “Doc, I took the drug, then withdrew from it, started crying and going crazy, so took it again and stopped crying and being crazy.”
DOC: “Yes, that will happen, it’s proof that you need the drug because your underlying illness needs treating – it’s not the drug, it’s the illness.”
One only has to look at the advice on antidepressant withdrawal from the RCP to see exactly how they spin this.
The first question I ask patients,most of whom are second opinions,is what drugs,both prescription and over the counter ,are you taking?Amazing how many are suffering from “adverse effects”.
I guess the general public, as well as all professionals, need to hear your findings loud and clear, as soon as possible and repeatedly until the message is finally accepted.
Especially the elderly. When you are very old, it’s worse than just being thought crazy. You are thought to be stupid and crazy, and plagued by acute and chronic ailments that arise without cause or explanation other then the drug you just started for no reason, which is the last thing your family and doctors will consider as the cause of your bad reaction to a drug.
If a drug doesn’t work as expected, a very backwards reaction will generally arise in your doctor. Forgetting that the elderly are typically more powerfully affected by drugs, they will double the dose. If you started on the standard adult dose, it might be the equivalent of a double dose for a young person. Doubling it makes it effectively quadruple. You’ll enjoy quadruple-strength side effects and no benefit whatsoever. Doubling the dose of a drug with no benefit whatsoever is multiplying by zero. You’re always going to get zero.
also incapable of causing unpleasant consequences for the sloppy, lazy jerks who drug them and possibly kill them in hospitals. Many are drugged and some are killed. They’ll do that to keep old people from carrying out such terrible acts as getting out of bed or leaving against medical advice. They will lay hands on them and an elderly patient struggles in their grasp or bats a nurse’s assaulting hands away with her own in self defense, she will be labeled combative. The moment that happens she is at risk of injected haloperidol, even in this day and age, and six point restraints, even in this day and age.
That’s the psychiatric facility experience for people of all ages, but for old people, it is an experience that can be inflicted any time they set foot in any hospital. They set foot in hospitals far too often, victims of orthostatic hypotension that leads to falling that leads to broken bones or concussion. The hypotension is induced too often by drugs, not the area rugs and unsuitable footwear the USA’s CDC likes to scold about.
The Vanishing Point ….. .
wendy burn @wendyburn 15h15 hours ago
wendy burn Retweeted Reluctant
Only recently discovered no phones on psychiatric inpatient units. Will have to be sectioned if I ever need inpatient care.
AR Crow @IAmACr0w 14h14 hours ago
Replying to @wendyburn @Sectioned_
Cw: self harm. Think the SH risk folk are concerned about most is use of the length of cable as a ligature.
wendy burn @wendyburn 4h4 hours ago
Enterprising solution. Would a patient info leaflet with suggestions like this be helpful?
I can confirm from my own experience with trying to get some kind of acknowledgement from AWP (Avon Wiltshire Partnership mental health trust), about my PSSD; that when you try to report a serious adverse event like PSSD, that great lengths are taken to make out the drug is not responsible, and that it is you, or anything else but the drug, that has caused the problem.
I know that citalopram caused my ongoing sexual problems for me, as they started on the day i took the drug. Also i know my own body, and i had been taking lorazepam for almost a year before taking citalopram, and hadn’t had any sexual problems at all before taking citalopram.
Also my ongoing sexual problems have all the signature hallmarks of the sexual problems caused by SSRI’s such as genital numbing and anorgasmia.
I pointed all of this out clearly to Avon Wiltshire Partnership.
No matter what i said they kept referring to the possibility that my ongoing sexual problems could have been caused by OCD, anxiety, low mood, or benzodiazepines.
I then clearly pointed out the good reasons why i didn’t think my sexual problems were caused by OCD, anxiety, low mood, or benzodiazepines. No matter what i said, they wouldn’t shift from their stance that it was likely “other factors” that were responsible.
I took my complaint to the ombudsman hoping they would see sense, and i pointed out all the reasons i felt strongly my sexual problems had been caused by citalopram.
I even sent them articles on PSSD from doctors and scientists who were concerned about PSSD (i had sent this to AWP as well).
Despite this the ombudsman agreed with AWP, saying my ongoing sexual problems could just have much been caused by the “other factors” that were suggested by AWP.
I knew the ombudsman was wrong, and had my case reviewed, but nothing i said made any difference. In fact it was claimed by AWP that my sexual problems were even “pre existing” to when i took citalopram.
I have mentioned in previous comments about the dishonesty i experienced from AWP around their claim my sexual problems were “pre existing” to them prescribing me citalopram, so i wont go into it all again.
All i can say is i know with 100% certainty that i never had any sexual problems before taking citalopram. I know my own body.
I felt trying to report an adverse event was like trying to report 2 + 2 equals 4, and then being told that 2 + 2 might equal 5. I knew my PSSD was caused by citalopram, as much as i knew 2 + 2 equals 4.
Originally i thought AWP must surely see sense, and say “of course 2 + 2 equals 4”, or “yes, it seems very likely citalopram caused your ongoing sexual problems, the problem started the day you took the drug, SSRI’s are well known for causing the specific sexual side effects you are experiencing, and other doctors and scientists have expressed concern about these side effects persisting after you stop SSRI’s; this is serious, lets see what we can do to help”.
But instead i felt like i was being told that if you look at 2 + 2 when the light is a bit dim, or at a certain angle, or when you are a bit tired, or when you have a cold, or when you are distracted by the t.v, or when you click your coffee mug five times with a spoon from tescos instead of sainsburys, then it could equal anything but 4.
There is a very dark side to the mental health care in the UK, which i have experienced for myself.
Spruce your comments make me melt it really makes me feel for you so much. I wish I could help you but sadly I cant. I too have experienced the denial from the Authority’s such as you have with a different side effect and the blame being put onto me rather than the SSRI even when I have provided them with research as evidence too.
You are not alone at all I am also in the same/similar shoes as you. I was lied to, blamed and fobbed off. It seems to be a common theme amongst us all.
Keep strong fighting for answers, you will eventually get there.
Now that the PILeaflets of so many medications show the possibility of problems, I wonder if doctors are beginning to feel that following the pharma companies without questioning their implications was a silly idea? With all those warnings present there is hardly the possibility of the companies being blamed when things go wrong is there? The patients cannot be blamed – except for mis-use of the drugs – as they are following ‘expert’ advice. The doctor becomes the vulnerable ‘middle man’ surely?
How will that affect the patients? Will doctors STOP giving out drugs as if they are sweets? Will doctors PREPARE patients properly by informing of the possible reactions? Will doctors INSTIL in their patients that these medications are to be used WITH CARE? Will doctors ENCOURAGE patients to come back if they notice ANY PROBLEMS with the medication? If they DO – then we need to extend appointment times to about 20 minutes for sufficient time to be available to the doctors to do so – which really means that it’s an impossible task whilst their numbers are dwindling. If they DON’T – who will back them if a patient suffers harm and their case goes to court?
Bob – the RCP’s advice on AD withdrawal is laughable in my opinion. Thanks for the blog, which I’ve re-read for the umpteenth time. Every time, I feel that I must have missed their main points – surely no-one can be so clueless in their attempt to support. There is nothing there to support anyone is there?I could do a better job myself!
Providing all the enthusiasm ..
Simon Wessely Retweeted
Chris Gray @ChrisGSGray Aug 7
.@BBCSimonMcCoy providing all the enthusiasm this story about surfing dogs deserves.
this story about surfing dogs deserves ..
The Position is Clear – Rxisk is the new Surfboard ..
Doctors have laughed at parents who believe their children have been affected by medication the mother took during pregnancy.
AED and psych drugs cause neurodevelopmental and physical birth defects but suspected cases are not being reported.
The MHRA certainly is not a perfect organisation, especially when concerns are raised about GSK products but at least they have now made it possible for patients to report suspected ADRs using Yellow Card.
As for Drs…. They don’t have time to read safety data and journals. Many are dismissive of patient concerns and their knowledge. They don’t question the safety of the products they prescribe, they are too trusting and that means I don’t trust them anymore.
Drs and patient groups are also quite hostile to discussions about safety concerns. Just look at comments on social media following panorama programme or vaxxed. They make accusations that people are scaremongering and that those who question safety are therefore responsible for illness in patients who have been prescribed a drug and decided not to take it.
My son harmed for life by valproate Epilim.
I want informed choice.
“The MHRA certainly is not a perfect organisation, especially when concerns are raised about GSK products but at least they have now made it possible for patients to report suspected ADRs using Yellow Card.”
A token gesture, Emma. Appeasement.
The Yellow card system is merely a back-slapping exercise for the MHRA. They can confidently say that they are “monitoring”. Thing is, they log the ADRs and do nothing else. This is like you or I reporting a loose rivet on a plane wing and the airline making a note of it but not investigating it.
Charles Medawar hit the nail on the head many years ago when he said of the Yellow Card system, “It’s deeply flawed.”
Nothing has changed.
The statistics and stories on Zoloft in this 2015 RxISK column — including violence, alcohol abuse and personality change — are worth another look:
How many revolving doors do we have to go through, before anyone takes our concerns seriously?
Valium (diazepam) can be offered to people as a muscle relaxant, for bad backs. No mention seems to be made of the fact that it affects the mind at the same time. I am very concerned as a farmer we know well, has for years been given some diazepam on and off over that time. He also always had long periods of insomnia for which he was given Zopiclone for many years but he recently stopped taking it.
But over the past 10 years or so, this guy has suffered pains and ‘panicky weird feelings’ intermittently as well as being admitted to hospital with what seemed like heart attack episodes, and terrible groin and stomach pain, alongside feeling pains in his feet, sweating through his feet, and an over-riding intermittent feeling of depression. This is not constant, but he never knows from day to day if he’s going to be ok or not. He has to keep going, for the running of the farm and caring for the animals, both of which he loves.
Recently the GP stopped letting him have any diazepam, but a year or so ago he was persuaded to see a private psychiatrist who put him on Citalopram, which he’s been on ever since. But the pain throughout his body, moving all around it, coming and going for no apparent reason, has gone on and got worse and worse. Yesterday I spoke with him on the phone, when he was out attending to an injured horse on the farm. He said the pain was so bad, like IBS (trapped wind at its very worst) and it affects the bladder too, which is not working right. He’s had two hernias in the past which have been surgically dealt with. He’s in his early 60’s and a very physically fit, active kind of guy. He has had every test under the sun for these pains and is being sent to see a urologist next. He says the GPs don’t believe him about the pain any more, they hint that it’s all in his mind. He feels sometimes there’s no point in struggling on, he wonders if it’s depression, but why this terrible circulating intermittent pain? Surely that’s enough to depress anyone?
My question is, ‘Could this be due to the long term on and off use of the diazepam in the past?’ As a farmer he’s obviously sprayed chemicals on his fields for years. He also has a little involuntary head movement like a spasm, which I don’t even think he’s aware of, and it comes and goes.
I wondered if anyone could tell me whether the diazepam is likely to have caused these problems? I’ve read the side effects list on RxISK.org but wondered also if anyone could quote first hand experience. I am really seriously concerned about this very hard working suffering human being.
No one can tell you this. All pills are poisons that can do great good – diazepam, isotretinoin and paroxetine. The key thing is not the pill but the relationship in which it is given and increasingly also the relationship between a doctor and pharmaceutical companies once and just as much media companies like SMC now
Concerning ‘the relationship in which it is given’ between him and the local GP practice, and the fact that they seem to have got exhausted with his reported on going fluctuating dreadful physical pain, I wonder if they’ve thought at all about the possible diazepam connection, and if he was brave enough and open minded enough to raise it, whether they would have a look at the RxISK.org side effects. I guess the only thing to do is to try it and see.
I just wondered if anyone else following these blogs had suffered the same symptoms after long term on and off use of diazepam.
In the meantime I have recommended he try turmeric tea, (I used commercially sold Three Gingers Tea, which includes turmeric) which is an old spice and has for a long time been used widely in Asia for joint, gut (ulcerative colitis) and even depression apparently. I have tested it myself for joint and neck stiffness, and to my amazement, the improvement has been quite marked. It also definitely lifts my mood. You only need to use it for short periods, say, a week at a time and then again when symptoms recur, so it’s not necessarily a cure, but a helpful aid to coping. But check it’s possible side effects before use, and use in careful moderation.
Heather, i can tell you from first hand experience that diazepam can definitely cause the effects the farmer you described has had.
If you go onto the benzo buddy website, you will see a lot of people suffer the symptoms the farmer describes, with long term benzodiazepine use.
I used to have a lot of the same symptoms as him, when withdrawing off diazepam, including severe panic attacks, that felt almost like i was having a heart attack, that put me in hospital once or twice.
Since doing a slow taper off diazepam, and jumping off at a low dose, i have had virtually no anxiety whatsoever, i feel so much more healthy, and have had nothing close to a panic attack.
All of my panic attacks were caused by withdrawing from benzodiazepines.
The doctors saw my panic attacks as evidence i should continue to take benzodiazepines.
I was a much more anxious person on the diazepam, than i am off it (i barely have any anxiety at all anymore).
It has been shown time and time again that long term use of benzodiazepines makes anxiety worse in the long run.
What is probably happening, is because the farmer isn’t taking a regular daily dose, he is going into withdrawal as the diazepam is leaving his body. This is likely causing a lot of his symptoms.
One of the main withdrawal symptoms from diazepam is severe anxiety (the exact opposite of diazepams main theraputic effect), which often can result in panic attacks, that can be very severe, and which can make you feel like you are having a heart attack.
I would also like to say that the anxiety created from acute benzodiazepine withdrawal can be very severe, and can be like something created from the ninth circle of hell, and was a lot worse than any anxiety i have ever experienced from regular life.
Unless someone has experienced acute benzodiazepine withdrawal, they can never really understand what i mean by this. But i can promise you it really can be that bad.
To give a comparison, I was about 10 times more terrified being in acute benzo withdrawal, than the anxiety i had when i jumped out of a plane when i did a parachute jump.
I was literally terrified of everything in acute benzodiazepine withdrawal. Every noise in my flat was overwhelming, the sound of a car going by in the street terrified me, the sound of the toilet flushing terrified me, seagulls cawing outside terrified me, the brightness of a light turning on terrified me.
I even had nightmares about being in acute benzo withdrawal for about a year after a psychiatrist tried taking me off lorazepam too quickly.
When i did the parachute jump, although i was scared, and my heart was racing, and i felt almost like throwing up, i could control it.
The fear i experienced in acute benzodiazepine withdrawal was uncontrollable and like something out of this world. It was like real terror.
On the plus side, after going through such an unpleasant experience with the severe anxiety caused by benzodiazepine withdrawal, i can handle normal life anxiety so much better now.
I was addicted to benzodiazepines for 9 years, so i am well versed in the effects of benzodiazepine withdrawal.
Without meeting the person or their family it very difficult perhaps impossible to say a drug has caused a problem. One of the big difficulties in this area is experts who even after meeting the person claim the drug has caused the problem when it clearly hasn’t. There is an expertise in assessing what a drug that can cause something has in fact done so. That said there are some problems like PSSD that stand out from the pack as things that are very unlikely to happen without a drug. But this is unusual.
I just re read your comment heather.
You say the farmer is off diazepam now, but he still gets pains and spasms etc. If you look back at the video “the benzodiazepine medical disaster” that i posted on the drug wrecked page, you will see a lot of people suffered many similar symptoms that your farmer complains of, even years after they came off benzodiazepines. Including pains in various parts of their body, and spasms. There was another documentary on benzodiazepines that said about benzodiazepines causing spasms even after you come off etc. I will try and find it, and post it on here.
I think i recall even the guy presenting the “benzodiazepine medical disaster documentary” had similar symptoms, and he had been off benzodiazepines for 8 years.
I am not saying the farmer you mentioned symptoms are definitely caused by benzodiazepines, but i wouldn’t be the least surprised if they were.
I may be able to shed some light on your friends condition. I am not an expert in medicine however, having experienced so much suffering as a result of ingesting Valium and having researched this topic, I may have some information which may give you and others a better understanding of why this poor man is suffering.
The hardwire of nerves eventually deteriorates, once they have been injured or attacked.
I am of the opinion, that once you ingest these meds, they have the capability of destroying the fatty white substance that surrounds the axon of some nerve cells, that form an electrical insulating layer. This myelin sheath is important for the functioning of the nervous system.
It is similar to an electrical cord that connects your phone to the wall socket. Given time, if the plastic around the cord, that connects the phone to the wall socket deteriorates, with time the electrical wires that are exposed, will become fragile and weak and one day the phone ceases to work.
That fatty substance that protects the myelin sheath is somehow damaged by these meds or other toxins.
I believe there is something in the meds or the toxins your friend has been exposed to (or a combination of both) that damages this delicate myelin sheath.
I believe your friend, Heather and I am not a medical expert, may be suffering from neuropathy, which is a malfunction of the nerves.
It is important that researchers seek better understanding as to what is in these meds that create damage to these delicate nerve fibres.
Nerves are everywhere in our body and it would be nice to understand what is in these meds that create these problems.
Our central nervous system is delicately wired and I believe that once damage is done to the protective insulating layer of the myelin sheath, it takes years and years for deterioration to gradually take place.
Taken from an abstract from e medicine health (What is neuropathy, causes and treatment)
There are so many types of neuropathy.
Peripheral neuropathy: Peripheral neuropathy is when the nerve problem affects the nerves outside of the brain and spinal cord. These nerves are part of the peripheral nervous system. Accordingly, peripheral neuropathy is neuropathy that affects the nerves of the extremities- the toes, feet, legs, fingers, hands, and arms. The term proximal neuropathy has been used to refer to nerve damage that specifically causes pain in the shoulders, thighs, hips, or buttocks.
Cranial neuropathy: Cranial neuropathy occurs when any of the twelve cranial nerves (nerves that exit from the brain directly) are damaged. Two specific types of cranial neuropathy are optic neuropathy and auditory neuropathy. Optic neuropathy refers to damage or disease of the optic nerve that transmits visual signals from the retina of the eye to the brain. Auditory neuropathy involves the nerve that carries signals from the inner ear to the brain and is responsible for hearing.
Autonomic neuropathy: Autonomic neuropathy is damage to the nerves of the involuntary nervous system. These nerves that control the heart and circulation (including blood pressure), digestion, bowel and bladder function, the sexual response, and perspiration. Nerves in other organs may also be affected.
Focal neuropathy: Focal neuropathy is neuropathy that is restricted to one nerve or group of nerves, or one area of the body.
There are many causes of neuropathy:
What Causes Neuropathy?
Nerve damage may be caused by a number of different diseases, injuries, infections, and even vitamin deficiency states.
•Diabetes: Diabetes is the condition most commonly associated with neuropathy. The characteristic symptoms of peripheral neuropathy often seen in people with diabetes are sometimes referred to as diabetic neuropathy. The risk of having diabetic neuropathy rises with age and duration of diabetes. Neuropathy is most common in people who have had diabetes for decades and is generally more severe in those who have had difficulty controlling their diabetes, or those who are overweight or have elevated blood lipids and high blood pressure.
•Vitamin deficiencies: Deficiencies of the vitamins B12 and folate as well as other B vitamins can cause damage to the nerves.
•Autoimmune neuropathy: Autoimmune diseases such as rheumatoid arthritis, systemic lupus, and Guillain-Barre syndrome can cause neuropathies.
•Infection: Some infections, including HIV/AIDS, Lyme disease, leprosy, and syphilis, can damage nerves.
•Post-herpetic neuralgia: Post-herpetic neuralgia, a complication of shingles (varicella-zoster virus infection) is a form of neuropathy.
•Alcoholic neuropathy: Alcoholism is often associated with peripheral neuropathy. Although the exact reasons for the nerve damage are unclear, it probably arises from a combination of damage to the nerves by alcohol itself along with the poor nutrition and associated vitamin deficiencies that are common in alcoholics.
•Genetic or inherited disorders: Genetic or inherited disorders can affect the nerves and are responsible for some cases of neuropathy. Examples include Friedreich’s ataxia and Charcot-Marie-Tooth disease.
•Amyloidosis: Amyloidosis is a condition in which abnormal protein fibers are deposited in tissues and organs. These protein deposits can lead to varying degrees of organ damage and may be a cause of neuropathy.
•Uremia: Uremia (a high concentration of waste products in the blood due to kidney failure) can lead to neuropathy.
•Toxins and poisons can damage nerves. Examples include, gold compounds, lead, arsenic, mercury, some industrial solvents, nitrous oxide, and organophosphate pesticides.
•Drugs or medication: Certain drugs and medications can cause nerve damage. Examples include cancer therapy drugs such as vincristine (Oncovin, Vincasar), and antibiotics such as metronidazole (Flagyl), and isoniazid (Nydrazid, Laniazid).
•Trauma/Injury: Trauma or injury to nerves, including prolonged pressure on a nerve or group of nerves, is a common cause of neuropathy. Decreased blood flow (ischemia) to the nerves can also lead to long-term damage.
•Tumors: Benign or malignant tumors of the nerves or nearby structures may damage the nerves directly, by invading the nerves, or cause neuropathy due to pressure on the nerves.
•Idiopathic: Idiopathic neuropathy is neuropathy for which no cause has been established. The term idiopathic is used in medicine to denote the fact that no cause is known.
It is sad that your friends GPs dismiss this poor man.
From my understanding, there is a variety of treatments which are available for regulating neuropathic pain. Effective natural treatments include acupuncture, massage and exercise to stimulate the nerves. Dietary changes are also important in assisting with well being.
This poor man deserves to be understood, better.
Yes i understand what you are saying Dr Healy.
Maybe i was a bit too quick to assume the farmers symptoms were caused by past diazepam use. But benzodiazepines can cause similar symptoms to what the farmer is experiencing even years after you come off them.
I didn’t read Heathers first comment properly when i made my first comment, and then realised i had misunderstood part of her first comment.
Still if the symptoms the farmer experienced started when he started taking benzodiazepines, then i think it is possible that they could have been caused by benzodiazepines.
For me at least, it has always been very obvious when a drug has caused a certain set of symptoms.
Just because a drug can cause something, if someone has that something and has been on the drug, it doesn’t mean the drug has caused it. You almost need to get to a position of knowing its highly likely a jury of 12 people with all the biases they are likely to have and the arguments from Pharma they would hear would agree the drug has caused it before you can say it has.
Otherwise you are in a position where others can look at it and just dismiss whatever is claimed
Sorry, David however, I believe strongly that if the poor person concerned did not have these health problems before they ingested Valium, then the med is GULTY as charged.
My husband and I both ingested Valium and we both suffer from sore feet syndrome.
Is it all in our heads?????
That attitude makes you the best friend Pharma and SMC could have
David Healy :
That attitude makes you the best friend Pharma and SMC could have.
Please explain David.
All our health issues possibly can not be all coincidental?
Big Pharma and the SMC (whoever, they are?) believe me, are not my friends.
What counts are facts not beliefs. You – we – are up against a belief system – Salvation comes through Pharmaceuticals. There is no belief system you can put in the field that stands a chance of competing against this. When you claim this man’s problems were caused by his drugs without checking the facts of his case – there may be lots of other things that could have caused it – you make it clear you are operating from a belief system. One that is doomed to failure the minute you open your mouth.
This is all rather like the Fake News situation. In a world of competing news we need facts. And until the full details of this man’s case are looked at including by people in favor of the drugs we don’t have facts.
Sorry David, it is not a belief. These health issues are a result from ingesting this med.
You are absolutely right. I do not have all the information surrounding this poor mans case however, I am of the opinion (take belief out of the equation) that the drug may have caused his medical health issues (in conjunction with the pesticides or any other chemicals) he may be using on his farm.
It could be one or the other or both.
PSSD does not cause all health issues. Not all patients are hypochondriacs. Some of us suffer on a daily basis. Unless, anyone has walked half a mile in your shoes, it is best if one refrains from assumptions.
Like Spruce mentioned:
Many are experiencing similar complaints so I am of the assumption that it is not all in our heads.
If you have not experienced the health issues we are suffering from, as a result of ingesting these meds, sorry, it is best if one refrains.
Thank you, David forexpert your opinion.
I <3 these lively debates.
It gets us all thinking and getting to the 'heart of the matters' ~ thank you, David.
I understand the difficulty in convincing a jury about whether a drug has caused a particular problem.
But as you have said yourself, the best person to know whether something has been caused by a drug, is the person taking it.
I think you quoted on the Rxisk website that in 80% of cases if a person feels something has been caused by a drug, then they are usually right.
I would say 80% suggests a fairly high degree of accuracy.
I suppose the best person to ask about whether the farmers ongoing symptoms were caused by diazepam, would be the farmer.
For me at least, i have taken quite a few prescription drugs throughout my life.
I have had temporary side effects from many of the drugs i have taken, most of which have been fairly mild, and mostly just an inconvenience, such as gastric reflux when taking tetracycline, and strong fatigue once when i took cephalexine.
Each time when i had these side effects it was very obvious that the drug had caused them, as they started shortly after i took the drug, were symptoms i didn’t experience when i wasn’t taking the drug, often were known side effects of the drug i took, and they went away shortly after i stopped taking the drug.
I have had other times, where the side effects and experiences of withdrawal have been very long lasting and unpleasant, like the PSSD i got from citalopram, and the length of time it took to withdraw completely from benzodiazepines. On both of these occasions it was also very obvious to me that the drug was responsible.
This is why i struggle to understand why people can be so disbelieving about the person (who has taken the drug) experience and belief that the drug has caused the problem.
It frustrates me the scepticism i have experienced regarding problems i know were definitely caused by the drug, and how these problems were constantly blamed on “other factors” when i know these “other factors” weren’t responsible.
So yes you are right, i was a bit quick to jump the gun and assume the farmers symptoms were caused by past use of diazepam, when i didn’t know anything about the farmers history, and also a range of other factors that might need to be taken into account.
But if after having a chat with the farmer, and taking those other factors into account, if he had told me the symptoms had started shortly after taking diazepam, he doesn’t usually suffer those symptoms, and that he felt the drug had caused the problem, then i wouldn’t struggle to believe the drug most likely caused his symptoms.
80% is not 100%. Plus its not the case that 80% of the time people are necessarily right. It might be more or less. In the case of PSSD it suspect its close to 100% right. But until there is objective support from people who have considered all aspects of the case we don’t have a fact. It doesn’t need everyone to believe you but if in your case some doctor believes you having reviewing all aspects of your history and better again if some doctors reviewing other people with a similar issue come to the same conclusion then we can say its a fact this drug can cause regardless of what the clinical trial evidence might show.
After that, in every single case based on the details of that case we have to go through the same procedure to establish whether the drug probably did cause the problem in this case
Dr Healy you are right that facts are what count, and that every aspect of a situation should be carefully considered before a conclusion is made about whether a drug could have caused a problem.
But if after “other factors” have been ruled out, or are unlikely, i feel a lot more weight should be given to the experience and belief of the person who has taken the drug, about whether they believe the drug caused the problem.
You can’t privilege the experience of the person claiming a drug has caused a problem. It should be the most important thing but is at present ignored completely and what we need is a restoration of balance. But if a doctor listening sympathetically points to other things that might have produced the situation this needs to be taken into account as well – such as the problem was there before the drug.
Yes well my PSSD certainly wasn’t there before i took the drug.
So what is the way forward in this smoke and mirrors situation, with getting to the truth about the damage these drugs can cause.
Do you think the truth will eventually come out Dr Healy?
A lot of its got nothing to do with truth. Its much more to do with power and the power of others to define us – as neurotic for instance rather than poisoned. Watch the posts on DH and RxISK over the next few weeks. Hopefully this will be brought out in more detail
Do you think this power imbalance can be levelled though?
Is there a way for the power structure to be sucessfully challenged?
This is what the posts will be about. You’ll have to tell me whether it stands any chance of working
We only have hope when there are many people who complain about the same symptoms.
If we had no support when we were going through hell, the only hope we have is if there is a class action.
They can twist, bend, manipulate and distort how much they want however, when you have people complain with the same common symptoms, I have no doubts whatsoever, that a reasonable outcome can be achieved.
The stigma we face is when some of the medical professionals are willing to stand up for their patients when there was ‘no duty of care’ in the first place.
Convince a judge and jury when all the cards are stacked up against you. It is not big pharma who is the problem it is some of the professionals who left many in a lurch.
Carla and Spruce, thank you so much for your experienced accounts of side effects and withdrawal effects of benzodiazepines. It helps my understanding enormously. Thank you too DH for taking time to add your comments on this.
The ‘facts’ in the farmer’s case (and I’ve known him very well all my life, since we were children so I think I have a pretty good grasp of these) are the following:-
1. He’s been in farming all his life, it’s very physically taxing and his back gets a lot of stress, lifting, loading trailers, turning sheep over to cut their toenails, endless physical work, as well as hours spent driving farm machinery and then crawling underneath it to fix it. So his back is always pushed to its limits, and in the last 25 years, he’s often got problems with it, muscle strain, vertebrae jamming, that kind of thing. For this, his GP regularly prescribed some Valium each time it happened.
So he’s been on and off it, for several months at a time, for literally years. But always ‘for his bad back’. Any possible effects on his brain were never explained to him, and being a trusting, and dare I say, ‘uninterested in the psyche’ kind of guy, he’s never thought about it, and doesn’t even now.
2. He doesn’t have any obvious mental health issues, and he loses patience with himself when this plethora of physical unexplained ailments keep circulating round different areas of his body.
3. Because he’s had brief hospital admissions for investigations of ?heart problems and ?stomach problems (apart in addition for two surgically repaired hernias) and nothing was found, he is now being told by GPs and current woman friend that maybe all this pain is ‘in his mind’ and he may be depressed. That is, all these symptoms – IBS, urine retention, chest pain, neck pain, throat pain, racing heart, roaring tinnitus and thudding in head, sweating feet, and more, not forgetting the on and off back problems, must be psychological because WHAT ELSE COULD THEY POSSIBLY BE?
So he found himself a psychiatrist to get an opinion on this. And she said she wasn’t sure really but he could do CBT (which I am afraid he just found ridiculous -sorry, but he couldn’t see the relevance in his case, he did it a little though when he’d got a spare hour or two) and a year ago she gave him Citalopram. Which he’s still taking, there’s been no follow up.
He’s pretty desperate. Hence my question. The pain is awful, it’s wearing him down, he’s in a sort of ‘living death’. He’s a very popular, sociable guy, he loves parties. He works all day out on the farm, eats sensibly. He has to keep cancelling events last minute because these alternating symptoms engulf him. Or he goes along and struggles through, trying to hide how ill he feels. It frustrates him. He has a drink after work, without that, he says he couldn’t get through. He told the psychiatrist about the drinking, (it’s moderate) she said well no, he shouldn’t drink whilst taking Citalopram but to do his best to cut it down. Which he tries to, goes for a month without any alcohol, but then starts again, and so on.
I know he will probably dismiss my diazepam theory, so I wanted some other experienced accounts before raising it. He shrugs off my concerns re crop spraying chemicals. He shrugs off my references to his having nearly died as a baby from Pinks’ Disease (something babies got from mercury in teething powders) just in case that could have caused this, deep in his neurology. I am very concerned about him. The problem is, the iller you get, the less you have the strength to be able to stand apart and really analyse what’s happening to you, you just slide into hopelessness and self blame. I saw it in my own son and I don’t want it to happen to him if I can possibly help him in any way at all. (He isn’t just a friend, he is a close relative for whom I have enormous respect).
So, thank you all for your very helpful carefully thought out input. And yes, DH, I know this diazepam theory of mine is not proven in his case, and I don’t even know what he can do to change things if I’m right, but at least he won’t blame himself any more (as my son did), he’ll understand better what these drugs can do. And knowledge is power.
Hi Heather, I understand your concern and confusion. I’ve been suffering from adverse effects of benzodiazepines, now benzo withdrawal, for over two years now. I’m not able to write/type much, at least not tonight. Much of my existence during this time has been hundreds of hours of research. If your friend is still taking either of these meds, or any, DO NOT STOP taking them without education.
If he has been off the benzo for awhile, don’t take any more. Please read up on kindling, the up down up down part only makes things worse, alcohol is like a ‘liquid benzo’, it acts on/alters the very same receptors in the brain/CNS. I have not researched, have no knowledge of, his other meds. I am a chef, not a doctor.
Suggestions; Start reading, alot. Wikapedia; Benzodiazepine Withdrawal. In short, the basics. Then benzo.uk.org. which contains The Ashton Manual. Then; Everything Matters, Beyond Meds. Then; various Facebook pages, where you ‘will find your farmer friend’ and thousands more just like him. BIC (benzo information coalition) Benzodiazepine Recovery. World Benzodiazepine Day (w-bad.org)
and many more. ANY F’book benzo page offering or selling drugs/meds/supplements… BEWARE.
Also, getting free of these meds can be a very long and scary process, but doable. We do heal, in time. My best to you both, and hugs as well.
Jean, thank you so much for your informative response to my concerns about someone who is suffering unexplained endless physical and mental problems and who has taken diazepam on and off over many years. DH is right when he says we don’t know if the problems are due to the drug, but i was just trying to look at possibilities, and your references here for me to follow up are really helpful, thank you. I’m so sorry you have suffered so much from benzodiazepams.
My difficulty is that the man in question doesn’t really want to accept that his symptoms are caused by the drug, he seems to blame himself for feeling depressed, and as a farmer, unattached, life is lonely, so he puts it down to depression from loneliness but I can’t see how you’d get raging almost unbearable stomach pain from that. But, like DH says, what do I know? We can only go on and try to get firmer evidence in this case. Anyway, I’ll follow up all you’ve written, and I really do appreciate your support Jean, so a big thank you!
Plus ca change…
Sertraline (the generic drug for Zoloft) had a really bad and serious side effect on me. I was on it for 6 weeks and my hip went out of place. Then I started having weird twisting pains in my knees like the leg was twisting the knee out of the socket. I wondered why my body was going to hell and then realized it must be the Sertraline. Apparently, Sertraline is toxic to my body. After stopping it all the weird musculoskeletal problems stopped. It seems that drugs or the binding agents or the capsules are causing all kinds of problems. For me – I would rather be depressed than go through such agony again.