This post by Steindór Erlingsson asks awkward questions in the week when the jury is likely to deliver a verdict in the sentencing part of James Holmes’ trial for the shooting dead of twelve people in Aurora Colorado at the premiere of the Batman movie, Dark Knight Rises, Holmes had no intentions of harming anyone before being put on Zoloft. His dose was increased twice and after each increase his thoughts became more malignant.
I have been haunted by serious emotional distress and suicidal thoughts for almost thirty years. This nightmarish existence has its genesis in traumatic experiences I had as a young man while working for several months as a volunteer for the Icelandic Red Cross in Ethiopia. (The worst was witnessing a passenger jet crash outside my town, working on the rescue and having to photograph the dead bodies while relatives were trying to identify their loved ones.) I arrived in Ethiopia a somewhat emotionally fragile individual, which might explain why on returning to my native Iceland I was suddenly living in a universe “divested of illusions and lights”, to quote Albert Camus, and felt like an “alien, a stranger”.
A two-year subsequent battle with diseases I contracted in Ethiopia (I had to leave the country seriously ill) and their consequences only increased my alienation. During this period I gradually sank into the realm of suicidal thoughts and entered the problematic world of psychiatry. Instead of asking me about the Ethiopian experience and what followed in its wake, I was given psychotropic drugs and electroconvulsive therapy (ECT).
Seven years after my return, I had an experience which made the Ethiopian traumas pale in comparison. At that time my emotional life had stabilized. I was living with my wife and new-born son and about to graduate from the University of Iceland. But a dark echo from the previous years sometimes reared its head in the form of spontaneous dizziness, rapid heartbeat and rapid breath. My psychiatrist at that time had the perfect solution: Cipramil, an SSRI antidepressant. (Note: This is citalopram, also sold as Celexa.) He told me this drug would make these symptoms disappear, while emphasizing that it had “no side effects.”
A few days after I started taking Cipramil, terrible thoughts came into my mind. I wanted to harm my wife and new-born son. Every time I saw a knife or thought about one an incredibly strong urge to injure them erupted. As a non-violent individual by nature, I had never experienced anything like this before. Even the death and destruction I’d witnessed in Ethiopia had never put such thoughts in my head. This went on for some time and I obviously did not dare to tell anyone, neither my psychiatrist nor family. I continued taking the drug and suffered in isolation. The feeling gradually disappeared.
I had the same experience eight years later. At that time my emotional life was extremely chaotic and I was in and out of hospital. The doctors who were treating me had no idea of how to relieve my suffering. Instead of trying extensive psychotherapy, among other things, I literally became a guinea pig. I was given numerous drugs. New drugs were regularly tried or the dosages changed. These included Effexor and Zyban (bupropion, also sold as Wellbutrin). My wife, who is a scientist, was very worried about all the drugs I was ingesting. By looking at the scientific literature she realized that some of them were being prescribed way above the recommended dosage. I did not listen to her.
The violent thoughts struck me during the summer. As before, seeing or thinking about knives created an almost irresistible urge to harm my wife and two children. I was terrified. My wife sensed that something was seriously wrong when I asked her to hide all the knives in the apartment. I was able to tell her in a roundabout way what was going on in my mind. I also alerted some of my friends. I was finally hospitalized at the end of the summer. And the solution to stopping my thoughts was … yes, you guessed correctly: bilateral ECT. As a result big sections of my memory from this year were permanently erased. I was able to piece it together by talking to my wife and reading emails I sent.
These two harrowing episodes, that brought me almost into a devilish domain, have in many ways trivialised the Ethiopian traumas. The crushing guilt that the violent thoughts created, which is indescribable, extended the suffering way beyond the episodes themselves.
That guilt haunted me until June 2009, when I read a book that has gradually enabled me to escape it. I cried when I read these lines in Peter R. Breggin’s book Medication Madness (2008):
Within a week of starting Prozac, Emily began to become obsessed with killing her mother. Never before had thoughts like these entered her mind. She imagined taking the eight-inch chef’s knife from the kitchen. She saw herself sneaking up on her mother at an unsuspecting moment … and plunging it into her back. The drive to kill wasn’t wrapped in any reason, excuses, or rationalization. Emily didn’t feel upset with her mother. In her words: ‘It came out of nowhere’ (p. 58).
This is exactly what I experienced during the Cipramil incident. Now I felt absolved. But Emily’s story did not fully explain what happened to me during the latter incident. I had to read further into Breggin’s book to find a convincing explanation:
Consistent with most of the cases in this book, severe adverse psychiatric reactions often take place within a day or two of starting or changing a dose of SSRI antidepressant, or adding other drugs (p. 135).
This is exactly what I experienced. I felt absolved again.
Two years prior to making this enlightening discovery I had stopped taking psychotropic drugs. I have had my share of difficult withdrawal symptoms. My newfound knowledge only increased my resolve to continue my journey through life without resorting to The Emperor’s New Drugs.
As I dug deeper, I came across a paper by Yolande Lucire and Christopher Crotty that lists diverse drugs that “all induce suicidal and homicidal thinking as an occasional side effect.” More specifically, Thomas J. Moore, Joseph Glenmullen, and Curt D. Furberg list 11 antidepressants that have consistently been tied to an elevated risk of violence, “even when compared with antipsychotics and mood stabilizers, which are used in psychiatric patient populations in which violent acts may occur.” Cipramil, Effexor and Zyban are all on this list.
I feel violated by psychiatry. I have longed for justice after I realized that Cipramil, Effexor and Zyban were most likely responsible for the violent thoughts that I had towards the people I love most dearly. Why didn’t anyone tell me about this possibility? Even though reading Breggin’s book relieved me of most of the guilt, it did not make me very optimistic that difficult subjects like these would eventually be discussed openly.
Shortly after reading Medication Madness I became conscious that difficult subjects would ever be discussed openly. It was David Healy’s book Let Them Eat Prozac (2004) that made me realize this:
No matter how many physicians or others reported to SmithKline suicides or homicides they thought related to [Paxil/Seroxat], SmithKline would deny any evidence for causation while there was no randomized controlled trial evidence. The fact that they had never undertaken any trials and had no plans to do so smacked of washing their hands in the face of crucifixion (p. 222).
We all remember accounts in the news of individuals who committed unspeakable acts of violence against their loved ones. As an individual who has never so much as hit another human being, I am now, at the invitation of Big Pharma, in the horrible position of understanding what was going on in the mind of some of these individuals. I assume that there are many more of us who did not give in to this terrible urge. I hope my story will relieve the crushing guilt of some of these individuals.