This article is posted with permission from our friends at
Greenmedinfo.com.
For more news from them, you can sign up for their newsletter here. It was written by Dr. Kelly Brogan.
Psychiatric medications have some dangerous, often-overlooked side effects, which could include suicide and homicide.
On May 17, 2017, we learned that
Chris Cornell of
Soundgarden had reportedly committed suicide by hanging. His family
reports knowing a different Chris than one who would make this fatal
decision, and suspect his
anti-anxiety prescription in the altered state he was witnessed to be in the night he died. Perhaps an
“addict turned psychiatric patient”,
like so many, Chris Cornell seemed to have left the frying pan of
substance abuse for the fire of psychiatric medication risks.
For reasons that remain mysterious,
those under the influence of psychiatric medication often specifically
choose to hang themselves in their moment of peak impulsivity. Some,
like
Kim’s husband Woody who
was never depressed a day in his life but prescribed Zoloft by his
internist, even verbalize a felt experience of his head coming apart
from his body in the days before he was found hanged in his garage.
Then there’s
14 year old Naika,
a foster child in Florida who hanged herself on a FB livestream after
being treated with 50mg of Vyvanse, a drug treatment for ADHD that leads
to a domino effect of diagnoses and psychiatric meds including a 13
fold increase in likelihood of being prescribed an antipsychotic
medication and 4 fold increase in antidepressant medications than
controls.[1]
Are these just rare anecdotes? Is this
just the cost of treatment that is helpful for most? Are we blaming
medication for what might have been severe mental illness that was
undertreated and/or undiagnosed?
Informed consent: the premise of ethical medicine
I believe first and foremost in informed
consent. If you are informed of the risks, benefits, and alternatives
to a given treatment, you will be empowered to make the best decision
for yourself based on your personal, family, philosophical, and
religious life context. But the truth is that prescribers are not in a
position to share the known risks of medications because we learn only
of their purported benefits with a short-tagline of dismissively rare
risks that are thought to be invariably outweighed by the presenting
clinical concern.
But what about serious risks – including
impulsive suicide and homicide – surely we are informing patients of
that possibility, right?
Wrong.
In fact, the
FDA and the pharmaceutical industry have
gone to great lengths to conceal multiple signals of harm so we
certainly can’t expect your average prescriber to have done the
investigative work required to get at the truth.
In fact, from 1999-2013, psychiatric
medication prescriptions have increased by a whopping 117% concurrent
with a 240% increase in death rates from these medications[2]. So let’s
review some of the evidence that suggests that it may not be in your
best interest or the best interest of those around you for you to travel
the path of medication-based psychiatry. Because, after all, if we
don’t screen for risk factors – if we don’t know who will become the
next victim of
psych-med-induced violence –
then how can we justify a single prescription? Are we at a point in the
history of medicine where random acts of personal and public violence
are defensible risks of treatment for stress, anxiety, depression,
inattention, psychosocial distress, irritable bowel syndrome, chronic
fatigue, and even stress incontinence?
Let the science speak
Suicide
Prescribed specifically to “prevent”
suicide, antidepressants now come with a black box warning label of
suicide risk since 2010. Multi-billion dollar lawsuits like the
settlement of Study 329[3] have been necessary to unlock the cabinet
drawers of an industry that cares more about profit than human lives. A
reanalysis of study 329[4] which initially served as a landmark study in
2001 supporting the prescription of antidepressants to children, has
now demonstrated that these medications are ineffective in this
population and play a causal role in suicidal behavior. Concealing and
manipulating data that shows this signal of harm, including a doubling
of risk of suicide with
antidepressant treatment,[5]
[6] [7] has generated seeming confusion around this incomprehensibly
unacceptable risk profile. In fact, a reanalysis[8] of an influential US
National Institute of Mental Health 2007 study, revealed a four-fold
increase in suicide despite the fact that the initial publication[9]
claimed no increased risk relative to placebo.
According to available data – 3 large
meta-analyses – more psychiatric treatment means more suicide.[10] [11]
[12] Well, that might seem a hazard of the field, right? Where blaming
medications for suicide would be like saying that umbrellas cause the
rain.
That’s why studies in non-suicidal
subjects[13] and even healthy volunteers who went on to experience
suicidality after taking antidepressants are so compelling[14].
Benzodiazepines (like
what Cornell was taking) and hypnotics (sleep and anxiety medications)
also have a documented potential to increase risk of completed and
attempted suicide[15] and have been implicated in impulsive self-harm
including self-inflicted stab wounds during changes to dosage[16]. We
also find the documented possibility that suicidality could emerge in
patients who are treated with this class of medications even when they
are not suicidal with recent research stating, “benzodiazepine receptor
agonist hypnotics can cause parasomnias, which in rare cases may lead to
suicidal ideation or suicidal behavior in persons who were not known to
be suicidal”[17]. And, of course, these medications themselves provide
the means and the method with a known lethal poisoning profile[18].
Homicide
Clearly murderers are mentally ill,
right? What if I told you that the science supports the concern that we
are medicating innocent civilians into states of murderous impulsivity?
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When
Andrew Thibault began
to research the safety of a stimulant drug recommended to his son, he
entered a rabbit hole he has yet to emerge from. After literally
teaching himself code to decrypt the data on the FDA Adverse Event
Reporting System website, he was able to cull 2000 pediatric fatalities
from psychotropic medications, and 700 homicides. A Freedom of
Information Act and a lawsuit later, he continues to struggle with
redacted and suppressed information around 24
homicides directly connected to the use of psychotropics including
the homicide by a 10 year old treated with Vyvanse of an infant.
Another case, ultimately recovered, involved statements from a 35 year
old perpetrator/patient, who murdered her own daughter, as directly
implicating as “When I took nortriptyline, I immediately wanted to kill
myself. I’d never had thoughts like that before”.
To begin to scientifically explore the
risk of violence induced by psychotropic medication, a study sample
needs to be representative, the reason for taking the drug needs to be
taken into consideration, the effect needs to be controlled for, as do
any other intoxicants. Professor Jari Tiihonen’s research group analysed
the use of prescription drugs of 959 persons convicted of a homicide in
Finland and found that pre-crime prescription of benzodiazepines and
opiates resulted in the highest risk (223% increase) of committing
homicide[19].
Relatedly, eleven antidepressants, six
sedative/hypnotics and three drugs for attention deficit hyperactivity
disorder represented the bulk of 31 medications associated with violence
reported to the FDA[20]. Now an international problem, a Swedish
registry study identified a statistically significant increase in
violence in males and females under 25 years old prescribed
antidepressants[21].
Implicated in school shootings, stabbings, and even the
Germanwings flight crash, prescribing of psychotropics prior to these incidences has been catalogued on
https://ssristories.org/ leading
me to suspect psychiatric prescribing as the most likely cause in any
and all reports of unusually violent behavior in the public sphere.
Is Association Really Causation?
Beyond the cases where violence to self
or others was induced in a non-violent, non-depressed, non-psychotic
individual, what other evidence is there that speaks to how this could
possibly be happening?
The most seminal paper in this regard,
in my opinion, was published in 2011 by Lucire and Crotty[22]. Ten cases
of extreme violence were committed by patients who were prescribed
antidepressants – not for major mental illness or even for depression –
but for psychosocial distress (ie work stress, dog died, divorce). What
these authors identified was that these ten subjects had variants to
liver enzymes responsible for drug metabolism exacerbated by
co-administration of other drugs and substances including herbs. All
returned to their baseline personalities when the antidepressant was
discontinued.
Now referred to as akathisia-induced
impulsivity[23], the genetic risk factors for this Russian Roulette of
violence are not screened for prior to psychotropic prescribing.
Akathisia is a state of severe restlessness associated with thoughts of
suicide and homicide. Many patients describe it as a feeling-less state
of apathy – and what I would describe as a disconnection from their own
souls, their own experience of human connection, and any measure of
self-reflection.
The genetic underpinnings of this kind
of medication-induced vulnerability are just beginning to be
explored[24] with identification of precursor symptoms to violence
including severe agitation. In a randomized, placebo-controlled trial,
healthy volunteers exhibited an almost 2 fold increased risk of symptoms
that can lead to violence[25]. A 4-5 fold increased risk was noted in
patients prescribed a generic version of the antidepressant Cymbalta,
off-label, for stress urinary incontinence (a non-psychiatric
indication)[26].
There is another way
We live in a cultural context that makes
no room for the relevance, meaning, and significance of symptoms –
symptoms are simply bad and scary and they must be managed. We don’t
make room for patients to ask why they are not ok.
If you knew that your symptoms were
reversible, healable, transformable, you might consider
walking that path instead of assuming this level of risk for placebo-level efficacy of psychotropic medication. We would only
euthanize a “mental patient” if we felt their condition was lifelong and unremitting. In fact, every woman I have ever
tapered off of psychiatric drugs into
experiences of total vitality once believed that she would be a
medicated psychiatric patient for life. If you knew that radical
self-healing potential lies within each and every one of us, if you only
knew that was possible, you might start
that journey today. It’s side effect free…
References
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