Did psychiatric drugs cause this suicide?

[Altostrata]

I posted this on The Last Psychiatrist blog http://thelastpsychiatrist.com/2009/04/how_dangerous_is_academic_psyc_1.html in August 2009 regarding David Foster Wallace's suicide (emphasis mine):

 

As the March 9, 2009 New Yorker profile by D. T. Max makes clear, before David Foster Wallace's death there was a trail of the usual psychiatric misinformation and cluelessness, including that 3 minutes of consultation led to 22 years of Nardil prescription.

 

The conclusion that Wallace died because Nardil was keeping him alive is erroneous. Withdrawal of Nardil did not cause relapse of his depression -- it caused obvious antidepressant withdrawal syndrome.

 

Wallace hung himself after more than a year of antidepressant withdrawal syndrome. The symptoms can be unbearable ... there are hundreds of heartbreaking stories about this iatrogenic condition.

 

Prolonged antidepressant withdrawal syndrome is almost always ignored, misdiagnosed, and mistreated by psychiatry.

 

Wallace suspected additional drugs were making him worse, and he probably was right. That's very common in withdrawal syndrome. Some patients become hypersensitive and prone to paradoxical reactions from any neurologically active medications or even vitamins.

 

Who wouldn't reasonably consider suicide if told he had a new, virulent, and apparently untreatable form of mental illness?

 

....

 

Disruption of sleep architecture is very common in antidepressant withdrawal syndrome, as is emotional blunting. (Heath Ledger died of self-medicating intractable insomnia after Zoloft withdrawal.)

 

The precipitating factor was not an inaccurate remark about a "dirty drug" (it's a fantasy that any of them are "clean"). Wallace was well-read about the drugs. He had suffered years of side effects. His life had progressed. His reasons for stopping Nardil made sense. But he was not prepared for withdrawal syndrome.

 

Wallace's death haunts me. If he had only known he had withdrawal syndrome, not an untreatable soul-killing relapse, and he would probably slowly recover from it....

 

Yes, academic psychiatry is dangerous. It has deliberately suppressed information about antidepressant withdrawal syndrome for more than a decade. Wallace's tragic, premature death nominally was by his own hand, but it was psychiatry that knotted the noose for him, as it has for thousands who suffer from antidepressant withdrawal syndrome.

 

-----------------------

I followed up with this e-mail:

 

To the last psychiatrist:

 

I just posted on your site about David Foster Wallace. I urge you to consider the role prolonged withdrawal syndrome played in his finally successful suicide attempt.

 

I have struggled with prolonged Paxil withdrawal syndrome for nearly 4.5 years and have become a lay expert on the topic.

 

Antidepressant withdrawal syndrome is probably epidemic but trivialized by psychiatric researchers. Although psychiatry would like to believe antidepressant withdrawal syndrome is mild and transient, there is no evidence that severe withdrawal syndrome and long-term post-acute damage from it is rare.

 

Two recent studies indicate severe withdrawal syndrome is common:

 

The effect of rate of antidepressant tapering on the incidence of discontinuation symptoms: a randomised study. J Psychopharmacol. 2008 May 30. Tint A, Haddad PM, Anderson IM (http://www.ncbi.nlm.nih.gov/pubmed/18515448?dopt=AbstractPlus) found 13 of 28 patients developed withdrawal symptoms. This study also notes "Antidepressant discontinuation in depressed patients can be associated with worsening depression and increased suicidality."

 

Effects of gradual discontinuation of selective serotonin reuptake inhibitors in panic disorder with agoraphobia. Int J Neuropsychopharmacol. 2007 Dec;10(6):835-8. Fava GA, Bernardi M, Tomba E, Rafanelli C. (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17224089&log$=activity) found 9 of 20 patients developed withdrawal syndrome, with several still showing symptoms after a year. This is the only study that followed patients after withdrawal for any length of time.

 

Both studies found the highest and most severe incidence of withdrawal syndrome was in patients taking Paxil. Paxil has been identified as the worst offender for more than a decade, but psychiatry has been all but silent about its dangers. For many years, it has been the best-selling antidepressant in the US.

 

....

 

There is an even more dreadful importance to psychiatry's denial of antidepressant withdrawal syndrome. It has contaminated key studies in antidepressant efficacy, causing erroneous assumptions to be enshrined in "expert opinion" advocating the unnecessary prescribing of antidepressants to millions of people.

 

It is noteworthy that ALL studies of antidepressant efficacy contain statistics of "relapse" after withdrawal -- thereby supposedly proving efficacy -- but not a single one reports any cases of withdrawal syndrome. Without a doubt, withdrawal syndrome has been misidentified as incidences of relapse and the statistical validity of EVERY study of antidepressant efficacy is questionable.

 

Given the generally razor-thin margins of statistical significance, certainly the evidence for "maintenance" of patients on antidepressants for years beyond initial response is dubious. Furthermore, it is likely that antidepressants are no more effective than placebo and, given other side effects such as suicidality, anxiety, and the so-called "unmasking" of hypomania, actually may be a lot worse.

 

If the incidence of antidepressant withdrawal syndrome were known, the entire industry, including psychiatric research, would collapse.

 

Because of psychiatry's denial of antidepressant withdrawal syndrome, it is almost always misdiagnosed, and the number of patients suffering from it may be very large. Usually, doctors will panic at the symptoms, which often are dramatic, and proceed to overmedicate the patient with irresponsible combinations of antidepressant, anti-anxiety, and anti-psychotic drugs, sometimes going as far as prescribing electro-convulsive therapy. This further damages the patient's nervous systems, but they believe they are in the grips of a psychiatric breakdown and continue the downward spiral.

 

Antidepressant withdrawal syndrome can cause death. Actor Heath Ledger died from overmedicating intractable insomnia after quitting Zoloft (severe insomnia is a very common withdrawal symptom). As detailed in the March 9, New Yorker, writer David Foster Wallace hung himself after more than a year of withdrawal syndrome after 22 years on Nardil. Both of these high-profile deaths were ascribed to suicide, accidental or not, rather than unbearable suffering from antidepressant withdrawal.

 

How many more deaths have been incurred by psychiatry's denial of the flaws in these drugs?

 

Instead, psychiatry sanctimoniously excuses its mistakes by pointing to a non-existent track record in stamping out the twin scourges of mood disorders (affecting 9.5%-20% of the US population and ever-increasing, depending on whose profit is at stake) and suicide (.011%, rate unchanged since 1965). Conveniently, it derogates patients who complain of adverse effects as mentally ill.

 

The medical profession is in dire need of education about psychiatric drug withdrawal syndromes, but few doctors have come forward to do it. Drs. Breggin and Glenmullen have published many books on this subject, but they have been marginalized and their warnings dismissed by clinicians. You would have to look at patient Web sites such as [survivingAntidepressants.org] to see what's really going on.

 

....

[The thousands of posts about withdrawal all over the Web] are a compendium not only of the suffering caused by withdrawal syndrome itself but from the frequent medical malfeasance in identifying it and treating it.

 

For your additional information, I've attached an e-mail I received from Dr. Richard Shelton. At the time he sent me this e-mail, in which he acknowledges prolonged withdrawal syndrome, he co-authored an authoritative paper about antidepressant discontinuation syndrome in the Journal of Clinical Psychiatry 2006 vol 67 Supplement 4, published June 2006. In that paper, he and his colleagues, who include the notorious Dr. Alan F. Schatzberg from Stanford, state categorically that antidepressant withdrawal syndrome lasts only a couple of weeks and any symptoms beyond that are to be attributed to something else.

 

This kind of "expert" advice leads doctors to misdiagnose withdrawal syndrome as a new or "unmasked" psychiatric disorder, rather than autonomic nervous system damage, and to overmedicate it, much to the detriment of the patient.

 

This supplement to the official journal of the American Society of Clinical Pharmacology was sponsored by Wyeth, manufacturer of Effexor.

 

Compromised by its relationship with the drug companies, research psychiatry has been turning out biased and almost worthless research extolling the use of new-generation psychiatric drugs and minimizing their dangers for decades. The misinformation is extended to clinical practitioners outside of psychiatry, who are also prescribing psychiatric drugs with abandon. It is patients who eventually pay the price.

 

It is entirely possible, if psychiatry was honest, it would be found that these drugs cause as much damage -- or more -- as benefit. Psychiatry is complicit in the greatest fraud ever perpetrated on the public.

 

-----------------------

To which The Last Psychiatrist replied:

 

I've been yelling about paxil withdrawal to anyone who would listen for 8 years, no one listens. It's real, it's painful, and I wonder if so many of the suicides/homicides that are attributed to the SSRIs are in fact not due to withdrawal from the pills (say, if you forget a dose, etc.) We'll never know the answer to that, but I'm certainly sympathize with your situation. The same could applyto DFW, though in the case of that post I was really just dealing with psychiatric arrogance.

 

Did anyone try and taper you down with micro doses of prozac? etc

 

Part of the issue is that not everyone gets the withdrawal, and not everyone who gets it gets it severely, so it often goes unrecognized by docs. In fact, when a patient tells me an SSRI caused a headache, I always ask if they were actually taking it daily, because missing one dose can be enough to cause it.

 

I'm sorry for you, I hope you get some relief.

Edited December 9, 2011 by Altostrata
edited

[Rhiannon]

I think this question often. In fact every time I hear of a suicide.

 

When I was living in New Mexico (in a very isolated rural small town literally three hours from the nearest city), a very nice elderly couple lived downstairs from me. I met their son and his wife, who had recently moved there from California. She was having a little trouble adjusting but was beginning to meet people and make a few friends.

 

Then the son got a job in another small New Mexico town about two hours from there, and they moved. As time went along I asked how things were going. At first she was very excited about fixing up the new house they bought and looking for a job. As time went along they told me she was feeling a little down about leaving her in-laws and the friends she had made, and wasn't able to find a job in the new place. Then about six weeks later I found out she had walked into the bedroom, pulled out a gun and shot herself.

 

Now, how much do you want to bet some doctor said "Oh, you're feeling a little down, here, why don't you start this antidepressant..."? Personally I'd bet a paycheck on it. This woman had NO prior history of being suicidal, and the circumstances of her life, although discouraging and temporarily difficult, weren't the sort of thing that ordinarily would lead someone to commit suicide.

 

But she'll never show up in the statistics. It was her "underlying depression" that killed her.

 

This happened just as I was going through my own "awakening" about these meds and I think it probably contributed to it. It was definitely a shock to me as I had just come through a period of being extremely suicidal due to med effects myself.

[Rhiannon]

Oh, and more: So, a few months after I started working at my new job in Oregon, we had a suicide case: a young woman, 24 years old, from a wealthy and prestigious family, laid down on the railroad tracks in front of an oncoming train.

 

Now, in her case, I have no idea what her background was. But I wonder.

 

And another one: Oregon was hit pretty hard by the economic crash. Unemployment statewide is still over 10% I believe, and since it's lower in Portland, it's higher than that in lots of the more rural areas of the state (it's mostly a rural state, actually). Recently I read that there's been an upswing in the suicide rate statewide. Now, you could say, well, people are killing themselves because they're unemployed and feeling hopeless, and I suppose that could be at least part of the case. But these folks out in the rural areas are the children and grandchildren and great-grandchildren of people who survived great hardships to get here and settle these areas. (I drive past Starvation Creek every time I go to Portland--and they weren't joking.) Life on the farm is hard-scrabble, never easy. These are tough folks.

 

How much do you want to bet they are going to the doctor and mentioning that they're feeling a little stressed or anxious or sad, or whatever, because the money's running out and they're going to lose their home and they can't feed their kids...well, what do you think the doctor's gonna say? It's time for a revolution in a country where 1% of the people own 80% of the wealth and corporations have the same rights as human beings? Or, let me spend an hour helping you troubleshoot solutions and look for resources?

 

Or "here's a pill"?

 

Well I know what +I+ think.

[Altostrata]

Rhi, thanks for keeping this topic alive. You reminded me I meant to put something in the first post!

[Altostrata]

To clarify for those who didn't recognize David Foster Wallace's name:

 

David Foster Wallace was a very famous novelist. The tragedy of his suicide in 2008 was all over the news.

 

He had attempted suicide many times in his life. He was suicidally minded. The period just before his suicide is reported in great detail in a long article by DT Max in the New Yorker in 2009.

 

You may wish to read the New Yorker article and decide for yourself what happened to David Foster Wallace. (A full-length biography by DT Max is due out next year.)

 

According to the article, to which his wife and family contributed, Wallace had gone off Nardil under the guidance of his psychiatrist and felt terrible afterward. Over 1.5 years, he was treated with many psychiatric drugs, but he believed they all made him worse. (This is typical of withdrawal syndrome, as many experience hypersensitivity to medication.)

 

He did not know he had Nardil withdrawal syndrome, and neither did his doctors. He probably thought that, at last, he was losing his mind and was untreatable. His doctors may have told him that. So he finally succeeded in killing himself.

 

I believe if he had known that what he was suffering was Nardil withdrawal syndrome, he might not have completely lost hope.

 

Antidepressant withdrawal syndrome can be very severe, and people do suffer so much they kill themselves. They become very frightened because doctors don't know what's wrong with them, and they think their brains are destroyed. This is very sad but true.

 

If you are reading this, you have done the right thing to learn about withdrawal syndrome. You might also read the Intro topics of other people and find out what they're going through.

 

Antidepressant withdrawal syndrome is not trivial.

[InNeedOfHope]

I have just read this and become even more scared. I am scared because I make no improvement at the dose I am on. I am scared because every time I try to attempt to do something normal, the withdrawal is unbearable. I am so scared I can't recover out of this spiral. I fight bad thoughts every day, sometimes hiding it by getting upset in private, so that I don't bring everyone down or just be told, "you know this is withdrawal..it will get better". But it isn't getting better. I am hanging on by a thread and the thought of living for years or the rest of my life in this kind of pain is too much to bear. I and my children are missing out on so much . They will look back at this time and I don't know what they will think. I am pathetic and useless to them in every way. They need a strong mum, not someone like me.

 

How do I survive each day like this?

[InNeedOfHope]

I know that people commit suicide all the time because of these drugs and to be honest it scares me rigid every time I read about it.

 

How do I do that to my children? How do I live like this? What damage am I doing to their childhood for them to see me like this every day. I hate myself and all I am. I hear so many bad stories. I know the damage from taking that extra tablet, in effect going up from around 45mg to 120mg and then back down again did some serious damage, because I feel that paralysis in my head all the time. Everyone says that is 10 months ago, it can't possibly be from that. But I know it is...I feel that same pain all the time...the damage is deep and it may never fully recover. After 10 months you would think it would show some kind of imrovement. Yet, every time I do activity or act normal...I feel that paralysis and pain in my head/shoulder. I feel that pain in my kidney. All the time I think of the fact I am still taking this stuff, shutting down more and more receptors every day, making it harder and harder to come down.

 

A woman here in England travelled abroad this week to die legally of euthanasia as she had cancer and unbearable pain. She said that a dog would be treated more humainely and she is right.

 

The level of pain and anguish we are talking about here is off the scale as many of you can appreciate. What if the damage is too deep? What if I am stuck on this dose and cannot reduce because I can't even breathe or swallow food without it. Please help me someone, what am I going to do?

[Altostrata]

InNeed, the drugs do not force people to commit suicide. The drugs cause symptoms that people don't know how to handle, and the individual makes the decision to solve the problem with suicide.

 

Yes, people kill themselves when they are suffering, whether a drug reaction is involved or not. This is a sad reality of the world we live in.

 

You need to find the strength within yourself to keep going. We keep on telling you the symptoms change, fade, and improve, but you keep on worrying "this is going to be forever."

 

It can take more than a few weeks or months for symptoms to change.

 

You are in a tough spot, and your tendency to go to extremes in worrying is making it worse. You need to take care of yourself and learn to manage this fear. You may need some coaching with this. Have you sought the services of a psychotherapist or counselor near you?

[summer]

 

You are in a tough spot, and your tendency to go to extremes in worrying is making it worse. You need to take care of yourself and learn to manage this fear. You may need some coaching with this. Have you sought the services of a psychotherapist or counselor near you?

The importance of this cannot be stated enough times! Just the emotional outlet of talking to/with someone brings relief in itself. If you haven't already, I hope you will consider what Alto has suggested.

[Altostrata]

Just found out David Foster Wallace's last psychiatrist was Dr. Jody Rawles, Orange County, CA.

 

http://faculty.uci.edu/profile.cfm?faculty_id=4921

[Wolfhound]

InNeed, the drugs do not force people to commit suicide. The drugs cause symptoms that people don't know how to handle, and the individual makes the decision to solve the problem with suicide. Yes, people kill themselves when they are suffering, whether a drug reaction is involved or not. This is a sad reality of the world we live in. You need to find the strength within yourself to keep going. We keep on telling you the symptoms change, fade, and improve, but you keep on worrying "this is going to be forever." It can take more than a few weeks or months for symptoms to change. You are in a tough spot, and your tendency to go to extremes in worrying is making it worse. You need to take care of yourself and learn to manage this fear. You may need some coaching with this. Have you sought the services of a psychotherapist or counselor near you?

 

I would like to add that the drugs push people to commit suicide. It is a well known adverse reaction and I had it. I can say it is really something so terrible that cannot be transmitted. My suicidal urges on trazadone were huge. My homicidal urges on mirtazapine were beoynd human imagination. This is something that definitely forces you to commit it.

The suicidality I have now in withdrawal is different, it´s more the kind of a symptom.

[Altostrata]

Yes, people find the withdrawal-induced horrible images and feelings to be overwhelming.

[Wolfhound]

Yes, people find the withdrawal-induced horrible images and feelings to be overwhelming.

Well, Altostrata, I find the drug induced images absolutely macabre.

Of course, the withdrawal images are different and scary as well, but nothing compares the homicidal urges I had on mirtazapine.

[Jemima]

I was given Remeron (mirtazapine) for sleep after being hospitalized for what turned out to be Lipitor-induced depression, and had some of the most bizarre dreams I've ever had, often including very strong (to the point of painful) orgasms. Thank God I only took it for four months!  It made me feel like I had flu all the time and I got off of it quickly with no problems (over about a two week period) perhaps because I hadn't been on it long or possibly because I was also drugged up on Pristiq and Ativan at the time. How ironic that most people who stay on it get severe insomnia and sexual dysfunction.

[GiaK]

I hadn't seen this thread before. I'm sharing a post I wrote quite a long time ago now when I started noticing how many people reported suicidal feelings remitting upon drug withdrawal...

 

Many psychiatric symptoms remit upon drug withdrawal - even suicidal impulses http://beyondmeds.com/2011/02/23/withdrawlesssuicide/

[Aria]

I acted totally out of character on psych drugs and at times had an overwhelming urge to hurt myself. I'm ashamed to say what I did but when I tapered off all of the drugs the behavior went away. I know my determination to get off every psych drug kept me tapering when I was at wits end.

[uncomfortablynumb]

Slightly off topic but Ledger dealing with intractable insomnia from withdrawal is what lead to his death is scary. Intractable as in permanent? Can this happen? I am trying to be hopeful and believing with time my extreme insomnia would get better.

[uncomfortablynumb]

I bet pharma is well aware of the withdrawal problems. It is more money for them - people will try to ease withdrawal symptoms with other psych drugs or other. For me, my withdrawal insomnia has caused my immune system to go out of whack. I got an infection that would normally heal but needed drugs. The withdrawal insomnia also caused my testosterone levels to drop to levels of senior (I am 34). I won't support Pharma and go on test pills for that. I am hoping my testosterone goes back to normal with sleep and time. All this lack of sleep can cause diabetes. This would be more money for them. There can be so much collateral damage from withdrawal and pharma is cashing in.

[Altostrata]

Intractable meaning no drug he could take seemed to fix it.

[compsports]

I bet pharma is well aware of the withdrawal problems. It is more money for them - people will try to ease withdrawal symptoms with other psych drugs or other. For me, my withdrawal insomnia has caused my immune system to go out of whack. I got an infection that would normally heal but needed drugs. The withdrawal insomnia also caused my testosterone levels to drop to levels of senior (I am 34). I won't support Pharma and go on test pills for that. I am hoping my testosterone goes back to normal with sleep and time. All this lack of sleep can cause diabetes. This would be more money for them. There can be so much collateral damage from withdrawal and pharma is cashing in.

Exactly.  Due to my sleep issues, I joined the pre diabetic club and am sticking to as little carbs as possible so I don't get any worse.  The gifts that keep on giving. 

[btdt]

Alto 

". Some patients become hypersensitive and prone to paradoxical reactions from any neurologically active medications or even vitamins."

 

Do you have any knowledge of how long these drug reactions can last .. forever.. a few years?  Anything?

 

With all the drug reactions I have had I am wondering if there are any studies to back up Ads have something to do with this?  I think the reactions started when I was in tolerance and got worse after I quit cold turkey. 

[btdt]

I was given Remeron (mirtazapine) for sleep after being hospitalized for what turned out to be Lipitor-induced depression, and had some of the most bizarre dreams I've ever had, often including very strong (to the point of painful) orgasms. Thank God I only took it for four months!  It made me feel like I had flu all the time and I got off of it quickly with no problems (over about a two week period) perhaps because I hadn't been on it long or possibly because I was also drugged up on Pristiq and Ativan at the time. How ironic that most people who stay on it get severe insomnia and sexual dysfunction.

Liptor induced depression... one of the pills I quit the day I quit effexor for good. 

I had to look it up but did not find conclusive reports this one says the jury is still out but it is good enough for me. 

http://www.psychiatrictimes.com/mood-disorders/statins-cholesterol-depletion%E2%80%94and-mood-disorders-what%E2%80%99s-link