Thursday, 14 August 2014

The epidemic of 'antidepressant'/ SSRI-triggered suicides by hanging: hidden in plain sight


The suicide by hanging of Robin Williams while (reportedly) being treated for depression brings this to mind, Williams apparently following the similar and very rare suicide method used by Mick Jagger's girlfriend, L'Wren Scott.


The overall suicide rate is going down, but the rate of suicide by hanging is going-up

There is a stereotypical pattern of SSRI triggered suicides - which used to be rare but is now becoming much more common:

On March 17th L’Wren Scott hung herself in her Manhattan apartment. She hung herself from a door handle. Hanging with your feet or body on the ground is a classic antidepressant MO when it comes to suicide. Hanging in this way led Pfizer to claim that Matt Miller, a 13 year old boy, hadn’t committed suicide but had died from auto-erotic asphyxiation gone wrong. It has led people in Bridgend and Wales to speculate on the influence of Satanic cults to explain the rash of bizarre suicides there. What happens is this. Antidepressants trigger thoughts of self-harm. These thoughts can vary from the mild to the malignant. The drugs can trigger thoughts like this in perfectly normal people, who have rarely if ever thought of harming themselves. Partly because these are such unfamiliar thoughts, someone like Matt Miller, Yvonne Woodley or L’Wren Scott can play with them by attaching a noose around their neck and leaning forward to see what it would be like. But leaning forward like this can put pressure on the carotid bodies, cause a person to lose consciousness, slip forward and asphyxiate.


The rate of prescription of drugs as a whole is going down, but the rate of prescription of antidepressants (SSRIs and similar) is going up, and probably faster than any other  major group of drugs - despite its being three decades since their introduction.

This is almost-certainly due to drug dependence.

It is difficult to stop taking SSRIs after taking a significant dose for several months to due withdrawal effects - which may be severe.

Therefore, once people have been on SSRIs for a while, they tend to stay on them forever.

Prescriptions for SSRIs therefore accumulate: each new antidepressant user tending to become a permanent user, each new prescription for antidepressant tending to become a permanent prescription.


(To summarize a lot of literature) SSRIs overall cause, and do not prevent, suicide.

Suicide rates are known to be high in people with moderate to severe melancholia/ endogenous depression - but these severely depressed people are very rare (less than one percent prevalence) and almost always treated as hospital inpatients; and SSRIs are ineffective (they do not work) in inpatient, endogenous depression.


In practice SSRIs are given to a large group of about 15 percent of the population outside of hospital, in general practice and outpatient psychiatry - people who suffer unpleasant symptoms such as anxiety, worry, severe and unpleasant mood swings, chronic unhappiness, guilt and so on - people in distress but people who continue to live at home, continue to look after themselves, often continue to work.

This group of SSRI-users do not intrinsically have a raised suicide rate - if they were not taking drugs, they would be no more likely to kill themselves than normal controls.


It is thoroughly established that SSRIs increase suicide rates.

This was known during their pre-marketing trials. It is officially acknowledged that SSRIs should not be given to children and young people due to increased suicide risk

There are plausible pharmacological and psychological reasons to explain why SSRIs can trigger suicide, and these symptoms have also been found when healthy volunteers take the drugs as well as among patients with psychological symptoms.


So, SSRIs do not prevent suicide, and they are only useful in a group of people who do not have a raised risk of suicide; but SSRIs are dependence-producing and prescriptions are growing faster than any other major drug, and they do increase the risk of suicide and the suicide is often of a violent, unusual, impulsive nature (most stereotypically casing death by asphyxiation by hanging from a kneeling position) and the suicide may be out-of character for that person, and indeed comes out-of-the-blue.


In conclusion there is a very high visibility epidemic of what look-like SSRI-triggered suicides, now becoming visible among the rich and famous who are reportedly being treated for depression, and who kill themselves violently and unexpectedly; and yet this epidemic is hidden in plain sight.

It as if we cannot believe that a drug prescribed officially and with good intentions cannot do harm!

It is as if we assume that powerful, mind-altering, dependence-producing chemicals are necessarily innocent until proven guilty - merely because they are prescribed by a doctor!

Indeed these antidepressant-triggered suicides are generally spun into indicating the need for even-more antidepressant treatment - more treatment to 'prevent' the suicides which were actually triggered by antidepressant treatment.

The situation is Kafka-esque: the more treatment-triggered suicides, the more demand for treatment - the more suicides... 


The bad news is that suicidality is also a probable side effect of some other types of antidepressant as well as the SSRIs; and also of the antipsychotic/ neuroleptic/ 'mood stabilizer' group of drugs - which are heavily and increasingly prescribed(in multiple combinations - often five drugs together!) for the vaguely-defined pseudo-diagnosis of 'Bipolar Disorder'.


The take-home-message is that all powerful drugs have serious possible risks as well as bad inevitable side effects - and all psychoactive drugs create dependence.

Therefore they should only be used carefully (prepared to stop at signs of trouble, or when not clearly effective), at as low a dose and for as short a time as possible; and when the hoped-for benefits outweigh the certain risks - which, in practice, means only when the psychological illness is severe, debilitating, incapacitating.

And (in general) drugs which cause severe definite present side effects and have dangerous risks and cause dependence - should not be used on the excuse of 'trying to prevent future problems'.