Antidepressants – Risks. With 20 reasons to be concerned — (MythsandRisksInfo.com)

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MythsandRisksInfo.com

Mick Bramham

Whether or not to take antidepressants is a personal choice.   I respect that choice, but wonder if fewer people would rely on them so much if they were more aware of some of the risks.

You may know friends or colleagues who are on antidepressant drugs. Maybe you also are taking them (or wondering whether or not to start).

Drugs like Prozac and Seroxat have become household names, and yet many people who take them know so little about them. Here we take a closer look at some of the risks associated with antidepressants.

Depression and low serotonin

It may surprise you to hear that most antidepressants have been passed for medical use on the basis of trials on people of around 6-8 weeks duration – Prozac was approved after just 6 week trials. Unfortunately, many of the problems with these (and other) drugs only surface when they are prescribed for longer periods

So the fact that a drug has been approved does not mean that it is necessarily as safe or effective as we would like to think. Consider, for example, the high (considerably higher than those in placebo comparison groups) number of suicides and suicide attempts by people taking antidepresssants during the testing trials (Table 1) 1. We now know that many people react badly to antidepressants and becoming suicidal is one of the possible adverse effects.

Eli Lilly, the maker of Prozac, knew about its suicide risks long before it was launched and wanted to keep this information quiet. (More about this in the Guardian here, and from this wise blogger here.)

In addition, drug testing trials (Random Controlled Trials – RCTs) are often much smaller than one might expect: Prozac, for example, gained approval on the basis of just 286 patients finishing the trials 2.

It seems to me that many people have unrealistic expectations when it comes to these drugs and the benefits can be offset by troublesome side effects (such as disturbed sleep, increased agitation and anxiety, sexual problems) and serious health risks (see below). Furthermore, although some people find it quite easy to stop them, others struggle for many years to stop these drugs and attribute permanent damage to their use.

he Andrews study mentioned below gives a helpful overview of some of the risks, but in more depth than is covered here. See study Andrews et al 2012. 3

Don’t make any sudden changes – check with your doctor

Psychiatric drug warning

Some of the risks associated with antidepressants are alarming. Although some of the adverse effects may be quite rare, others occur more frequently.

If you are taking antidepressants – please don’t rush to change your dose or even stop them – without working closely with a doctor you trust and who understands you. I say this, as medical concerns do sometimes arise. For further safety information and advice please click the warning image to the left.    It is widely believed that antidepressant medications are both safe and effective;  however, this belief was
formed in the absence of adequate scientific verification.  The weight of current evidence suggests that, in general, antidepressants are
neither safe nor effective; they appear to do more harm than good.

Antidepressants come with side effects that are not in the mind – risks of getting hooked, birth defects, impaired sexual functioning, strokes, fractures, suicide and
homicide, and in children stunted growth.    Guidelines your doctor should be familiar with: “the use of antidepressants has been linked with suicidal thoughts and behaviour. Where necessary patients should be monitored for suicidal behaviour, self-harm or hostility, particularly at the beginning of treatment or if the dose is changed”.  British National Formulary (BNF)

20 Reasons To Be Concerned By Antidepressants

1. Antidepressants can cause depression

Some studies assert that antidepressants can actually cause depression and “antidepressant use appears to increase susceptibility to depression” so that people may be more likely to get further times of depression having been on antidepressants.3, 4, 5, 6,16

2. Antidepressants can cause mania and psychosis

Taking antidepressants can lead to mania 18 and being diagnosed as bipolar as they can have a stimulant effect – this may not just be a temporary change to the brain 4. All types of antidepressants can also lead to psychosis and to auditory and/or visual hallucinations 7.

3. Antidepressants can make people suicidal

Antidepressants can cause both adults and children to become suicidal 8. “Worsening of depression and/or increased suicidal thinking or behavior may always be a possibility in patients treated with antidepressant medications”9. So-called “healthy volunteers” have been tested on antidepressants and become suicidal, so it would be wrong to blame a person’s depression rather than the drugs.

4. Antidepressants can make people violent

Antidepressants have been shown to be associated with a “consistently elevated risk” of violence towards others 10.This means that some people, quite out of character, have become violent, and in some instances committed murder.

5. Antidepressants can cause cancer

Some studies indicate that antidepressant use can lead to an increased risk of breast and ovarian cancer even with low doses and short-term use. Furthermore, researchers with affiliations to the pharmaceutical industry are significantly less likely to conclude that antidepressants increase the risk of breast or ovarian cancer (compared to studies by those not affiliated to the industry) 11.

6. Antidepressants can damage babies during pregnancy, including an increased risk of autism

Selective serotonin reuptake inhibitor antidepressants, SSRIs (like Prozac) are now widely used by pregnant women. Prof Urato writes: “Croen, et al showed that SSRI exposure during pregnancy was associated with a doubling of the risk of autism…Current evidence suggests that use of the SSRI antidepressants during pregnancy is [also] associated with miscarriagebirth defectspreterm births and newborn behavioral syndrome along with other pregnancy complications such as preclampsia and low birth weight.” [Taken from here].

7. Antidepressants damage brain cells

Neuronal (brain cell) damage: Dr Grace Jackson points out that there are indications that antidepressants have the potential to actually change the structure of the brain (reducing dendritic length and dendritic spine density of serotonin nerve cells). In rat studies these changes did not reverse after the drugs were stopped.7 Alarmingly, serotonin “receptors actually die back and disappear. In some regions of the brain, the dieback may result in losses of 40-60% of serotonin receptors.”13

8. Antidepressants can weaken bones

Antidepressants (SSRIs and the older Tricyclic ones) have been associated with the possibility of reducing bone mineral density leading to an increased risk for fractures and osteoporosis 7. According to one study: “The weight of epidemiological evidence suggests that SSRIs are associated with reduced bone mass, increased bone loss, and increased risk of fractures…clinicians should be vigilant about detection of bone disease in patients who are using SSRIs.” 24

9. Antidepressants can increase the risk of diabetes

According to this study: “Long-term use of antidepressants in at least moderate daily doses was associated with an increased risk of diabetes. This association was observed for both tricyclic antidepressants and selective serotonin reuptake inhibitors.”14

10. Antidepressants can cause uncontrollable body movements

SSRI antidepressant drugs are increasingly being associated with serious movement disorders sometimes referred to EPS (Extra Pyramidal Symptoms) which create uncontrollable body and facial movements as well as slowing down the overall functioning of the body and brain.  These can become very serious disabilities and socially embarrassing too 13,16.

11. Antidepressants can increase the risk of stroke

The older Tricyclic antidepressants are associated with an increase cardiac risk with an increased risk of stroke 3.“Tricyclic antidepressants have potentially dangerous effects on the functioning of the heart…In high doses they can cause dangerous irregularities of the heartbeat” (arrhythmias) and “even at normal doses they may very occasionally cause sudden death due to the heart malfunctioning 15. SSRI antidepressants are also associated with an increased risk of stroke. 25

12. Antidepressants can increase the risk for dementia

I recognize that many people experience memory problems when taking antidepressants, but these drugs may actually cause cognitive decline and dementia with prolonged use 3.

13. Antidepressants lead to restlessness, nervousness and insomnia

All SSRIs can cause insomnia, anxiety, agitation and nervousness.  One study showed 38% of people on Prozac (in short trials) struggled with these adverse effects 13.

14. Antidepressants can cause cell death

Apoptosis – cell death: “there is good evidence from several different lines that antidepressants trigger apoptosis.”3

15. Antidepressants could lead to ongoing weight problems, even after stopping

Antidepressant use may “be a covert, insidious and enduring risk factor for obesity, even after discontinuation of antidepressant treatment” for some people in some circumstances.23

16. Antidepressants can make people apathetic and demotivated (and impair memory)

“Apathy syndrome”. SSRI antidepressants have been associated with impairing memory and leading to people feeling apathetic and demotivated: a marked reduction in blood flow to the frontal lobes of the brain has been noted in connection with this 7,17.

17. Antidepressants often cause sexual problems that may continue even when the drugs are stopped

Although sexual dysfunctions have been played down by drug companies, they are thought to occur in over 50% of people taking antidepressants 9. These problems may persist after stopping the use of these drugs 21. I wonder how many people would start on these drugs if they were warned about this, and the other risks, prior to treatment.

“It is important that patients are informed about the high probability of sexual side effects while on SSRI medications…Patients should also be told that there are indications that in an unknown number of cases, the side effects may not resolve with cessation of the medication, and could be potentially irreversible.”22

18. Antidepressants can (rarely) be life-threatening

Serotonin toxicity is an uncommon but potentially life-threatening effect of SSRI antidperessant use (and also possible from taking L-tryptophan) 19.

19. Antidepressants may reduce the long-term capacity of the brain to self-regulate

A significant body of research suggests that antidepressants may reduce the long-term capacity of the brain to autoregulate (self-regulate) neurotransmitter systems 7.

20. Antidepressants can be seriously addictive and terrible to withdraw from

Although people do not usually crave antidepressants as someone might crave drugs like cocaine or heroin, antidepressants are seriously addictive in the sense that they can cause extreme withdrawal reactions and it can be extremely difficult to stop taking them.9. “Many antidepressants cause people to be hooked to them – it becomes impossible to stop because of how bad the person feels on stopping and the relief from restarting treatment … Companies and their experts refer to discontinuation syndromes – another term for withdrawal or being hooked – in attempt to avoid the stigma of withdrawal. But even national regulators now concede it may be impossible to stop certain antidepressants 20.”

The bottom line

I am not suggesting that people should not take antidepressant drugs. That is a personal decison. However, I do find that people are poorly informed of the risks and so are not making properly informed choices.

In considering the adverse effects and the risks of antidepressants, we also need to bear in mind that there is some variation between the various types of antidepressant. Although in one-to-one work I discuss some of these differences, here I generalise and trust you to check out the details where necessary.

References – Bibliography – Further reading

1 Healy, D and Whitaker, C. Antidepressants and suicide: risk–benefit conundrums.  J Psychiatry Neurosci. 2003 September; 28(5): 331–337. Table 1 Full study

2 Breggin, P & Breggin, G. (1994) Talking Back to Prozac. New York: St Martin’s Press.

3 Andrews et al. Primum non nocere: an evolutionary analysis of whether antidepressants do more harm than good. Frontiers in Psychology April 2012 Vol 3 Article 117 Full study

4 Fava, G.A. Can long-term treatment with antidepressant drugs worsen the course of depression? Journal Clinical Psychiatry2003;64123-133). Full study here.

5 Fava, G.A. The mechanisms of tolerance in antidepressant action. Progress in Neuropsychopharmacology & Biological Psychiatry,Aug 2010, Aug 2010

6 Fava, G.A. Long-term treatment with antidepressant drugs: The spectacular achievements of propaganda. Psychotherapy Psychosomatics 2002;71: 127-132. Full study here.

7 Jackson, G. (2005) Rethinking Psychiatric Drugs. USA: Anchor House

8 Healy, D. Lines of Evidence on the Risks of Suicide with Selective Serotonin Reuptake Inhibitors. Psychotherapy & Psychosomatics2003 Full study

9 Healy, D. et al 2012 Data Based Medicine Position Paper: Antidepressants for Takers (RxISK). Full article

10 Prescription Drugs Associated with Reports of Violence Towards Others. Moore, T. et al PLoS ONE 2010. Full study

11Cosgrove, L. et al. Antidepressants and Breast & Ovarian Cancer Risk: A Review of the Literature and Researchers’ Financial Associations with Industry. PLoS ONE 2011. Full study

13 Breggin, P. (2001) The Antidepressant Fact Book. US: Da Capo Press. Breggin, P. (2008) Brain-Disabling Treatments in Psychiatry. New York: Springer Books

14 Andersohn, F. et al.  Long-Term Use of Antidepressants for Depressive Disorders and the Risk of Diabetes Mellitus. American Journal Psychiatry 2009. Full study

15 Moncrieff, J. (2009) A Straight Talking Introduction to Psychiatric Drugs. UK: PCCS Books Ltd

16 El-Mallakh, R. et al. Tardive dysphoria: The role of long-term antidepressant use in-inducing chronic depression. Medical Hypotheses2011. Full study

17 Opbroek, A. Emotional blunting associated with SSRI-induced sexual dysfunction. Do SSRIs inhibit emotional responses? Int Journal of Neuropsychopharmacology (2002), 5, 147-151. Full study

18 Preda, A. et al. 2001 Antidepressant-associated mania and psychosis resulting in psychiatric admissions. Journal Clinical Psychiatry62:1, Jan 2001. Full study

19 Talarico, G. et al. Serotonin toxicity: a short review of the literature and two case reports involving citalopram. Neurol Sci. 2011 Jun;32(3):507-9. Epub 2011. Abstract

20 Healy, D et al. Data Based Medicine Position Paper: Antidepressants for Prescribers. PDF available from RxISK

21 Bahrick, A. (2008) Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence. The Open Psychology Journal, 2008, 1, 42-50. PDF available here.

22 Csoka, A. (2008) Persistent Sexual Dysfunction After Discontinuation of Selective Serotonin Reuptake Inhibitors. J Sex Med2008;5:227–233. Abstract available here.

23 Mastronardi, C. (2011) Long-term body weight outcomes of antidepressant–environment interactions. Mol Psychiatry. 2011 March; 16(3): 265–272. Available here.

24 Bliziotes, M. (2010) Update on serotonin and bone. Journal of Clinical Endocrinology and Metabolism, 95 (9), 2124-4132. Abstracthere.

25 Hackman, D. & Mrkobrada, M. (2012) Selective serotonin reuptake inhibitors and brain hemorrhage – A meta-analysis.

Neurology WNL.0b013e318271f848. Abstract here.

Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study — (JAMA Internal Medicine)

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JAMA Internal Medicine

Published online January 26, 2015. doi:10.1001/jamainternmed.2014.7663

Shelly L. Gray, PharmD, MS1; Melissa L. Anderson, MS2; Sascha Dublin, MD, PhD2,3; Joseph T. Hanlon, PharmD, MS4; Rebecca Hubbard, PhD2,5,6; Rod Walker, MS2; Onchee Yu, MS2; Paul K. Crane, MD, MPH7; Eric B. Larson, MD, MPH2,7

ABSTRACT

Objective  To examine whether cumulative anticholinergic use is associated with a higher risk for incident dementia.

Design, Setting, and Participants  Prospective population-based cohort study using data from the Adult Changes in Thought study in Group Health, an integrated health care delivery system in Seattle, Washington. We included 3434 participants 65 years or older with no dementia at study entry. Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003. Beginning in 2004, continuous replacement for deaths occurred. All participants were followed up every 2 years. Data through September 30, 2012, were included in these analyses.

Exposures  Computerized pharmacy dispensing data were used to ascertain cumulative anticholinergic exposure, which was defined as the total standardized daily doses (TSDDs) dispensed in the past 10 years. The most recent 12 months of use was excluded to avoid use related to prodromal symptoms. Cumulative exposure was updated as participants were followed up over time.

Main Outcomes and Measures  Incident dementia and Alzheimer disease using standard diagnostic criteria. Statistical analysis used Cox proportional hazards regression models adjusted for demographic characteristics, health behaviors, and health status, including comorbidities.

Results  The most common anticholinergic classes used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. During a mean follow-up of 7.3 years, 797 participants (23.2%) developed dementia (637 of these [79.9%] developed Alzheimer disease). A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease (test for trend, P < .001). For dementia, adjusted hazard ratios for cumulative anticholinergic use compared with nonuse were 0.92 (95% CI, 0.74-1.16) for TSDDs of 1 to 90; 1.19 (95% CI, 0.94-1.51) for TSDDs of 91 to 365; 1.23 (95% CI, 0.94-1.62) for TSDDs of 366 to 1095; and 1.54 (95% CI, 1.21-1.96) for TSDDs greater than 1095. A similar pattern of results was noted for Alzheimer disease. Results were robust in secondary, sensitivity, and post hoc analyses.

Conclusions and Relevance  Higher cumulative anticholinergic use is associated with an increased risk for dementia. Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time.

The Chemical Imbalance Theory: Why It’s Wrong And Why You Need To Get Off Antidepressants — (The People’s Chemist)

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The People’s Chemist

Shane Ellison

January , 2015

Get ready for the big antidepressant push. In 2015, Big Pharma will continue their tireless push to medicate us all with antidepressants. Don’t fall for the hype.

When I worked for the drug giant as a young chemist, Prozac (fluoxetine) was being marketed as a “happy pill.” Newsweek hailed it as, “A Breakthrough Drug for Depression.” Sales raked in enough profit to solve world hunger for a hundred years.

Fortunately, I didn’t have to try them to know they weren’t going to help me when I got depressed – like every time I looked at the taxes being taken out of my paycheck. In-house studies proved they didn’t work.

Astute doctors have followed the research trail. In Your Drug May Be Your Problem, Harvard trained psychiatrist Dr. Peter Breggin showed that antidepressants didn’t work better than dummy pills in clinical trials. To his dismay, he also discovered that they can cause the very thing they’re trying to cure and push depressed people further over the edge.

Big Pharma buried the detrimental findings in an avalanche of false advertising.

The marketing triumph played out like the tobacco conspiracy and was well documented in Dr. David Healy’s Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression. But, antidepressant sales are still soaring.

When you walk into a doctor’s office, you’re more likely to be prescribed an antidepressant medication than any other drug. More frightening, foster children, the military troops and our elderly population are being drugged in record numbers. This trend is only going to grow in 2015.

This swell of prescribing habits is driven by the “chemical imbalance” theory, which antidepressants aim to correct. But the science isn’t there.

Marcia Angell, former editor of The New England Journal of Medicine, wrote that , “After decades trying to prove [the chemical imbalance theory], researchers have still come up empty-handed.” Since the theory of depression is false, using it to diagnose and medicate an emotion is an atrocity.

If their ineffectiveness doesn’t deter the depressed, antidepressant side effects will.

According to the Food and Drug Administration (FDA), antidepressants can cause suicidal thoughts and behavior, worsening depression, anxiety, panic attacks, insomnia, irritability, hostility, impulsivity, aggression, psychotic episodes and violence. Physical side effects occur too and include abnormal bleeding, birth defects, heart attack, seizures and sudden death. Over one hundred and seventy drug regulatory warnings and studies have been issued on antidepressants to sound the alarm on these side effects.

So, what’s the alternative to treating depression?

The Roman Emperor Hadrian had severe bouts of depression. His mood swings lead to capricious cruelty. Without any real way to diagnose his mental state, it was said that he was possessed by evil spirits. Not much has changed today. Instead of blaming evil spirits, psychiatry blames neurotransmitters, which nobody can see or accurately measure. And even if you could, how could you define what’s normal?

Unlike the disease of Type II diabetes, where muscles fail to respond to rising insulin levels and blood sugar shoots sky high, depression lacks a unifying cause. There’s no blood test or medical exam to diagnose it. This makes depression hard to treat. If you don’t know the enemy, how can you fight the war? After all, emotions are not diseases.

This shouldn’t detract from the suffering depression brings. Headaches, air sickness and even being homesick or having a “broken heart” lack reliable blood tests, too. But, we know they’re real and have physical outcomes than can make life unbearable too.

Regardless of any blood test, depression cripples willpower, productivity and responsibility. By definition then, a remedy should be sought.

Therefore, the only thing we can do is look at depression as well as the outcome of antidepressant use over the last few decades to mount a new theory and treatment. In the same way doctors bust a blood clot with aspirin among heart attack victims, the old view was that the depressed brain was diseased and needed drugs. But, decades of trial and error show that drugs are the villain, not the cure.

Emerging from this, the new view sees “the war within” not as a disease, but as emotional instability precipitated by malnutrition or even drug and alcohol use. The American Journal of Psychiatry made this view official, saying, “malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior.”

This is easy to explain. When depleted, the brain lacks the ability to:

  • Focus
  • Manage mood and proper behavior
  • Activate the growth of new nerve cells

Together, the biological trios guide rationale, thinking and mood when confronted with initiators of stress – like when the IRS robs you blind via taxation without representation. However, just as a muscle fails when it lacks electrolytes, a malnourished mind and body are ill-equipped for elevating mood.

Therefore, when initiators of depression (or stress, anxiety and rage) are present, sufferers can “feel blue,” lay passively in bed all day or become a tyrannical, barbaric ruler who takes out their despair on others.

There’s a potential fix…

Scientists have found that a rare mineral may help curb malnutrition and therefore, emotional instability. Serving as nature’s most effective nutrient booster, observational studies show that the non-toxic mineral lowers depressive outcomes much better than drugs as measured by behavioral habits among those who suffer from alcoholism, drug addiction and even suicidal thoughts. To learn how best to use this non-toxic alternative natural antidepressant and how to wean from your meds, read Over-The-Counter Natural Cures Expanded.

Vietnamese community prays for Edmonton murder victims, forgives killer — (The Globe and Mail)

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The Globe and Mail

Key Developments in Case of 2 Slain NYPD Officers — (New York Times)

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NYTimes.com

Reader’s Letter — (SSRI Stories)

December 12, 2014

Reader’s Letter to SSRIStories:

I need to talk for all the children, teens, women and men who died from antidepressants, and for those who are suffering because of them.    Here is my story:

I ‘ve been depressed since my teens because of bullying in school.  I started taking pills to treat it in 2011.  I took citalopram for 3 years and my depression get worse.  I was so depressed I wanted to die.

After those 3 years I thought Cymbalta would resolve all and that the former drug was ineffective.  I felt well at first under Citalopram but then my depression get worse than ever.  With Cymbalta it was the same story: at first I was well and then my depression get worse than ever.  I was in hospital for a month for suicidal thoughts and deep depression.  I was at the point of  wanting to kill myself.  They put me back on 60 mg and then 90 mg of Cymbalta, even though the doctors should have known that the drug was not effective. But at that time I trusted the doctors and I never thought that the antidepressants were causing my depression, and the suicidal thoughts, anger, and paranoia.   So same story again… At first I felt better with the Cymbalta but when they increased the dose I got worse again.

This time, I decided to stop taking the antidepressant after doing some research and finding out the truth about these drugs.   I am now taking 60 mg instead of the 90 mg my doctor prescribed, to try to get off this drug gradually.

The doctor is not sure if it is good to reduce it further as the withdrawal effects affect my health.  I can’t walk easily, all my muscles hurt, I have nausea, dizziness,  and I’m so tired I sleep all day but I’m really motivated to stop this drug and to not taking anymore pills.

I’ve created thetruthaboutantidepressants.wordpress.com to alert people to the dangers and truth behind those psychiatric drugs.  These drugs ruined my life.

Mental health care system failed ‘low-risk’ suicide mother of two — (The Gloucestershire Review)

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The Gloucestershire Review

Thursday, 23 October 2014

THE DISTRAUGHT family of a 39-year-old woman who hanged herself after being assessed as a low suicide risk have lashed out at the mental health treatment the mum-of-two received.

After an inquest into the death of Victoria Phelps of Wilton Road, Gloucester on August 6th, 2012, the mother of the deceased, Gayle Tucker said: “After one of her suicide attempts I begged that my daughter be sectioned so that she could be looked after properly.

“To say someone is at a low risk of suicide when she has made previous attempts is just not on. My daughter has been let down.”
Victoria’s brother Brett Phelps added: “My sister only started having suicide thoughts and making attempts when she was prescribed Fluoxetine. I’ve been doing some research into the drug and reckon that it was a death sentence for my sister.”

Senior Coroner for Gloucestershire Katy Skerrett said: “It is quite clear that from 1992 this lady suffered on-off with anxiety. She was a working lady with two sons and had been taking anti-depressants since 2000.   “In April 2012 things came to a head due to a relationship breakdown and this triggered events in a bad way.”

Victoria took a drug overdose and was admitted to Gloucestershire Royal Hospital. She then waded into a canal and spoke to friends about ending her life, the inquest at Barnwood was told.   Police Constable Karen Raistrick told the inquest: “I attended her home on a previous occasion when she tried to hang herself in the garage and I was on duty when I was again called to the house on August 6th that same year, but this time we found her dead.”

Victoria’s son had handed police a key to the garage and was just prevented in time by a friend from walking in and seeing his mother hanging by a dressing gown cord.   Despite the previous history of anxiety and depression and suicide attempts, which included superficially cutting her wrist, mental health liaison nurse Julie Nicholson assessed her as being at low risk of self-harm “but this increased when alcohol was consumed.”

In a written statement to the inquest the nurse said that the family was asked to look after her medication “to reduce the risk of overdose.”   “The patient did not want to die but told me that she would sometimes drift into a tunnel,” said the nurse. “She seemed flat and worried.”

Ms Skerrett reiterated the deceased’s recent mental health history: depression after an aunt died in 2005, anxiety in 2007 and 2008, panic attacks in 2009 and 2011, overdose and hospital admission in 2012, insomnia after relationship breakdown the same year, depressed and suicidal thoughts in July 2012.

She was referred to psychiatrist Prakash Muthu for a crisis assessment in July 2012 and he gave evidence at the inquest yesterday.   “She told me about the overdose and the episode wading into the canal and also the cut wrists but she clearly regretted her actions, felt scared of what she had done and wanted help,” said the psychiatrist.   “But she told me that she had no more suicidal thoughts and I assessed her as being of low risk of suicide. She maintained good eye contact during my assessment and seemed to be looking to the future.”

Dr Muthu said that he recommended a change in medication and told her that, as part of her risk management, she should contact The Samaritans. But the psychiatrist denied that there was an increased risk of suicide associated with Fluoxetine.

Ms Skerrett concluded that she could not be sure that Victoria intended to take her own life and there was reasonable doubt.   “This may have been a cry for help and I will give a narrative conclusion,” she said.    After retiring for ten minutes the coroner returned to the courtroom and delivered her narrative conclusion: “This 39-year-old lady was suffering from depression and anxiety, triggered by a relationship breakdown in March 2012.   “She made a few suicidal attempts in the weeks preceding her death. However it is unclear whether she had formed a clear intention to die.”

All content © of Gloucester Review unless stated otherwise.

Magnotta complained of hearing voices, being stalked, doctor testifies — (The Globe and Mail)

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The Globe and Mail

Sidhartha Banerjee

Robin Williams — Suicide Triggered by Depression, Parkinson’s, Paranoia — (TMZ.com)

By Caroline Graham for Mail On Sunday

A close friend of Robin Williams has blamed the drugs the comedian was taking to combat Parkinson’s disease for his suicide.

Actor Rob Schneider tweeted: ‘Now that we can talk about it #Robin Williams was on a drug treating the symptoms of Parkinson’s. One of the side effects is suicide.’

Schneider, 50, met Williams more than two decades ago when they appeared on the US TV show, Saturday Night Live. They remained close friends and often performed together in stand-up comedy clubs.

Williams’s spokeswoman declined to comment when asked by The Mail on Sunday about rumours that the tragic comic’s family blames the medication he was on for ‘pushing him over the edge’.

A source said: ‘Robin had recently left rehab. He was on medication for anxiety and depression and had also started taking drugs to combat the early onset of Parkinson’s.

‘Many of these drugs list suicidal thoughts as a possible side effect. A lot of Robin’s friends are convinced that the cocktail of prescription pills he was on somehow contributed to his mental state deteriorating as quickly as it did.

‘Robin had always suffered from depression and addiction but the diagnosis and treatment of his Parkinson’s was new, as was the combination of drugs he was on.’

Williams, 63, was last photographed at an art show near his home in Tiburon, northern California, last Saturday night. He appeared frail and thin.

He took his life last Sunday as his third wife Susan Schneider (who is not related to Rob Schneider) slept in the next room. The pair are thought to have been sleeping in separate rooms because Williams was suffering from insomnia brought on by the drugs he was taking.

Williams’s body was found on Monday morning by his personal assistant. Results of toxicology tests are expected to take six weeks.

Experts say Parkinson’s disease can make symptoms of depression worse.  America’s National Institute of Mental Health says on its website that people struggling with depression and Parkinson’s ‘suffer higher levels of anxiety and more problems with concentration’ than those suffering from only one of the ailments.

Dr Jeff Bronstein, neurologist specialising in Parkinson’s, said: ‘Obviously getting the diagnosis can make people depressed but we also know there is a much higher incidence of depression even before the disease is recognised. We think it’s one of the early symptoms.’

The funeral of the star of Good Will Hunting, Good Morning Vietnam and Mrs Doubtfire could take place as early as this weekend.

A source told The Mail on Sunday: ‘The funeral will be private and small for family and very close friends only. There will be larger memorials in Los Angeles and New York at a later date.’

Williams was involved in raising money for Parkinson’s research through his friend Michael J. Fox’s foundation before he was diagnosed with the disease.

Back To The Future star Fox tweeted: ‘Stunned to learn Robin had PD. A true friend. I wish him peace.’

Actress Lynsey Pow found hanged after battles with cocaine and gambling debts — (London Evening Standard)

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London Evening Standard

An actress who appeared in BBC dramas Waterloo Road and Doctors took her own life after battling drug and gambling problems, an inquest heard.

Lynsey Pow, 34, who also appeared alongside Billie Piper in Secret Diary Of A Call Girl, was found dead at her flat in Honor Oak Park on November 28 last year.

An inquest at Southwark coroner’s court heard yesterday how her husband Ashley House, a Eurosport TV presenter, rushed back home from work after growing concerned about her welfare.

The inquest heard Ms Pow told her husband by phone that she was sorry for her online gambling and that she had bought some cocaine.

She was found hanging, with drugs paraphernalia and open bank statements showing gambling debts nearby. A post-mortem examination found traces of cocaine and alcohol in her body.

Her father, James Pow, had tried to take her to his home in Scotland a month before she died so she could get help with her drug habit.

Revealing a bitter family rift, a statement from Mr Pow read to the court said: “I sought to separate my daughter from her husband after he failed to fulfil his marriage vows to act as a custodian and guardian.”

Dr Johan Hugo, a GP who met Ms Pow on October 13, said she told him that she “felt like a failure” and was using cocaine on a daily basis and had tried to self-harm.

Ms Pow was prescribed anti-depressants and referred for psychiatric treatment. When she met Dr Hugo on October 30 she told him she was off drugs and seemed like a “different person”, eager to get back to her life in London and work commitments.

Her brother, actor Duncan Pow, told the inquest that his sister had twice previously tried to take her life. On October 16, he and his younger sister, Kathryn, found her in a “catatonic” state. The inquest also heard how Ms Pow left a note before her death.

Assistant Coroner Sarah Ormond-Walshe recorded a narrative verdict, saying the presence of drugs in Ms Pow’s system meant it could not be proven she intended to kill herself.

She said: “[Ms Pow] appeared to have obtained some cocaine and while under the influence of cocaine she appeared to hang herself.

“It is likely to have influenced her mind so it cannot be said that she intended to die. I am recording this as a drug-related self-harm death.”

Ms Pow’s father said he was pleased the coroner did not record a suicide verdict as he blamed his daughter’s death on her relapse into drugs.

Mr Pow, owner of the Country Attire clothing company, told the Standard: “She was getting better. The tragedy is that she could have been saved. We did everything we could when we found out about the drugs. Lynsey touched so many lives. There were 1,400 people at her memorial service. The only thing that has helped is that it has brought our family even closer together.”

Mr House declined to speak at the inquest and declined to comment when approached by the Standard.