Original book review no longer available
Globe and Mail MENTAL HEALTH
September 20, 2008
By Peter Breggin
A Psychiatrist Exposes the Dangers of Mood-Altering Medications
You might think losing a child, a brother or a parent to suicide is the worst tragedy in the world.
But, as a colleague who experienced such a loss said to me, it’s not. The worst thing is learning that loved ones might not have intended to kill themselves; the deaths could have been caused by a legally prescribed drug. The second worst thing is finding out a pharmaceutical company stood to profit from concealing scientific data that might have saved lives.
For decades, a handful of psychiatrists have suggested that antidepressant drugs such as Prozac and Paxil lead to suicidal and homicidal reactions in some users.
Recently, with accounts of school-aged deaths frequenting the news in Canada and the United States, the suggestion of a link between antidepressants and suicide has become major news.
Eric Harris, one of the Columbine shooters, had been prescribed Luvox, a popular antidepressant in the same class as Prozac. Christopher Pittman, convicted of murdering his grandparents at the age of 12, was taking the bestselling antidepressant Zoloft.
The anecdotes pile on top of one another, filling parents with fear over whom to trust in deciding whether to treat a child’s mental illness with psychiatric drugs. The Internet is filled with unsubstantiated blogs on sites such as http://www.globalserialkillers.com, a spoof of GlaxoSmithKline, manufacturers of Paxil. The media focus on high-profile cases such as the Columbine shooting, leaving unheard the voice of a boy such as Andy, the 11-year-old suicide victim described in Peter Breggin’s latest book, Medication Madness.
Parents need a balanced source they can turn to for evidence of the effects of prescription drugs. I was hoping Breggin might have written such a book. With more restraint and careful editing he might have. But he hasn’t, confirming the many critics who feel Breggin is an antagonist, impugning his own scientific credibility with the tone of his anti-psychiatry tirades.
Churlish as he is at times, Breggin can’t be accused of a lack of compassion for his subject. One of the world’s most infamous critics of psychiatric practice, Breggin has published over a dozen books which suggest that drugs such as Prozac, Ritalin and Xanax often exacerbate the very symptoms – depression, restlessness, suicidal feelings – they are meant to help.
Breggin has the authority to address the topic. A practising physician, he regularly treats patients, and has served as a scientific expert on product-liability lawsuits involving drugs such as Prozac, giving him access to scientific studies previously kept secret by manufacturers such as Eli Lilly.
His experience helps to salvage the book, which is worth reading – however distressing in places – for the description of those affected by psychiatric drugs, such as Andy Jordan, pseudonym for an 11- year-old boy whose parents came to Breggin for help.
Though Andy was a happy child, two events seemed to weigh heavily on him: the death of his grandfather, when he was 10, and the death four years earlier of a neighbour, a boy his age.
Concerned about a note in which Andy said he was feeling sad and frustrated, Andy’s parents took him to a psychologist, who suggested Andy’s pediatrician prescribe a dose of Zoloft. A week later, the dose was doubled to 50 milligrams a day. Andy was also placed on a low dose of Risperdal, an antipsychotic drug. After a week or two, he began to complain of incessant head pain, holding his head and saying, “Mom, I can’t take this any more.”
It’s one of the saddest paradoxes of psychiatric treatment: It’s hard to know whether a drug, or the underlying condition the drug is intended to treat, leads to worrying behaviour. Andy’s psychologist said his Zoloft prescription was too low. She suggested it be increased to 75 mg. Another psychiatrist, noticing Andy’s deteriorating state, suggesting he be taken off Zoloft. In its place, the psychiatrist prescribed Effexor, a nearly identical antidepressant drug.
While on the drugs, Andy’s behaviour shifted so radically his parents feared letting him from their sight. One day, his mother needed to pick up Andy’s 15-year-old sister from school. Andy reassured his mother he was fine, telling her to call if she wanted to check on him. Her husband was scheduled to arrive home any moment, so Mrs. Jordan left her son.
Andy committed suicide that afternoon, holding himself aloft on gym equipment in a way that caused strangulation. He had been taking his prescriptions for under a month, and was just shy of his 12th birthday.
Andy’s death occurred in 2002. Two years later, in 2004, after 15 years of warnings from psychiatrists, the FDA in the United States announced that a re-analysis of company-held clinical trial data revealed antidepressants including Zoloft and Effexor could lead to suicidal behaviour. They mandated all companies to include a black-box label indicating the risk of suicide. To this day, some psychiatrists and pharmaceutical manufacturers continue to lobby for the label’s removal.
If there weren’t a lack of affordable treatments for mental illnesses, the answer would seem obvious: All antidepressants should be removed from the market and company executives who knowingly marketed unsafe drugs should be held criminally responsible.
The problem, one that Breggin refuses to admit, is that not all mental distress is drug-induced, and for every Andy Jordan, there are millions who swear drugs such as Zoloft and Prozac saved their lives. Rather than lampooning such individuals, Breggin could acknowledge that no scientist understands the full benefit or risks of psychotropic drugs. The science remains uncertain. Six years after Andy’s death, mental illness continues to be one of the most misunderstood hardships people can endure. Condemning those who are helped by medication only compounds the stigma that they face.
Linsey McGoey is a sociologist at the University of Oxford, and co-founder of the European Neuroscience and Society Network