Antidepressants and Suicide

There was an interesting article, Antidepressant regulations tightened following suicide, in the Copenhagen Post on January 7.  Thanks to Mad in America for the link. It is reported that Danilo Terrida, aged 20, committed suicide in 2011

“…eleven days after he was prescribed antidepressants following an eight-minute-long conversation with a doctor.” 

The doctor has been deemed responsible for the suicide by the National Agency for Patients’ Rights and Complaints.  According to its website:

“The National Agency for Patients’ Rights and Complaints functions as a single point of access for patients who wish to complain about the professional treatment in the Danish health service.”

As a result of this case, Sundhedsstyrelsen, the Danish Health and Medicines Authority, has issued a directive requiring a more thorough assessment before these drugs can be prescribed to people aged 18 to 24.

Here are some quotes from the article:

“The case has sparked a debate about the dangers of psychiatric drugs, and in Politiken newspaper today Peter Gøtzsche, medical researcher and leader of the Nordic Cochrane Center at Copenhagen’s Rigshospitalet, wrote that antidepressants have caused healthy people to commit suicide.”

“He [Gøtzsche] added that psychiatric medication often does more harm than good and that patients would often be better off without medication.”

“‘Doctors cannot cope with the paradox that drugs that can be useful for short-term treatment can be highly dangerous when used for years and even create the illnesses that they were supposed to prevent, or even bring on an even worse illness,’ Gøtzsche wrote.”

So, we have one more piece of confirmation of something that’s been known for years.  Antidepressants increase the risk of suicide for some individuals, especially in the period immediately following initiation.  For decades, the pharmaceutical companies and the psychiatrists spun this embarrassing fact as evidence that the drugs were working.  The story went like this:  when people are deeply depressed, they lack the energy or motivation to even take their own lives.  But as the antidepressant “kicks in,” the person begins to feel more motivation, though still considerably depressed.  So he kills himself.

And psychiatry actually embraced and promulgated that nonsense.  Today it is clear that the drugs, especially the serotonin boosters, actually generate suicidal thoughts and intentions in some individuals, especially young people.

Requiring a more thorough assessment, as the Danes plan to do, seems a fairly minimal precaution, but it’s better than the 8-minute conversation that Danilo Terrida got.  The ongoing problem, however, is that there is, as far as I know, no way to identify those people who pose particular risk in this regard, other than intensive individualized monitoring for all people who are prescribed these products.  It seems unlikely that screening of that magnitude will become general practice, given the frequency with which antidepressants are being prescribed.  So instead of an 8-minute interview, there’ll be a 30-minute interview, but the results may not be much different.

In addition, this whole issue needs to be publicized more in order to ensure that clients are making informed choices.

  • Francesca Allan

    Phil, you wrote “The story went like this: when people are deeply depressed, they lack the energy or motivation to even take their own lives.”

    What absurd psychiatric “logic.” I take it then that SSRI homicidal disasters (also listed as a possible side effect by the FDA) happen when depressed people (secretly hoping to commit murder) gain the motivation to do so?

  • Phil_Hickey

    Francesca,

    Only psychiatrists, by virtue of their special training and anointment, can apply psychiatric logic. It takes years of dedicated practice to get it right!

  • Cledwyn o the bulbs

    The model of pharmacological determinism is just as reductionistic as the model of neurological determinism and reduces the scope of responsibility. As for the FDA listing homicide as a “side-effect”, homicide is not a side-effect of a drug any more than suicide is, it is something people do, whereas the pharmacological determinist basically states that these are things that happen to people as a result of a taking a drug. People are not puppets pharmacologically manipulated, committing violence against the self or others independent of will and motivation.

    All that can be stated with some certainty is that there are certain situational and emotional preconditions within which flourish suicidal thought and tendency, but the act itself presupposes agency, ergo it is wrong to talk of psychiatric drugs causing suicide or homicide.

    Suicide prohibition is an act of quasi-religious persecution, whereby one individual imposes violently his version of the truth on others, justifying it by saying it is the only compassionate thing to do, that it is morally imperative, as if there’s anything compassionate about forcing someone to remain in a life where, at least those higher up the intellectual scale, have only to look forward to a slow, conscious process of bodily decay, mental disillusionment, and sensual disenchantment; a life where man’s fundamental ontological condition is misery.

    Beyond an evil, nauseating stew of despair, fear, boredom, trauma, anger, disgust, shame, guilt, conflict, and humiliation, parsimoniously seasoned with an inifinitesimal amount of contentment, life offers little in the way of spiritual nourishment. It is a seemingly endless procession of frustrations, betrayals, indignities, catstrophes and ignominies. Yet, supposedly, the man who says so is an ingrate, and the man who wants out, is mad, acting on an impulse and against best interests, yet strangely, few of the true aristocrats of the intellect ever authored such insipidities.

    If life has any meaning at all it is to sweeten the appreciation of nothingness, whose virtues are thrown into sharper relief when set against the grotesque tapestry of human existence which resembles nothing so much in the experience of it as an expressionist painting by Edward Munch. Life is a glorified physical and mental endurance test that intolerant religionists would have us believe is a gift, bestowed by a benign god, when in reality if god does really exist, then we are nothing more than the flies caught up in his universal web.

    People say life is beautiful, but as Solzhenitsyn pointed in “the Gulag Archipelago”, the Gulag is a part of life. He might also have asked how is life beautiful when all the animals who embody this essence are all killing each other, incorporating into themselves the carcass of that which they have just mercily attacked and ripped to shreds? The kind of people who utter such insipidities are the kind of people who upon viewing a witch-burning, remark not upon the suffering of the poor wretch being
    slowly and agonizingly consumed by the flames, but on the “beauty” of the amber of the flames against the night sky.

    Yet the animals are lucky; it is we humans who are the most cursed of all, our every living moment weighed down with the burden of consciousness, which is usually in the service of tormenting either ourselves or others.

    If life is so sodding beautiful, why do we spend so much time looking forward to an illusory future and back to an illusory past? Simple, because life is utterly disappointing and hideous, so we take solace in our dreams. We spend our lives looking back to a past refracted through the prism of nostalgia, and forward either to a vision of eschatological bliss or of sublunary bliss in our current existence.

    Depression is man’s default state of mind, and against this ineluctable fact all the panaceas proferred by religion and ideology, as well as the secular religion of psychiatry, are useless.

    Happiness is at best nothing more than an all too fleeting punctuation of the darkness of existence, nothing more, yet nevertheless, it’s all worth it supposedly. In its more durable form, happiness, if there be such a thing, is merely the monopoly of swines and fools.

    The man who claims to be happy is a liar, afraid of being tarred with the mad brush, who deep down is just as miserable most of the time as the rest of us. There is only a difference in degree, and not in kind, on this issue. Some people learn to live better with their misery through experience and by fortifying themselves against the provocations of nature and society through the self-inculcation of a Stoical forbearance; some just live in denial of their own misery.

    A man is not saved when he is stopped from killing himself, but is saved when he consummates the act, saved from the horror of existence. That’s just my view, I certainly wouldn’t impose it upon anyone else, which is more than can be said for the suicide prohibitionists….

  • Francesca Allan

    I think it’s perfectly reasonable to find that a drug can make a person violent, whether towards himself or towards others. Psych meds are, after all, psychoactive i.e. mind altering.