from 14/10/2002 mental health charity Defeatdepression gives it's considered views of the SeroxatUserGroup

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Information - Articles on Medication


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THE SEROXAT (PAXIL) STORY: HAPPY PILLS THAT MAKE YOU MAD??
By Richard Hornsby
Some thirty years ago my father got up early in the morning went to the end of our house, took out a shotgun to his head, and shot himself in a horrific act of self destruction. None of us suspected that he would or could do anything like this. It was unthinkable. On Panorama a story based on the unknown causes of suicide were attributed to Seroxat – a popular antidepressant.
Some thirty years ago my father got up early in the morning went to the end of our house, took out a shotgun to his head, and shot himself in a horrific act of self destruction. None of us suspected that he would or could do anything like this. It was unthinkable. On Panorama a story based on the unknown causes of suicide were attributed to Seroxat – a popular antidepressant. Unfortunately, I have nothing to blame my father’s death on, except a hidden and underlying profound depression he had disguised from us all. I too suffer from depression, and rely on antidepressants to keep things straight. The programme on Seroxat by Panorma raised these life and death issues, and in doing so it deserves more serious scrutiny. What is worrying is that the so called ‘facts’ that were presented if examined more closely are by no means as cut and dry, are perhaps not even true. In the end they may do far more harm than good. The current attack on Seroxat and its manufacturer GlaxoSmithKline is a much more complex story than the rating grabbing stories portrayed by Panorama. It is not simply a story of alleged side effects of Seroxat reported by a minority of patients. It is also about how we have become steeped in a climate of anti-science, anti-psychiatry, and of course anti-pharmaceutical companies who make drugs. All of the above are to blame for innumerable ills – they stand accused of being part of an evil empire that wants to make adults and children alike take horrible mind-bending drugs, with ghastly side effects. These pharmaceutical giants should of course be sued and made to pay for these sins. The victims must be “compensated” – by being rewarded with huge payouts. It is all so simple when you live in a culture of blame, when we are always ready to seek retribution for any side effects we can attribute to medicine. Yet despite this readiness to seek retribution, when anyone of us falls seriously ill, how many of us rush to the naturopath, to the homoeopathist, or to the faith healer – no we run to the NHS and our GP, and we expect the miracles of modern medicine to be freely available as a right. Who makes these medicines that we now take for granted? - why these self same pharmaceutical companies. The sheer folly of this line of pursuit is mind-boggling. Where is the sense in this - the answer is that one has to look outside the realms of science and medical reasoning and into a culture which expects everything without risk of any kind, and ignores the undoubted benefits of modern medicine. In this case the benefits that modern antidepressants have brought to millions of sufferersLet me make it clear - I don’t give a fig about GlaxoSmithKline, its bottom line or anything about the company. What I do know however is that there are vitally important issues at stake in this debate. These should deeply concern anyone who is either depressed, knows someone who is depressed, or works with those with common mental illness – i.e. just about everyone. Depression is a life threatening illness – it is not just a question of getting the blues. People do commit suicide, and real people die from this disease every day. Suicide is the leading cause of death in young people in the US. Where is the story about this tragedy. The programme chose to simply focus on the shock horror story that drugs might be given to children. But children don’t really suffer from depression or mental health problems do they? We all may wish that they did not, but these are not the facts. Of all the cases of suicide in young people, most parents have no idea what is wrong with their child until one day they find them hanging in their bedroom. Few people, adults or children, will let on that they are going to kill themselves if they are serious, because someone might stop them. If any one of these children had been taking an antidepressant, would it not be tempting to place the blame on the drug. Someone, something somewhere has to be blamed. Human nature will shy away from accepting its own inherent frailty. The development of psychotropic drugs to treat depression and other severe mental illnesses has been the single most important advance in helping sufferers. If you consider the nature of the illness, that antidepressants are not as portrayed “happy pills” but vital drugs to treat a deadly disease then things should take on a different light. Many people have died from taking aspirin, been rushed to hospital with breathing problems – yet we all take them. One only has to think of the appalling side effects people willingly put up taking chemotherapy to wonder what this is all about. The previous generation of anti-depressants (Tricyclics as opposed to SSRI’s). helped to relieve depression, but people often found the side effects impossible to cope with. They were the only option, and no-one sued for side effects. Patients now have plenty of other options, and no one forces anyone to take Seroxat. There are plenty of other antidepressants on offer. Perhaps Seroxat has made some people become agitated in the early days of taking the drug, and by doing so make them feel ill and even perhaps act strangely. People who are deeply depressed in fact seldom commit suicide, they are most at risk when they are coming out of their depression, when they have renewed energy. If this is true, and someone commits suicide when recovering from depression who or what is to blame. Perhaps the doctor who should have been more cautious, or perhaps the chronic poor mental health services that exist for people with depression or perhaps no one. It is by no means clear that the blame could be placed on the medication.It is interesting that Panorama should have had to rely almost exclusively on the views of Dr. David Healy, who was heralded as an “expert”. Why did they not seek the advice of other experts. All the experts I know and have talked to about issues surrounding the side effects of antidepressants, most regard David Healy’s views as unscientific and lacking credible evidence. Most psychiatrists and psychiatric researchers in this country believe that these views are deeply flawed. Why were their views not aired? I suspect it was because this show was not really about evidence in the real sense of the word, but about an emotionally charged attack, which did not want the inconvenience of differing views, especially by those eminently more qualified than Dr Healy. I remember over 10 years ago visiting a patient self-help group in the US. A part of this occasion was a group of people called the Survivors of Prozac. They told a series of heartrending and horrific stories. It was scary stuff, and enough to put you off taking Prozac for life. This was indeed the idea. Only later, I discovered that this was a road show putting on appearances all over the US funded by the Church of Scientology. However the views put forward on Panorama by Dr David Healy are shared principally only with Scientologists and other fringe groups. His opinions are widely regarded by experts and fellow academics as wrong, unscientific and lacking any credible evidence.The Royal College of Psychiatry ran a five year Defeat Depression campaign to educate the public about the their misconceptions about treatments especially antidepressants. The campaign found that the majority of the public were prejudiced against people with mental illness and especially the drug treatments they took. Taking antidepressants was regarded as a sign of weakness. After much effort some of the stigma of mental illness has been removed, and the prejudice against using pharmacological treatments is now better understood. What makes me so angry about the Seroxat story and the Panorama spin on the story is that it does nothing but turn the clock back. It does nothing to help those of us who suffer from depression. It is scaremongering and sensation seeking at the expense of the mentally ill. It glossed over and virtually ignored all the evidence that the proper use of antidepressants has saved countless lives.I don’t know anyone who thinks the current generation antidepressants are perfect. Most of us long for the day when better products are discovered. Antidepressants are nevertheless drugs, and as with all drugs there is no such thing as a free lunch. The problem with the fears surrounding Seroxat is that they are not really about Seroxat, they are about stirring up new and unreasonable fears about all antidepressants. If the pharmaceutical industry as a whole could do one thing better it is to help promote a better public understanding of depression and the drugs and other non-pharmacological treatments that are available. Patients and the public must also accept that all drugs carry risks – you only have to read the side effect lists for almost any product. But the more the public knows about the real dangers the more they can take reasoned decisions about which medication they will take. Most of us feel happy to take aspirin even though we know that some people have been killed by them. It is important that all people suffering from depression know that their treatments are not guaranteed, that they will experience some discomfort on the road to recovery, and how to deal with these changes. The right mental health services need to be there to support them. Just giving out a pill will not stop someone who is suicidal from taking their lives, and so where do you place the blame. It is also important to know that antidepressants do not work for everyone, some 30% of people with major depression do not respond at all.The Seroxat claims have all the hallmarks of a classic David and Goliath meltdown. The wronged will deal the evil giant (GSK) such a blow that it will never recover, and the world will be a safer place. It all sounds very emotionally reassuring, especially since we all hate the idea of a company profiting from treating illness. I am however far from convinced that the alleged ‘facts’ stack up. Could it be that it is not the little man fighting for the common good, but in fact a bunch of money hungry lawyers quick to see that they might be on the road to a nice little earner?There is a new group in the UK called the Seroxat Users Group. This of course is not what it is – it is a group of anti-seroxat users, and a trojan horse if ever there was one. The names deliberately disguise their real purpose. “Oh I see, these people represent all the people who take Seroxat” you might reasonably think. Of course they don’t - nothing could be further from the truth, and that’s the trick. Mark Harvey is a solicitor who also represents this self appointed Seroxat Users Group in the UK, and who says that the number of people joining this group is growing daily, rapidly reaching 1,000 members. Last Thursday GSK won a lawsuit in California which had been taken against the company accusing it of wrongly advertising Seroxat as being “non addictive”. The federal judge ruled the case had no merit. The current ruling in California will no doubt be something of a setback to Mr Harvey, and Messrs Hugh James. In the meantime Mr Harvey and others continue to try to get more members to join the Seroxat Users Group.For those of us who have suffered from depression the only thing that matters is effective treatment for people who suffer from depression and related disorders. There have been some 100 million users of Seroxat worldwide. Are all these people suffering from appalling side effects, being driven suicidal? I think not. Most are presumably better, and are getting on with their lives, otherwise we would have heard about it. One can only presume that they have not had pause for thought that this drug did anything awful to them. After the drug has been on the market for nearly ten years a small minority, with a variety of motives, has whipped up a scare mongering drive.No one is against serious investigation into drugs that may have serious side effects, provided they are based on scientifically verifiable facts. It would be a good idea to start out on a level playing field. If GSK were to be found to have acted against the public interest and sued, it would also be fair if it can be proved that if there are those who have knowing misrepresented facts about Seroxat (or any other drug), resulting in public disinformation, then they also can be sued. This might put a brake on people coming up with “facts” that they think could profit them in court.I have no idea if Seroxat is a particularly good antidepressant, I don’t take it – but I know many people who have taken it without complaint. Professor Lewis Wolpert, author of Manic Sadness, feels that it saved his life and is happy to take it for the rest of his days. Most new antidepressants operate in almost exactly the same way. A more serious point which was not even mentioned was that resources and services for people with depression are still woefully inadequate. Mental health is the lowest on the list of health priorities in nearly every country. The preliminary results of the largest study of depression ever undertaken - The European Study of Epidemiology of Mental Disorders –looking at the prevalence and impact of depression and anxiety disorders in Europe were released last week in Barcelona. Less than 20% of individuals with a diagnosis of major depression received any drug therapy during the previous twelve months, despite this being the medically accepted best treatment. This is equivalent to leaving the majority of people with high blood pressure untreated and simply waiting for a stroke. While we need to prevent the incorrect use of anti-depressant drugs, there is a much more urgent need to ensure that all patients who may benefit from effective drug treatment for depression actually receive them. Healy has claimed in the past that people became suicidal when starting taking Prozac, and now apparently they become suicidal when starting or stopping Seroxat. People with depression are always at risk of self harm and suicide – over one million people commit suicide worldwide every year. All psychiatrists know that the reason for prescribing antidepressants is to reduce the likelihood of suicide, and many patients know that they have been often pulled back from the brink by the proper use of these drugs. As someone who got perilously close to that brink, I and many other sufferers know this to be true. It is perhaps telling that Panorama should have resorted to discredited sources for their information. They have largely ignored the experts, among whom I would suggest are the majority of patients, not a few isolated cases in which complex issues make blame almost impossible. This programme does not serve those it claims to speak for, it has merely exploited some difficult and painful cases, and made a monster out of clay. We can only hope the public will not fall for this sort of clever but irresponsible journalism – it may get the ratings up, but in trying to scare us it threatens the health of many people with depression. One can only hope that real scientists and real experts are allowed to put the facts into a sensible perspective