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Monday, 31 January 2011

NHS could already have saved £1,072 billion - but where was the therapy?

If you had read it you would know that I have not only studied the ever increasing SSRI, SNRI prescribing trends - but also the costs of those prescriptions over the same period and what has influenced those.

It highlights the fact that the "Report of the CSM Expert Working Group on the Safety of Selective Serotonin Reuptake Inhibitors (SSRIs)" published December 2004 and "House of Commons, Health Committee's examination into The Influence of the Pharmaceutical Industry" April 2005 caused an anomaly in prescribing trends.

It also shows that the Government appears to have used the two reports to force the net cost of the drugs down far beyond what would be expected by end of license reductions. Since 2004, when SSRI, SNRI drug class annual net costs peaked at £355.4 m, the net costs have reduced to a 2009 low of £187.5 despite annual total prescriptions increasing from 18.4 m to 26.9 m over the same period . the lowest annual total net cost since 1998/9 when only 9.9 m prescriptions were issued.

So the government did clamp down on the industry but to what cost . on one hand - letting another insidious class of drugs, Statins, to be sold as OTC drugs for one introducing stringent monitoring for mental health and anti social behaviour prognosis problems in pregnant women, mothers and babies lining up the next generation of prospective MH patients for another and probably a whole myriad of other things they have sneaked through!

On the other hand it makes it harder to complain to government officials that the pharmaceutical companies have it all their own way or to complain that the government have not acted responsibly or in the best interest of the NHS and the population although since the price reductions began they seem to have completely ignored the CSM Expert Working Groups report which found ALL drugs in the class lacking in efficacy and safety.

You seem to be very concerned about there being no money for alternative therapies and supplements . so what about this lack of funding and those SSRI, SNRI price reductions and the substantial savings the government have made since 2004

In 2009 the 26.9 m SSRI, SNRI prescriptions total net cost was £187.5 m, a median average net cost per prescription of £6.69.

26.9 m SSRI, SNRI prescriptions at the peak 2004 price of £355.4 m, equates to a median average net cost per prescription of £13.19 showing a projected saving for the period 2004/5 to 2009 excluding accrued 10% inflation of £662.58 m.

26.9 m SSRI, SNRI prescriptions at the peak 2004 median average net cost per prescription of £19.23 would have cost £518.12 m and shows a projected saving 2004/5 to 2009 of £1,072 billion.

The UK Government cannot refute their own information, facts and figures and I would love to know why the government have not used at least some of these saving to put in place the alternative therapies recommended in the "NICE Clinical Guidelines 23: Depression" published December 2004 as I'm sure you would.

extracted from -

Hugh James Solicitors focused on Seroxat which was NOT the WORST drug in class

"It is noteworthy however that the original MHRA, EMEA and FDA investigations of SSRIs arose as a direct result of the focus on Seroxat and Paxil by the litigators both here and in the US and the media. That focus has highlighted the class issue."

SEROXAT suicide (young adults) lower than active comparator

Suicide, suicidal thoughts and self-harm

5.2.2 The Group was informed that the MAH has conducted further analysis of their clinical trials data to examine:

5.2.4 The Group commented that this was contrary to the data from clinical trials where paroxetine was compared with an active comparator. In these studies the incidence of suicide-related events in young adults treated with paroxetine was lower than that in the active comparator group, but this was not sufficiently reassuring given that this may indicate that the problem may be worse with other active comparators. The Group commented that it would be important to obtain data on efficacy of paroxetine in young adults.

Hugh James has to show drug is worst of comparator class

Thank you for this.

"The Seroxat Group Action does not involve suicide issues; only discontinuation where Seroxat is the worst of the comparator treatments   "

Seroxat Group Action does not involve suicide issues - Mark Harvey said

From: Mark Harvey

Date: 06/02/2008 13:26:15

To: Jeremy Bryce

Subject: RE: ' Implementation of warnings on suicidal thoughts and behaviour in antidepressants' ..................source MHRA

Thank you for this.

The Seroxat Group Action does not involve suicide issues; only discontinuation where Seroxat is the worst of the comparator treatments."

We found some time ago that there was a Class Phenomenon for suicidal ideation and acts which meant that, together with other notable problems both in science and in law, successful litigation was unlikely. That was a decision I had to make irrespective of my personal concerns about these drugs and their links with suicidal ideation. It is noteworthy however that the original MHRA, EMEA and FDA investigations of SSRIs arose as a direct result of the focus on Seroxat and Paxil by the litigators both here and in the US and the media. That focus has highlighted the class issue.

NHS therapy to replace antidepressant reliance - Sunday Times 30 Jan 2011

It *could* just be coincidence

It *could* just be coincidence

Hypothesis: a decent knowledge of mathematics reveals that correlation is not causation, that most coincidences actually are the result of chance

Visit xkcd, a webcomic of romance, sarcasm, math and language.

ANTI VAX march a massive success - just like the PAXILPROTEST

Anti Vax march a massive success

As you can see from this photo, the anti-vaccination march in Edinburgh today has been a massive success.

If you can't spot it, the protest is behind the bloke in the brown jacket.

(Thanks to @endless_psych for the photo) 12 December 2009

Dystonia from a flu vaccine? ...... hoax

The movements and symptoms that Ms. Jennings displays on the public videos I have seen (linked to above) are not compatible with the diagnosis of dystonia, or any other movement disorder. Dystonia is one type of involuntary contraction of muscles. It can be reduced or exacerbated by certain movements or positions, and there are "task specific" dystonia, such as writer's cramp, that come out only with certain activity. Jennings does not display the type of movements that are consistent with dystonia. Her speech and movement are, however, very suggestive of a psychogenic disorder.

This also seems to be the consensus opinion of experts who have viewed this case. The Dystonia Medical Research Foundation had this to say about the case:

Because of the concern of individuals with dystonia as to whether or not to get a flu shot because of this reported case, we have sought the opinion of dystonia experts on this case. Based on the footage that has been shared with the public, it is their unanimous consensus that this case does not appear to be dystonia.

The one news report that I saw that actually consulted an expert for their opinion was Fox News. Leigh Vinocur, and emergency room physician, was interviewed and relayed the opinion that the neurologists she consulted were of the opinion that Jennings' symptoms were consistent with a psychogenic disorder. In other words - her symptoms are not neurological, they are psychological. This does not mean she has any insight or voluntary control over her symptoms - they are involuntary and "real" - just not neurological in origin. Symptoms such as this are not uncommon reactions to emotional stress in some individuals. Given the evidence presented, I think this is a reasonable opinion.
read on

Sunday, 30 January 2011

MMR - no thimerosal in MMR

Class actions - no scrutiny of pharmaceutical companies by UK courts in the last 15 years

"There has been no scrutiny of pharmaceutical companies by UK courts in the last 15 years," said Beth Reay, one of the lawyers at Irwin Mitchell representing the families. "If you look at group actions that have been brought, they have come to an end not because the judge has said they lack merit, but because of funding constraints."

Families devastated after legal aid withdrawn for birth defects caseParents say epilepsy drugs containing a controversial anti-convulsant are to blame for disabilities

Share34 Afua Hirsch, legal affairs correspondent, Friday 28 January 2011 19.57 GMT Article history

Karen Buck and her daughter Bridget, 12, outside the law courts in London. Campaigners believe hundreds of children suffered birth defects as a result of drugs such as Epilim. Photograph: Graham Turner for the Guardian

When Samantha Scott wanted to have a baby, she consulted her neurologist about whether it was safe. She has epilepsy and was concerned that her medication, Epilim, could be unsafe in pregnancy.

"The doctors said it was fine," said Scott, 31, from Cumbria. "In fact, they upped my dose."

But Scott's daughter Faith was born with an extra digit, a cleft palate, a hole in the heart, and no muscle tone. Now aged seven, Faith has a mental age of two and weighs only two stone (13kg). She has spent most of her life so far in hospital.

Faith is one of hundreds of children campaigners believe suffered birth defects as a result of drugs such as Epilim, which contain a controversial anti-convulsant called sodium valproate.

"We have 624 children on our books from these drugs and 351 are from mothers who were taking Epilim," said Janet Williams, secretary of OACS, the organisation for anti-convulsant syndromes. "That is nowhere near the figure for the total number of children out there who are actually affected."

Six years ago, Sheffield-based lawyers at the national law firm Irwin Mitchell began a legal action against Sanofi Aventis, the manufacturer of Epilim, on behalf of 164 children whose mothers say they suffered birth defects because the drug was taken during pregnancy.

The case was publicly funded by legal aid through the Legal Services Commission, and the lawyers say they have evidence proving Sanofi is responsible for the injuries, and is liable to pay compensation.

But in November, six weeks before the trial was due to start, the LSC announced it was withdrawing funding. Today, the families attended the Law Courts in London to hear the LSC confirm its intention before Mr Justice Eady, although formal termination of the case was adjourned until May.

"Our clients are understandably devastated that their case will never be heard in court after six years of preparation for trial," said David Body, a partner at Irwin Mitchell who was representing the families. "This is exactly the kind of wide public interest case the LSC should be funding … now it will never come to court."

In a statement defending its decision, the LSC said that it had "great sympathy" with the families, but that its legal experts had advised against backing the case any further. "We have great sympathy with those who claim to have had adverse effects in connection with this medication, but our funding decisions must always be based on solid legal grounds."

Legal aid funding, already only available in a small number of personal injury cases, could be removed altogether under proposals currently being considered.

But claimants say the growing impossibility of funding cases such as the Epilim action is leaving pharmaceutical companies increasingly unaccountable.

Sanofi denies all liability for the birth defects that the families say are caused by Epilim, but in a similar class action brought against one of its affiliate companies in the US, it has settled, leading to calls for a review of UK law. More than 70 MPs have signed an early day motion about the case

"Four major drug companies have gone through the litigation and never gone to court," said Janet Stock-Pollard, who has two children that suffered birth defects after she took Epilim during her pregnancies. "The law appears to protect the drug company and not the consumer."

Emma Friedmann, whose son Andy is 12 years old with a mental age of three and is one of the claimants in the UK case, says that the lack of legal aid funding denies vulnerable people access to justice.

"Andy has been damaged for life, and he's not allowed his claim to be heard in court," she said. "Everyone who uses pharmaceutical products is less safe because of this. If you take a product and you or your dependants have a problem with it, you will not be successful in court."

"There has been no scrutiny of pharmaceutical companies by UK courts in the last 15 years," said Beth Reay, one of the lawyers at Irwin Mitchell representing the families. "If you look at group actions that have been brought, they have come to an end not because the judge has said they lack merit, but because of funding constraints."

"This case demonstrates most starkly where you have inequality between claimant and vastly well funded defendant," said Linda Lee, president of the Law Society. "Defendants are able to throw money at the case to stop it getting near court.""The settlement in the American case has been reached on a confidential basis, so we don't know exactly what was agreed," said Body. "But my guess is that because in the US it would have been tried in front of a jury, the pharmaceutical company there was more likely to settle."

Epilim litigants could face costs order?

End to epilepsy drug action delayed

By Cathy Gordon, PA 28 January 2011

A move to discontinue legal action brought by families who blame an epilepsy drug for causing defects in their children suffered a delay today.

Claims by more than 150 families were expected to be formally discontinued at a hearing before a judge at the High Court in London.

But Mr Justice Eady was told that a “difficulty” had arisen which meant that the proceedings would have to be adjourned.

Lawyers representing the families had earlier announced they had been forced to abandon the trial of the action following the withdrawal of legal aid.

The Legal Services Commission (LSC) said in November it was no longer funding an action against the makers of sodium valproate, a drug used to prevent epileptic seizures.

Claimants allege that the drug, also known as Epilim, caused a range of birth defects, including spina bifida, damage to the heart, learning difficulties, cleft palate and deformities of the hands and feet.

They have been pursuing a legal action for damages against manufacturer sanofi-aventis, claiming there were inadequate warnings about possible harm in the 1990s.

The firm has denied the claims, saying it has always provided appropriate precautions and warnings on the risks associated with possible side-effects of the medicine.

The plan for today was for lawyers for the families to advise the judge that the case against the manufacturers must be discontinued because continuing without legal aid funding would place their clients at “too great a financial risk”.

But the proceedings were adjourned for clarification to be sought relating to the terms of a proposed final order in the case.

Mr Justice Eady heard that the defendant would be taking instructions from representatives in France relating to one part of the order – that concerning the circumstances in which it would seek to enforce costs at any time in the future.

The court heard that there may have to be further consultation with all of the claimants by their lawyers to explain the situation to them with regard to the costs implications – a process which could take three months.

A further hearing is now expected to take place at the High Court in May.

Announcing the move to discontinue recently, solicitors Irwin Mitchell said their clients were “devastated” that their case would never be heard in court after six years of preparation for trial.

Despite the fact that the legal action has had to be dropped, families have vowed to continue their campaign.

A Legal Services Commission spokesman said: “Following advice from counsel, the Legal Services Commission has withdrawn legal aid funding for the multi-party action claim against the makers of the drug Epilim.

“Before making the decision, LSC had to await the exchange of evidence and the provision of comprehensive opinions from counsel – this process was only completed by the solicitors in late October.

“The claimants then exercised their right to appeal to a panel of lawyers who are independent of the LSC. This panel upheld the decision to withdraw funding.

“We have great sympathy with those who claim to have had adverse effects in connection with this medication, but our funding decisions must always be based on solid legal grounds.”

Saturday, 29 January 2011

Sertraline / Zoloft / Lustral - Pfizer had judged that there was a causal relationship between sertraline and suicidal events

CSM EWG 3rd meeting - June 20 2003

7.3 SSRIs and suicide 7.3.1 Dr Healy presented data on fluoxetine and suicide and suicidal acts from clinical trials which showed no apparent difference in the percentage of suicides and suicidal acts between fluoxetine and ‘comparator’ when ‘comparator’ included all the times the patients were not on fluoxetine. However an apparent increase in the percentage of suicides and suicidal acts with fluoxetine was seen when ‘washout/run in’ and ‘other’ periods were excluded from the ‘comparator’ group.

7.3.2 Dr Healy believed that because patients may be at greater risk of suicide on starting and stopping treatment it was more appropriate to consider absolute numbers of events rather than present data using patient exposure years. Dr Healy also considered that it was important to take dose-response data into account.

7.3.3 Dr Healy presented further data on paroxetine and sertraline from clinical trials which also suggested an increase in the percentage of suicides and suicidal acts with paroxetine and sertraline compared with placebo when the washout/run in periods were separated from the comparator group in the analysis.

7.3.4 Dr Healy reported that Pfizer had judged that there was a causal relationship between sertraline and suicidal events in a number of cases in their clinical trials. He was unable present these data in full at the meeting as the data were confidential.

7.3.5 Dr Healy also presented data on citalopram and venlafaxine which showed an apparent increase in percentage of suicide and suicidal acts with these drugs compared with placebo. He said that combined data on all SSRIs also suggested an increase in percentage of suicide and suicidal acts with all SSRIs compared with placebo.

7.3.6 Dr Healy finished his presentation by stating that in his view there is now enough evidence to show that SSRIs may be causally associated with suicide and that patients would be helped by better product information.

Efexor (Venlafaxine) - Red/Amber - Specialist Medicine

The Amber list is an advisory list where it is considered by the Regional Group, that responsibility for prescribing may be transferred from secondary to primary care when agreed shared care arrangements have been established. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.

source -

Definition of a Specialist Medicine - Red/Amber List

Definition of a Specialist Medicine

For the purposes of development of the Red/Amber list, a specialist medicine is defined as a medicine, which has significant pharmacological complexity and/or rarity of use to make the prescribing of the medicine relatively uncommon in the community. Patients for whom complex medicines are prescribed, may have particular complex monitoring requirements, which require specialist knowledge for the appropriate interpretation of results. In such circumstances, due consideration needs to be given to the settings and knowledge required by the professional to undertake the prescribing, monitoring and supply of the medicine, in order to ensure high quality patient care.

Red List The Red list is an advisory list where it is considered by the Regional Group, that responsibility for prescribing should remain with the consultant or specialist clinician. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy.

Amber List

The Amber list is an advisory list where it is considered by the Regional Group, that responsibility for prescribing may be transferred from secondary to primary care when agreed shared care arrangements have been established. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties. Appendix 1 provides an example of a template for development of a shared care guideline for Amber listed medicines. A shared care guideline details the respective clinical responsibilities of both parties. It is recommended that the development of a regional guideline for specific medicines or therapeutic group of medicines be facilitated by the Interface Pharmacist Network Specialist Medicines and developed in collaboration with consultants, GPs and others. Following endorsement by the Regional Group, the guidance could be adapted for local use with implementation being brought forward at local level through the Area Prescribing Forum in liaison with the Interface Pharmacist Network Specialist Medicines. A repository of regional guidelines will be held on the IPNSM website.

Amber Sub Group

Medicines which fall under this category, while not falling within the definition of a ‘specialist medicine’, may cause particular monitoring difficulties for GPs. Individual Boards should have local flexibility in deciding whether these require a shared care agreement.

Friday, 28 January 2011

Nurses Drug Handbook 2010

Pages 775 and 777

Take a look at this, read it, digest it and then tell me there is no warning about over rapid withdrawal

Nurses Drug Handbook 2010

Is SEROXAT the worst SSRI - The Evidence is clear that it is not !

:-Does Seroxat have a capacity to cause asverse effects consequent upon or following discontinuance (withdrawl) such as prevent or make more difficult the ability of users to discontinue, withdraw from or remain free from taking Seroxat to a greater extent than all other Selective Serotonin Re-uptake Inhibitors (SSRIs)
No matter how he tried to ORCHESTRATE it, the truth is, that this was a transparent scam from the outset

Venlafaxine suicides alone = total of the rest of the entire SSRI class !

Clinical trials - A Godsend, Till a Life Unravels - Traci Johnson - duloxetine

A Godsend, Till a Life Unravels

Traci Johnson joined a clinical trial of an antidepressant to pay for college. The devout woman ended up taking her own life

INDIANAPOLIS — Traci Johnson believed it was God's plan for her to leave home to attend a tiny Bible college here — and she prayed every day for the Lord to provide for her tuition.

Then an unusual opportunity presented itself.

Eli Lilly & Co., the pharmaceutical giant headquartered a few miles from Indiana Bible College, was seeking healthy subjects for a live-in clinical drug trial. The 19-year-old freshman told her friends back home in Pennsylvania that the study was her best hope to stay in school.

"Trace, that don't sound right," her friend Colleen Jacoby told her. "I never heard of a human guinea pig."

But the students at the Bible college knew all about the trials. They made perfect subjects for studies requiring healthy people — and they were used often, receiving hundreds, even thousands of dollars for a few weeks work.

If accepted into the study, she could make $150 a day for 49 days — more than a year's worth of her school expenses — for taking a drug known as duloxetine, an antidepressant that had already been given to thousands of people and was on the verge of approval by the Food and Drug Administration.

She had faith that God would find a way. "It was in his hands," she wrote in her diary.

Just before the new semester, a Lilly representative called. Her prayers were answered.

A month later, she was dead.


Indiana Bible College is on the outskirts of Indianapolis, in a former hospital. With 260 students, it is a tight-knit community of Pentecostals. TV is banned and girls are required to wear long skirts. It's not unusual to see students drop their knapsacks and form an impromptu circle, praying for a sick aunt or alcoholic cousin.

For Johnson it was a sanctuary.

She grew up in blue-collar Bensalem, Pa., but the center of her childhood was a Pentacostal church in a rough Philadelphia neighborhood. Every Wednesday morning, she walked with the pastor past bars and discount stores canopied by train tracks. They huddled around prostitutes and drug addicts. She prayed so hard for them that tears rolled down her cheeks.

Then last summer, she announced that the Lord had told her to attend Bible school.

"She just went wherever the Lord was leading her," said Kathy DePalma, who ran the Christian day-care center where Johnson had worked.

When friends came to visit in Indianapolis, Johnson chattered about the college's football team, her new church and the young men who had caught her eye.

"I think my highest want right now is the person who Jesus wants me with," she noted in her diary soon after starting school, "someone I can pray with."

In a school essay, she envisioned herself as a preacher's wife, raising her children and sitting in the first pew of church.

All she needed was $3,470 a semester. She had arrived with little money, and her father had recently lost his job as a machinist.

"I REALLY REALLY REALLY need you to open a way for me to pay my bill," she wrote to God in her diary. "Please provide a way."

One Final Trial

A few miles from the Bible college, the neon logo of Eli Lilly glows atop the company's headquarters in south Indianapolis.

In 1972, a Lilly biochemist discovered that a patented chemical, fluoxetine, enhanced the action of the brain chemical serotonin, which affects mood. More testing showed the chemical could dissolve feelings of despair and sadness.

The FDA approved the drug, Prozac, in 1987 and since then, sales have totaled more than $21 billion. But by the late 1990s, the patent on Prozac was about to expire, and the company needed a sequel. Lilly began looking at duloxetine, a patented agent that not only affects serotonin, like Prozac, but also norepinephrine, another brain chemical.

Duloxetine had been shelved in the early 1990s, in part because low doses had no effect on depression. But higher doses, Lilly scientists discovered, relieved depression at least as well as Prozac. Subsequent testing proved the drug also curbed stress-related urinary incontinence.

By 2003 Lilly had a trade name, Cymbalta, and industry analysts were projecting sales of $2.5 billion a year for depression alone, a figure rivaling the high-water mark for Prozac.

The drug already had been tested in 8,500 people, but the FDA wanted one last clinical trial to measure its effect on heart rhythm. It would use doses as much as up to five times that recommended for incontinence, and six times the dose for depression.

Lilly needed 100 healthy females between 18 and 75 (women are more prone to incontinence) for seven weeks.

The inventors of Prozac had their sequel. They just had to complete one last trial.

A Great Fundraiser

Lilly's human test clinic, located at the University of Indiana Medical Center, is a resort-like facility with a library, rooftop sundeck and a panoramic view of downtown. "I felt I was on a mini-vacation," reads one testimonial on the clinic's website.

The site touts the drug trials as a great way for schools, churches and community organizations to raise money.

There are hundreds of similar test centers around the country, many of them near college campuses because of the ready supply of students looking for part-time work.

Healthy subjects, free of the ailment for which the drug is designed, are typically used to measure a drug's side effects and health risks. By the time a drug has reached this stage, it has been extensively tested in animals, and the risk of death is considered minimal.

"My test was for a medicine for schizophrenia," said Nasri Ashkar, a 21-year-old senior at Indiana Bible College.

The medicine made him itchy, but "it wasn't a bad experience at all," he said.

Another classmate, 22-year-old Gary Parks, said he had applied to nearly two dozen studies at the clinic and participated in nine. Ticking them off, he quickly lost track: "Something to prevent the spread of cancer … a diabetes one."

Parks made $2,600 in the diabetes study for a week of work, although he recalled that "everybody was throwing up."

Nausea, Parks concluded, was just part of the job.

Before every trial, a Lilly official explained the risks and asked him to sign a consent form, a legal document which protects both the subject and the company. It entitles participants to medical care for health problems arising from the trial, allows them to leave the study at any time and warns of the danger of withholding information from researchers.

Parks said the worst risk he ever heard of during a drug trial was the possibility of fainting from low blood sugar. He wasn't worried. "They have I.V.'s," Parks said, referring to intravenous fluids. "They can bring you back."

Enough students joined the Lilly trials over the years that they became a routine way of making money, like delivering pizzas or parking cars. That worried some members of the Cavalry Tabernacle Church, which all the students attended.

At a dinner with students, one woman told them that "your body is the temple of the Holy Ghost."

The Rev. Paul Mooney, who heads the college and the church, said participating in a Lilly trial was just for "raising pocket money." He said he neither encouraged nor discouraged students from taking part in such trials.

"We're not talking about illegal drugs," Mooney said. "And these programs are very well monitored by the government and so forth, and they have all kinds of guidelines."

An Overdose at 15

Johnson seemed like a good candidate for the duloxetine trial. At 5-foot-4 and 130 pounds, she was physically fit and, by all accounts, reliable and upbeat.

But during her interview, she told screeners that when she was 15, she had landed in the emergency room after overdosing on Tylenol pills and had to have her stomach cleared, according to a psychiatrist studying duloxetine who has read a report on Johnson's case. The doctor spoke on condition of anonymity because the information was considered confidential.

A family friend said the overdose occurred after Johnson's first boyfriend broke up with her, and involved a cholesterol-lowering medication used by her father, not Tylenol.

Johnson denied to screeners she was suicidal then or depressed now, the psychiatrist said.

The researchers accepted her in the study, which was conducted at several sites across the country.

Then they presented her with a consent form that listed side effects common in previous duloxetine trials, including insomnia, nervousness and anxiety. It also noted rarer effects, such as fainting and an occasional feeling of indifference.

She signed the form.

At the time, a controversy was brewing over antidepressants that affect serotonin.

Six months before the trial began, drug maker GlaxoSmithKline sent a letter to doctors in England warning that its drug Seroxat (known as Paxil in the United States) should not be prescribed to people under 18. It reported that in its own pediatric trial, subjects reported side effects including "crying, mood fluctuations, self-harm, suicidal thoughts and attempted suicide" when they stopped taking the drug.

Two months later, drug maker Wyeth cautioned U.S. doctors that its drug Effexor — the FDA-approved antidepressant most similar to duloxetine — increased the risk in teenagers of "suicide-related adverse events such as suicidal thoughts and self-harm."

In December, British health officials effectively banned the use of most antidepressants in children and teens.

Lilly's chief medical officer, Dr. Alan Breier, said in an interview that the company was confident that duloxetine was safe. Previous trials did not reveal a statistically significant number of suicides, Breier said.

The trial's overseers agreed. Dr. Rafat Abonour, head of the University of Indiana board that approved the duloxetine protocol, said he did not recall that suicide was ever mentioned during the review process.

Five suicides had occurred among 4,124 depressed subjects in studies of the drug. One subject had taken only a placebo. In a recent study of about 1,000 depressed people taking duloxetine for up to a year, seven people attempted suicide and seven others reported that they'd thought seriously about it.

Breier said that was less than would be expected in a group of depressed patients. The annual suicide rate in the general population is about one in 10,000. The risk in people diagnosed with depression can be 10 to 30 times higher.

Lilly spokesman David Shaffer said that because data did not link duloxetine to suicide, a history of depression — even a past suicide attempt — would not necessarily disqualify somebody from the trial.

Several people in the trial had struggled with moodiness and despair.

Yullan Valor, a freelance product consultant, was among about two dozen subjects who took part in the duloxetine trial at California Clinical Trials in Glendale. She said screeners seemed interested only in depression suffered during the last seven years. She said they did not ask for details about the depression she said she suffered two decades ago — and so never learned that she had once called a suicide hotline for counseling.

Tatiana Sikic, another participant, didn't tell screeners that five years ago she cut her wrists and took some pills in an attempt to kill herself.

All she said was that she had a history of depression.

"I really needed to be in the study," said Sikic, who was out of work at the time. "And I felt fine."

A Host of Odd Reactions

On Jan. 10, Johnson, along with the Bible college's secretary and another student, entered the enclosed world of Lilly's clinical drug trial.

The experience blends dorm living and medical quarantine. Subjects share meals and TV time, opinions and life stories, forming a makeshift community.

In this study, subjects took duloxetine twice a day. At regular intervals, the medical staff took blood samples and checked heart rhythms.

Each participant took the drug for 20 days: 16 days working up to a dose of 400 milligrams of duloxetine, followed by a four-day weaning period in which the dosage dropped to zero. For the rest of the study, they were given a placebo.

Almost everyone had some odd reaction to the drug. Some could not sleep. Others could not get out of bed. There was constant bickering.

One woman at the Glendale site said she was stunned when she felt an overwhelming urge to run over her husband with the family car as he walked past. Some subjects cut in front of Alzheimer's patients for use of coveted VCRs.

"It was turning into a madhouse," said 38-year-old Carmellia Wright, an actress. "Every minute someone was breaking down crying or laughing."

Two weeks into the experiment, Johnson dropped out of school. Even though she could leave the clinic, she was missing classes and skipped the funeral of her grandfather.

Still, she found time to socialize. And there was a young man, a sophomore, a Christian. "I LOVE his love for you," she wrote to God about the boy in her diary. "God, please work it out."

They quarreled, but on Jan. 28 — a day when she took the maximum 400-milligram dose of duloxetine — they went on a date and parted with a kiss. "So yeah talking about DRAMA!!" she wrote in her diary.

She took 240 milligrams the next day, beginning a withdrawal period when brain chemicals can swing wildly. On Feb. 3, Johnson took 120 milligrams of duloxetine before starting on the placebo.

She seemed fine and baby-sat three nights later, telling one mother she couldn't wait to get back to school. She talked with friends back home and was anxious to be there for the delivery of her sister's baby.

At 3 p.m. the next day she spoke by phone with John Crompton, a church friend from Philadelphia, and told him she felt sick and needed to rest.

Sometime in the next few hours, the young woman took the multicolored scarf that she wore around her waist and looped it around her neck. She tied the other end to a shower rod.

And there she hung, feet dangling close to the floor, until a nurse found her body shortly after 8:30 p.m.

Reassuring Stockholders

The Rev. Joel Barnaby, Johnson's pastor back home in Pennsylvania, broke the news to her parents in their living room.

Reporters barraged Lilly with questions.

At one of the trial sites, in Evansville, Ind., directors shut down the study, sending home all 16 subjects, according to a Lilly spokesman. But enough people remained in the study to ensure the trial was still scientifically valid, the spokesman said.

Lilly assured stockholders that the suicide would not delay the drug's release later this year. The company also reported Johnson's earlier pill-swallowing episode to the FDA and the scientists who were studying duloxetine for Lilly.

While company officials declined to comment in detail on Johnson's death, they said they did not believe the duloxetine contributed to it — and that the reasons behind her suicide were a mystery. She left no note.

At the Glendale test site, clinic staffers tried to ease worries by telling subjects that Johnson had tried to commit suicide before, and that problems with money and other matters had pushed her over the brink, several subjects said.

"The psychiatrist told me that she had a history of depression and that she had just broken up with her boyfriend," Wright said.

Lilly asked test subjects to sign new consent forms and started daily psychological evaluations. It also doubled the weaning period from the drug to eight days. The new forms disclosed the suicide, saying that "at this point the sponsor believes that this event was not caused by duloxetine or the study."

Most of the Glendale subjects stayed in the trial, but they were infuriated to discover in an online news article that they were being paid less than their counterparts in Indiana.

To quell revolt, the clinic raised their pay to match the $150 a day in Indiana.

Convergence of Beliefs

Those closest to Traci Johnson blame her death on the drug — and the lure of money.

"This is a terrible spiritual breach of Christian ethics," Barnaby said. "Christians should never have to experiment with psychotropic medicine as a means to make money."

Johnson believed that faith would protect her — faith that God had led her down a path to $7,000, that other people at the Bible college wouldn't participate in an unsafe study, that a company as huge as Eli Lilly would not let anything happen to her.

Lilly officials believed that their data ruled out a link between duloxetine and suicide, and that it wasn't necessary to tell subjects about the suicide controversy.

Even after studies of antidepressants involving thousands of people, the debate over their risk still rages.

Most psychiatrists say antidepressants are more likely to prevent suicide than trigger it. "Looking at the analysis the British regulators did, I see no significant difference between the drugs and placebo when it comes to suicide risk," said Dr. David Brent, a psychia- trist at the University of Pittsburgh who studies suicide prevention.

But some researchers point out that suicide is inherently difficult to study. It occurs too rarely to provide reliable data, and too many factors, often deeply personal, can spark a plunge into depression.

They say Lilly would have to conduct a thorough investigation of each suicide during the duloxetine trials to determine whether the drug was involved. Company officials, who knew few details about the previous suicides, said they now plan to study all six deaths.

The concerns over antidepressants were already serious enough that on March 22 the FDA warned that some patients could become suicidal when they first started antidepressants or during withdrawal. The agency urged the makers of 10 drugs currently on the market to include labels alerting doctors and consumers to danger signs such as anxiety, hostility and agitation in patients of all ages.

The FDA is still reviewing duloxetine. If the drug wins approval, regulators will likely advise that it, too, carry the warning.

Painful Questions

On a blustery day in February, 17 students rode a bus from Indiana to Pennsylvania with Pastor Mooney for Johnson's funeral.

Among them was the young man from the Bible college who Johnson had been dating. He has refused to talk about her death. The night she died, he had been scheduled to join an unrelated study at the Lilly clinic.

He never showed up.

More than 300 mourners gathered at her old church. "Traci Johnson died last Saturday night, by no fault of her own," Barnaby said from the pulpit.

The worshipers could not reconcile their memories of Johnson with her suicide. "I was surprised because she had the Holy Spirit," said Ernest Copple, 79, an official at the Indiana church Sunday school.

To fathom the possibility that Johnson freely chose suicide would be to challenge the very foundations of her faith. She would never forsake God's most precious gift.

"We know if you take your own life, you don't go to heaven," said Jacoby, her friend from home. "We wouldn't do that."

The day after the suicide, Pastor Mooney invited Dr. Michael Turek, the top Lilly investigator in the Indianapolis duloxetine trial, to church. Students who attended said Turek expressed Lilly's sympathy and answered questions.

One student asked if they should still participate in trials.

That, Turek replied, was up to them.

GSK Clinical trials - Healthy Volunteers - recruiting healthy males and females aged between 18-60

We are recruiting healthy males and females aged between 18-60 onto our panel to take part in a range of phase 1, 2 and experimental medicines trials.

You will be paid Compensation for time and inconvenience varies depending on the study but could be between £200 and £2000.

Reasonable travel expenses are also paid.

We recruit non smoking, healthy volunteers with BMI in the range 18-30 (not over or under weight) throughout the year.


Thursday, 27 January 2011

Efexor (venlafaxine) suicides 8x times greater than Seroxat

Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose

Keith Hawton, Helen Bergen, Sue Simkin, Jayne Cooper, Keith Waters, David Gunnell

and Navneet Kapur
The British Journal of Psychiatry (2010)
196, 354–358. doi: 10.1192/bjp.bp.109.070219

Seroxat liars - how many must die because of your actions?

"Jofre says although problems with whole class of antidepressants we (bbc) decided to concentrate on Seroxat Why we narrowed down on Seroxat 1 because it was made by GSK 2 all the drugs in class cause suicidal thinking on dose change 3 Seroxat had a unique problem of withdrawal BECAUSE IT WAS LONGER ACTING … we decided to focus research into this drug ...."

Citalopram suicides 5x times greater than Seroxat - largest selling SSRI becomes most lethal

Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose

Keith Hawton, Helen Bergen, Sue Simkin, Jayne Cooper, Keith Waters, David Gunnell
and Navneet Kapur

The British Journal of Psychiatry (2010)

196, 354–358. doi: 10.1192/bjp.bp.109.070219

Seroxat worked for Fiddaman - they masked his illness !

They [Seroxat] worked for me… if masking the illness and losing all empathy is working.

You want to try getting off them. It took me 18 months to taper slowly from 40mg per day to 22mg per day.

click image to enlarge

check out original url

SSRI patients put at risk by Prozac lawyers secret deals

Hide and Secrets in Louisville

from The Moral Compass of the American Lawyer

by Richard Zitrin & Carol M. Langford

Ballantine Books, 1999

This story is not about Prozac, which from the weight of evidence appears to be a relatively safe drug. Rather, this is a tale of what happens when secret settlements are taken to their illogical extreme -- in this case, a "sham" trial in which the plaintiffs and their lawyers were paid to pull their punches so the defendant could get a favorable verdict.

It started in September 1989, when Joseph Wesbecker armed himself with an AK-47, walked into the Louisville printing plant where he had worked, and started shooting. He killed eight people, wounded twelve more, and finished matters by blowing his own brains out. One month before, Wesbecker had begun taking Prozac. The lawyers for the shooting victims soon focused on the drug as the cause for Wesbecker's extraordinary violence, and they targeted Eli Lilly, Prozac's manufacturer, as the "deep pocket."

The Fentress case, named for one of Wesbecker's victims, was the first of 160 cases pending against Prozac to go to trial in the autumn of 1994. By then, Prozac had become the aspirin of anti-depressants -- the wonder drug everyone was talking about and millions were using. Prozac represented almost one-third of all Lilly sales in 1994 -- $1.7 billion. A great deal was at stake: If Lilly lost, other plaintiffs waiting in the wings would gain strength and resolve. But a verdict for the drug company might make those other plaintiffs reconsider.

Throughout the case, plaintiffs' attorneys pushed Judge John Potter to allow evidence about another Lilly product, the anti-inflammatory drug Oraflex, which had been taken off the market in 1982 as too dangerous. In 1985, Lilly had pled guilty to 25 criminal counts of failing to report adverse reactions to Oraflex, including four deaths, to the Food & Drug Administration. Central to the plaintiffs's claims was that Lilly had done the same thing with Prozac. Potter refused to allow the evidence, saying it was marginally relevant at best, and would prejudice the jury more than it would prove anything.

But when Lilly executives testified that the company had an excellent reputation for reporting problem incidents -- what they euphemistically called "adverse events" -- plaintiffs' counsel immediately renewed their request to bring in the Oraflex evidence. Potter agreed, noting that "Lilly has injected the issue into the trial." Potter's ruling set off a flurry of activity around his courtroom. The lawyers jointly asked for a recess, and then asked to adjourn for a day.

By mid-afternoon, a strong scent of settlement was in the air. But when Judge Potter reconvened the case the following afternoon, he was surprised by what he heard. Chief plaintiffs' counsel Paul Smith announced that the plaintiffs would rest without presenting the Oraflex evidence unless the trial went to its second phase, which would address the amount of the financial award. That stage would occur only if the jury decided in the first phase that Lilly was liable. If the jury found Lilly not liable, the case would be over, and the Oraflex evidence would never be heard.

The plaintiffs' high-risk strategy puzzled Judge Potter; they could lose their whole case without presenting their best evidence. Potter asked the lawyers whether they had reached a settlement. He was told unequivocally that they had not. While the jury was deliberating, a juror came forward and told Judge Potter that she had overheard settlement negotiations going on in the hallway. She repeated this in chambers with the lawyers present and was then excused. Potter turned to the lawyers and said, "Does anybody have anything they want to say?" A moment later, he asked again, "Does anybody have the slightest clue?" "No," said Smith. "I can't imagine," said one of the defense lawyers.

In other chambers meetings, lawyers from both sides emphasized their plans for Phase Two of the trial -- the money, or "damages" phase -- and the possibility of settlement discussions if the plaintiffs won Phase One. All this would be unnecessary, of course, if the case actually had been settled already. On December 12, only three court days after Potter's ruling allowing the Oraflex evidence, the jury returned a verdict for Lilly.

In January 1995, Judge Potter formally entered his order in Fentress v. Eli Lilly, dismissing the case after verdict by jury. As soon as the verdict was in, Lilly and its lawyers trumpeted their victory across the country. "We were able, finally," said one of Lilly's lead attorneys, "to get people head to head in a courtroom and say 'Put up or shut up.' ... [T]his is a complete vindication of the medicine."

Had John Potter not been the judge, the Fentress case might have ended there. He asked himself why any lawyer would fight so hard over the key Oraflex evidence and then not present it in the most important part of the case.

Despite what the lawyers had told him, Potter suspected that some kind of deal had been made. But he decided to be patient. He waited to see whether the plaintiffs filed a notice of their intent to appeal, a routine matter after losing a case. When they didn't, Potter called in the lawyers from both sides. They continued to deny that a settlement had been reached. Although Potter was more suspicious than ever, he had no power to do anything, except as to his own order of dismissal. So in April 1995, stating "it is more likely than not that the case was settled," Potter filed an unusual document: his own motion to change his post-trial order from a dismissal after verdict to "dismissed as settled." He set a hearing for May.

Quickly, the lawyers on both sides joined forces to file an objection with Kentucky's appeals court to prevent Judge Potter's hearing anything about what they considered a closed case. Paul Smith stated flatly that "there was no secret settlement.... This was a hard fought case." Potter, meanwhile, now needed a lawyer himself. After Potter's changed order had become public, Richard Hay, then President of the Kentucky Academy of Trial Attorneys, told reporters that if money had been traded for evidence, the trial was "a sham," like "taking a dive in a boxing match."

Potter read Hay's comments, called him, and asked how outraged Hay was about the case. "Enough to represent you," Hay replied. Together, Hay and Potter filed a brief that emphasized a "public silence [that] has been bought and paid for," robbing millions who "want the truth."

In June 1995, the appeals court ruled against Potter, saying he no longer had jurisdiction over the case. Potter appealed to the Kentucky Supreme Court. Before the fall Supreme Court hearing, lawyers for both sides finally acknowledged that they had indeed settled all money issues and had agreed to go through only the first phase of the trial no matter what the result. Still, they refused to disclose specifics.

Meanwhile, in Indianapolis, Lilly's hometown, Paul Smith suddenly withdrew as lead counsel in a series of consolidated Prozac cases in federal court. He wouldn't say whether he had settled his Indianapolis cases as part of the Fentress settlement, and the judge refused to ask. In their appeal to the Supreme Court, Potter and Hay de-emphasized the importance of public disclosure, and focused instead on the lawyers' failure to be candid with the judge.

On May 23, 1996, the Kentucky Supreme Court decided the case of Hon. John W. Potter v. Eli Lilly unanimously in Judge Potter's favor, citing the lawyers' "serious lack of candor" and evidence of bad faith, abuse of process, even fraud. Although the court said that "the only result" of exposing the secret Fentress agreement "is that the truth will be revealed," the decision was less a victory for open settlements, and more a demand that the judge be included in the secret.

Judge Potter, though, still saw the larger issue. Armed with Supreme Court authority to conduct an investigation and hold a hearing, Potter asked Deputy State Attorney General Ann Sheadel to investigate, giving her the power to subpoena documents and question witnesses under oath. Sheadel's March 1997 report uncovered new twists to the story. A complex agreement did exist between Lilly and the plaintiffs, one so secret that it was never fully reduced to writing. All Sheadel could find was a written summary of the verbal agreement. No lawyer would admit preparing it, and no plaintiff was allowed to have it.

In exchange for the plaintiffs agreeing not to present the evidence of Lilly's criminal conduct with Oraflex, Lilly had agreed to pay all plaintiffs, win or lose. Part of the agreement was that all of chief plaintiffs' counsel Smith's Prozac cases, including those in Indianapolis, were settled, and half his overall expenses paid by Lilly.

Judge Potter set a hearing to take sworn testimony on March 27, 1997. The hearing never happened.

On March 24, in a surprise move, attorneys for Lilly and the plaintiffs presented Judge Potter with a new stipulation and order in Fentress showing that the case was dismissed "as settled," exactly what Potter had insisted on two years before. The judge signed the order. Three days later, Lilly's attorney went before the appeals court to argue that any further proceedings were now moot. He also claimed that Potter had violated judicial ethics and was on a "vendetta" against Lilly. Potter recused himself, saying "the spotlight should be on what ... is under the log, not the person trying to roll it over."

The judge had succeeded in uncovering the collusive settlement. But of the approximately 160 active Prozac cases in December 1994, less than half remained.

Inexplicably, Fentress had received almost no attention in the national media, and the Kentucky court of appeal closed any further hearings to the public. Plaintiffs' attorney Paul Smith was still practicing law in Dallas.

And the only thing that anyone ever learned about the amount of the settlement was the comment of a Louisville lawyer who represented one of the Fentress plaintiffs in a divorce. The amount, he said, was "tremendous."

Adopted from pages 193-201 of The Moral Compass of the American Lawyer: Truth, Justice, Power, and Greed, © 1999, Richard Zitrin & Carol M. Langford All rights reserved.

This critically acclaimed book, about how the legal system allows lawyers to define "ethics" as what they can get away with rather than how they should behave, is written by two noted legal ethics professors who write frequently about ethics and morality in the legal profession.

Seroxat / Paxil continues to be prescribed - Ireland

Prescribing of sleeping pills hits record levels

By Jennifer Hough

Thursday, January 27, 2011

THE prescribing of sleeping tablets has reached record levels, falling just below common cholesterol and diabetes drugs, HSE figures have shown.

Read more:

Data from the Primary Care Reimbursement Service (PCRS) for 2009 shows over 596,000 prescriptions were written for the insomnia drug, Zopiclone.

More than 492,000 were prescribed under the state- funded General Medical Scheme (GMS), with a further 104,000 prescriptions written under the Drug Payment Scheme. There is no way of telling how many more were taken by people outside these schemes.

Zopiclone ranks 21 in the table of top 100 prescribed drugs in the GMS, with an increase of more than 100,000 prescriptions since 2005 and at least 40,000 more than in 2008.

The prescribing rates for the benzodiazepine drug, Diazapam — better known as Valium and which is used to treat anxiety — also rose in 2009, as has been the year-on-year trend, despite concerns over the use of this class of drugs. It falls just below Zopiclone in the top 100 list.

The use of another benzodiazepine drug Xanax, also used to treat anxiety and panic disorder, has also dramatically increased in recent years, with 283,000 prescriptions written in 2005 compared with 382,921 in 2008 and 399,798 last year.

The risk of overuse, abuse and dependence on benzodiazepines has been well documented. Earlier this year, the inspector of Mental Health Services found in some hospitals, up to 80% of long-term patients were being prescribed sedatives.

The latest PCRS data for 2009, published this month, shows Paroxetine, a class of anti-depressants known as SSRIs, and marketed as Paxil or Seroxat, continues to be prescribed here despite serious concerns about bad reactions including violent behaviour and suicide. HSE data from 2008 shows Seroxat was prescribed for under-16s, despite only being licensed for those over 18.

This appeared in the printed version of the Irish Examiner Thursday, January 27, 2011

Read more:

Wednesday, 26 January 2011

Paxil Cocaine interactions

Amphetamine, cocaine, and dextroamphetamine may stimulate the release of serotonin in the CNS and thus may interact with other serotonergic agents, such as the SSRIs, venlafaxine or nefazodone. These interactions could lead to serotonin excess and, potentially, the ‘serotonin syndrome’ (presenting as agitation, restlessness, aggressive behavior, insomnia, poor concentration, headache, paresthesia, incoordination, worsening of obsessive thoughts or compulsive behaviors, nausea, abdominal cramps, diarrhea, palpitations, or chills). If serotonin syndrome is suspected, offending agents should be discontinued. In addition, the MAOI activity of amphetamines may be of concern with SSRI use. While fluoxetine, sertraline, or venlafaxine have occasionally been prescribed for the treatment of ADHD, the concurrent use of amphetamines with medications that inhibit serotonin reuptake should be approached with caution. Additionally, in vitro studies have demonstrated that agents such as fluoxetine, paroxetine and cocaine may inhibit the metabolism of other CNS stimulants, such as methylenedioxymethamphetamine (MDMA or ‘Ecstasy’), via inhibition of CYP2D6.



Early Day Motion

Williams, Hywel

That this House expresses concern at the presentation of the case for reform of Disability Living Allowance (DLA) in the public consultation published on 6 December 2010; believes that the consultation incorrectly confuses correlation with causation between DLA claimants and employment levels or motivation to work; notes that DLA claimants tend to be older, less well-qualified, on benefits for longer and in poorer health than other disabled people; is of the opinion that many of the claims made in support of changing DLA are unsubstantiated in the consultation text or the supporting evidence; does not accept the argument that the identified problems with the present format of DLA are insoluble without the introduction of a costly new benefit; further believes that the presentation of the case for these reforms is highly flawed; and further expresses concern that the language used in the consultation may mislead readers when drawing conclusions from the evidence presented, and may therefore influence their response to the consultation.

ATOS - euthanasia options for the sick and disabled - video

Call your local ATOS to enquire about euthanasia options for the sick and disabled.

Birmingham 0121 626 2941

Bootle 0151 934 6070

Bristol 0117 971 8382

Cardiff 029 2058 6750

Croydon 0208 633 1324

Edinburgh 0131 222 5055

Glasgow 0141 249 3616

Leeds 0113 230 9068

Manchester 0121 335 0720

Newcastle 01264 837 789

Nottingham 0115 975 8362

Wembley 0208 795 8772

Tuesday, 25 January 2011

TEEN SUICIDE Global rates - @ 15 per 100,000 Canada is amongst the worst in the world !

Suicide rates per 100,000 young persons aged 15-19 in 26 countries (areas) with data available for 1965-1999

extracted from -

TEEN SUICIDE Canadian rate 15 per 100,000

Canadian suicide rates greatly increased in the 1960s and 1970s and, while they have levelled out in the 1980s, they are still at the highest level in Canadian history. Between 1960 and 1978, the overall suicide rate rose from 7.6 per 100,000 population to 14.8, according to Statistics Canada figures. During the last decade, the suicide rate, though relatively stable, has been about double the rate throughout most of the period from1921 to 1961 and well above previous highs recorded during the Depression of the 1930s. It is important to remember that the actual number of suicides in Canada may be under-reported. A death is only certified as a suicide by medical and legal authorities when the victim’s intent is clearly proven.

The federal government moved to address the suicide problem by appointing a National Task Force on Suicide in Canada in 1980. Its report was made public in 1987. Though the statistics used are from 1985 at the latest, and more often earlier, the study is the most comprehensive examination of the phenomenon ever done in Canada. Seven population groups were identified by the Task Force as being at high risk; one of these was young people. While males aged 20-24 constitute the age group with the most significant rise in suicide deaths in the past 20 years, marked increases have been noted in the 15-19 age group, again most significantly among males. The report describes and evaluates a range of prevention, intervention and follow-up programs, and makes a number of recommendations having to do not only with the determinants of suicide but with the means of preventing it. No major federal policy initiatives have resulted from the report. It is not the aim of this paper to review the findings of the Task Force report but rather to comment on changes in dealing with certain aspects of the teenage suicide phenomenon that have taken place since the Task Force research and have been discussed in the literature since 1987.

TEEN SUICIDE crisis Ontario Canada - rates among the highest in industrialized nations

OAKVILLE, Ont. – Joanne Genovy's youngest child was just 15 the first time she tried to end her life.

It's a memory etched in her mind -- receiving a call from a friend's mom alerting her Cassandra had "swallowed a bunch of pills," racing home frantically, not knowing if her daughter would be alive or dead when she got there.

That was 14 months ago and fortunately her daughter survived.

But Joanne has lived in fear every day since, wondering when her daughter will try to end her life again.

"We never thought she was capable of something like that," Joanne told QMI Agency recently.

Teen suicides have doubled in Canada since 1961 and rates here remain among the highest in industrialized nations. In Ontario, more than 50 teens commit suicide annually.

There are various and conflicting explanations -- including our long winters -- but universal agreement among experts that there is a woefully inadequate lack of funding, treatment facilities and trained child psychiatrists in Canada.

For desperate parents, the harsh reality is there are few places to turn to for help.

While Joanne admits there was some dysfunction in her home in the past, not unlike most families, she has tried to give her youngest of four girls all the attention and love she can muster hoping to help her overcome depression and a severe eating disorder.

She's even been off work for the last year trying to care for Cassandra, a decision that's caused major financial strain for her family.

But despite her efforts, her now 17-year-old daughter's mental health has only worsened. In fact, she has now attempted suicide, or come dangerously close, five times in just over a year -- three times in the last few months.

"Each time it gets scarier," Joanne said. "I'm terrified that the next time she goes to the hospital will be in a body bag."

In spite of multiple stays in the psychiatric ward at Oakville Trafalgar Memorial Hospital, where Cassandra was last checked in on June 11, finding the right help to save her child's life has been next to impossible.

Joanne pointed out that getting immediate help for someone who is suicidal is easy enough, you can simply call 911 or visit the emergency department at any hospital.

But a hospital stay is only a temporary fix, something she has learned the hard way.

Cassandra's most recent admission to Oakville-Trafalgar lasted two weeks, but only because her mom pleaded repeatedly with staff not to release her.

As is often the case, drugs and alcohol are part of Cassandra's problem, exasperated by an eating disorder.

Joanne has looked into an assortment of aftercare programs, for both inpatients and outpatients. But they are few and far between and it can take six months to a year, or even longer, to get into such programs.

Her biggest fear is that her bulimic daughter will end up like Sara Carlin, another 17-year-old Oakville girl, who hung herself in her parents' basement in 2007. Carlin's death was recently at the centre of an inquiry into the use of Paxil, a prescription drug used to treat depression and anxiety.

After her initial suicide attempt, Cassandra was prescribed anti-depressants and began attending an eating disorder program in Halton Region. But Joanne claims she was dubbed "too risky" and was "kicked out."

Upset she was no longer allowed to attend the group counselling sessions, Cassandra stopped taking her medication.

A few days later she tried to kill herself for the second time.

The troubled teen was then admitted into a program at North York General Hospital. Her mom drove her into Toronto every day and she was "doing good" for a while.

But Cassandra managed to convince her counsellors and doctors that she was "fine" and they sent her on her way, the girl's mom claims.

"We told everybody she wasn't ready, but nobody would listen," Joanne said, adding her daughter soon fell back into her old habits.

Twice this year, in May following a break-up with a boyfriend, and on her 17th Birthday, the troubled teen again tried to kill herself.

Cassandra's illness has been tearing her family apart.

"My daughter wants help. And I can't be with her every minute of every day," said Joanne, who is now faced with either returning to work and leaving her daughter completely unattended or selling her home.

She believes her daughter needs to be admitted as an inpatient to a program with round-the-clock care. But that's easier said than done.

So far, Joanne claims she's been told her daughter is too old, too young, too sick or not sick enough, among other things.

"It shouldn't be so hard," said Joanne. She is currently trying desperately to get her daughter into Homewood, a private facility in Guelph.

Homewood has only one OHIP-covered bed and the wait for that spot is more than a year.

"All I want to do is save my child and I'll do whatever it takes to keep her alive and get her well, even if that means she ends up hating me."


The countless scars wrapped around her wrist like bracelets indicate there's a darkness lurking beneath her beautiful facade.

Feint marks left from razor blade slashes are a constant reminder of the 17-year-old's struggles with depression, an eating disorder and periodic desires to end it all.

"I never really fit in," Cassandra Genovy told QMI Agency, while home on a weekend pass from Oakville-Trafalgar Memorial about a month ago.

She was admitted to hospital after her latest attempt at suicide, her fifth in just over a year.

Cassandra had few friends in her final years of elementary school and believes that's when her mental health issues first surfaced.

"I felt so alone ... unwanted ... and that's when I started scratching myself," she said, explaining she would claw at her forearm until it bled.

She attributes many of her woes to a lack of friends, boy troubles and clashes with her dad -- issues that may not seem like much to an adult but can be earth-shattering for a young girl, especially one who is suffering from depression.

"I started not liking school," Cassandra explained. "Then one day I just woke up and felt I didn't deserve to eat."

She became "obsessed" with exercising and began "restricting" herself to 500 calories a day -- about 1,700 calories less than is recommended for a teenage girl.

"When everything in your life is spiralling out of control, food is the one thing you can control," Cassandra said.

She then began "bingeing and purging," eating until she felt sick and then throwing up.

To control her weight, she started swallowing over-the-counter medications by the handful. And she became a master at hiding her illness.

When her mom put locks on the kitchen cupboards, she stole food from the grocery store. When she got in trouble for clogging up the toilet with vomit, she threw up into a garbage bag and hid it in her bedroom closet.

But eventually it all caught up with her.

Cassandra dropped out of school early this year, then her boyfriend dumped her in May on their one-year anniversary. She started sleeping all day, going out all night, drinking heavily and using street drugs, mainly marijuana.

"Things just became overwhelming and I had a meltdown," Cassandra admitted.

Doctors recently told her she has caused lasting damage to her body, which includes weakening her heart.

It seems unimaginable that such a sweet girl could be battling such demons.

But it becomes crystal clear in a second interview a few weeks later, after her release from hospital, that there are two starkly different Cassandras.

This one is sprawled on the couch of her parent's home, still too drunk and high from the night before to even sit up.

She's covered from head to toe with unexplained bruises and scratches, and her speech is so slurred that she's barely able to string together a sentence.

She looks more like someone who should be curled up on a grate in downtown Toronto than a teenager who has grown up in upscale Oakville.

Her mom, Joanne, and two of her sisters, Emily and Vicky, hover around Cassandra, obviously concerned for her well-being and for good reason.

She has just admitted to using cocaine for the first time, after learning a brother-in-law faces a potentially life-threatening medical issue.

"She has no coping skills, so this is how she deals with things like this," Vicky said. "But we truly believe the real Cassy is inside screaming for help."