UK SEROXAT GROUP ACTION
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October 11, 2010
11:37:18 AM Google hugh james withdraws from uk paxil court case
Monday, 11 October 2010
Sunday, 10 October 2010
Seroxat child killer Canada..self medicating on Paxil
popped his antidepressants like candy" ..self medicating
http://torontosun.com/News/Canada/2008/05/25/5662531-sun.html
Sun, May 25, 2008
Four years ago David Carmichael killed his son. Now free, he is crusading against 'happy drugs,' saying they -- not him -- are to blame
By MICHELE MANDEL
He popped his antidepressants like candy and believes Paxil made him kill his son.
And now David Carmichael is worried drug companies will soon have the go-ahead to push their potentially dangerous "happy pills" on more unsuspecting Canadians, with similarly dire results.
With new Bill C-51, the Conservative initiative to overhaul Canada's food and drug act, critics like Carmichael worry it will open the door to big pharma circumventing the current ban on direct-to-consumer advertising.
"It will make it easier for big chemical drug pharmaceutical companies to mislead the public about the effectiveness and lethal side-effects of SSRIs (selective serotonin reuptake inhibitors)," he insists. "I am now more afraid of the excruciating pain that many more Canadian families will experience if Bill C-51 is passed than of the consequences of speaking out against Paxil and SSRIs."
This summer will mark four years since Carmichael murdered his 11-year-old boy. In a psychotic delusion, he drove Ian to a motel in London, Ont. and after a night of playing video games, the former director of ParticipAction placed his hands around his son's throat.
'IT WAS THE DRUG'
At his trial, psychiatrists testified the loving father had been suffering from untreated depression and had become convinced that instead of suffering from a mild form of epilepsy, Ian really had severe brain damage that was endangering his family and making his life a living hell.
No blame was placed then on the antidepressants he had begun taking and Carmichael was found not criminally responsible due to a mental disorder in 2005.
Just over a year later, the Ontario Review Board determined he no longer posed a danger to himself or others and he was discharged from the Brockville Psychiatric Hospital as an outpatient. His wife and daughter moved from Toronto to live with him in Brockville where he sees a counsellor every two weeks.
"We're working hard to build a shattered life," he explains over the long distance line. "It's moving in the right direction."
Finding work, though, remains a challenge. "The stigma around mental illness is huge in itself. The stigma around killing your own child is amazing."
For his sake, though, you wonder why he doesn't try to rebuild by fading into the shadows.
Instead, Carmichael seems compelled to go public yet again on a new crusade.
Initially, it was to fight the stigma around mental illness.
Today it is insisting that it was Paxil, and not his mental disorder, that triggered his psychotic episode.
He says tests right after the murder, but never introduced at his trial, revealed that he was not suffering from a major depression.
"If depression didn't trigger the psychosis, what was it? That's where it suggests it was the drug."
At the time of the murder, Carmichael was overwhelmed by his second bout of severe depression. Without consulting his doctor, he began taking Paxil, the antidepressant he had left over from his first struggle with the illness the year before. When he became tormented by suicidal thoughts, he decided -- on his own -- to increase his dosage by 50%.
"I took my medication like it was Aspirin -- the more the better. What a mistake that was and there are still people who do that.
"We have to do a better job of educating the public about the potentially lethal side- effects these drugs have."
Yet Canadians are popping them like never before. The number of prescriptions for SSRIs has more than doubled in the past five years, with 17.5 million prescriptions filled in 2005.
To his credit, Carmichael admits that millions have been helped by these drugs. But there is also growing evidence that for a rare few, especially in the first weeks of treatment, antidepressants may have triggered acts of violence.
THE BLAME GAME
In fact, just a few months before Ian's murder, Health Canada issued a strong warning that SSRIs may put patients at increased risk of self-harm and harm to others.
Several calls to GlaxoSmithKline, makers of Paxil, were not returned.
As he campaigns to raise awareness of the drugs' potential side effects, Carmichael has also been in contact with the family of Carleton University student Nadia Kajouji, who committed suicide a few weeks after being prescribed an SSRI.
"My heart breaks for them," he says. "Between Nadia's case and Bill C-51, I felt I had to speak out. People need to start questioning."
And while you want to applaud his courage and altruism, you wonder if this poor man is also in desperate need of a crusade -- anything to ease the pain of dealing with the horror of what he has done.
Blaming a drug must be so much easier than blaming yourself.
"Bill C-51 has to be killed," he insists, "to prevent many more innocent children like my son Ian from being killed."
http://torontosun.com/News/Canada/2008/05/25/5662531-sun.html
Sun, May 25, 2008
Four years ago David Carmichael killed his son. Now free, he is crusading against 'happy drugs,' saying they -- not him -- are to blame
By MICHELE MANDEL
He popped his antidepressants like candy and believes Paxil made him kill his son.
And now David Carmichael is worried drug companies will soon have the go-ahead to push their potentially dangerous "happy pills" on more unsuspecting Canadians, with similarly dire results.
With new Bill C-51, the Conservative initiative to overhaul Canada's food and drug act, critics like Carmichael worry it will open the door to big pharma circumventing the current ban on direct-to-consumer advertising.
"It will make it easier for big chemical drug pharmaceutical companies to mislead the public about the effectiveness and lethal side-effects of SSRIs (selective serotonin reuptake inhibitors)," he insists. "I am now more afraid of the excruciating pain that many more Canadian families will experience if Bill C-51 is passed than of the consequences of speaking out against Paxil and SSRIs."
This summer will mark four years since Carmichael murdered his 11-year-old boy. In a psychotic delusion, he drove Ian to a motel in London, Ont. and after a night of playing video games, the former director of ParticipAction placed his hands around his son's throat.
'IT WAS THE DRUG'
At his trial, psychiatrists testified the loving father had been suffering from untreated depression and had become convinced that instead of suffering from a mild form of epilepsy, Ian really had severe brain damage that was endangering his family and making his life a living hell.
No blame was placed then on the antidepressants he had begun taking and Carmichael was found not criminally responsible due to a mental disorder in 2005.
Just over a year later, the Ontario Review Board determined he no longer posed a danger to himself or others and he was discharged from the Brockville Psychiatric Hospital as an outpatient. His wife and daughter moved from Toronto to live with him in Brockville where he sees a counsellor every two weeks.
"We're working hard to build a shattered life," he explains over the long distance line. "It's moving in the right direction."
Finding work, though, remains a challenge. "The stigma around mental illness is huge in itself. The stigma around killing your own child is amazing."
For his sake, though, you wonder why he doesn't try to rebuild by fading into the shadows.
Instead, Carmichael seems compelled to go public yet again on a new crusade.
Initially, it was to fight the stigma around mental illness.
Today it is insisting that it was Paxil, and not his mental disorder, that triggered his psychotic episode.
He says tests right after the murder, but never introduced at his trial, revealed that he was not suffering from a major depression.
"If depression didn't trigger the psychosis, what was it? That's where it suggests it was the drug."
At the time of the murder, Carmichael was overwhelmed by his second bout of severe depression. Without consulting his doctor, he began taking Paxil, the antidepressant he had left over from his first struggle with the illness the year before. When he became tormented by suicidal thoughts, he decided -- on his own -- to increase his dosage by 50%.
"I took my medication like it was Aspirin -- the more the better. What a mistake that was and there are still people who do that.
"We have to do a better job of educating the public about the potentially lethal side- effects these drugs have."
Yet Canadians are popping them like never before. The number of prescriptions for SSRIs has more than doubled in the past five years, with 17.5 million prescriptions filled in 2005.
To his credit, Carmichael admits that millions have been helped by these drugs. But there is also growing evidence that for a rare few, especially in the first weeks of treatment, antidepressants may have triggered acts of violence.
THE BLAME GAME
In fact, just a few months before Ian's murder, Health Canada issued a strong warning that SSRIs may put patients at increased risk of self-harm and harm to others.
Several calls to GlaxoSmithKline, makers of Paxil, were not returned.
As he campaigns to raise awareness of the drugs' potential side effects, Carmichael has also been in contact with the family of Carleton University student Nadia Kajouji, who committed suicide a few weeks after being prescribed an SSRI.
"My heart breaks for them," he says. "Between Nadia's case and Bill C-51, I felt I had to speak out. People need to start questioning."
And while you want to applaud his courage and altruism, you wonder if this poor man is also in desperate need of a crusade -- anything to ease the pain of dealing with the horror of what he has done.
Blaming a drug must be so much easier than blaming yourself.
"Bill C-51 has to be killed," he insists, "to prevent many more innocent children like my son Ian from being killed."
GSK will NOT remove the words 'not addictive' from seroxat SPC
http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4001122#
18 May 03
GlaxoSmithKline will change the wording on the patient information leaflet for Seroxat (paroxetine) to remove the claim that the drug is 'not addictive'.
GSK made its decision after considering 1,400 e-mails from patients about their experiences of taking Seroxat, which were featured on BBC TV's Panorama earlier this month.
The company will not change the wording provided to GPs in the summary of product characteristics. A statement said: 'We acknowledge that patients may get symptoms on stopping Seroxat. Although we maintain Seroxat is not addictive, we have proposed to take out that specific wording as we realised on talking to patients it did not add to their understanding of what to expect when they stop taking the product.
'We are not proposing to change the wording to doctors on the SPC. The statement that Seroxat does not cause dependence will remain because this terminology is clearly understood by health care professionals.
18 May 03
GlaxoSmithKline will change the wording on the patient information leaflet for Seroxat (paroxetine) to remove the claim that the drug is 'not addictive'.
GSK made its decision after considering 1,400 e-mails from patients about their experiences of taking Seroxat, which were featured on BBC TV's Panorama earlier this month.
The company will not change the wording provided to GPs in the summary of product characteristics. A statement said: 'We acknowledge that patients may get symptoms on stopping Seroxat. Although we maintain Seroxat is not addictive, we have proposed to take out that specific wording as we realised on talking to patients it did not add to their understanding of what to expect when they stop taking the product.
'We are not proposing to change the wording to doctors on the SPC. The statement that Seroxat does not cause dependence will remain because this terminology is clearly understood by health care professionals.
Saturday, 9 October 2010
Mad Pride Welfare Benefits & Services Protest - WARNING
Mad Pride Welfare Benefits & Services Protest Warning madpride.org.uk
Slightly off topic – but It has come to my attention that MadPride.org.uk are organising a protest at Speaker's Corner, Hyde Park, London on Tuesday October 26th 2010 at 1 pm –
"A Public Execution and Assorted Horrors"
"A Demonstration against Cuts to Benefits and Services"
Promoted in their press release as
"A day of action to appose welfare benefit cuts for people labelled mentally ill"
including the promotion of
"A 24 hour nationwide medication strike!"
Whilst the sentiments of the protest against cuts to welfare benefit for the mentally ill is commendable, this suggested action –
given the nature of both the side effects caused by missed doses and the consequences of rapid withdrawal associated with powerful psychiatric drugs that all, including severely mentally ill patients, will be taking –
is irresponsible and possibly dangerous.
For years a few members of Yahoo group UKSurvivors have made great efforts to raise awareness of the dangers psychiatric drugs pose in relation to side effects, missed doses and withdrawal –
which Mark Roberts the groups owner, madpride.org.uk's founder member, protest and "24 hour medication strike" promoter - has consciously and deliberately chosen to ignore,
whilst putting in place the following Blog, Forum and Twitter accounts to promote his protest campaign and "The 24 hour medication strike"
http://madpride.org.uk/blogs/madprideblog/
http://madpride.org.uk/forum/index.php
http://twitter.com/madpridemark
Please, by all means support the protest – BUT please under NO circumstances follow the promoted course of action or encourage others on medication to join "the 24 hour medication strike" - as it may have dire and possibly tragic consequences.
Tuesday
--
Posted by Tuesday at 19:34
Slightly off topic – but It has come to my attention that MadPride.org.uk are organising a protest at Speaker's Corner, Hyde Park, London on Tuesday October 26th 2010 at 1 pm –
"A Public Execution and Assorted Horrors"
"A Demonstration against Cuts to Benefits and Services"
Promoted in their press release as
"A day of action to appose welfare benefit cuts for people labelled mentally ill"
including the promotion of
"A 24 hour nationwide medication strike!"
Whilst the sentiments of the protest against cuts to welfare benefit for the mentally ill is commendable, this suggested action –
given the nature of both the side effects caused by missed doses and the consequences of rapid withdrawal associated with powerful psychiatric drugs that all, including severely mentally ill patients, will be taking –
is irresponsible and possibly dangerous.
For years a few members of Yahoo group UKSurvivors have made great efforts to raise awareness of the dangers psychiatric drugs pose in relation to side effects, missed doses and withdrawal –
which Mark Roberts the groups owner, madpride.org.uk's founder member, protest and "24 hour medication strike" promoter - has consciously and deliberately chosen to ignore,
whilst putting in place the following Blog, Forum and Twitter accounts to promote his protest campaign and "The 24 hour medication strike"
http://madpride.org.uk/blogs/madprideblog/
http://madpride.org.uk/forum/index.php
http://twitter.com/madpridemark
Please, by all means support the protest – BUT please under NO circumstances follow the promoted course of action or encourage others on medication to join "the 24 hour medication strike" - as it may have dire and possibly tragic consequences.
Tuesday
--
Posted by Tuesday at 19:34
Baum Hedlund named as Scientology attorneys - note CCHR lost against Lilly
Baum Hedlund named as Scientology attorneys - note CCHR lost against Lilly
Know the Attorneys for Scientology: knowledge is key!
George “Skip” William Murgatroyd III 61y attorney (PTS/SP '88, patron '06) (UT) (Tracey Forbes Murgatroyd 58y (Solo Nots I '97), ex-w: Joy L. Callahan, Jack William Murgatroyd (TR '05), f:George W. Murgatroyd II b:12-4-16 d:3-15-99
CCHR (lost against Eli Lilly pharma. Company)
Coale, Kananak & Murgatroyd
6956 Dume Drive
Malibu, CA 90265-4227 (310) 457-6035 skipmurgatroyd@hotmail.com
Michael Lin Baum 57 years old Clinton, OK, attorney (119511)(D.C.) unindicted co-conspirators (Operation SnowWhite, 'so scientology can have snow white hands' steals federal documents about Hubbard and scientology) (Melissa J. Sirkel Baum 43y)
Baum, Hedlund, Aristei, Schiavo law firm
Paul James Hedlund 63 years old (wife is Marta Louise (Brewer) Hedlund 52y teacher at Rosemont Middle School), ex-wife is Marie Olga (Kiraly) Hedlund 62
J. Clark Aristei
Gary Alan Brown 59 years old (litigant assistant, OSA, Integrity '87)
12100 Wilshire Blvd., Suite 950,
Los Angeles, CA 90025-7106 310-207-3233
Know the Attorneys for Scientology: knowledge is key!
George “Skip” William Murgatroyd III 61y attorney (PTS/SP '88, patron '06) (UT) (Tracey Forbes Murgatroyd 58y (Solo Nots I '97), ex-w: Joy L. Callahan, Jack William Murgatroyd (TR '05), f:George W. Murgatroyd II b:12-4-16 d:3-15-99
CCHR (lost against Eli Lilly pharma. Company)
Coale, Kananak & Murgatroyd
6956 Dume Drive
Malibu, CA 90265-4227 (310) 457-6035 skipmurgatroyd@hotmail.com
Michael Lin Baum 57 years old Clinton, OK, attorney (119511)(D.C.) unindicted co-conspirators (Operation SnowWhite, 'so scientology can have snow white hands' steals federal documents about Hubbard and scientology) (Melissa J. Sirkel Baum 43y)
Baum, Hedlund, Aristei, Schiavo law firm
Paul James Hedlund 63 years old (wife is Marta Louise (Brewer) Hedlund 52y teacher at Rosemont Middle School), ex-wife is Marie Olga (Kiraly) Hedlund 62
J. Clark Aristei
Gary Alan Brown 59 years old (litigant assistant, OSA, Integrity '87)
12100 Wilshire Blvd., Suite 950,
Los Angeles, CA 90025-7106 310-207-3233
Friday, 8 October 2010
Thursday, 7 October 2010
The Evidence, However, is Clear - Seroxat NOT banned for under 18's
Seroxat NOT banned for under 18's UK - clarification from MHRA
extract from -
ADVICE ON SEROXAT FROM THE COMMITTEE ON SAFETY OF MEDICINES
source - http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con019508.pdf
date 10 June 2003
Q5. Is Seroxat licensed for the treatment of children and adolescents?
Seroxat has never been licensed for use in children and adolescents, however it is used in this age group outside its licence. Doctors may prescribe a medicine off licence if this is considered to be in the best interests of the patient.
Q6. My child is taking Seroxat for a condition other than depression – what should I do?
Seroxat has never been approved for use in children under the age of 18, however your child may have been prescribed Seroxat outside of its licence if their doctor considers it is the best treatment for their condition. If your child has been prescribed Seroxat for a reason other than depressive illness – e.g. obsessive compulsive disorder or an anxiety disorder, and you are concerned about their treatment, you should contact your doctor and discuss your concerns
extract from -
ADVICE ON SEROXAT FROM THE COMMITTEE ON SAFETY OF MEDICINES
source - http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con019508.pdf
date 10 June 2003
Q5. Is Seroxat licensed for the treatment of children and adolescents?
Seroxat has never been licensed for use in children and adolescents, however it is used in this age group outside its licence. Doctors may prescribe a medicine off licence if this is considered to be in the best interests of the patient.
Q6. My child is taking Seroxat for a condition other than depression – what should I do?
Seroxat has never been approved for use in children under the age of 18, however your child may have been prescribed Seroxat outside of its licence if their doctor considers it is the best treatment for their condition. If your child has been prescribed Seroxat for a reason other than depressive illness – e.g. obsessive compulsive disorder or an anxiety disorder, and you are concerned about their treatment, you should contact your doctor and discuss your concerns
Seroxat NOT banned for under 18's UK - clarification from MHRA
extract from -
ADVICE ON SEROXAT FROM THE COMMITTEE ON SAFETY OF MEDICINES
source - http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con019508.pdf
date 10 June 2003
Q5. Is Seroxat licensed for the treatment of children and adolescents?
Seroxat has never been licensed for use in children and adolescents, however it is used in this age group outside its licence. Doctors may prescribe a medicine off licence if this is considered to be in the best interests of the patient.
Q6. My child is taking Seroxat for a condition other than depression – what should I do?
Seroxat has never been approved for use in children under the age of 18, however your child may have been prescribed Seroxat outside of its licence if their doctor considers it is the best treatment for their condition. If your child has been prescribed Seroxat for a reason other than depressive illness – e.g. obsessive compulsive disorder or an anxiety disorder, and you are concerned about their treatment, you should contact your doctor and discuss your concerns.
ADVICE ON SEROXAT FROM THE COMMITTEE ON SAFETY OF MEDICINES
source - http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con019508.pdf
date 10 June 2003
Q5. Is Seroxat licensed for the treatment of children and adolescents?
Q6. My child is taking Seroxat for a condition other than depression – what should I do?
Seroxat has never been approved for use in children under the age of 18, however your child may have been prescribed Seroxat outside of its licence if their doctor considers it is the best treatment for their condition. If your child has been prescribed Seroxat for a reason other than depressive illness – e.g. obsessive compulsive disorder or an anxiety disorder, and you are concerned about their treatment, you should contact your doctor and discuss your concerns.
LORD MONTAGU - suppression of the truth - benzo to SSRI swap
re -
http://health.groups.yahoo.com/group/SSRI-Crusaders/message/35924
Terry
I hope that this gives a flavour of what we are up against on this side of the Atlanic. The Earl of Sandwich sits in our upper house of parliament, the House of Lords. Whilst it was perfectly proper to bring to attention via video
( http://health.groups.yahoo.com/group/SSRI-Crusaders/message/35923 )
that there are some 1.5 millions addicted to benzo's in the UK he has failed to point out, the remedy he has sought for his own family, Citalopram swap carries, the exact same risks he seeks to avoid whilst higlighting the prior benzo addiction problem.
The Earl of Sandwich mentions also the role of CITA (Pam Armstrong) yet fails to mention her association with the SeroxatUsersGroup & lawyers. Pam Armstrong knows full well the nature of SSRI/SNRI withdrawal (google Pam+Armstrong+CITA+ Seroxat)
Due to the nature of the arena where the matter was raised (House of Lords) what we have here is suppression of the truth at the highest echelons of government.
Perhaps you could understand a little better now that my friends frustrations are further fired by deliberate attacks upon us by narcisists/activists whos only role is self promotion & the sale of innacurate e-books
"A member of my family has been withdrawing from the prescribed drug clonazepam since last January, and has recently benefited from a cross-over to citalopram followed the advice of Pam Armstrong of CITA in Liverpool. You can imagine the pain and distress that this has caused him, and all my family, over the last few months. During this time he has received no help from the health services, since there are none."
(1) http://www.publications.parliament.uk/pa/ld200809/ldhansrd/text/91103-0001.htmhttp://health.groups.yahoo.com/group/SSRI-Crusaders/message/35924
Terry
I hope that this gives a flavour of what we are up against on this side of the Atlanic. The Earl of Sandwich sits in our upper house of parliament, the House of Lords. Whilst it was perfectly proper to bring to attention via video
( http://health.groups.yahoo.com/group/SSRI-Crusaders/message/35923 )
that there are some 1.5 millions addicted to benzo's in the UK he has failed to point out, the remedy he has sought for his own family, Citalopram swap carries, the exact same risks he seeks to avoid whilst higlighting the prior benzo addiction problem.
The Earl of Sandwich mentions also the role of CITA (Pam Armstrong) yet fails to mention her association with the SeroxatUsersGroup & lawyers. Pam Armstrong knows full well the nature of SSRI/SNRI withdrawal (google Pam+Armstrong+CITA+ Seroxat)
Due to the nature of the arena where the matter was raised (House of Lords) what we have here is suppression of the truth at the highest echelons of government.
Perhaps you could understand a little better now that my friends frustrations are further fired by deliberate attacks upon us by narcisists/activists whos only role is self promotion & the sale of innacurate e-books
LORD MONTAGU - backing swaps from tranquillisers to SSRI citalopram !
Sunday, December 20, 2009
Letter to G Merron MP from Lord Sandwich
Gillian Merron MP,
Under-Secretary of State,
Department of Health 17 December 2009
I am writing to you as the Minister responsible for drugs and drugs policy. You may remember that I asked you a question at the recent meeting of the All-Party Group on the Misuse of Drugs, and I wanted to give you a little more background.
A member of my family has been withdrawing from the prescribed drug clonazepam since last January, and has recently benefited from a cross-over to citalopram followed the advice of Pam Armstrong of CITA in Liverpool. You can imagine the pain and distress that this has caused him, and all my family, over the last few months. During this time he has received no help from the health services, since there are none.
Following exchanges with Baroness Thornton in this House during my question on November 3rd (1) I am well aware that the Department is conducting a review of policy concerning prescribed drugs, with a report to be published ‘later in the spring’. However, with the election coming on and the wide range of issues to be examined, I am very concerned that this review may not be given the priority and resources it deserves.
Accordingly I have put further questions down this week, and I have applied for a short debate in January or early February. I am copying this letter to colleagues in this House, including Lord Williamson, Lord Crisp, Lord Ashley and others who I hope may be able to speak in this debate, and to members of Parliament who have taken an interest in the issue.
Yours sincerely,
Earl of Sandwich
(1) http://www.publications.parliament.uk/pa/ld200809/ldhansrd/text/91103-0001.htm
Letter to G Merron MP from Lord Sandwich
Gillian Merron MP,
Under-Secretary of State,
Department of Health 17 December 2009
I am writing to you as the Minister responsible for drugs and drugs policy. You may remember that I asked you a question at the recent meeting of the All-Party Group on the Misuse of Drugs, and I wanted to give you a little more background.
A member of my family has been withdrawing from the prescribed drug clonazepam since last January, and has recently benefited from a cross-over to citalopram followed the advice of Pam Armstrong of CITA in Liverpool. You can imagine the pain and distress that this has caused him, and all my family, over the last few months. During this time he has received no help from the health services, since there are none.
Following exchanges with Baroness Thornton in this House during my question on November 3rd (1) I am well aware that the Department is conducting a review of policy concerning prescribed drugs, with a report to be published ‘later in the spring’. However, with the election coming on and the wide range of issues to be examined, I am very concerned that this review may not be given the priority and resources it deserves.
Accordingly I have put further questions down this week, and I have applied for a short debate in January or early February. I am copying this letter to colleagues in this House, including Lord Williamson, Lord Crisp, Lord Ashley and others who I hope may be able to speak in this debate, and to members of Parliament who have taken an interest in the issue.
Yours sincerely,
Earl of Sandwich
(1) http://www.publications.parliament.uk/pa/ld200809/ldhansrd/text/91103-0001.htm
LORD MONTAGU CALLS FOR "URGENT ACTION" TO HELP PEOPLE ADDICTED TO PRESCRIPTION DRUGS
On 6 October 2010, The Earl of Sandwich, Lord Montagu, led a short debate on addiction to prescribed drugs.
The crossbench peer asked the government what progress is being made in its review of dependence on, and withdrawal from, benzodiazepines and other tranquillisers.
Benzodiazepines (BZD) are prescribed to treat anxiety, insomnia and spasms and can also be used as a premedication for medical or dental procedures.
But Lord Montagu has called for "urgent action" to help people addicted to prescription drugs, such as the creation of a network of clinics to care for those affected.
Wednesday, 6 October 2010
Gary Null - Quackwatch - when will Fiddaman ever learn?
A Critical Look at Gary Null's
Activities and Credentials
http://www.quackwatch.com/04ConsumerEducation/null.html
Activities and Credentials
http://www.quackwatch.com/04ConsumerEducation/null.html
PRESCRIPTION FOR DISASTER - Gary Null
PRESCRIPTION FOR DISASTER - Gary Null Wikipedia
Null is the owner of the dietary supplement and media company Gary Null & Associates, Inc.[10] He owns a health food store, Gary Null's Uptown Whole Foods Market,[11] in New York City.
In 2010, Null filed suit against Triarco Industries, a company that manufactured a product called Gary Null's Ultimate Power Meal. Null's suit contends that flawed testing and manufacturing practices led to the inclusion of 1,000 times the daily recommended amount of vitamin D, and that as a result he suffered kidney damage and intense pain.[12][13][14]
[edit] Criticisms
Many of Null's viewpoints are controversial and he has attracted the attention of Stephen Barrett of the alternative medicine watchdog website, Quackwatch. Barrett criticizes the validity of Null's PhD thesis, his alternative health claims, and several of his commercial products.[15]
The James Randi Educational Foundation, an organization that aims to promote critical thinking, has accused him, together with Wayne Dyer, of "dealing in nonsense", promoting the notion of eternal youth, and prescribing magnets and "other medieval tools" to prevent aging.[16]
In 2009, Null was criticized for his remarks as a keynote speaker at a political rally against mandatory H1N1 influenza vaccination at the New York State Capitol in Albany, New York.[17] New York State Health Commissioner Richard Daines said, "Like any number of things he’s wrong about, he’s wrong about that."[17]
[edit] See also
Health freedom movement
Null is the owner of the dietary supplement and media company Gary Null & Associates, Inc.[10] He owns a health food store, Gary Null's Uptown Whole Foods Market,[11] in New York City.
In 2010, Null filed suit against Triarco Industries, a company that manufactured a product called Gary Null's Ultimate Power Meal. Null's suit contends that flawed testing and manufacturing practices led to the inclusion of 1,000 times the daily recommended amount of vitamin D, and that as a result he suffered kidney damage and intense pain.[12][13][14]
[edit] Criticisms
Many of Null's viewpoints are controversial and he has attracted the attention of Stephen Barrett of the alternative medicine watchdog website, Quackwatch. Barrett criticizes the validity of Null's PhD thesis, his alternative health claims, and several of his commercial products.[15]
The James Randi Educational Foundation, an organization that aims to promote critical thinking, has accused him, together with Wayne Dyer, of "dealing in nonsense", promoting the notion of eternal youth, and prescribing magnets and "other medieval tools" to prevent aging.[16]
In 2009, Null was criticized for his remarks as a keynote speaker at a political rally against mandatory H1N1 influenza vaccination at the New York State Capitol in Albany, New York.[17] New York State Health Commissioner Richard Daines said, "Like any number of things he’s wrong about, he’s wrong about that."[17]
[edit] See also
Health freedom movement
Scientology's LEAF Project - Letters To The Editor Attack Force - post that won't go away
Scientology's LEAF Project - Letters To The Editor Attack Force - Exposed
http://webcache.googleusercontent.com/search?q=cache:wCyDwmrOfTkJ:groups.google.com/group/alt.religion.scientology/browse_thread/thread/944ee8cf50e0ee56/a661ab2134a23a9a+%22LEAF%22+%3D+Letters+to+the+Editor+Attack+Force&cd=1&hl=en&ct=clnk&gl=uk
Every thing in Scientology is choreographed... a SHOW, an apparency,
designed to leave the uniformed public confused and to provide an
apparency of agreement that there is belief is a certain desired
fallacy that benefits the coffers of $cientology.
Teen Screen is legislation to interview school kids to prevent
SUICIDES...that is opoosed by the scam of scientology, because it is
based upon psychology and psychiatry...
I never had any doubt that all the letters to editors and the anti-
psych spam was coordinated, but you'll LOVE THIS:
"LEAF" = Letters to the Editor Attack Force
It was / is an actual group set up to do this...
Run by Doyle Mills, CW scientologist and OSA volunteer. He also works at Digital Light Wave
Note that in some of the letters he says: "report compliance by email"
So his "LEAF" operatives are commanded to report completion of
assignments back to him
From: "Mr Doyle Mills"
To: "Mr Doyle Mills"
Subject: LEAF - TeenScreen Letter
Date: Mon, 9 Oct 2006 21:25:38 -0500
Message-ID: <20061010022538.97374.qmail@web30001.mail.mud.yahoo.com>
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
Content-Transfer-Encoding: 7bit
X-Mailer: Microsoft Offi
ce Outlook, Build 11.0.5510
Thread-Index: AcbsE2RsSxYtpg2mTXOxYZlar4H3Yg==
x-mimeole: Produced By Microsoft MimeOLE V6.00.2900.3198
Need a quick TeenScreen comment.
http://www.stevenspointjournal.com/apps/pbcs.dll/article?AID=/2006100...
01/610070349/1983
Click on the above link and read the short article
which mentions TeenScreen.
Then scroll down to the bottom of the page and write
your comments.
You can write what you want. If you need hatting go to
www.psychsearch.net/teenscreen.html
I do have a request though. If your last name ends in
A-B, J-M or T-Z, include the TeenScreen petition link
in your letter. Here's the link
http://www.petitiononline.com/TScreen/petition.html
And if your last name ends in C, H or S, I'd like you
to also write an email to the reporter. Tell him to
dig a little deeper next time, to find out the full
truth about TeenScreen or something like that.
And report compliance by email.
Thank you,
Doyle
-----------------------------
----------------------------
Crew,
I don't usually forward these things. But since I
haven't given any LEAF assignments in the last few
days I thought some of you might be antsy to get in
some production.
If you have the time and fit the qualifications, help
out. If not, no sweat, I'll get out a real LEAF
assignment in a day or two.
Best,
Doyle
-----------------------------
From: Tulia Connan [mailto:tu...@cchr.org]
Sent: Wednesday, December 27, 2006 12:57 AM
To: Undisclosed-Recipient:;
Subject: VOLUNTEERS NEEDED FOR HTML
Importance: High
Dear All,
We are launching the biggest mass mailing campaign and
a major part of it will occurr at our website. We
have a big project, that if we get at least 10 people
doing it, it will only take you about a day or two.
We are looking for volunteers that know some HTML.
This is urgent, and it can be done from anywhere!.
Please call us or email us if you can help or know
someone who could.
This needs to be a donation offcourse, commendations
will be given!
Please contact our Webmaster at webmas...@cchr.org.
Thanks!
Best,
Tulia
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection
around
http://mail.yahoo.com
----------------
http://webcache.googleusercontent.com/search?q=cache:wCyDwmrOfTkJ:groups.google.com/group/alt.religion.scientology/browse_thread/thread/944ee8cf50e0ee56/a661ab2134a23a9a+%22LEAF%22+%3D+Letters+to+the+Editor+Attack+Force&cd=1&hl=en&ct=clnk&gl=uk
Every thing in Scientology is choreographed... a SHOW, an apparency,
designed to leave the uniformed public confused and to provide an
apparency of agreement that there is belief is a certain desired
fallacy that benefits the coffers of $cientology.
Teen Screen is legislation to interview school kids to prevent
SUICIDES...that is opoosed by the scam of scientology, because it is
based upon psychology and psychiatry...
I never had any doubt that all the letters to editors and the anti-
psych spam was coordinated, but you'll LOVE THIS:
"LEAF" = Letters to the Editor Attack Force
It was / is an actual group set up to do this...
Run by Doyle Mills, CW scientologist and OSA volunteer. He also works at Digital Light Wave
Note that in some of the letters he says: "report compliance by email"
So his "LEAF" operatives are commanded to report completion of
assignments back to him
From: "Mr Doyle Mills"
To: "Mr Doyle Mills"
Subject: LEAF - TeenScreen Letter
Date: Mon, 9 Oct 2006 21:25:38 -0500
Message-ID: <20061010022538.97374.qmail@web30001.mail.mud.yahoo.com>
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
Content-Transfer-Encoding: 7bit
X-Mailer: Microsoft Offi
ce Outlook, Build 11.0.5510
Thread-Index: AcbsE2RsSxYtpg2mTXOxYZlar4H3Yg==
x-mimeole: Produced By Microsoft MimeOLE V6.00.2900.3198
Need a quick TeenScreen comment.
http://www.stevenspointjournal.com/apps/pbcs.dll/article?AID=/2006100...
01/610070349/1983
Click on the above link and read the short article
which mentions TeenScreen.
Then scroll down to the bottom of the page and write
your comments.
You can write what you want. If you need hatting go to
www.psychsearch.net/teenscreen.html
I do have a request though. If your last name ends in
A-B, J-M or T-Z, include the TeenScreen petition link
in your letter. Here's the link
http://www.petitiononline.com/TScreen/petition.html
And if your last name ends in C, H or S, I'd like you
to also write an email to the reporter. Tell him to
dig a little deeper next time, to find out the full
truth about TeenScreen or something like that.
And report compliance by email.
Thank you,
Doyle
-----------------------------
----------------------------
Crew,
I don't usually forward these things. But since I
haven't given any LEAF assignments in the last few
days I thought some of you might be antsy to get in
some production.
If you have the time and fit the qualifications, help
out. If not, no sweat, I'll get out a real LEAF
assignment in a day or two.
Best,
Doyle
-----------------------------
From: Tulia Connan [mailto:tu...@cchr.org]
Sent: Wednesday, December 27, 2006 12:57 AM
To: Undisclosed-Recipient:;
Subject: VOLUNTEERS NEEDED FOR HTML
Importance: High
Dear All,
We are launching the biggest mass mailing campaign and
a major part of it will occurr at our website. We
have a big project, that if we get at least 10 people
doing it, it will only take you about a day or two.
We are looking for volunteers that know some HTML.
This is urgent, and it can be done from anywhere!.
Please call us or email us if you can help or know
someone who could.
This needs to be a donation offcourse, commendations
will be given!
Please contact our Webmaster at webmas...@cchr.org.
Thanks!
Best,
Tulia
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection
around
http://mail.yahoo.com
----------------
Bob Fiddaman to give up blogging - cache of post that won't go away
Bob Fiddaman to give up blogging ? !
http://health.groups.yahoo.com/group/criticalpsychiatry/message/62822
http://health.groups.yahoo.com/group/criticalpsychiatry/message/62822
Monday, 4 October 2010
Scientology is using antipsychiatry to further proseletising to vulnerable people - says Professor Dean
Re: [psychiatry-research] Re: Secrets of Scientology - BBC1 Panorama 1 hour programme tonight
http://tech.groups.yahoo.com/group/psychiatry-research/message/23061
I questioned Lady MacNair about that:
"Why does Scientology criticise without offering an alternative approach? If you're unaware of options, which is hard to believe if you're sincere in that work, I've placed the Social Model and its CMMT Trial proposal before you. Promote that - join forces with the Ears Campaign. Then you'll be seen as acting on your words"
She said, "We don't have the resources" to which I replied: "D'you think I don't know how big Scientology is? You're evading the question with a falsehood yet claim to preach God's word. That's inconsistent, Lady MacNair, so from this conversation I can only conclude Scientology is using antipsychiatry to further proseletising to vulnerable people"
She was extremely uncomfortable and said she would consult with her superiors. Guess what? Never heard another squeak out of her
dixie
http://tech.groups.yahoo.com/group/psychiatry-research/message/23061
I questioned Lady MacNair about that:
"Why does Scientology criticise without offering an alternative approach? If you're unaware of options, which is hard to believe if you're sincere in that work, I've placed the Social Model and its CMMT Trial proposal before you. Promote that - join forces with the Ears Campaign. Then you'll be seen as acting on your words"
She said, "We don't have the resources" to which I replied: "D'you think I don't know how big Scientology is? You're evading the question with a falsehood yet claim to preach God's word. That's inconsistent, Lady MacNair, so from this conversation I can only conclude Scientology is using antipsychiatry to further proseletising to vulnerable people"
She was extremely uncomfortable and said she would consult with her superiors. Guess what? Never heard another squeak out of her
dixie
Sunday, 3 October 2010
Saturday, 2 October 2010
Cymbalta and Effexor: Hype Over Science
Cymbalta and Effexor: Hype Over Science
http://clinpsyc.blogspot.com/2010/10/cymbalta-and-effexor-hype-over-science.html
Remember the hype around the serotonin-norepinephrine reuptake inhibitors (SNRIs)? Effexor and Cymbalta impact both serotonin and norepinephrine, so they should be more effective than SSRI’s in treating depression? Mind you, that’s not a high bar to clear - it’s not like SSRI’s are much better than placebo. So get the hell outta the way, Prozac and Paxil, because Cymbalta and Effexor will unleash their incredible efficacy onto the world of psychiatry. Doubt me? Read this 2009 article regarding the wonders of Pristiq (son of Effexor) and learn about how “The emergence of the selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) antidepressants has improved the treatment of MDD.” Or this press release from Wyeth. Or Dr. Danny Carlat’s experience selling Effexor to his peers. I don’t think anyone who has followed drug marketing would deny that both Wyeth and Lilly tried to pimp Effexor and Cymbalta as working better because of their SNRI properties.
But is that actually true? A team of German researchers examined the data and concluded that neither Effexor nor Cymbalta really work better than SSRIs. They actually found a small advantage for Effexor over SSRIs for treatment response (but not depression remission), but they also found that the manufacturer was hiding studies from them (and the rest of the world). I haven’t said this for a while, but enter Charles Nemeroff. To understand the research by the Germans, we first need to recall that a 2008 study (lead author: Nemeroff) found
...the pooled effect size across all comparisons of venlafaxine versus SSRIs reflected an average difference in remission rates of 5.9%, which reflected a NNT of 17 (1/.059), that is, one would expect to treat approximately 17 patients with venlafaxine to see one more success than if all had been treated with another SSRI. Although this difference was reliable and would be important if applied to populations of depressed patients, it is also true that it is modest and might not be noticed by busy clinicians in everyday practice. Nonetheless, an NNT of 17 may be of public health relevance given the large number of patients treated for depression and the significant burden of illness associated with this disorder. [my emphasis]
As I wrote then, the benefit to public health claim is ridiculous. To understand the reasons why this is so laughable, please check out my prior post on the topic. This meta-analysis included a bunch of data from Wyeth that was previously unpublished...
Which leads to the freshly published meta-analysis on how Effexor compares to SSRIs. The German researchers requested unpublished data from Wyeth and only got some of it - you’d think that just maybe Wyeth sent them the “good news” data and maybe held back on some of the “bad news” data. So when an ever-so-small benefit emerged for Effexor (5% high treatment response rate), well, call me crazy, but I ignored it. We’re not playing with a full dataset because the manufacturer wants to keep some of it hidden, so shame on Wyeth and let’s look at Effexor with a little bit of suspicion. So Effexor vs. SSRIs - no difference. Except that more people drop out of clinical trials on Effexor due to side effects compared to SSRIs (about 3% more). So even if you believe that Wyeth’s hidden data really doesn’t impact these findings, we’re left with a very small advantage for Effexor that is probably negated by its slightly higher dropout rates.
Cymbalta. It had a 3% higher dropout rate due to adverse events and the same efficacy as SSRIs. So nothing to write home about, except that it costs a boatload more than generic SSRIs and is harder to tolerate. But Cymbalta has been marketed to the gills and is clearing $3 billion a year in sales. Hey, this is the company marketed Zyprexa for dementia (oops), and for, well, lots of other stuff (1, 2). So it’s not surprising at all that they can take a mediocre antidepressant like Cymbalta and turn it into a big moneymaker - the wonders of a good marketing department. But Depression Hurts and Cymbalta is a painkiller. Well, that’s fine and dandy until you actually look at the data which show Cymbalta doesn’t do much for pain in depression.
It’s time to get over the hype surrounding SNRIs. The next “advance” in antidepressants, well, who knows what it will be - but let’s hope it’s something a little more substantial than SNRIs. But I’m not hopeful. And no, I don’t want to hear anything more about agomelatine.
I know it’s been a long time between posts. So pardon me if my writing is more awful than usual. And it doesn’t mean I will be posting regularly. Thanks to the multiple readers who sent me a copy of this article.
Citation to new meta-analysis of Effexor and Cymbalta:
Schueler, Y., Koesters, M., Wieseler, B., Grouven, U., Kromp, M., Kerekes, M., Kreis, J., Kaiser, T., Becker, T., & Weinmann, S. (2010). A systematic review of duloxetine and venlafaxine in major depression, including unpublished data Acta Psychiatrica Scandinavica DOI: 10.1111/j.1600-0447.2010.01599.x
http://clinpsyc.blogspot.com/2010/10/cymbalta-and-effexor-hype-over-science.html
Remember the hype around the serotonin-norepinephrine reuptake inhibitors (SNRIs)? Effexor and Cymbalta impact both serotonin and norepinephrine, so they should be more effective than SSRI’s in treating depression? Mind you, that’s not a high bar to clear - it’s not like SSRI’s are much better than placebo. So get the hell outta the way, Prozac and Paxil, because Cymbalta and Effexor will unleash their incredible efficacy onto the world of psychiatry. Doubt me? Read this 2009 article regarding the wonders of Pristiq (son of Effexor) and learn about how “The emergence of the selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) antidepressants has improved the treatment of MDD.” Or this press release from Wyeth. Or Dr. Danny Carlat’s experience selling Effexor to his peers. I don’t think anyone who has followed drug marketing would deny that both Wyeth and Lilly tried to pimp Effexor and Cymbalta as working better because of their SNRI properties.
But is that actually true? A team of German researchers examined the data and concluded that neither Effexor nor Cymbalta really work better than SSRIs. They actually found a small advantage for Effexor over SSRIs for treatment response (but not depression remission), but they also found that the manufacturer was hiding studies from them (and the rest of the world). I haven’t said this for a while, but enter Charles Nemeroff. To understand the research by the Germans, we first need to recall that a 2008 study (lead author: Nemeroff) found
...the pooled effect size across all comparisons of venlafaxine versus SSRIs reflected an average difference in remission rates of 5.9%, which reflected a NNT of 17 (1/.059), that is, one would expect to treat approximately 17 patients with venlafaxine to see one more success than if all had been treated with another SSRI. Although this difference was reliable and would be important if applied to populations of depressed patients, it is also true that it is modest and might not be noticed by busy clinicians in everyday practice. Nonetheless, an NNT of 17 may be of public health relevance given the large number of patients treated for depression and the significant burden of illness associated with this disorder. [my emphasis]
As I wrote then, the benefit to public health claim is ridiculous. To understand the reasons why this is so laughable, please check out my prior post on the topic. This meta-analysis included a bunch of data from Wyeth that was previously unpublished...
Which leads to the freshly published meta-analysis on how Effexor compares to SSRIs. The German researchers requested unpublished data from Wyeth and only got some of it - you’d think that just maybe Wyeth sent them the “good news” data and maybe held back on some of the “bad news” data. So when an ever-so-small benefit emerged for Effexor (5% high treatment response rate), well, call me crazy, but I ignored it. We’re not playing with a full dataset because the manufacturer wants to keep some of it hidden, so shame on Wyeth and let’s look at Effexor with a little bit of suspicion. So Effexor vs. SSRIs - no difference. Except that more people drop out of clinical trials on Effexor due to side effects compared to SSRIs (about 3% more). So even if you believe that Wyeth’s hidden data really doesn’t impact these findings, we’re left with a very small advantage for Effexor that is probably negated by its slightly higher dropout rates.
Cymbalta. It had a 3% higher dropout rate due to adverse events and the same efficacy as SSRIs. So nothing to write home about, except that it costs a boatload more than generic SSRIs and is harder to tolerate. But Cymbalta has been marketed to the gills and is clearing $3 billion a year in sales. Hey, this is the company marketed Zyprexa for dementia (oops), and for, well, lots of other stuff (1, 2). So it’s not surprising at all that they can take a mediocre antidepressant like Cymbalta and turn it into a big moneymaker - the wonders of a good marketing department. But Depression Hurts and Cymbalta is a painkiller. Well, that’s fine and dandy until you actually look at the data which show Cymbalta doesn’t do much for pain in depression.
It’s time to get over the hype surrounding SNRIs. The next “advance” in antidepressants, well, who knows what it will be - but let’s hope it’s something a little more substantial than SNRIs. But I’m not hopeful. And no, I don’t want to hear anything more about agomelatine.
I know it’s been a long time between posts. So pardon me if my writing is more awful than usual. And it doesn’t mean I will be posting regularly. Thanks to the multiple readers who sent me a copy of this article.
Citation to new meta-analysis of Effexor and Cymbalta:
Schueler, Y., Koesters, M., Wieseler, B., Grouven, U., Kromp, M., Kerekes, M., Kreis, J., Kaiser, T., Becker, T., & Weinmann, S. (2010). A systematic review of duloxetine and venlafaxine in major depression, including unpublished data Acta Psychiatrica Scandinavica DOI: 10.1111/j.1600-0447.2010.01599.x
Friday, 1 October 2010
the most lethal become the most prolific
--------------------------------------------------------------------------------
The figures below are extracted from UK Department of Health, Prescription Cost Analysis (PCA) Statistics for England .........available from the governments Office of National Statistics.
Since this data is obtained from records of prescription forms redeemed at pharmacy shops, they can be relied on to show accurate long term trends.
Not only does Paxil/Seroxat show a downward trend, that for Citalopram rises at a rate xtimes higher than Seroxat fell.
Thus clearly UK people are being placed at disproporinate increasing risk.
source-
http://www.dh.gov.uk/en/PublicationsAndStatistics/Statistics/StatisticalWorkAreas/StatisticalHealthCare/DH_4086488#_4
Citalopram Hydrochloride -Cipramil
2001 2,811.700
2009 10,501.000
+ 7,689.300
Mirtazapine - Zispin
2001 430.300
2009 2,854.500
+ 2,424.200
Venlafaxine Hydrochloride -
Efexor
2001 1,503.700
2009 2,509.000
+ 1,005.300
*** Total Increases + 11.118.800 .... Million
***
Paroxetine Hydrochloride -
Seroxat
2001 3,786.900
2009 1,637.700
- 2,149.200
The figures below are extracted from UK Department of Health, Prescription Cost Analysis (PCA) Statistics for England .........available from the governments Office of National Statistics.
Since this data is obtained from records of prescription forms redeemed at pharmacy shops, they can be relied on to show accurate long term trends.
Not only does Paxil/Seroxat show a downward trend, that for Citalopram rises at a rate xtimes higher than Seroxat fell.
Thus clearly UK people are being placed at disproporinate increasing risk.
source-
http://www.dh.gov.uk/en/PublicationsAndStatistics/Statistics/StatisticalWorkAreas/StatisticalHealthCare/DH_4086488#_4
Citalopram Hydrochloride -Cipramil
2001 2,811.700
2009 10,501.000
+ 7,689.300
Mirtazapine - Zispin
2001 430.300
2009 2,854.500
+ 2,424.200
Venlafaxine Hydrochloride -
Efexor
2001 1,503.700
2009 2,509.000
+ 1,005.300
*** Total Increases + 11.118.800 .... Million
***
Paroxetine Hydrochloride -
Seroxat
2001 3,786.900
2009 1,637.700
- 2,149.200
newer antidepressants, citalopram, venlafaxine, and mirtazapine are potentially the most lethal in overdose (Br J Psychiatry. 2010;196:354-358).
newer antidepressants, citalopram, venlafaxine, and mirtazapine are potentially the most lethal in overdose (Br J Psychiatry. 2010;196:354-358).
http://www.medscape.com/viewarticle/729452
Prescription and Nonprescription Medications Implicated in Overdose Suicides
Kate Johnson
September 27, 2010 (Toronto, Ontario) — Psychotropic and other prescription drugs, as well as over-the-counter medications, are frequently used in overdose suicides, according to preliminary findings from a study reported at here at the Canadian Psychiatric Association 60th Annual Conference.
"The key point is that physicians prescribing certain classes of medications should be extravigilant if a patient is depressed or suicidal," said Mark Sinyor, MD, a fourth-year resident at the Department of Psychiatry, University of Toronto in Ontario, Canada.
A medical record review revealed 397 overdose suicides in Toronto during a 10-year period (1998-2007), which were divided evenly between men and women.
Medical examiner reports showed that pain killers, most commonly opioids, either alone or in combination with other drugs, were implicated in almost one-third (n = 112) of these suicides.
The second most common class of drugs was sedative hypnotics/benzodiazepines, which were implicated, either alone or in combination, in 105 cases.
Over-the-counter medications were the third most common source of overdose (n = 85), in particular diphenhydramine.
Tricyclic antidepressants came fourth on the list, either alone or in combination with other drugs (n = 81), with amitriptyline being the most common choice.
Newer Antidepressants Possibly the Most Lethal
In 10 cases, the only drug considered to be present in a lethal amount was a newer antidepressant," said Dr. Sinyor, noting a recent study showing that of the selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants, citalopram, venlafaxine, and mirtazapine are potentially the most lethal in overdose (Br J Psychiatry. 2010;196:354-358).
"In 7 of the 10 cases at least one of those drugs was present," he added.
Most suicides occurred in 40- to 59-year-olds, with 50% of all male and 45% of all female suicides falling into this age group.
This supports 2007 data from the US National Violent Deaths Reporting study that found the highest rate for suicide in 45- to 54-year-olds.
The most common psychiatric diagnoses in the cohort included major depressive disorder, substance abuse disorders, bipolar disorder, and schizophrenia.
However, all diagnoses, including others such as anxiety disorders and personality disorders, were most likely underreported, said co–lead investigator Andrew Howlett, MD, also a fourth-year resident at the University of Toronto.
"There was very little evidence in the charts [about diagnoses], but compared to previous research, we think these other diagnoses were underreported," he added.
Most suicides occurred in people who were unmarried (79%) and who overdosed at home (71%).
Forty-three percent of the cohort had medical conditions (unspecified), 42% had made a previous suicide attempt, and only 38% had left a suicide note.
Important Reminder
Predictors for overdose with specific psychotropic medications were not obvious. However, individuals with a general medical condition were twice as likely to overdose with nonpsychotropic medications compared with healthy individuals.
For over-the-counter overdose, predictive factors were being unmarried (odds ratio, 3.1; P < .01) and no previous suicide attempts (odds ratio, 2.7; P < .01).
"What's kind of interesting is that if they had a prior suicide attempt they were less likely to leave a note [P < .01]," said Dr. Sinyor. He noted that with almost two-thirds (62%) not leaving a suicide note and a large percentage (42%) with a history of suicide attempts, many cases are suggestive of chronic impulsivity.
"It seems like a large percentage of these were impulsive acts. It wasn't part of our research, but reading through the charts there were tons of personal crises, often relationships breaking up, that tended to precede the overdose.
"I certainly think it's a reminder to those of us prescribing psychotropic medications," said session moderator Jennifer Brasch, MD, medical director of Psychiatric Emergency Services at St. Joseph's Healthcare and associate professor in the Department of Psychiatry and Behavioral Neurosciences at McMaster University in Hamilton, Ontario, Canada.
"There are so many different medications in involved in the use of overdose. Tricyclics are well known to be highly toxic, but there were a number of SSRIs implicated in deaths by overdose, and it's a reminder to healthcare providers to be cautious in prescribing and to limit the number of pills that a patient has available."
In addition to awareness about prescribing medications, physicians should also note that a significant number of suicides involved diphenhydramine, added Dr. Sinyor.
"Diphenhydramine is the active ingredient in Benadryl, but it's also the active ingredient in SleepEze and Nytol and the newer sleep supplements. Diphenhydramine is a readily available drug that is now frequently used for overdose — at least in Toronto."
Dr. Brasch has disclosed no relevant financial relationships. Dr. Sinyor, Dr. Howlett, and Dr. Cheung have disclosed no relevant financial relationships and no funding for the trial; however, one of their coinvestigators (Dr. Ayal Schaffer) provided the following disclosure statements for previous research: Advisory Board: AstraZeneca Canada Inc, Bristol-Myers Squibb Inc, and Eli Lilly Canada Inc; Clinical Trials or Studies: AstraZeneca Canada Inc, Brain Cells Inc, and Servier Canada; Honoraria or Other Fees: AstraZeneca Canada Inc, Bristol-Myers Squibb Inc, Eli Lilly Canada Inc, Lundbeck Canada Inc, and Pfizer Canada Inc; Research Grants: AstraZeneca Canada Inc, BrainCells Inc, and Servier Canada.
Canadian Psychiatric Association (CPA) 60th Annual Conference: Abstract PS1d. Presented September 23, 2010.
http://www.medscape.com/viewarticle/729452
Prescription and Nonprescription Medications Implicated in Overdose Suicides
Kate Johnson
September 27, 2010 (Toronto, Ontario) — Psychotropic and other prescription drugs, as well as over-the-counter medications, are frequently used in overdose suicides, according to preliminary findings from a study reported at here at the Canadian Psychiatric Association 60th Annual Conference.
"The key point is that physicians prescribing certain classes of medications should be extravigilant if a patient is depressed or suicidal," said Mark Sinyor, MD, a fourth-year resident at the Department of Psychiatry, University of Toronto in Ontario, Canada.
A medical record review revealed 397 overdose suicides in Toronto during a 10-year period (1998-2007), which were divided evenly between men and women.
Medical examiner reports showed that pain killers, most commonly opioids, either alone or in combination with other drugs, were implicated in almost one-third (n = 112) of these suicides.
The second most common class of drugs was sedative hypnotics/benzodiazepines, which were implicated, either alone or in combination, in 105 cases.
Over-the-counter medications were the third most common source of overdose (n = 85), in particular diphenhydramine.
Tricyclic antidepressants came fourth on the list, either alone or in combination with other drugs (n = 81), with amitriptyline being the most common choice.
Newer Antidepressants Possibly the Most Lethal
In 10 cases, the only drug considered to be present in a lethal amount was a newer antidepressant," said Dr. Sinyor, noting a recent study showing that of the selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants, citalopram, venlafaxine, and mirtazapine are potentially the most lethal in overdose (Br J Psychiatry. 2010;196:354-358).
"In 7 of the 10 cases at least one of those drugs was present," he added.
Most suicides occurred in 40- to 59-year-olds, with 50% of all male and 45% of all female suicides falling into this age group.
This supports 2007 data from the US National Violent Deaths Reporting study that found the highest rate for suicide in 45- to 54-year-olds.
The most common psychiatric diagnoses in the cohort included major depressive disorder, substance abuse disorders, bipolar disorder, and schizophrenia.
However, all diagnoses, including others such as anxiety disorders and personality disorders, were most likely underreported, said co–lead investigator Andrew Howlett, MD, also a fourth-year resident at the University of Toronto.
"There was very little evidence in the charts [about diagnoses], but compared to previous research, we think these other diagnoses were underreported," he added.
Most suicides occurred in people who were unmarried (79%) and who overdosed at home (71%).
Forty-three percent of the cohort had medical conditions (unspecified), 42% had made a previous suicide attempt, and only 38% had left a suicide note.
Important Reminder
Predictors for overdose with specific psychotropic medications were not obvious. However, individuals with a general medical condition were twice as likely to overdose with nonpsychotropic medications compared with healthy individuals.
For over-the-counter overdose, predictive factors were being unmarried (odds ratio, 3.1; P < .01) and no previous suicide attempts (odds ratio, 2.7; P < .01).
"What's kind of interesting is that if they had a prior suicide attempt they were less likely to leave a note [P < .01]," said Dr. Sinyor. He noted that with almost two-thirds (62%) not leaving a suicide note and a large percentage (42%) with a history of suicide attempts, many cases are suggestive of chronic impulsivity.
"It seems like a large percentage of these were impulsive acts. It wasn't part of our research, but reading through the charts there were tons of personal crises, often relationships breaking up, that tended to precede the overdose.
"I certainly think it's a reminder to those of us prescribing psychotropic medications," said session moderator Jennifer Brasch, MD, medical director of Psychiatric Emergency Services at St. Joseph's Healthcare and associate professor in the Department of Psychiatry and Behavioral Neurosciences at McMaster University in Hamilton, Ontario, Canada.
"There are so many different medications in involved in the use of overdose. Tricyclics are well known to be highly toxic, but there were a number of SSRIs implicated in deaths by overdose, and it's a reminder to healthcare providers to be cautious in prescribing and to limit the number of pills that a patient has available."
In addition to awareness about prescribing medications, physicians should also note that a significant number of suicides involved diphenhydramine, added Dr. Sinyor.
"Diphenhydramine is the active ingredient in Benadryl, but it's also the active ingredient in SleepEze and Nytol and the newer sleep supplements. Diphenhydramine is a readily available drug that is now frequently used for overdose — at least in Toronto."
Dr. Brasch has disclosed no relevant financial relationships. Dr. Sinyor, Dr. Howlett, and Dr. Cheung have disclosed no relevant financial relationships and no funding for the trial; however, one of their coinvestigators (Dr. Ayal Schaffer) provided the following disclosure statements for previous research: Advisory Board: AstraZeneca Canada Inc, Bristol-Myers Squibb Inc, and Eli Lilly Canada Inc; Clinical Trials or Studies: AstraZeneca Canada Inc, Brain Cells Inc, and Servier Canada; Honoraria or Other Fees: AstraZeneca Canada Inc, Bristol-Myers Squibb Inc, Eli Lilly Canada Inc, Lundbeck Canada Inc, and Pfizer Canada Inc; Research Grants: AstraZeneca Canada Inc, BrainCells Inc, and Servier Canada.
Canadian Psychiatric Association (CPA) 60th Annual Conference: Abstract PS1d. Presented September 23, 2010.
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