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From ... in Psychology —

Suicide and Murder — Side Effects of Medication

Editor's Note: This article is a reprint.

Suicide and Murder — Side Effects of Medication

It was originally published October 5, 2019. According to a 2017 study, 1 in 6 Americans between the ages of 18 and 85 were on psychiatric drugs in 2013, most of them antidepressants. Of them, 84.3% reported long- term use, and having filled three or more prescriptions during the study year.

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Despite such pervasive antidepressant use, we've not seen any improvement in depression rates. On the contrary, it just seems to be getting worse, and the highest rates of depression are now reported among 18- to 25-year-olds. Suicide rates are at an all-time high as well. Statistics reveal suicide rates rose 31% between 2001 and 2017. In 2017, nearly 47,000 Americans committed suicide, making it the 10th most common cause of death that year. While antidepressants are routinely used as a first-line treatment for depression, evidence suggests they cause more problems than they solve. Several studies have shown their effectiveness is on par with placebo, and some of the worst side effects have long been ignored, or worse, hidden. Among them is the risk of violent acts against oneself and others. Research shows the proportion of adults taking at least one drug where suicide is a potential side effect hit 23.5% as of 2013, up from 17.3% in 2005, and 38.4% of American adults were in 2014 on one or more medications that can cause depression as a side effect. Unfortunately, doctors are more likely to prescribe an antidepressant than do the detective work required to determine whether the depression might be caused by a drug you're on. Aside from antidepressants, some 200 different drugs have been identified as having depression as a side effect, including birth control pills and drugs for heartburn, allergies and pain.

Psychiatric Medication and Violence

Many studies have noted that psychiatric drugs can destabilize patients to the point of suicide or homicide. In a June 4, 2019, article, "The Depression Pill Epidemic," professor Peter C. Gøtzsche highlights some of his own research that showed antidepressants "double the occurrence of events that can lead to suicide and violence in healthy adult volunteers." Other research has shown antidepressants "increase aggression in children and adolescents by a factor of 2 to 3 — an important finding considering the many school

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shootings where the killers were on depression pills," Gøtzsche writes. In 2017, Wendy Dolin was awarded $3 million by a jury in a lawsuit against GlaxoSmithKline, the maker of Paxil. Dolin's husband committed suicide six days after taking his first dose of a Paxil generic, and evidence brought forth in the case convincingly showed his suicide was the result of the drug, not emotional stress or mental illness. In fact, according to Dolin's legal team, Baum Hedlund Aristei Goldman, GSK's own clinical placebo-controlled trials revealed subjects on Paxil had nearly nine times the risk of attempting or committing suicide than the placebo group. An internal GSK analysis of its suicide data also showed that "patients taking Paxil were nearly seven times more likely to attempt suicide than those on placebo," Baum Hedlund Aristei Goldman reports, adding: "Jurors in the Dolin trial also heard from psychiatrist David Healy, one of the world's foremost experts on Paxil and drugs in its class … Healy told the jurors that Paxil and drugs like it can create in some people a state of extreme 'emotional turmoil' and intense inner restlessness known as akathisia … 'People have described it like a state worse than death. Death will be a blessed relief. I want to jump out of my skin,' Dr. Healy said. Healthy volunteer studies have found that akathisia can happen even to people with no psychiatric condition who take the drug … Another Paxil side effect known to increase the risk of suicide is emotional blunting … apathy or emotional indifference … [E]motional blunting, combined with akathisia, can lead to a mental state in which an individual has thoughts of harming themselves or others, but is 'numbed' to the consequences of their actions. Drugs in the Paxil class can also cause someone to 'go psychotic, become delirious,' Dr. Healy explained."

Eli Lilly Hid Prozac's Dangers

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Another antidepressant notorious for its adverse mental health effects is Prozac, made by Eli Lilly. A scientific and medical expert for over 100 plaintiffs suing Eli Lilly over violence and suicide in the early '90s was Dr. Peter Breggin. In his blog, Breggin talks about the first case brought before the court: "Joseph Wesbecker was on Prozac in September 1989 when he walked into his workplace, a Louisville, KY printing plant, shot dead eight colleagues, wounded 12 others, and killed himself. Survivors and relatives of the dead took Lily to court in 1994. They claimed that Wesbecker's violence was due to Prozac." To this day, it was the worst mass shooting in Kentucky history. The Wesbecker case also turned out to be more dramatic than expected. So much so, Breggin wrote a book about it, "Medication Madness," published in 2008. His incentive for writing the book was the fact that it was later determined that the trial was rigged. Eli Lilly won the Wesbecker case. The jury decided Prozac was not at fault for the devastating loss of life. However, the judge later discovered Eli Lilly "had paid the plaintiffs to throw the trial by withholding damaging evidence," Breggin writes. According to a September 12, 2019 article in the Louisville Courier Journal (a USA Today publication), the payoff amount in question was $20 million. Surprisingly, the damaging evidence plaintiffs agreed to withhold was not about Prozac but, rather, another Eli Lilly drug called Orafiex. However, the agreement between Eli Lilly and the plaintiffs in the case also resulted in many of the documents Breggin evaluated and testified about from ever being known outside the courtroom. (PDFs of the key documents are available on Breggin's blog. ) "After the trial, with its secret agreement between the plaintiffs and the drug company, the documents once held by plaintiffs' attorney Paul Smith could not be recovered by other attorneys or their experts. Their disappearance was so thorough that other attorneys in the consortium of combined Prozac suits … apparently did not know that they ever existed …

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I … continued to cite them as a medical expert in product liability lawsuits against Eli Lilly. However, the drug company has reached sealed settlements in every Prozac product liability case in which I have been an expert. In this manner the company has avoided making the documents public in a trial," Breggin explains.

BMJ Accuses Eli Lilly of Hiding the 'Smoking Gun'

The vanished documents didn't become public knowledge until 2004, when they were anonymously sent to the BMJ, which published them along with an article. "Though criticizing the BMJ for saying that the company had in effect hidden the smoking guns, Eli Lilly never actually contested the allegations surrounding the documents," Breggin writes. Just what did the vanished documents show? That Prozac significantly increased the risk of suicide. In a letter to the BMJ, Breggin authenticates the documents and explains their importance: "The second group of documents is a 1985 in-house analysis by Eli Lilly in which the company found a large statistically significant increase in suicide attempts for patients taking Prozac during their placebo controlled clinical trials. Twelve suicide attempts were found in the Prozac group and only one each in the control group and the comparison drug, a tricyclic antidepressant. Even after the company winnowed out six of the suicide attempts, the remaining 6:1 ratio was alarming. Furthermore, Eli Lilly hid many of their Prozac-related suicide attempts under false categories (see ahead). Like the activation study, Eli Lilly withheld the suicide study and did not turn it over to the German regulatory agency or to the FDA.

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The third group of documents involves a study conducted by the FDA concerning increased spontaneous postmarketing reports of 'hostility' and 'intentional injury' on Prozac. The FDA used a comparison antidepressant, trazodone, as a control. The FDA found a relative increase of reports of hostility and intentional injury per prescription of Prozac compared to trazodone. The spike in Prozac reports occurred even before any public controversy surrounding Prozac and violence. After the Wesbecker trial, I repeatedly attempted to obtain the FDA study through Freedom of Information Act (FOIA) requests. The FDA finally told me that these documents were lost. The fourth group of documents includes in-house Eli Lilly memoranda showing that the company consciously hid Prozac-induced suicidal acts under misleading categories, such as 'no drug effect,' so that they remained undisclosed to the FDA. In one memo, an Eli Lilly employee expresses shame and regret about hiding this data."

Prozac Victims Paid to Shield Damaging Data on Another Drug

As for the $20 million payoff, that was, as mentioned, to prevent plaintiffs from bringing out damaging evidence about Orafiex — a different drug entirely. As explained by the Louisville Courier Journal: "In exchange for the payment, the plaintiffs — eight estates and 11 survivors — agreed to withhold damaging evidence about the arthritis drug Orafiex that Lilly withdrew from the market. Lilly pleaded guilty to 25 criminal misdemeanor counts for failing to report adverse reactions that patients suffered from the drug, and the drug company feared that the Prozac jury would be more inclined to rule against the drugmaker if it learned of it. The plaintiffs agreed that if the jury found Lilly

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liable, they would not seek damages, nor would they appeal the verdict if they lost." The payoff was made without the knowledge of the judge, John Potter, and when he discovered it, Potter fought for the disclosure of the details of the agreement, including the amount. Louisville Courier Journal reports: "Two of the victims recently told the Courier Journal that the payment totaled $20 million, worth about $41 million in today's dollars … The two victims told the Courier Journal they felt compelled to accept the money because they suffered egregious injuries that kept them from working again and they needed it to survive … Lilly publicly trashed Potter and his investigation and won an order from the Kentucky Court of Appeals blocking it. Potter appealed, and the state Supreme Court unanimously ruled in his favor in 1996, allowing him to press Lilly for details of the deal. 'In this case, there was a serious lack of candor with the trial court, and there may have been deception, bad-faith conduct, abuse of the judicial process or perhaps even fraud,' the court said. 'We cannot tolerate even the possibility of such conduct.' Potter set a hearing at which he intended to require attorneys for both sides to testify under oath. Lilly accused him of conducting a vendetta, and he recused himself. The judge who inherited the case let the matter drop, and Potter's questions were never answered."

The Tale of Eli Lilly and a Governor of Indiana

As noted by Louisville Courier Journal in the years since the Wesbecker case, Eli Lilly has used the acquittal "to tout that Prozac had been proved a safe and effective antidepressant," which clearly was not the case if you're looking at science-based evidence.

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But the story doesn't end there. Mitch Daniels, who served as governor of Indiana from 2005 to 2013, was a top executive at Eli Lilly from 1993 until 2001. Once governor, he also brought several other senior Eli Lilly staffers into his administration. At the time of the Wesbecker trial, he was the president of Eli Lilly's North American Pharmaceutical Operations, a position he held between 1993 and 1997. In 2005, then-governor Daniels rammed a mental health mandate through the Indiana legislature — Senate Enrolled Act 529, Indiana Code 20-19-5 — requiring all Indiana children up to the age of 22 to undergo mental health testing. The lawmakers didn't even know they'd voted for this mandate as it was pushed through on the last day of their "long" session. What's more, the writing of the plan wasn't even completed by the time it came up for vote. Opponents of the state-directed "Children's Social, Emotional and Behavioral Health Plan" such as Dr. Karen Effrem, argued the bill threatened parental autonomy with regard to the mental health care of their children, and would promote the use of "dangerous, ineffective psychiatric medication" as a result of misdiagnoses. A 2011 article by Public Integrity points out that Daniels' career at Eli Lilly was marked by thousands of lawsuits filed by injured patients and legal settlements in the billions of dollars. "In the decade that Daniels climbed the corporate ladder at Eli Lilly, the company was illegally marketing its leading osteoporosis drug, Evista, as well as its blockbuster antipsychotic, Zyprexa, putting tens of thousands of patients in harm's way. Lilly pleaded guilty to two criminal misdemeanors, paid more than $2.7 billion in fines and damages, settled more than 32,000 personal injury claims … Daniels became increasingly infiuential as he rose through the company's ranks in positions that involved polishing the drugmaker's image and then shaping its policies …

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Daniels was Lilly's president of North American operations in 1996 when the FDA approved Zyprexa. Within a year, he rose to senior vice president for corporate strategy and policy as the company aggressively — and illegally — marketed the drug." Public Integrity also points out that Daniels received "at least $80,000 from top Lilly executives in the 2004 and 2008 election cycles," and that the Eli Lilly political action committee donated $86,750 to Daniels' campaigns. In short, it would appear the former Eli Lilly executive cum governor used his newly acquired political clout to significantly increase the use of psychiatric drugs in children — a trend that has only gotten more indefensible with each passing year as other states have followed suit with similar mental health screening programs aimed at young children. In 2014, the Citizens Commission on Human Rights, a mental health watchdog group, highlighted data showing that in 2013, an astounding 274,000 babies under the age of 1 were given psychiatric drugs. Of these, 249,699 were on anti-anxiety meds like Xanax; 26,406 were on antidepressants such as Prozac or Paxil, 1,422 were on ADHD drugs such as Ritalin and Adderall, and 654 were on antipsychotics such as Risperdal and Zyprexa. In the toddler category (2- to 3-year-olds), 318,997 were on anti-anxiety drugs, 46,102 were on antidepressants, 10,000 were prescribed ADHD drugs and 3,760 were on antipsychotics. Among children aged 5 and younger, 1,080,168 were on psychiatric drugs. These are astounding statistics. How could children that young possibly be diagnosed with serious mental health issues requiring the use of such potent and dangerous drugs?

The TeenScreen Debacle

In 2005, Indiana also became the center of national attention when a lawsuit was filed against an Indiana school and mental health agency in connection to their use of

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TeenScreen — a mental health screening test developed at Columbia University and administered through school systems in at least 40 states — to "diagnose" mental illness in the schools' students. The lawsuit was initiated by the parents of a student diagnosed with social anxiety disorder and obsessive-compulsive disorder — all because she preferred to study than party, and liked to keep things clean. A report on the dangers of TeenScreen was written by Effrem in 2014, detailing the test's exceptionally high rate of false diagnoses, and the devastating effects such a misdiagnosis can have. In one heart-wrenching case, a 13-year-old girl was removed from her parents and forcibly restrained and medicated with a dozen different drugs (some of which were not approved for her age group) for five months after the TeenScreen test "diagnosed" her as being at high risk for suicide. While the Indiana law is still on the books, TeenScreen closed down in 2012, but is now making a comeback — a trend Effrem warns against in a 2018 article in The National Pulse. In it, she points out that the dramatic increase in psychiatric drug use among children and teens with "less severe or no impairment" is a direct result of widespread use of TeenScreen and similar mental screening instruments that are misdiagnosing them with serious mental health problems. What's worse, it appears that universal mental health screening of children in schools could soon be getting a national push, as illustrated by a 2017 article in Health Research Science laying out a blueprint for implementing such a program. Citing the need for funds, policy changes and strategies to collect data on this, as well as general support for the testing, study authors said: "Universal mental health screening in the school setting is an important tool for gathering these data; however, the issues that are prompting the need for policy change are the same issues that make it dificult to implement these screening procedures.

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Therefore, funding for studies such as we describe … plays an important role in achieving greater advocacy for meaningful school behavioral health policy change by providing a means to gather universal screening data." In other words, the only things keeping school-based mental health testing from being implemented nationwide are funding and support on the part of schools and staffs to pull it off. Unfortunately, if universal testing is implemented, it may very well take them right back to the problems Indiana had when they tried it: diagnoses resulting in incorrect or unnecessary treatment. While depression and other mental health problems need to be diagnosed and taken seriously, psychiatric drugs should be the option of last resort, not the first. Again, one very serious side effect associated with at least 25 different psychiatric drugs is violence. The 2014 U.S. Senate report, "A Review of How Prescribed Psychiatric Medications Could be Driving Members of the Armed Forces and Vets to Acts of Violence & Suicide" by Citizens Commission on Human Rights International, drives home the clear danger posed by these drugs. The report notes, in part: "There are 22 international drug-regulatory agency warnings about these medications causing violent behavior, mania, psychosis and homicidal ideation. There are almost 50 international drug-regulatory agency warnings about psychiatric drugs causing suicidal ideation … Prescriptions written for antipsychotic drugs for active-duty troops increased 1,083 percent from 2005 to 2011 … A total of 841 Service members had one or more attempted suicides reported … for CY 2012 … Potentially up to 50 percent of those committing suicide had at some point taken psychiatric drugs and up to nearly 46 percent had taken them within 90 days."

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If you, your child, or another family member is on a psychiatric drug, I urge you to educate yourself about the true risks, and to consider switching to safer alternatives. You can learn more about the diagnosis and treatment of depression and anxiety in the following articles: " How Exercise Treats Depression " and " Anxiety May Be an Inherited Trait ."

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