Sunday, February 17, 2008

Prozac Mania- The Dark Side of Antidepressants

Early in 2000, in a non-jury trial, a Connecticut judge acquitted Christopher DeAngelo, an insurance agent, of robbing a bank after his lawyer successfully argued that his client's state of mind was due to the Prozac he had been taking at the time. Listed in the manufacturer's warning as an "infrequent" adverse reaction is "akathisia," which may cause an unsuspecting victim to become mentally restless and lose all inhibitions about his actions.

In October 1999, Pfizer, makers of Zoloft, settled for an undisclosed sum with the estate of Brynn Hartman, who had shot her husband comedian Phil Hartman dead, and then killed herself. Ms Hartman had been taking Zoloft at the time of the murder/suicide. According to the lawsuit, Ms Hartman had complained to friends that she felt as if she were going to "jump out of her skin."

Then there are the well-publicized school shootings: One of the killers in the Columbine tragedy had been prescribed Luvox. Listed in the manufacturer's warning as "frequent" adverse reactions to Luvox are "manic reaction" and "psychotic reaction." Meanwhile, Kip Kinkel, who killed four people in Oregon, including his parents, had been on Prozac at the time.

Two years earlier, Michael Hutchence, lead singer of the rock group INX, was found hanging by his belt in a Sydney hotel room, a bottle of Prozac on his possession.

Is it fair to connect these popular antidepressants to these horrible events? Yes and no. For the most part we are simply speculating. Moreover, it is difficult, if not impossible, to separate an individual's condition from the drug. Common sense, after all, dictates that some Prozac users, many who are deeply depressed or agitated at the time, are bound to attempt suicide - 2,246 reported cases between 1987 and 1995, with the true figure probably many times higher.

But if Prozac were not to blame, then the suicide rate for Prozac users would be equal or lower than for other antidepressants, right? Maybe not. A University of Wales study by David Healy took the liberty of extrapolating from a small sample to conclude that 187 Prozac users attempt or commit suicide per 100,000 patient years, far higher than for older antidepressants.

In the past, Prozac has been tested only on unhealthy (ie depressed) people. But another study by Dr Healy done on HEALTHY people found that between 10 to 20 percent of those taking Prozac can be affected by mania or mental restlessness and may lose inhibition about their reactions.

If this study is to be taken at face value, then one can no longer blame a patient's bizarre behavior simply on his or her condition prior to taking the drug. According to Dr Healy

"People [on Prozac] don't care about the consequences as you'd normally expect. They're not bothered about contemplating something they would usually be scared of ... We can make healthy volunteers belligerent, fearful, suicidal, and even pose a risk to others."

Other scientists are quick to say this is an extreme overstatement. Moreover, Healy's research methods have been called into question. In an article in the New York Times Dr Matthew Rudorfer, associate director for treatment research at the National Institute of Mental Health's Division of Services and Intervention Research, acknowledges that SSRIs are "not innocuous, and they should not be used casually." Nevertheless, "it's a vast overinterpretation to say that they are dangerous and should be avoided."

Even Dr Martin Teicher of Harvard, who first sounded the alarm in 1990, says he views the suicide risk as something "that clinicians need to be aware of but it's generally not a huge problem."

But that comes as cold comfort to the handful of unlucky ones:

Until recently, Eli Lilly, makers of Prozac, had managed to settle all of its 200 or so civil claims out of court. But that changed in 2000:

In 1992, Bill Forsyth, a retiree living in Hawaii, was prescribed Prozac for his anxiety and depression. The next day, he called his doctor to say he felt 200 percent better. The day after, however, he requested to be taken to a psychiatric hospital, where doctors continued giving him the drug. Eleven days later, he returned home, stabbed to death his wife of 37 years, then impaled himself on a kitchen knife.

Eli Lilly won the case, but possibly lost a long-term war, for the company was obliged to make public incriminating internal documents dating back to 1978.

According to company minutes, Eli Lilly had full knowledge of what its top-selling drug could do to some people. In the company's own words, back in 1978: "There have been a fairly large number of reports of adverse reactions ... Another depressed patient developed psychosis ... Akathisia and restlessness were reported in some patients."

In another meeting, it was noted that, "some patients have converted from severe depression to agitation within a few days; in one case the agitation was marked and the patient had to be taken off [the] drug."

The minutes also revealed that during the approval process, Eli Lilly's trial subjects were put on tranquilizers to counter the akathisia (and presumably skew the drug trial findings in their favor), though no warning was given when the drug came on the market in the US. In Germany, however, Eli Lilly was obliged to put this caveat on its package insert:

"For his/her own safety, the patient must be sufficiently observed, until the antidepressive effect of Fluctin [Prozac] sets in. Taking an additional sedative may be necessary."

The documents also reveal that Eli Lilly excluded from scrutiny at-risk subjects in a so-called suicide study requested by the FDA, as well as 76 out of 97 suicides. A reinterpretation of Lilly's figures by David Healy, testifying as an expert witness, came up with 3,000 suicides or attempts per 100,000 patient years.

One Prozac user was literally saved by the bell. Stephen Bryson, a surgical nurse, had this to say of his Prozac experience:

"I was swearing, touching friends up in private parts and would pick arguments for the sake of it and threaten their lives. I ran around town stark naked and ran up debts of £10,000. I became quite violent. I had no awareness of ... right from wrong. I was high as a kite.'"

Stephen eventually attacked his partner with a knife, and swears he would have committed murder had not the phone rung at the critical moment. As it was, he received a 12-month jail sentence. Three months after going off Prozac, he was 'back to my old self."

Reginald Payne, 63, a teacher from Cornwall, wasn't so lucky. In March, 1996, he suffocated his wife and threw himself off a cliff. He had been taking Prozac for just 11 days. His family has issued court proceedings against Eli Lilly.

What makes these and other stories credible to a good many people is their own experience with antidepressants, this writer being no exception. In early 1999, I was an undiagnosed manic depressive seeking help for severe depression. Within a few days of going on the medication (not Prozac), my mind was racing, my manner agitated, and I was vividly hallucinating. I couldn't sleep, my heart was going like the so-called music you hear blaring out of cars, and I could swear I heard voices every time the bathroom fan went on. Naturally, I was fearful of what another dose might do to me, but I had to weigh that risk against the very real possibility of plummeting back into the depression I had only just barely survived. I had been awake a good 48 hours, and it was time for my morning pill.

In the end, I went with the devil I knew, but it took me another 24 hours to come down off of that terrible high. Who knows what would have happened had I taken that extra tablet. Would my family's lawyers be negotiating with the drug company's lawyers at this very moment? Or would I be trying to convince a skeptical judge and jury that "a pill made me do it?" Perhaps I would have made only a minor ass of myself, and deemed myself lucky as I buried my head in the ground to hide my shame.

Of course, most consumers of antidepressants don't have to worry about such things. Hundreds of millions of people worldwide have used SSRIs and other newer antidepressants, after all, the overwehelming majority with no major incident. Clearly the greater good far outweighs the harm and risk of harm, but users need to be aware of those risks and exercise due care. The drug companies, after all, have been exceedingly less than candid, and the medical profession has largely fallen down in its duties to inform its patients.

Accordingly, if soon after beginning antidepressant treatment you start feeling uncharacteristically hyper, call your doctor at once and stop taking the medication while you still have your wits about you. Your doctor may adjust your dose or switch medications to get you on something that works for you. If you are experiencing anxiety or agitation in the early going, the effect is usually temporary, but it won't hurt to keep your doctor informed.

A recent study by Eli Lilly has found low dose Prozac (20 mg a day) to be effective against depression, with lower frequencies of "adverse events" compared to earlier studies of patients receiving doses of up to 80 mgs a day. Moreover, there was no difference in discontinuation between the Prozac group and the control subjects, though there have been studies showing antidepressants at lower doses result in higher rates of relapse.

Those who have had bad experiences with the drug mentioned in this article may have been on high doses. The bank robber cited at the beginning of this piece was on an unusually high dose of more than 100 mgs.

If, after reading this, you feel you are ready to flush your pills down the toilet - hold on. If you have been taking antidepressants for some time, then you will need to be gradually weaned off of them under a doctor's supervision over a period of weeks or months.

If an antidepressant has harmed you or your family, you may have cause for a legal action, but this is something you would need to take up with a lawyer who specializes in these kinds of cases.

On a final note, notwithstanding my bad initial antidepressant experience, I am now on a "cocktail" that includes an antidepressant and a mood stabilizer.

Update (June 22, 2000 and April 28, 2001)

Paradox: If you do the right thing and make your current product safer, does this amount to an express admission that your original product was found wanting? Could you be held liable? Could your behavior even be construed as fraudulent?

This is the problem Eli Lilly, makers of Prozac (fluoxetine), may be facing. The company had been preparing to launch a new version of its blockbuster antidepressant in 2001 under a license agreement with Boston-area Sepracor, just as its 14-year patent was due to expire. (Later Eli Lilly dropped its plans.) The original Prozac, in the wording of the patent, carries a number of risks:

"Fluoxetine produces a state of inner restlessness (akathisia), which is one of its more significant side effects ... It is also known that in some patients, use of fluoxetine is associated with severe anxiety leading to intense violent suicidal thoughts and self mutilation .... In other patients manic behavior follows treatment with fluoxetine."

According to the patent, the new Prozac would have eliminated the side effects of the old drug. Sepracor filed for the patent in 1995 and it was granted in January 1998. Because technically the patent does not belong to Eli Lilly, the drug-maker may be able to distance itself from the wording on the patent.

Nevertheless, the Forsyths filed a federal lawsuit accusing the Eli Lilly of fraud.

Dr David Healy of the North Wales Department of Psychological Medicine at the University of Wales, who testified as an expert witness at the Forsyth trial, estimates that "probably 50,000 people have committed suicide on Prozac since its launch, over and above the number who would have done so if left untreated."

The jury in the Forsyth trial did not buy this testimony, and neither do a lot of scientists. Moreover, an Eli Lilly spokesman maintains: "There is no credible evidence that establishes a causal link between Prozac and violent or suicidal behavior. There is, to the contrary, scientific evidence showing that Prozac and medicines like it actually protect against such behaviors."

No doubt, the company will have ample opportunity to defend that claim in court.

Update (June 12, 2001)

A Wyoming jury has returned a verdict in a wrongful death suit against GlaxoSmithKline (formerly SmithKline Beecham), makers of Paxil, with damages amounting to $6.4 million. On Feb 13, 1998, Donald Schell, 60, took two Paxil tablets, then shot to death his wife, daughter, and grand-daughter before killing himself. Unpublished data from SmithKline revealed that its own investigators had attributed a variety of side effects to the drug, including akathisia (turmoil), mania, psychosis, aggression, and attempted suicides. Dr David Healy, who has published studies on Prozac (but not Paxil) side effects, testified as an expert witness, along with Harvard psychiatrist Terry Maltsberger.

This is the first successful wrongful death suit in the US involving SSRIs. The plaintiffs in the Forsyth and Tobin cases were represented by the same legal team, Vickery and Waldner of Houston, Texas. Andrew Vickery told this writer what was different about taking a drug company to court this time around:

"We had additional experts in Tobin. We tried SKB on a ‘failure to test’ theory in addition to failure to warn. In Tobin we wised up and emphasized that homicide and suicide are ‘multifactorial’ and ‘biological’ phenomena.’ These and other tactical changes made a big difference."

As for how this case may affect future litigation: "Courts may decide that they may not [need to] relitigate the question of whether Paxil causes some individuals to commit suicide and/or homicide, and [if] SKB is at fault for failing to test or warn." The case should also "set a psychological precedent for other SSRI manufacturers. And finally, it should lead the FDA to insist on real warnings about SSRI induced violence and suicide."

For three free online issues of McMan's Depression and Bipolar Weekly, email me and put "Sample" in the heading and your email address in the body.

Treatment articles All articles

Mark (March 6, 2002): My brother was on Paxil almost 5 weeks when he went into an empty hot tub and shot himself in the chest. This was not my brother in his normal state of mind. He was depressed but I know that Paxil gave him a helping hand and removed any inhibitions about taking his own life. Knowing how dangerous this drug is it needs more research or removed from the public.

McMan (March 6): My condolences for your brother, Mark. For all my reservations about these drugs, I would be the last to advocate them being withdrawn from the market. An antidepressant probably saved my life, and I'm sure they have saved tens of thousands of other lives. I do think a good case could be made, however, by putting stronger warnings on the inserts and holding doctors liable as well for failing to point out the risks.

Anonymous (Sept 20, 2002): I am currently 22 and have suffered periods of severe depression and anxiety alternating with times where I was either 'normal' or extremely happy and outgoing, since I was 18. Last month when my current episode of depression had become so severe that I couldn't function, my doctor prescribed Prozac. The result was numerous physical symptoms, such as nausea and dry mouth but also agitation so extreme that I felt like I was being given constant electric shocks. After 3 days of this, I finally 'freaked out' and had to be taken into hospital. I was released the next day with my medication changed to Effexor and Valium. After a week of severe depression and lethargy, I started feeling energized and wildly happy. After a few days the depressed thoughts came back x 100 but I still felt scarily speeded up.
I ended up taking 50 paracetamol after just 10 days on Effexor, not so much out of a wish to die but rather to silence my brain.
My parents got me to hospital in time but I now have liver damage and have no idea what happened. The person who overdosed was not me, as I know that I would never, ever do such a thing, no matter how bad things got.

I am now on a TCA and while still depressed, I at least feel in control of my own brain again. I know that everyone reacts differently to medication, but it seems obvious to me from the cases cited in your article and my own insane experience that the new generation anti-depressants can have potentially lethal side effects. More people should know about this so that a they can make an informed decision about medication and b) so that non-specialist doctors (in Britain we call them GPs) can be more careful about whom they prescribe them to.

Tom (Oct 1, 2002): My dr just prescribed some Zoloft for my mild anxiety. Now this scares me. He told me there were no side effects. The good news is that he told me to take only 1/2 of a 25mg tab once a day, in the morning. That is a small dose - he is a cautious dr. I have a mild headache and feel spacey today. I am having second thoughts about taking this stuff. I have a wife and a 2yr old child and if God forbid I hurt them I would have to finish with myself. Not that I am thinking of such a thing - it's horrid, but as the article states sometimes these drugs seem to "possess" you and by the time you realize it the deed is done. It's one thing to say that the horrid examples are rare, but who wants to take the chance that they might be one of the rare instances??

Are there any warning signs beyond feeling hyper?

McMan (Oct 1): Hi, Tom. Zoloft's own labeling makes a liar out of your doctor. As well as a list of side effects as long as your arm, the labeling also mentions that 14 percent of the subjects in their trials dropped out due to adverse effects. So if your doctor won't level with you, it might be worth finding one you can trust. On the positive side, these side effects usually go away as your body adjusts to the drug. The cases mentioned in this article are extremely rare, but not to bring them to the attention of readers would have been irresponsible. Your wife will be the first to notice any odd behavior from you, so trust her. If you do find yourself getting hyper, you can return to normal very soon after quitting the medication.

Heather (Oct 10, 2002): No wonder us mentally ill have such a bad rap! Because of things like this being printed, of course people are going to think we are crazy! We have enough problems without this crap being printed. I don't believe it for a minute!!!

McMan (Oct 10): Maybe I - and all the other people - just made up our stories, Heather. Sweet delusions to you.

Peter (Oct 12, 2002): My condolences also to Mark and others who have suffered tragic consequences from Prozac or other meds. I accept that Prozac has helped many without adverse effect, but for me it had the immediate and frightening effect of causing extreme irritation and impatience. I found myself slamming doors and hanging up the phone on people. This was totally out of character for me and I could hardly believe I was doing it. I stopped the drug within days without waiting to call my doctor. No other antidepressant of the 6 or 8 I've tried among the tricyclics, other SSRIs, and MAOIs, had any remotely similar effect. Maybe it kicked me into the manic state from hell. I don't know - I just know it was horrible.

Bryan (Oct 13, 2002): I was very interested to hear that Prozac and other SSRI's have been found to induce mania. My own story is very similar, although not as extreme as that of John. The initial diagnosis of my doctor was GAD (Generalized Anxiety Disorder) so he put me on Zoloft. I was riding high for about two weeks. I didn't need to sleep and I didn't have nearly enough inhibitions. We switched to Paxil after two weeks and it was more steady, but after increasing the dose to 20mgs per day, I started to rapid cycle. This is actually how I came to find out that I was bipolar. The mania induced by the Paxil was incredible. I was euphoric, on top of the world; but it only lasted for three days at a time. The other four days were spent down in the very low and very dark place we call depression. It was a vicious cycle. I found this article very helpful because it described my own story (though mine is not as extreme) and let me know that I was not the only one experiencing these kinds of reactions to the SSRIs.

Gemma (Oct 21, 2002): I was put onto Prozac earlier this year. i had been depressed for about a year previous, just feeling down and i had no confidence. within 4 days of taking the medication i was feeling spaced out and i couldn't concentrate. i took a taxi miles from home and took 15 tablets, i still don't know why. i ended up going to a strangers house and terrifying them by calling her a witch and not leaving. the police were called and although i can't remember this i apparently acted like a wild animal. i was cuffed and forced into the car where i bit kicked and screamed. when i was taken to the cell, seeming to have calmed down they removed one cuff, i punched the female officer in the face and had to have my shoes and anything dangerous removed from me for their protection. in the morning i had a bad head injury from the restraint but i couldn't remember a thing. i was charged and appeared in court. i stopped taking the pills immediately but i could still feel them affecting my body perhaps due to the large quantity i took. the evening after my arrest i took a paracetamol overdose and ended up in hospital. a few days later i cut into my wrist, using scissors and a stanley knife and played around with the tendons eventually cutting through them. i did all of this calmly and then took a taxi to hospital. eventually a week later i seemed to be back to my old self. a few months on i have now been prescribed Lustral US name Zoloft. it has been three days now and i feel spaced out but not much else. i am watching for signs of mania and i am warning my partner to watch me closer than ever. it's a catch 22 you need the pills to make you better but its the very cure that could make you worse!

Linda (Oct 15, 2002): i had a horrible experience with Prozac. my dr., at the time, insisted i keep taking the med and even recommended i double the dose.. i felt like i was losing my mind and in a manic state the entire 3 wks. i quit the med on my own. a couple of years later found the medication that works for me and have been stable for almost 10 yrs thanks.

Brandi (Oct 27, 2002): Looking back before I was diagnosed bipolar this year, it is obvious to me that Prozac induced rapid cycling in me. I was first prescribed Prozac for post-partum depression in March 1998 and was on a roller coaster ride until April of 2000. Since the hypomania felt so wonderful, I never reported it to my psychiatrist. During my last trimester of my last pregnancy, I was hypomanic while on Zoloft (the first two trimesters I was severely depressed). My credit card bills were outrageous!!! I was mopping floors at two a.m. After the baby was born, I was superwoman doing everything on very little sleep and then hit pure mania and ended up in the hospital. I believe that these antidepressants can induce mania and I am grateful that nothing horrible happened while I was on them without mood stabilizers.

Gemma (Oct 28, 2002): Heather, you are fortunate enough not to have had side effects to medication. the fact that the leaflets display the side effects some of us have mentioned (although some of our cases are extreme) shows that we are not printing rubbish. We are telling factual tales of bad experiences. I pray that you are never given a drug you react adversely to and if you are I hope you have sites like this to let you know you aren't alone or a freak for acting that way

Gemma (Nov 12, 2002): just thought i would let everyone know that lustral or Zoloft (US) gave me the same problems as Prozac on a slightly less dangerous scale. after three weeks i began to get that all too familiar numbness and started to walk around in a daze. i quit college and last week i took a tantrum and started throwing things at my parents and locked myself in the bathroom til my mother kicked the door in. i then took a needle the following day and pushed it over and over into my legs and started to superficially cut them. i recognised the symptoms and knew if i didn't act then i could end up in serious trouble. i went to my GP and he switched me to lofepramine. BUT i have to wait a week to take them because i still have SSRI in my system. for the last week i have sat at home alone all day crying and contemplating suicide. apparently the drug i have been given is a safer tca but the thought of taking all 56 has crossed my mind to stop this emptiness. anyway i'm "coping" for now just thought i would update.

Kim (Dec 18, 2002): How do you know if it's Prozac Mania or a revelation of bipolar disorder? Four years ago I was diagnosed with bipolar after being on Prozac for depression. After a few weeks on the Prozac, I went into a manic phase where suicidal tendencies entered my mind & landed me in the hospital. I've often questioned my diagnosis. Three doctors have confirmed it, one saying there's no such thing as Prozac Mania. Reading this article & it's comments, it seems the doctors really don't know what they're doing, & that it's imperative the patient be informed about mental illness. Does one have to be manic for a certain period of time for it to be considered bipolar? What makes Prozac Mania different from the happenstance of the anti-depressant revealing bipolar disorder? I would appreciate any information on this topic.

McMan (Dec 18): Hi, Kim, if you go into mania, you are generally regarded as having bipolar, whether it was induced by an antidepressant or not. There is no distinction between "Prozac mania" and bipolar. One authority has actually proposed there be a BP III classification for antidepressant-induced mania. Having said that, there is a state, akathisia or mental restlessness where you feel like jumping out of your skin, that is different from mania. Antidepressants can induce akathisia. The distinction between this and mania can be very subtle, which is why we need competent pdocs. For more on giving antidepressants to potentially manic patients, please see the articles, Bipolar Depression, and Multipolar Depression.

Gemma's sister (Feb 3, 2003): I found out Gem was emailing this address from checking her hotmail account. Just thought I should let you know Gem died last week. The doctor prescribed Prozac AGAIN. We didn't know she had a problem with this so encouraged her to take it. 9 days later she hung herself and left a note to tell us she was sorry but she couldn't live with her head anymore. I guess she meant shed lost her mind in a way. She said she felt empty and lost, and the physical pain she felt killing herself was nothing compared to the mental strain of living. She said she knew Prozac would make it easy and in a way she thought it was God's will that she was put on it again. I know this is only hearsay but I do know Gem was so strong before she started taking meds of any kind. Gradually they broke her down. I feel so low since she died to the point of understanding why she thought she needed tablets to cope. She's given me a lesson in a way. I'm going to a counsellor for help, not a pharmacy! Good luck.

McMan (Feb 3). My thoughts and prayers go out to you, sister of Gemma. Please be assured you did everything possible for her and nothing different would have helped. This illness is bitterly cruel, but its hardest blow often falls on the people left behind. This is a burden you shouldn't bear alone, so please do seek out a counselor.

Note to readers: Please do not jump to hasty conclusions that the Prozac was the cause of Gemma's death. It is tempting to say her doctor should have known better than to prescribe the Prozac a second time, but she might not have told her doctor what she has told us. If there is one lesson from this terrible tragedy, it is if you are experiencing trouble with your medication or any aspect of your illness, make sure your doctor or psychiatrist knows, and make sure your friends and family are in the loop.

Gabby (April 27, 2003): My father committed suicide July 20th 2000 after having three different side effects of Prozac mania withdrawal and Akathisia.
Dad stopped taking Prozac because of the sever mania he developed while on Prozac, he wasn't told not to just stop that he needed to be weaned off, after he went cold turkey he went through a sever withdrawal which the doctors said was a recurrent depression and put him back on 20mgs of Prozac. Every pill was if dad was eating rat poisoning he became sicker and sicker he could no longer eat or drink anything he was hospitalized for dehydration and released. Dad kept telling everyone that he felt as if he was coming out of his skin like someone was behind him scaring him constantly we didn't know at the time dad had Akathisia a severe inner restlessness. Dad stopped talking to anyone, just sat and stared at the wall even noises from the neighbors yard was more than he could stand. The doctors were told of his state and increased his dose to 40mgs and three days later mom found him in there shower a gunshot wound to his head. Before Prozac dad was never a suicidal person and I believe it was the Akathisia that pushed him over edge.

McMan (April 27): My sincere condolences, Gabby. As I told Gemma's sister, be assured there is nothing you could have done to prevent this awful tragedy. To the rest of my readers: If I could afford a lawyer, he or she would advise me to say that Gabby's opinion on the cause of her father's death is her opinion only and doesn't reflect the views of John McManamy or this website.

Alan (May 15, 2003): In the summer of 1998, I began experiencing what would later be diagnosed as "panic attacks." 3-5 times/day, my heart would race up to 160bpm, I'd become short of breath, feel like I'd not eaten in days and sweat through 2 layers of clothes. Prior to the rapid onset of these symptoms, I'd been healthy, athletic, very social and possessed of an active sex life and stable emotional platform. After many blood tests, EKG's, imaging, etc, I was pronounced free of diabetes, hypoglycemia, HIV, heart disease and a host of other underlying conditions which could have explained the symptoms. I lived with the problem until January 2001, when the MDs informed me that, because they couldn't identify the cause, it had to be anxiety disorder, in spite of the fact that there was never an emotional component to these episodes. My body was freaking out, but I never experienced feelings of fear, panic or doom. Just annoyance that my body was misbehaving.

A psychologist who treats my autistic sibling talked me into seeing a psychiatrist, who prescribed Prozac and klonopin after spending only 20 minutes with me. This marked the end of my life as I had previously lived it.
It took 2 1/2 years of "panic attacks" to wear me down enough to get depressed. It took Prozac 2 months to induce manic behaviour and an emotional rollercoaster. For the 1st time in my life, I blew through a lot of money, alienated most of my friends and family and have remained completely impotent since the 7th week of Prozac therapy (2 years ago!).
The "doctors' " response to all this was MORE DRUGS. I needed additional drugs...I needed higher doses. In spite of the fact that the drug therapies never alleviated the original problem and seemed to be causing new ones.
After cycling through Prozac, Wellbutrin, Xanax, Klonpin, lithium, Lamectil, Zyphrexa, Trileptal and Depakot, I was still sweating through my clothes and suffering palpitations and high blood pressure.

I discontinued all drug therapy in October 2002, except for Xanax which required 12 weeks of withdrawal. In January 2003, I was diagnosed with oral thrush, but tested negative again for any underlying condition (diabetes, HIV, etc). In an effort to treat the thrush, I removed from my diet all sugar and most starchy carbohydrates. 72 hours later, I realized I had gone an entire day without a "panic attack," the first time in almost 5 years! My blood pressure has returned to 120/80, my pulse is normal and I no longer sweat through my clothes 3 times a day. The animals who treated me have no explanation, and insist their original diagnosis of panic disorder is correct, in spite of my downward spiral under their drug therapies and my rapid recovery following the dietary change. Has anyone heard anything similar to this rather long winded tale?

McMan (April 15): Hi, Alan. Check out my article on sugar. Sugar can throw some people completely off. Unfortunately, doctors and psychiatrists are apt to prescribe drugs before they rule out dietary causes or vitamin or mineral deficiencies. The bad news is five years of your life shot to hell. The good news is you've reclaimed the next 50 or more years. I hope you will be able to look ahead to all the good things life has to offer.

Ruth (July 15, 2003): I have been on almost every anti-depressant and been in counseling for over four years this time. This is about my fourth bad cycle I think. I have fought depression since I was a teenager. Four generations of my family are on anti-depressants. I started on Prozac about 2 months ago after coming off Effexor. Within days I was so high. But it felt so good compared to wanting to kill myself. I started on 20 mg. They wanted to cut back to 10 mg. but then I started to dive again. A week later I was upped to 30 mg and now I am up to 40 mg. My mood is continuing to go up and down. Now they are adding Lamictal. I am so tired of fighting this disease. I also have cardiomyopathy, migraines, blood pressure problems, had cervical cancer and am going deaf. Many times I want to call it quits because the State pays for my health care and I cost them so much. I have also trie.. and again, it helped for awhile and then I started to go down again. We tried maintenance ECT but the effects lasted about a week and then boom again. Do you know anything about the implants they have been trying for depression?

SonOfJohrel (Dec 10, 2003): I was diagnosed with major depression about a year ago and was prescribed Prozac. After two weeks taking 20mg a day, I found that for once in my life I was actually happy. However, I noticed that when I drank a certain amount of Alcohol (like maybe a pint of beer), I would become manic and behave like a mad-man. The final straw came when I threw a bucket of paint over my neighbour's car and left a trail of footprints leading right to my front door. There was also another time where I exposed myself to a female flat-mate. Both of these incidents caused me extreme embarrassment and so I had to quit Prozac. I tried to quit drinking but found that impossible, as it's much easier to just not take a tablet, rather than deprive yourself of something you enjoy. Anyway. What I want to know is, do I have Bipolar disorder if I am only ever manic after taking Alcohol and/or Prozac? And if so, is there any way for me to take Prozac safely?

McMan (Dec 10): Hi, SonOFJohrel. Hagop Akiskal MD of the University of California, San Diego argues that people whose mania only happens when taking an antidepressant should be considered part of the bipolar population. What the mania trigger reveals is that antidepressants may not work for you, that what you need for your depression are meds that treat bipolar depression such as Lamictal. If you have bipolar, an antidepressant can only be used safely with an antimania drug such as Depakote or Zyprexa, and even then there is a risk of a manic switch.

Lynda (Nov 26, 2004): I was put on Prozac on Oct 16th 2003 I have a court date on Monday Nov 29th 2004. I went to jail 2 times in 4 days.. Tried to kill myself in the same 4 days. Need I say more?

Marium (Jan 30, 2004): On October 23,2003, my 31 year-old son shot himself. He had been diagnosed as bipolar in March. The doctor put him on Xanax, Effexor, a mood stabilizer, and a sleep enhancer (all at once). His whole personality changed. He became hostile to his wife and children. He began seeing other women, turned his back on God, and began talking about suicide. His father called his doctor about three weeks before he committed suicide and told the doctor that this wasn't our son. The nurse (doctor wouldn't talk with his father) told him that our son would have to VOLUNTEERILY go to a hospital for an evaluation. The nurse was told of the danger we feared he was in. (That weekend he had gone off alone camping and had carried the very gun he killed himself with.) As far as we know, he saw the doctor once more and nothing was done. We feel that he did this because the medicines drove him totally crazy. He had gone 30 years without meds and had been stable. I knew he had an addictive personality because he fooled around with marijuana, etc. in high school, but had been 'straight' for years. His wife did say 'after the fact' that he would take pain killers, etc. when they were prescribed, but that he would get them refilled to the max.

There are so many unanswered questions, so much pain. Could someone please help our family to get some concrete answers? Can we force the doctor to talk with us? What does the law say about this???? Since our tragedy, I have heard many horror stories about misdiagnoses, over medication, etc.

McMan (Jan 30): My deepest condolences, Miriam. The meds the doctor prescribed are fairly normal for a bipolar patient with either anxiety or a sleeping problem. Any legal action against his doctor would hinge on whether his doctor negligently or recklessly disregarded your son's complaints, assuming your son made his complaint known. I don't know whether his medical records could be made public. Your best bet is to consult a lawyer. The other option is a legal action against one of the drug companies. There have been out of court settlements and at least one successful legal action regarding antidepressants, but it will be a long battle.

Andee (July 6, 2004): Fourteen months ago, after the birth of our second daughter, my husband was put of Effexor. I told him I personally had a horrible reaction to it and fought endlessly to get him off it. Things became worse, much worse. He was unpredictable by the minute on what mood he was in. On 7/1/04 with out any warning I found him in our garage after slitting his wrist. This was completely out of character for him. We took him to the ER and he was admitted to the psych ward. He came home yesterday. The diagnoses was bi-polar II and the culprit was the Effexor that manifested all of this. Things will never be the same. I will fight to the day I die to get this drug off the damn market. Pissed? I'm way beyond that! I almost lost my husband, best friends and a wonderful Daddy to our 2 girls over a damn drug that was prescribed as if it was candy! Not once was any "therapy" recommended. The worse part, I never saw it coming. It should be mandatory to have a psychological evaluation before ANY anti-depressants are handed over. All of this could have been prevented, no one would listen to me despite all my attempts. Rather the doc doubled the dose. Makes you wonder?

MP (Dec 14, 2004): Prozac is being given like candy to a baby I went to the doctor last week and told him I might be depressed. I told him that I've had an addictive personality for years and that I often hid my depression with marijuana and alcohol. I then start using E because it made me feel up. I recently stopped using drugs and alcohol and went back to school. That when I realized the severity of my condition. I would study for hours on end as if I were compelled to do it. I then would just feel down when I wasn't and it felt horrible. I went to the doctor for the first time about this and he prescribed prozac within about 15 minutes. I have now being reading several article and am terrified at what I have now done. I don't know what to do. I wanted to get away from drugs and feel clear headed and normal, but I now feel in a haze and don't care about things much. I am not suicidal but in the past I have always thought I would die young. I have two young children and want to make sure I am there for them and I don't completely lose my mind. Should I get off this drug and what type of solution is there for me? I also have anxiety. Please help. MP

McMan (Dec 14): Hi, MP. Believe me, the Prozac is by far the least dangerous drug you've taken out of the ones you mentioned, plus it has a pretty good chance of improving your depression and compulsions. But it might not be the right drug for you. Also, 15 minutes is not enough time for a comprehensive depression or anxiety screening. My guess is you saw a GP. You might want to make an appointment with a psychiatrist, who not only will give you a more careful screening, but will follow through with more careful treatment.

Sarah (Jan 18, 2005): Mother in law has Ms, aged 53 diagnosed at 27, prescribed prozac in 2000, admitted under voluntary section to psychiatric hospital sept 2003 following episodes of mania which VERY gradually became extreme and uncontrollable. Dr who originally prescribed for her depression referred her to psychiatrist to oversee Prozac prescription when we complained that she was doing peculiar things in the house such as laying items out in piles, collecting newspapers and putting things like T-towels on the floor in patterns etc... when behaviour became more unpredictable he blamed manic depression as cause and tripled dose causing insomnia, irritability, extremity of mood wings never previously seen. With Ms comes memory dysfunction, we only realised once we moved in to care following a scary incident involving a fluffy toy found burning on a light bulb that she had been hiding prozac for 'rainy days' and doubling doses thinking she had forgotten to take them, we still don't know how many tablets she took.. final straw was when we found her cutting open a raw chicken with gardening clippers on the kitchen floor whilst swearing repeatedly...

As a police officer I telephoned the Gp and local Mental health team to attend the address or I would take her personally under section 136 to the local psychiatric hospital. They came, as she sat in her incontinence pad and t shirt rambling incoherently in the kitchen, finally agreed to arrange a bed. To add insult to injury did not carry out an urgent detox but placed her onto a cocktail of drugs including diazepam zopiclone prozac temazipam and a stabilizer for bipolar (name I have forgotten). To cover their negligence diagnosed her with bipolar to explain away her manic behaviour. We took mum home early as the drugs zombiefied her like the elderly in care homes with altzheimers (drug em and keep em quiet) , cared for her 24 hours a day weaned her off the cocktail of drugs they prescribed cutting her bipolar drug into quarters then half over the course of two months. Mum has been drug free for almost one year, her memory serves her very well now and she recalls many but not all of the incidents. She is anti depressant free and coping with life like your average person. She never had bipolar, has been signed off the mental health books and is building her life up again with NOT ONE single manic episode since prozac left her veins. Why oh WHY? do doctors prescribe drugs like smarties when they have absolutely no idea how the individual may respond? We are still paying the debts from her catalogue spending sprees but we have her back as a human being and it was thanks to the internet that allowed us to reach this stage, I will NEVER trust a doctor again. God help those poor souls with no-one to help them.

Stephanie (Jan 7, 2005). all i know is that i was also put on prozac before my doctor diagnosed me with bipolar and it made me hallucinate and sent me into the worst manic state ever! i tried to strangle my mom...and i probably would've killed her but my brother called the cops and they took me away.

Sandra (Jan 27, 2005): Prozac induced mania in me after just 5 days of taking it. I have been bipolar ever since. I had no previous history of this. SSRIs should be banned.

Joe 3/10: After taking Celexa, I had amnesia, mania, suicide attempt with shot gun, hallucination, pneumonia, spending spree and a one time alcohol abuse. I missed with a shot gun. The police shot me with a bean bag bullet three times. I struggled with police and was finally subdued. they told my wife that they thought I was on PCP, I was put in the psych hospital for 2 weeks 2 years later I'm still fighting the justice department.

Mary 4/24: My employers expressed their "concern about my manic behaviour" in two letters to my Occ. Health Doctor,8 months apart, on the two occasions I admitted to be very low and flat! I was on 40 - 60 mg Prozac daily at the times! Because I am in Health Care Delivery, credance has been given to their views, and I am tormenting myself and friends to explain where my behaviour has shown to be manic. I have always been talkative normally, and enjoy a good laugh, and can get annoyed , as is normal for almost everyone. Since coming off Prozac, I find I am able to "feel" again, as if the straitjacket of restraint has been removed, but my GP has never considered treating me for symptoms of mania, as they have never been exhibited in his presence. Am I missing something, or could I be correct in thinking my employers assessment akin to malicious -ness?

No comments: