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The issue of antidepressant-induced homicide brings into focus the broader problems with prescription drugs, psychiatrist Dr. David Healy said during an Oct. 5 webinar.
Those problems include the failure of medical professionals to recognize serious side effects of drugs, and the justice system’s tendency to protect pharmaceutical companies — not people.
Healy, one of the United Kingdom’s foremost experts on serotonin reuptake inhibitors (SSRIs) has studied antidepressants for 40 years as a researcher, clinician and consultant for Big Pharma.
In the webinar, he presented cases involving people who were living stable and healthy lives — until they were prescribed antidepressants, after which they became aggressive, delusional and homicidal.
Those impulses subsided once the people stopped taking the drugs. However, in many of the cases Healy highlighted, by the time they stopped taking the drugs, they had already committed homicide.
One well-documented case involved 12-year-old Christopher Pittman. Pittman began exhibiting aggressive behavior — fighting with other children and acting extremely agitated in church — almost immediately after taking Zoloft.
Less than one month after starting the drug, he said he heard a voice tell him to kill his grandparents, with whom he lived. That night, he shot them and burned down their house.
In 2005, Pittman was sentenced to 30 years in prison, after a jury declined to find that Zoloft had caused his homicidal behavior. However, U.S. Circuit Judge Daniel Pieper gave him the most lenient sentence possible.
Healy quoted Pieper’s statement during sentencing:
“It seems to turn the whole medical system on its side if you can’t rely on the medication your doctor prescribes. It potentially forces you into a situation of lifetime commitment if that drug induces an effect of which you are unaware when you go on it. There’s something disconcerting about that … probably of a legal nature, that’s troubling me.”
That same year, just before the verdict, the U.S. Food and Drug Administration (FDA) began requiring SSRIs like Zoloft to carry suicide warnings, The New York Times reported. In Canada, SSRIs also carry an additional warning: a potential increase in hostility, aggression and “harm to others.”
Zoloft’s manufacturer, Pfizer, maintained the drug was safe. However, according to the Times, Pfizer also reported immediately following the verdict that 14 other criminal cases blamed Zoloft for people’s actions.
Eli Lilly, the manufacturer of Prozac, confirmed the drug had been blamed in over 75 criminal cases. The drugmaker said it was unaware of any cases in which the defense had succeeded.
That’s precisely the problem, according to Healy. Today, nearly 20 years after Pittman’s case, no jury has acquitted a person who claimed antidepressants caused them to commit a murder.
However, there were a few cases in which courts recognized the link between antidepressants and homicide, Healy said.
In one case, a man killed his wife, children and himself 48 hours after being put on GSK’s SSRI, Paxil. One of the daughter’s husbands sued GSK in Wyoming and won financial damages.
In Australia, the case of a man who killed his wife after he was prescribed Zoloft was heard by a judge — not a jury. The judge dismissed the charges, ruling that Zoloft had caused the man’s behavior.
Healy said that when these defenses — blaming antidepressants for violent behavior — first emerged, Pfizer and GSK developed a strategy to combat them. The Zoloft prosecutor’s manual, which Healy said was later refined and revised, was a playbook for prosecutors to rebut the “Zoloft defense.”
The manual’s rebuttal hinges on the claims that violence is common in the U.S. and that the FDA has found the drug to be safe. It also advises lawyers to emphasize the lack of statistically significant evidence from double-blind placebo-controlled clinical trials causally linking Zoloft to aggressive behavior or to akathisia, which are strong subjective feelings of distress or discomfort that could also induce violent behavior.
Pharma knew the dangers but manipulated the data
During the “Mad in America” webinar, Healy outlined a long history of the link between drugs and “automatism” — when drugs produce involuntary actions in people taking them. Those involuntary actions can range from pacing to sleepwalking to homicide.
Swedish neuropharmacologist and Nobel Prize winner Arvid Carlsson, M.D., Ph.D., created the first SSRI, Zelmid, which went on the market in 1982. Carlsson recognized from the outset that the drugs would have positive effects for some people and negative effects for others, Healy said.
When Pfizer started marketing Zoloft in 1992, Carlsson — knowing that SSRIs affect people differently — advised the company to carefully monitor how different people responded to the drug. But that approach ran counter to Pfizer’s ambitious plans to have the drug prescribed widely, replacing addictive drugs like valium, Healy said.
According to Healy, at the time, Pfizer already knew that Zoloft had caused suicidal and homicidal impulses, even in healthy trial volunteers.
The challenge of identifying these serious adverse effects is compounded by the fact that “doctors today have great trouble” monitoring how a drug actually affects each patient, as opposed to how the doctor believes the drug should work.
“They are people of the book increasingly and not able to see and hear what’s happening when you’re on these drugs,” he said.
Healy believes most people mistakenly think SSRIs act on the brain, but that most of their effects occur in the body.
The drugs are meant to produce a “serenic effect,” or anti-aggressive effect, which they often do. The problem is that in some people, they have the opposite effect.
SSRIs reduce sensory input from the body to the brain, which can cause feelings of physical and emotional numbness, Healy said. That’s also why SSRIs are often associated with loss of libido and sexual dysfunction.
The drugs work less by treating an illness and more by changing personality, he said. The emotional muting and feelings of aggression and akathisia are what can make the drugs induce suicide or homicide.
Healy walked through a range of examples, including cases documented in the scientific literature and cases he has seen in his own clinical practice of people who experienced dramatic and violent personality changes — changes that disappeared once they stopped taking the drugs.
He also said that companies like Pfizer and GSK — with the FDA’s full knowledge — manipulated and buried much of the data indicating drugs like Zoloft were either ineffective for the conditions they were supposed to treat or induced aggressive behaviors toward self or others.
The drugmakers’ altered studies were then published in journals like the New England Journal of Medicine, Healy alleged.
Healy said he believes most people have great faith in these institutions. This makes it difficult for them to accept that the FDA could license a drug that could cause a person to commit murder, or that top journals could publish trial results manufactured by Big Pharma.
“The greatest concentration of ‘fake news’ on this earth centers on the drugs your doctor gives you. Not just the SSRIs, but all of them,” he said.
Healy called for a return to a clinical practice of medicine where doctors and patients engage in dialogue, and together analyze how a drug affects each patient. He also called for a legal system that recognizes when drugs have caused serious problems.
Watch Healy’s presentation here:
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