Freethought & Rationalism Archive

lunachick · 08-07-2003, 03:30 AM

http://www.nytimes.com/2003/08/07/health/07DEPR.html?th

This is a three page report, and I chose to quote material from the third page, although the whole article is interesting, and a little confusing. The first page is more relevant to some of our younger members here who are using SSRI's, but I quoted material that is more relevant to adults.

Your thoughts on this are appreciated. Cheers.

Quote:

F.D.A. procedures required Lilly to inform the agency of any concerns about Prozac raised by other national health authorities. But court records show that Lilly never told the F.D.A. or the expert panel that German regulators initially refused to approve Prozac's sale in 1985 because of concerns over a link with suicide.

In their analysis of Lilly's data, the German authorities said that Prozac seemed to have caused a substantial increase in suicide among users, according to court records. Ultimately, the Germans approved Prozac with a warning that physicians should consider using sedatives for patients at risk of suicide.

No such warning is included in Prozac's label in the United States, although the risk of suicidal thinking is listed among the drug's side effects.

Gary Tollefson, a Lilly executive who spoke before the 1991 panel, was asked in a deposition why he did not tell the experts about the German concerns. "That was not a question I was asked," he said, according to court records, "so I did not answer that question."

Documents brought to light in other cases suggest that Lilly struggled for years to reconcile suicidal events among patients taking Prozac in its trials. One memo shows that a top Lilly executive asked the company's own researchers to record suicide attempts as "overdose" and thoughts of suicide as "depression."

In another memo, a Lilly employee objected to those instructions, making reference to the German health authority, known by its initials as the B.G.A. "I do not think I could explain to the B.G.A., a judge, to a reporter or even to my family why we would do this especially on the sensitive issue of suicide and suicidal ideation," he wrote.

In a recent statement, Lilly said: "There is no credible scientific evidence that establishes a causal connection between Prozac and violent or suicidal behavior. To the contrary, scientific evidence shows that Prozac and other antidepressant medications appear to reduce these behaviors."

Lilly representatives told the 1991 panel that the company had put together a series of proposed studies to examine the suicide issue and said one of the studies had already been started. According to plaintiffs' lawyers, Lilly never completed the study; Lilly declined to comment.

Were the F.D.A. to reconstitute the 1991 panel, its members would again be presented with a confusing mix of data on the issue � despite the passage of 16 years since Prozac's introduction and the use by tens of millions of people of it and other S.S.R.I.'s.

Under the circumstances, one member of the panel, Dr. Keh-Ming Lin, a professor of psychiatry at the University of California at Los Angeles, said the new information unearthed by regulators might lead him to change his vote absolving S.S.R.I.'s of suicide risk.

js_africanus · 08-07-2003, 05:43 AM

IIRC, Prozac is a motivator. If you're already suicidal, but too depressed to go through with it, Prozac may be just the thing to help you help yourself to kill yourself. That's how an old nerual-psych prof. explained it to my class.

Coragyps · 08-07-2003, 09:18 AM

My own experience with Prozac back in 1990 is in agreement with that idea, js. Had I been a little more suicidal or a little less supervised by my psychiatrist, I might not be posting here today. Before I started Prozac, I had only enough motivation to sit up in a chair.

js_africanus · 08-07-2003, 10:16 AM

Quote:

Originally posted by Coragyps
Had I been a little more suicidal or a little less supervised by my psychiatrist, I might not be posting here today.

I'm glad to see you're still with us.

Sharif · 08-07-2003, 12:00 PM

Quote:

Originally posted by Coragyps
My own experience with Prozac back in 1990 is in agreement with that idea, js. Had I been a little more suicidal or a little less supervised by my psychiatrist, I might not be posting here today. Before I started Prozac, I had only enough motivation to sit up in a chair.

My experience with Prozac is very similar, though I must note that after my intial increased desire to end my life, my depression did abate.

lunachick · 08-08-2003, 12:02 AM

Thanks for your replies, folks. What you have to say is interesting, and follows my own experience of a generic prozac drug. I've had blacker, more seriously suicidal thoughts while using them, too. In fact, the closest I have ever come was while on Prozac.

Personally, it makes me wonder about whether they had anything to do with the death of one of IIDB's members last year.

Mods - seeing as this thread is more anecdotal, rather than scientific study and analysis, may I requst that this topic be moved to Misc Disc, where some of the other IIDB members, particularly the younger ones here who have struggled with suicidal thoughts, may read the article and realise that it's not them - it's the drugs. It may help them to overcome the worst of their suicidal feelings if they have that new awareness.

Those of you, younger and older, who have or are using SSRI's, and still find yourselves struggling with suicide, please sign up with the New York Times to read the entire article - it's a free (and spam-free) sign-up, and well worth it.

Prozac is not the only drug discussed.

Take care,
Petra

reprise · 08-08-2003, 12:14 AM

I don't remember ever not being aware that SSRIs can amplify suicidal tendencies - it's one reason why patients to whom they are prescribed are supposed to be monitored extremely closely during the initial prescription period and following any changes of dose. When I was prescribed fluoxetine, my doctor told me to call him immediately if I experienced any unusual feelings (including, but not limited to suicidal ideation) and made sure that I had all of the phone numbers at which he could be reached 24/7. The backup plan if I could not reach him was for me to call an ambulance and get to a hospital ASAP.

From what I have read, this is precisely how SSRIs should be prescribed, but they are quite often inappropriately prescribed and the patients to whom they are prescribed inadequately monitored.

lunachick · 08-08-2003, 10:16 PM

Wow, reprise.

I have to say that you must have a much better, or at least better informed, doctor than most.

Stick with him/her!

jayh · 08-09-2003, 05:47 PM

I've heard it observed that patients in full scale depression rarely suicide, it's when they are coming out that they actually acquire the motivation (with our without Prozac).

What this seems is is another hyping of fear. Psychoactive drugs have real risks, that is why they require close supervision. But the risks of non treatment are even greater. A study just published compared deterioration of the hypothalmus in depressed people (a known phenomenon) with a matched group who go (predominantly) drug treatment. The treated group showed less deterioration.

Philosoft · 08-09-2003, 07:33 PM

Quote:

Originally posted by jayh
I've heard it observed that patients in full scale depression rarely suicide, it's when they are coming out that they actually acquire the motivation (with our without Prozac).

That's it. People in deep depression often lack the motivation to do anything, including kill themselves. Something that removes a "portion" of the depression will often increase motivation.

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08-07-2003, 05:43 AM	#2
js_africanus Junior Member Join Date: Jul 2003 Location: Rural Michigan Posts: 55	IIRC, Prozac is a motivator. If you're already suicidal, but too depressed to go through with it, Prozac may be just the thing to help you help yourself to kill yourself. That's how an old nerual-psych prof. explained it to my class.

08-07-2003, 09:18 AM	#3
Coragyps Veteran Join Date: Aug 2001 Location: Snyder,Texas,USA Posts: 4,411	My own experience with Prozac back in 1990 is in agreement with that idea, js. Had I been a little more suicidal or a little less supervised by my psychiatrist, I might not be posting here today. Before I started Prozac, I had only enough motivation to sit up in a chair.

08-08-2003, 12:02 AM	#6
lunachick Veteran Member Join Date: Sep 2002 Location: NZ Posts: 7,895	Thanks for your replies, folks. What you have to say is interesting, and follows my own experience of a generic prozac drug. I've had blacker, more seriously suicidal thoughts while using them, too. In fact, the closest I have ever come was while on Prozac. Personally, it makes me wonder about whether they had anything to do with the death of one of IIDB's members last year. Mods - seeing as this thread is more anecdotal, rather than scientific study and analysis, may I requst that this topic be moved to Misc Disc, where some of the other IIDB members, particularly the younger ones here who have struggled with suicidal thoughts, may read the article and realise that it's not them - it's the drugs. It may help them to overcome the worst of their suicidal feelings if they have that new awareness. Those of you, younger and older, who have or are using SSRI's, and still find yourselves struggling with suicide, please sign up with the New York Times to read the entire article - it's a free (and spam-free) sign-up, and well worth it. Prozac is not the only drug discussed. Take care, Petra

08-08-2003, 12:14 AM	#7
reprise Veteran Member Join Date: Jul 2003 Location: Sydney Posts: 3,997	I don't remember ever not being aware that SSRIs can amplify suicidal tendencies - it's one reason why patients to whom they are prescribed are supposed to be monitored extremely closely during the initial prescription period and following any changes of dose. When I was prescribed fluoxetine, my doctor told me to call him immediately if I experienced any unusual feelings (including, but not limited to suicidal ideation) and made sure that I had all of the phone numbers at which he could be reached 24/7. The backup plan if I could not reach him was for me to call an ambulance and get to a hospital ASAP. From what I have read, this is precisely how SSRIs should be prescribed, but they are quite often inappropriately prescribed and the patients to whom they are prescribed inadequately monitored.

08-08-2003, 10:16 PM	#8
lunachick Veteran Member Join Date: Sep 2002 Location: NZ Posts: 7,895	Wow, reprise. I have to say that you must have a much better, or at least better informed, doctor than most. Stick with him/her!

08-09-2003, 05:47 PM	#9
jayh Veteran Member Join Date: Oct 2001 Posts: 4,606	I've heard it observed that patients in full scale depression rarely suicide, it's when they are coming out that they actually acquire the motivation (with our without Prozac). What this seems is is another hyping of fear. Psychoactive drugs have real risks, that is why they require close supervision. But the risks of non treatment are even greater. A study just published compared deterioration of the hypothalmus in depressed people (a known phenomenon) with a matched group who go (predominantly) drug treatment. The treated group showed less deterioration.

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