Overprescribed: Suicides Haunt the Dubious Approval of Antidepressants
Overprescribed: Suicides Haunt the Dubious Approval of Antidepressants

By Huey Freeman

On Friday, Sept. 8, 2023, a gorgeous late summer day in Wisconsin, Dale Niggemann came home and saw a note left on the door by Maggie Stern, 55, his best friend and partner for the past five years.

The note said, “Call 911.” First responders arrived at their home and discovered Ms. Stern’s body.

“She said she was in a lot of pain all the time,” said Mr. Niggemann, 57, who was at Ms. Stern’s side as she struggled with the adverse effects of an antidepressant—and painful withdrawal symptoms each time she tried to wean off them.

“She suffered from migraine headaches, tremors, burning pain sensations in her nerves, and dark thoughts about demons and hell.“ Mr. Niggemann said Maggie knew she had everything to live for, but the pain, caused by the effects of the medication, was too intense. ”Her teeth were grinding down, her toes were curled. That is what these antidepressants do.”

Dale Niggemann and Maggie Stern. (Courtesy of Dale Niggemann)

Mr. Niggemann said Maggie described her life as a burning inferno of pain.

Overprescribed and Growing

More than 1 in 8 Americans take antidepressants, according to the Centers for Disease Control and Prevention and the number likely increased during the pandemic, according to limited research. Many people take antidepressants for off-label uses or uses other than for depression, including anxiety and trouble sleeping.

The most common antidepressants prescribed for depression are selective serotonin reuptake inhibitors (SSRIs). However, a study published in 2022 highlights the controversy over whether the use of SSRIs to increase available serotonin in the brain can alleviate depression.

Off-label and additional uses of antidepressants are important market segments for drug makers. The total market for antidepressants was $15.6 billion in 2022 and projected to reach $23.22 billion by 2030, according to market research firm SNS Insider.

Estimates of overprescription range widely from 20 percent among the general population to 24 percent or more among the elderly.

In an article for the American Psychological Association, Steven Hollon, a psychology professor at Vanderbilt University who researches the effectiveness of antidepressants, suggested the rate could be much higher.

“I would say at least half the folks who are being treated with antidepressants aren’t benefiting from the active pharmacological effects of the drugs themselves but from a placebo effect,” said Mr. Hollon.

Seeking Relief Leads to Suffering

About 20 years ago, Ms. Stern was prescribed the SSRI Zoloft (generic name sertraline) after complaining to a doctor of anxiety as she prepared to move from Wisconsin to Alaska to start a new chapter of her life.

Mr. Niggemann said her doctor told her it was a “brain vitamin.” Ms. Stern told him that the doctor did not inform her of possible adverse effects.

Two weeks after Ms. Stern’s death, Mr. Niggemann found her suicide note—the last entry in her pain journal:

“If you read this journal, you will have an idea how hard I worked/tried to survive. ”The Pharma crap killed my body, but not my spirit. “I’m still me. But the PAIN is too much to endure. “Please educate/ADVOCATE against All Pharma Drugs, especially vaccines & ‘antidepressants.’”

Although the suicides of people who use antidepressant drugs are often blamed on their depression, a rising chorus of family members and physicians say the drugs themselves can lead to suicide as well as violent behavior, agitation, and depression.

Physician Alleges Drug Studies Misreported Suicide Risks

Dr. Peter C. Gøtzsche, an internal medicine physician based in Denmark and author of the book, “Deadly Psychiatry and Organised Denial,” is a leading critic of antidepressant drugs. He published an open letter (pdf) in August 2023 to two prominent medical journals, calling for “retraction of three fraudulent trial reports of antidepressants in children and adolescents.”

In the letter, he alleges that “the trial reports seriously underreported suicide attempts, other suicidal events, and precursors to suicide and violence on active drug, and exaggerated the benefits of the drugs substantially.”

Dr. Gøtzsche and Dr. David Healy, a psychiatrist and author of “The Antidepressant Era,” analyzed two placebo-controlled studies of fluoxetine, commonly known as Prozac, which led to their approved use for children and adolescents. Their examination of the original documents, published in 2022 in the International Journal of Risk & Safety in Medicine, concluded that “fluoxetine is unsafe and ineffective.”

Drs. Gøtzsche and Healy said the studies, which included 96 and 219 participants respectively, “appear to have been misreported.” Suicidal events that occurred during the trials were missing from the studies’ publications and reports. “Precursors to suicidality or violence occurred more often on fluoxetine than on placebo,” they said, and, “Patient ratings did not find fluoxetine effective.”

The 96-participant study (children 7 to 17 years old) concluded that “fluoxetine was superior to placebo in the acute phase treatment of … outpatients with severe, persistent depression.” This report was published in Archives of General Psychiatry, the precursor to JAMA Psychiatry.

The participants were divided into two groups of 48. One group took fluoxetine, the other group took a placebo.

According to the two doctors’ review of the original trial documents of that study, two participants in the fluoxetine group attempted suicide during the trial, while 32 of the 48 experienced adverse effects. The suicide attempts were left out of the published report, wrote Dr. Gøtzsche, citing evidence uncovered about 10 years ago.

In the 219-participant study, published in the Journal of the American Academy of Child & Adolescent Psychiatry in 2002, the authors concluded that fluoxetine appeared “to be well tolerated and effective for acute treatment of MDD [major depressive disorder] in child and adolescent outpatients. Fluoxetine is the only antidepressant that demonstrated efficacy in two placebo-controlled, randomized clinical trials of pediatric depression.”

However, Dr. Gøtzsche noted in his review of the original trial document that one of the 10 young patients treated with fluoxetine was severely harmed and patients in the trial suffered from symptoms including mania, agitation, hyperactivity, physical aggression, and personality disorder.

Dr. Peter Gøtzsche, Danish physician, interviews Kim Witczak for his podcast, Broken Medical Science, November 2023. (Huey Freeman)

“Fluoxetine was approved even though a statistical review for the FDA [U.S. Food and Drug Administration] had noted there was not a statistically significant benefit for the drug on the primary outcome in either trial,” Dr. Gøtzsche said in his letter. “Fluoxetine (Prozac) paved the way for the approval of other antidepressants in children and adolescents, and these were the two pivotal placebo-controlled trials in depression.

The third clinical study Dr. Gøtzsche referred to in his letter was of paroxetine, trade name Paxil. The original study concluded that it “provides evidence of the efficacy and safety of the SSRI, paroxetine, in the treatment of adolescent depression.” It was published in the Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP) in 2001.

Other researchers have also re-examined trial data for key studies used to get antidepressants approved for adolescents and found striking problems.

Further Examinations

Researchers examining the original trial report found it misreported suicide-related events as “emotional lability.” Lability is the quality of being unstable or liable to lapse. The trial report said five patients had suicidal or self-harming behavior while using the drug, but the independent researchers found 11 patients in this category—more than twice the reported number. In their report, published in the BMJ in 2015, researchers concluded that “Neither paroxetine nor high dose imipramine [another antidepressant] showed efficacy for major depression in adolescents, and there was an increase in harms with both drugs.”

The BMJ report found that the original paroxetine clinical study report said five patients exhibited suicidal or self-injurious behaviors, but the independent researchers found 11 patients in this category. The clinical study report by SmithKline Beecham, maker of paroxetine, had mostly misreported suicide-related events as “emotional lability.”

The U. S. Food and Drug Administration has asked makers of popular antidepressants to add or strengthen suicide-related warnings on their labels as well as the possibility of worsening depression, especially at the beginning of treatment or when the doses are increased or decreased. (Photo Illustration by Joe Raedle/Getty Images)

In his letter to editors at the JAACAP and JAMA Psychiatry, Dr. Gøtzsche said the editors should retract the previously published trial reports because they underreported suicide attempts and exaggerated benefits of the drugs.

Mary K. Billingsley, managing editor of JAACAP, was a recipient of Dr. Gøtzsche’s letter. In an email to The Epoch Times, Ms. Billingsley wrote that the journal will pursue any allegations of misconduct. “Suspected misconduct and/or allegations of academic dishonesty” will be managed according to guidance from an ethics committee, the email said. The editor of JAMA Psychiatry, the other letter recipient, has not responded to a request for comment.

Dr. Gøtzsche’s letter was also signed by 10 other people, each of whom suffered the loss of a child or spouse to suicide as a result of being prescribed an antidepressant for a non-psychiatric condition. Antidepressants are routinely prescribed for off-label uses ranging from sleep disorders to urinary incontinence.

Suicides Among Young People

Impulsive suicides are more likely among younger people, a 2013 study found.

Among the signees was Mathy Downing, mother of 12-year-old Candace Leigh Downing. Candace was experiencing frustrations with tests and homework when she entered middle school, so she was taken to see a child psychiatrist. Although she was not depressed and had many friends, she was prescribed Zoloft.

“I went to check on her and found my beautiful little girl hanging, her knees drawn up,” Mrs. Downing told Epoch Times. “I began screaming for my husband and rushed to get her down. There was no note, no warning of what she intended to do.” Candace’s story is told in “Prescription: Suicide?,” an award-winning documentary film.

Kim Witczak, whose husband, Woody Witczak, 37, hanged himself five weeks after he began taking Zoloft, also signed the letter.

Woody and Kim Witczak on New Year’s Eve, 2002. (Courtesy of Kim Witczak)

“Woody wasn’t depressed—he had no history of depression or any other mental illness,” Mrs. Witczak told Epoch Times. “He had just started a new job, and was having trouble sleeping, so he went to his doctor. He was given Zoloft, and the doctor told him it would help him to sleep. Five weeks later Woody took his life. We never questioned the drug. It was given by our doctor, was FDA approved.”

“At the time of Woody’s death, there were no black box suicide warnings on antidepressants.” Mrs. Witczak added.

Mrs. Witczak lobbied Congress and the FDA to implement these warnings, which took effect for children and teens in 2004 and were expanded two years later to include young adults, for 36 different antidepressant drugs. Black box warnings, published on the inserts in prescription boxes, state there is a risk of suicidal thinking and behavior for users under 25 years of age.

The FDA mandated these warnings after evidence was presented by scientists and relatives of suicide victims at a series of hearings, and placebo-controlled, randomized trials proved these drugs increased risk of suicide. Mrs. Witczak serves on the FDA advisory committee for psychiatric drugs. Her story was the subject of an Epoch Times American Thought Leaders Documentary, “Are COVID Vaccines Just the Tip of the Iceberg?

Depression’s Controversial ‘Mechanism’

For the past 60 years, Dr. Peter Breggin, a psychiatrist with a psychotherapy practice in Ithaca, N.Y., has been sounding the alarm on the risks of psychiatric drugs. He has written more than 20 books, many co-authored with his wife, journalist Ginger Breggin—about half of which include warnings about the adverse effects of antidepressants. Books authored by Dr. Breggin, who has been called the “conscience of psychiatry,” include “Toxic Psychiatry,” “Medication Madness,” and “Talking Back To Prozac.”

Zoloft, Prozac, and Paxil are classified as selective serotonin reuptake inhibitors (SSRIs). In an interview with The Epoch Times, Dr. Breggin said doctors have made unsubstantiated claims that the inhibition of reuptake of serotonin alleviates depression. As neurotransmitters carry messages between nerves, the reuptake mechanism returns some of them to the nerves where they were created.

“This inhibition of reuptake will allegedly help depression by increasing serotonin in the synapses,” Dr. Breggin said.

This is the explanation psychiatrists give patients but many scientists have long doubted the overly simple explanation that serotonin could be responsible for depression, sadness, apathy, and other things linked to depression.

Dr. Peter Breggin, psychiatrist. (Courtesy of Dr. Peter Breggin)

“Serotonin is the most widespread neurotransmitter throughout the brain, so it affects all kinds of things. It is in the gut, it is in the bloodstream, so this idea is ridiculous.”

When this class of antidepressants was originally marketed, psychiatrists claimed they now had a gold standard to treat people because they were going to affect a particular chemical imbalance in their brains in an effective way, Dr. Breggin said.

“And everybody bought it, even though the idea that depression would be linked to one function of the brain was flawed,” Dr. Breggin said. “What anyone would have known, if they hadn’t been influenced by the drug companies, is that you can’t affect one neurotransmitter in the brain by itself because they all are connected. That is why we humans are so complicated.”

In light of the black box warnings associating antidepressants with suicide, several other researchers undertook studies to discover for themselves if there was a causal relationship. In a study published in 2006 in the Australian and New Zealand Journal of Psychiatry, researchers asked “How have the Selective Serotonin Reuptake Inhibitor Antidepressants Affected Suicide Mortality?”

Australian researchers, Dr. Wayne D. Hall, then professor of public health policy at University of Queensland, and Dr. Jayne Lucke, senior research fellow at the university, found that recent randomized controlled studies of SSRI antidepressants “increased suicidal ideation early in treatment compared to placebo. Observational studies have found an increased risk of self-harm within 9 days of an antidepressant drug being prescribed.”

They concluded, “If SSRIs increase suicide risk in some patients, the number of additional deaths is very small because ecological studies have generally found that suicide mortality has declined (or at least not increased) as SSRI use has increased.”

Ecological studies involve looking at a mass group of people to make inferences about population-level effects of a treatment and pattern. In the case of antidepressants, researchers did not find an increase in suicides after SSRIs were introduced. However, ecological studies can make it difficult to parse out specific causes and effects because of the number of confounding variables. For example, if there is a population-wide decrease in smoking or an increase in wealth, this could skew any potential insights.

Pain in Plain Sight

Army Sgt. Angela Peacock, then 24, was serving in Iraq when a fellow soldier was almost killed by an improvised explosive device. Sgt. Peacock was physically ill at that time, and not with her unit when the convoy was hit. Thoughts of death led her to see an Army psychiatrist, who prescribed a sedative and anti-anxiety drug. The drugs made her feel worse, and she was medically discharged from the service.

A few years later, Ms. Peacock was on 18 medications at the same time, including antidepressants. She was having suicidal thoughts, as well as thoughts about possibly killing students in her niece’s school.

“My original problem was compounded by the drugs,” Ms. Peacock told The Epoch Times. “I was put on more than 40 drugs during 13 years to treat the mental health symptoms and side effects. I didn’t realize it was the meds that were keeping me in these bad states until way later.”

Producers of a feature-length documentary film on people damaged by psychiatric drugs, “Medicating Normal“ contacted Ms. Peacock and chronicled her healing process, as well as her return to college, where she earned a master’s degree in social work. She now works as a healing coach, helping people who have been harmed by psychiatric medications.

Mary Neal Vieten, a board-certified clinical psychologist, is the director of Warfighter Advance, a group that assists warfighters in reintegration after their war experiences. Since 2010, she has treated many people suffering from severe adverse effects of antidepressant drugs. A 22-year Navy veteran, Dr. Vieten was featured alongside Ms. Peacock in the documentary.

She went along with the biochemical model of mental health treatment for the first years of her military career. “It took so many suicides before I asked myself, ‘What are we doing wrong?’” Dr. Vieten said in an interview with The Epoch Times. “I realized that a lot of what I was fed in graduate school was provided by parties that were not impartial, like pharmaceutical companies. Hiding in plain sight was the fact that people getting on antidepressants and killing themselves was a very common outcome.”

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