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Sunday, March 29, 2015

Did an Antidepressant Bring Down an Airliner?

Now that antidepressants have reportedly been found at the home of pilot Andreas Lubitz, we're finally getting to the true cause of the crash.

But will investigators be willing or able to put the pieces together? Or will they be oblivious to the power of certain drugs to completely alter human behavior?

I have written about this before. I know of very few things that can cause (and I do mean cause) an otherwise rational person to become homicidal more or less instantly, other than psychoactive drugs of a type that can (in susceptible individuals) elicit what has been called an akathisia reaction. I'm talking about antipsychotics and antidepressants.

If you don't think even a small number of doses of drugs like Zoloft, Prozac, Paxil, or Seroquel can cause a previously mild-mannered person to transform into a killer overnight, you haven't done your research. But that's okay, because you can get up to speed quickly by reading my previous post on akathisia. Read all of it. Read the references. Do some homework.  Don't be quick to dismiss things like the death of Robin Williams as a "fluke." It was no fluke. Neither was the downing of Germanwings Flight 9525.

I want to mention a couple of examples of what I'm talking about.

In a 2006 report in PLoS Medicine, we learn of the case of DS, a 60-year-old man with a history of five prior anxiety/depressive episodes, none of which involved suicidality or aggressive behaviour. His prior episodes had resolved within several weeks. In 1990, DS reported an episode of depression, which his doctor treated with fluoxetine (Prozac). The patient had a clear adverse reaction to fluoxetine involving agitation, restlessness, and possible hallucinations, which worsened over a three-week period despite treatment with trazodone and propranolol (which should have mitigated such reactions). After fluoxetine was discontinued, DS responded rapidly to imipramine, an older non-SSRI.

In 1998, a new family doctor, unaware of his adverse reaction to fluoxetine, prescribed paroxetine (Paxil, an SSRI), 20 mg daily, for DS, for what was diagnosed as an anxiety disorder. Two days later, after just two doses of the medication, DS used a gun to put three bullets each through the heads of his wife, his daughter who was visiting, and his nine-month-old granddaughter, before killing himself.

At the jury trial in Wyoming in June 2001, a jury found that paroxetine “can cause some people to become homicidal and/or suicidal.” SmithKline Beecham was deemed 80% responsible. The documentary evidence at the trial included an unpublished company study of incidents of serious aggression in 80 patients, 25 of which involved homicide.

Rothschild and Locke (1991) described three patients who became suicidal on fluoxetine (Prozac), then discontinued the drug, then were reintroduced to fluoxetine—and immediately became suicidal again. Said the researchers: "All three patients developed severe akathisia during retreatment with fluoxetine and stated that the development of the akathisia made them feel suicidal and that it had precipitated their prior suicide attempts. The akathisia and suicidal thinking abated upon the discontinuation of the fluoxetine or the addition of propranolol."

In 1999, a 74-year-old man from New South Wales with no prior history of violence took five doses of Zoloft in one night, then woke up the next morning and strangled his wife. The judge, who was persuaded that Zoloft played a key role in the killing (and who let the 74-year-old off with a suspended sentence), stated: “I am satisfied that but for the Zoloft he had taken he would not have strangled his wife.” (See story here, Case 3.)

Many additional "anecdotal reports" of this kind exist. We can add actor/comedian Robin Williams to that list; he had begun taking the antipsychotic Seroquel just eight days before he hung himself in 2014.

As I said in my original piece on akathisia, these sorts of reports are "just anecdotes" until they actually happen to someone you know.

We need to be told what medication(s) were found in the home of Andreas Lubitz, the Germanwings copilot. My guess is that SSRIs were found and that the bottle or bottles were nearly full; that Lubitz was new to the drug(s); and that he was blinsdsided by akathisia.

It's entirely possible Lubitz took as little as one dose of a medication like Zoloft or Paxil, had an adverse reaction to it, and literally went berserk a short time later, killing himself and 149 other people. This type of situation plays out over and over again, in courtrooms, jails, and hospitals, every year, and every time, we're "caught off guard," because (despite decades of evidence on akathisia, going back to reserpine days, and before) no one can believe that a sane, rational person could be perfectly fine one day, then become a homicidal maniac the next day, all because of a drug reaction.

I have personally witnessed this type of reaction in someone and I can say without hesitation that I believe this is what killed 150 people on Germanwings Flight 9525. I believe that Andreas Lubitz was not an evil person; probably not even particularly ill; but he took a medicaation that did not agree with him. And the medication made him kill himself and 149 other people.

The Germanwings crash will evolve into a drug trial. That's what this is about now.

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Have you checked out my free book Mental Health Myths Debunked? Tons of info, tons of live links, lots of straight talk about depression, meds, therapy, psychiatry, mental health trends, statistics, and more. And you know me, I call bullshit on bogus ideas (then give URLs to the actual data). The idea that antidepressants take weeks to do anything? Myth. Most people benefit from antidepressants? Myth. Antidepressants separate from placebo in clinical trials? Largely myth. (Half the trials show separation. Half don't.) Electroshock therapy is safe and effective? Bigtime myth. ECT is dangerous. But don't take my word for it: Read the science for yourself. It's all laid out (with references) in the book.

You can download the book (ePub or PDF) at NoiseTrade. Do it now while it's free.

 ☙ ❧ 

Hey listen, the following list of people who retweeted me yesterday might not be 100% complete, but it's as good as I can do with my silly notifications-scraping hack. In any case, you should get busy following the folks shown below. They're fantastic Twitter networkers, and they retweet! (Click their pictures; the pics are live links.)


Have you added your name to our mailing list? What the heck are you waiting for, a personal invitation from @TheTweetOfGod

Also please visit HackYourDepression.com when you have a chance, and share that link with someone you know who might be suffering from anxiety or depression.