British documentary film maker Katinka Blackford Newman’s 2016 book, The Pill That Steals Lives, opens with a nauseating story: a mother kills her eleven year old daughter and ten year old son, and then turns the carving knife on herself. She wakes in the secure unit of a private psychiatric unit convinced that there are cameras trained on her every movement. She’s on suicide watch and diagnosed with psychotic depression.
The mother in the story is Katinka Blackford Newman. But it turns out she didn’t kill her kids – she hallucinated killing her kids. Newman had had a toxic reaction to a selective serotonin re-uptake inhibitor (SSRI) antidepressant.
Instead of providing some medical scaffolding, the drug (and the ever-lengthening list of other medication she was prescribed) deconstructed her, and she lost a year of her life in a numbed haze, unable to take care of herself or her children. Eventually, suicidal, she was admitted to hospital and the doctors stopped all her drugs. And she was better. Just like that (if you don’t count the weeks of withdrawal symptoms).
Newman’s story is a stark contrast to my own benign experience on fluoxetine, which gives me a more level, brighter existence. Newman reacted badly to the SSRI escitalopram (aka Lexapro, Citralex), and then to the list of drugs prescribed to treat her ‘psychosis’. In The Pill That Steals Lives she writes:
It was pure luck I didn’t kill myself or someone else as I had no sense of reality … In fact I thought I was in a dream.”
After her recovery, Newman researched toxic reactions to SSRIs. She found that her story was shared by others. In The Pill that Steals Lives, Newman recounts stories of lives lost, destroyed or damaged by these drugs: people who cannot withdraw from the drugs because of debilitating symptoms; people with side effects that continue even after they have stopped taking the medication; people whose lives have been destroyed by their actions under the influence of their prescription medication. A summary of such stories can be found https://ssristories.org.
Newman cites medical experts such as psychiatrist, psychopharmacologist and scientist David Healy who estimates that there are 1000-1500 extra suicides in the US each year triggered by antidepressants, and probably 1000-1500 “episodes of violence that would not have happened without antidepressant input”. She quotes UK Professor Tim Kendall (the NHS’s advisor on drug guidelines), who presents evidence from previously unpublished trials suggesting that many of the drugs perform no better than placebos, and that some people have “very, very bad reactions” to these drugs.
In his New Scientist review of The Pill that Steals Lives, Robert Whitaker describes the debate about antidepressants as a “battle of narratives”. Whitaker writes:
The psychiatric profession tells of drugs that have a history of proven efficacy. The critics tell of drugs that have marginal short-term efficacy, may do more harm than good in the long term, and, on occasion, may cause a person to seriously deteriorate. Both claim science’s mantle, which leaves the public uncertain what to think.”
Whitaker compares Newman’s book with Ordinarily Well: The Case for Antidepressants (Farrar, Straus and Giroux 2016) by Peter Kramer. Kramer contends that antidepressants work well for 90 per cent of patients, including those with longstanding symptoms. Whitaker summarises Kramer’s view:
The drugs work in a diverse group of people, including those who are only mildly depressed, and can give dour people new personalities, making them more cheerful and less ruminative … antidepressants ‘restore resilience’ to mind and brain, and ‘confer overall well-being’.”
A review of Kramer’s book in the The Atlantic describes it as not only making the case for antidepressants, but also the “case for psychiatry itself as a humanistic science that bridges the impersonal ideals of the laboratory and the pragmatic exigencies of clinical intervention.” A New York Times review of Ordinarily Well explains that Kramer’s main argument for antidepressants is that they allow people to “regain custody of their lives.”
There are millions of people who are characters in this conflicted narrative – myself included. There are those who prescribe the drugs, study the drugs and design the drugs, and those who take the drugs. When it comes down to it, how many of us pay attention to the ‘rare’ side effects noted on the packaging insert: suicidal thoughts, psychosis and hallucinations (and, weirdly, depression), and how many doctors warn their patients (or those who care for them) that if you go ‘mad’ in the first wee while, it could be the drugs?
I return to the warning on the SSRI Stories site:
Adverse reactions are most likely to occur when starting or discontinuing the drug, increasing or lowering the dose or when switching from one SSRI to another. Adverse reactions are often diagnosed as bipolar disorder when the symptoms may be entirely iatrogenic (treatment induced). Withdrawal, especially abrupt withdrawal, from any of these medications can cause severe neuropsychiatric and physical symptoms. It is important to withdraw extremely slowly from these drugs, often over a period of a year or more, under the supervision of a qualified and experienced specialist. Withdrawal is sometimes more severe than the original symptoms or problems.”
And I click on the stories associated with Prozac/Fluoxetine. And I look at the green and white capsule on my palm.
Heather Bauchop is a researcher and writer who lives in Dunedin, New Zealand.
Read more by Heather Bauchop on Corpus here.