We need more honest conversations about psychiatric drugs and suicide.
1997 was the year I became acquainted with akathisia except I didn’t know it at the time. Akathisia wasn’t part of my vocabulary.
I was admitted to my local psychiatric hospital having abruptly come off Paroxetine. I had little understanding of antidepressant withdrawal and according to my medical notes the psychiatrist in charge of my care though aware of Paroxetine dependency treated what he saw as “intolerable anxiety symptoms”. I was commenced on Venlafaxine along with Thioridazine substituted for Droperidol after I developed postural hypotension. The Droperidol was gradually increased to 20 mgs four times a day. I was put on Thioridazine and Droperidol without benefit of knowing what they were. My psychiatrist expressed amazement that I still had anxiety symptoms. One of the most vivid and abiding memories I have of that time is of pacing the ward corridors praying I’d survive. My notes record I was prescribed Procyclidine for extra pyramidal symptoms, again something that wasn’t explained to me at the time.
In early 2011, within a week of completing a taper from Venlafaxine which I’d begun in late 2010, I felt that terrible symptom return. Many pharmacological interventions were tried and failed. Post-acute withdrawal syndrome persisted until in the summer of 2012 I attempted suicide by taking an overdose of Lorazepam, Diazepam, and Imipramine. A short trial of Moclobemide proved equally fruitless and I was left to taper off Diazepam and Zolpidem. I subsequently suffered severe suicidal ideation and enduring akathisia. These were years when I seriously doubted I would survive. Only my family kept me alive.
I’ve provided this snapshot of what I experienced to illustrate that suicide is an ever present danger because of adverse drug side-effects and when commencing/coming off or adjusting the dose of psychiatric drugs. Antidepressant withdrawal has been known about for decades but it was only at the end of May this year that the Royal College of Psychiatrists finally acknowledged what many patients have been at pains to tell them for some time, that withdrawal symptoms can be severe and long-lasting (1). This historical lack of recognition for severe and protracted withdrawal has led countless GPs and psychiatrists, including my own, to believe in relapse thereby compounding iatrogenic harm, increasing the likelihood of permanent neurological injury and ultimately increasing the risk of suicide. Drug companies I’m appalled to discover, knew that the newer SSRI antidepressants could cause akathisia in some patients as early as 1978 (2). I’ve also seen some of the evidence amassed by Professor David Healy where I note that healthy volunteers in clinical trials have become suicidal on SSRIs which challenges the idea that the problem lies with the patient and not the drugs. I constantly meet people like me on social media and in support forums, sadly, quite a few of them are no longer with us. I want to take this opportunity to warn doctors and psychiatrists that inevitably more will suffer and die if they aren’t willing to have honest conversations about withdrawal, akathisia, neurological injury, and suicide. (3)
Rapid Response:
We need more honest conversations about psychiatric drugs and suicide.
1997 was the year I became acquainted with akathisia except I didn’t know it at the time. Akathisia wasn’t part of my vocabulary.
I was admitted to my local psychiatric hospital having abruptly come off Paroxetine. I had little understanding of antidepressant withdrawal and according to my medical notes the psychiatrist in charge of my care though aware of Paroxetine dependency treated what he saw as “intolerable anxiety symptoms”. I was commenced on Venlafaxine along with Thioridazine substituted for Droperidol after I developed postural hypotension. The Droperidol was gradually increased to 20 mgs four times a day. I was put on Thioridazine and Droperidol without benefit of knowing what they were. My psychiatrist expressed amazement that I still had anxiety symptoms. One of the most vivid and abiding memories I have of that time is of pacing the ward corridors praying I’d survive. My notes record I was prescribed Procyclidine for extra pyramidal symptoms, again something that wasn’t explained to me at the time.
In early 2011, within a week of completing a taper from Venlafaxine which I’d begun in late 2010, I felt that terrible symptom return. Many pharmacological interventions were tried and failed. Post-acute withdrawal syndrome persisted until in the summer of 2012 I attempted suicide by taking an overdose of Lorazepam, Diazepam, and Imipramine. A short trial of Moclobemide proved equally fruitless and I was left to taper off Diazepam and Zolpidem. I subsequently suffered severe suicidal ideation and enduring akathisia. These were years when I seriously doubted I would survive. Only my family kept me alive.
I’ve provided this snapshot of what I experienced to illustrate that suicide is an ever present danger because of adverse drug side-effects and when commencing/coming off or adjusting the dose of psychiatric drugs. Antidepressant withdrawal has been known about for decades but it was only at the end of May this year that the Royal College of Psychiatrists finally acknowledged what many patients have been at pains to tell them for some time, that withdrawal symptoms can be severe and long-lasting (1). This historical lack of recognition for severe and protracted withdrawal has led countless GPs and psychiatrists, including my own, to believe in relapse thereby compounding iatrogenic harm, increasing the likelihood of permanent neurological injury and ultimately increasing the risk of suicide. Drug companies I’m appalled to discover, knew that the newer SSRI antidepressants could cause akathisia in some patients as early as 1978 (2). I’ve also seen some of the evidence amassed by Professor David Healy where I note that healthy volunteers in clinical trials have become suicidal on SSRIs which challenges the idea that the problem lies with the patient and not the drugs. I constantly meet people like me on social media and in support forums, sadly, quite a few of them are no longer with us. I want to take this opportunity to warn doctors and psychiatrists that inevitably more will suffer and die if they aren’t willing to have honest conversations about withdrawal, akathisia, neurological injury, and suicide. (3)
1) https://www.socialaudit.org.uk/4200DTAY.htm
2) https://www.theguardian.com/theguardian/1999/oct/30/weekend7.weekend1
3) Huff C. Don’t miss this adverse drug reaction when tapering benzodiazepines. Kevin MD.com 2018 Nov 27
Competing interests: No competing interests