Fwd: [SSRI-Research] Zoloft suicide -- parents question teen's death

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> JustSayNO

> Sun, 4 Jul 2004 18:22:25 -0700 (PDT)

> [sSRI-Research] Zoloft suicide -- parents

> question teen's death

>

> [--The ultimate 'Hollywood " sci-fi film... yet this

> is not a movie.]

>

>

> Sun, 4 Jul 2004 18:10:57 -0400

>

> Behind Kaitlyn's suicide

>

> Family questions antidepressant's role in teen's

> death

>

> By Carey Goldberg, Boston Globe Staff | June 27,

> 2004

>

> ''Dear everyone: I'm so sorry. I can't take living

> anymore, " 16-year-old

> Kaitlyn Kennedy wrote in big, urgent, red crayon

> letters. ''I love you so

> much, please don't be sad. "

>

> In the garage of her family's home in small-town

> Medway, she took a rope.

> She made a loop with a metal clip. She mounted a low

> stool.

>

> Kaitlyn had been ground down in recent months by an

> intense, on-and-off

> relationship with her controlling 20-year-old

> boyfriend, her parents say.

> Once a sunny comedian surrounded by friends, she had

> grown isolated,

> depressed, and anxious. She had taken to cutting

> herself. In January, she

> had swallowed a nonfatal overdose of Tylenol and

> prescription drugs.

>

> When her frightened parents sought a therapist's

> help, Kaitlyn was

> prescribed the antidepressant Zoloft on Jan. 17.

> From an initial modest

> dose, she was later bumped gradually up to 150

> milligrams, near the maximum

> dose.

>

> On Feb. 21, Kaitlyn hanged herself.

>

> ''She did have anxiety, she did have depression, but

> I do believe the

> impulse -- the agitated behavior and killing herself

> -- was due to the

> drugs, " said Kathleen Kennedy, Kaitlyn's mother. ''I

> do believe that. I

> don't believe she got the proper care she should

> have had. "

>

> Always unfathomable, the suicides that are the third

> most common cause of

> death among adolescents ages 10 through 19 have

> recently begun to prompt one

> additional, tormenting question for those left

> behind:

>

> Could it have been the antidepressant?

>

> American psychiatric authorities emphasize that

> antidepressants help a great

> many teens, and say that there is no proven link

> between drugs like

> Zoloft -- known as selective serotonin reuptake

> inhibitors -- and suicide.

>

> But the US Food and Drug Administration is examining

> the possible

> connection, amid much media attention, and is

> expected to come to a finding

> by this fall.

>

> The agency also issued a warning in March --the

> month after Kaitlyn killed

> herself -- that patients taking antidepressants

> could turn suicidal and

> should be closely watched. Britain, citing the

> suicide risk, has banned all

> the SSRIs for youngsters, except Prozac.

>

> Kaitlyn Kennedy's parents say they heard about the

> possible SSRI-suicide

> link for the first time in the media, not from her

> doctors. On the day

> before the night Kaitlyn killed herself, her father,

> Alan, brought a

> newspaper clipping about the possible risks to her

> therapist, who ''kind of

> blew it off, " he said.

>

> The Kennedys do not recall any of Kaitlyn's

> therapists or doctors warning

> them about the dangerous agitation that sometimes

> accompanies

> antidepressants. Her father, a sound technician,

> said Kaitlyn described

> feeling like she was ''crawling out of her skin " --

> typical of such

> agitation.

>

> The pull of the antidepressant theory for

> heartbroken parents like the

> Kennedys is clear: It offers a possible explanation

> for an unbearable

> mystery. Because otherwise, despite the paper trail

> of Kaitlyn's death --

> journals, medical records, e-mail messages, and the

> note, all of which her

> parents shared with the Globe -- her suicide is all

> but impossible to

> understand.

>

> ''There are so many questions I want to ask her, and

> it's so hard not being

> able to, " said Shannon Sullivan, 17, Kaitlyn's best

> friend. Shannon,

> Kaitlyn's parents, and her journals all point to

> relationship problems as

> the root of Kaitlyn's depression.

>

> When she was 14, she began going out with a boy whom

> Shannon and others

> described as controlling and troubled. The boy's

> mother, when contacted by

> the Globe, declined to pass on a request for an

> interview, or to comment

> herself.

>

> In her journals, Kaitlyn goes back and forth between

> saying how much she

> loves him and how much she hates him. Days before

> her death, she broke up

> with him and started going out with another boy. But

> Kaitlyn was still in

> contact with her old boyfriend, and he was the last

> person to see her the

> night she died, Kaitlyn's parents say.

>

> Twice in her journals, Kaitlyn talks about suicide

> as a way to hurt him. On

> Valentine's Day, she wrote: ''I hope [the boy] kills

> himself. I would smile.

> If I get home and my friends are the same, like just

> blah, I'm going to hang

> myself. My suicide note will say this is because of

> [the boy] and I hope you

> kill yourself too . . . "

>

> But, while briefly hospitalized in late January, she

> had also written about

> killing herself if she was forbidden to see him.

>

> Kaitlyn's journal entries depict an oppressive

> relationship. To bolster her

> plan to break up, she wrote a list of ''Pros. " They

> include: no control,

> laughing, not on phone 24/7, alone time, no more

> depression, parents off

> back, no feeling guilty, no lying, no checking up,

> and no more fights. And,

> underlined, ''BEING FREE! "

>

> Her journals also describe other problems. She was

> fighting with her parents

> about her boyfriend, and she was having trouble

> concentrating in school. She

> describes a high state of rapid-heartbeat anxiety as

> she faced tests she

> expected to fail and peers who might think ill of

> her.

>

> She talked in her journals of getting a tutor or

> some kind of

> home-schooling. In January, she described retreating

> often to the school

> walk-in center, where she felt comfortable with the

> school adjustment

> counselor, Meredith Poulten.

>

> Poulten, a former board member of the Samaritans, a

> suicide prevention

> group, respects the Kennedys' need for answers. The

> suicide of a child ''is

> the most devastating thing in the world, " she said.

>

> At the same time, she said, specialists on suicide

> agree that in general,

> there are no simple answers: ''It's never one thing

> or one person -- it's

> usually a combination of anxiety, relationships,

> mental health issues,

> medications, and you add everything together and

> come up with a horrendous

> result. "

>

> Kaitlyn was clearly affected by her relationship

> problems, Poulten said; she

> also showed signs of clinical depression and

> anxiety. But she asked for help

> and her parents were trying to get it for her.

> ''Everyone thought Katie was

> getting better, " she said. ''We don't know what

> happened from there. I think

> it was an impulsive act. I think it's not clear that

> she intended to go

> through with it. "

>

> In fact, just hours before she killed herself,

> Kaitlyn had been e-mailing

> her sister, Jennifer Olson, about dresses she might

> wear to her junior prom

> in May, Olson said.

>

> And Kaitlyn's suicide note in some places sounds

> like it is the farewell

> note of a runaway. It reads, in part, ''Please don't

> call the police. I'll

> be fine. Please trust me. I love you so much. I'll

> be back someday. "

> Kathleen Kennedy says Kaitlyn had packed a bag that

> night, as well.

>

> The Kennedys received Kaitlyn's medical records from

> Westwood Lodge in

> Westwood, where she was hospitalized for a week

> after she cut her arm with a

> paper clip badly enough to drip blood on Feb. 10. It

> was her 18-month

> anniversary with her boyfriend. Her journal entry

> from that day reads ''THIS

> IS HOW MY [expletive] DAY WENT " and the page is

> smeared in blotches of

> blood.

>

> Her Westwood Lodge discharge summary notes that when

> she was admitted on Feb

> 11, she said, ''I thought about hanging myself or

> killing myself with a

> razor. " She also said she had been waking up at

> night and ''hears voices

> telling her to kill herself. "

>

> The summary notes that her Zoloft dose had been

> raised from 100 to 150

> milligrams per day while in the hospital. Her

> Seroquel -- an antipsychotic

> drug -- was also increased.

>

> There is no hint in the records of any suspicion

> that Kaitlyn might be

> reacting badly to Zoloft. One nurse wrote on Feb.

> 11, a week after Kaitlyn's

> Zoloft had been raised to 100 milligrams a day, that

> the patient ''reports

> increase in emotional lability, irritability and

> anxiety, " but did not link

> it to the drug.

>

> Kaitlyn was diagnosed as having a mood disorder and

> possibly a borderline

> personality disorder, and a nurse's notes include

> recent stressors:

> ''ex-boyfriend threatened to kill himself yesterday "

> as well as ''conflicts

> with mother " and ''school failure, social isolation

> from friends, related to

> controlling ex-boyfriend. "

>

> One note also mentions that Kaitlyn needed a

> ''tattered, crocheted baby

> blanket " from home for comfort.

>

> After six days in the hospital, three of them on a

> holiday weekend, Kaitlyn

> was discharged, over her parents' protests that it

> was too early, said

> Kathleen Kennedy, who works as a companion to the

> elderly.

>

> They got no explanation for the timing of the

> discharge, she said, and none

> of the staff members told her what she later read in

> Kaitlyn's medical

> record: that she had repeatedly described her plan

> to hang herself.

>

> It was Feb. 17 when Kaitlyn was sent home. Four days

> later, she was dead.

>

> The Kennedys plan to ask a forensic psychiatrist to

> evaluate Kaitlyn's case

> to see if there are grounds for a lawsuit, Alan

> Kennedy said. They are still

> awaiting more information, including the toxicology

> report on Kaitlyn.

>

> Judith Merel, spokeswoman for Arbour Health System,

> the parent company of

> Westwood Lodge, said she could not comment on a

> patient's case because of

> confidentiality concerns.

>

> Pfizer, which makes Zoloft, ''cannot comment on

> individual cases, " said

> spokeswoman Shreya Prudlo.

>

> When Dr. Joseph Glenmullen, a Harvard psychiatrist

> and prominent critic of

> manufacturers of antidepressants, was told the basic

> outlines of Kaitlyn's

> case, he responded that it was ''very reasonable "

> for the family ''to ask

> whether or not the drug played a role " in her death.

> It is known that

> patients are particularly vulnerable to suicidal

> impulses when they have

> just started on an antidepressant or the dose has

> just been increased, he

> said.

>

> Dr. David Fassler, an authority for the American

> Psychiatric Association on

> the issue of SSRIs and suicide, responded to a

> description of Kaitlyn's case

> by noting that, ''We do not have data which clearly

> demonstrates an

> association between SSRI medication and increased

> risk of suicide. " In all

> the studies of SSRIs that the FDA is reviewing, he

> said, none of the more

> than 4,000 children and teens enrolled in the

> studies actually committed

> suicide .

>

> One top FDA epidemiologist has reported that the 22

> studies, involving seven

> SSRI-type drugs, indicate that children on the drugs

> were twice as likely to

> have suicidal thoughts and feelings as those on a

> placebo. But the agency

> has yet to issue an official opionion on the matter.

>

> ''Clearly any suicide is a tragedy, and any family

> is going to look at all

> possibilities to try to find an explanation, "

> Fassler said. ''And usually

> there are no simple answers. "

>

> The state Department of Mental Health is conducting

> a fact-finding

> investigation into Kaitlyn's death because she

> killed herself so soon after

> being discharged from a hospital, said Lester

> Blumberg, the department's

> chief of staff.

>

> Asked whether it would look into the possible Zoloft

> connection, Blumberg

> said it would probably note that Kaitlyn was taking

> the drug. But ''it would

> be unlikely to result in corrective action because

> the Commonwealth and the

> FDA have not said, 'Don't prescribe it,' " he said.

>

> The last entry in Kaitlyn's journal reads in part:

>

> ''2/21 I've done a complete 180. I'm so happy!

> [Happy face] I weigh 135 now!

> [another happy face] I hung out with [her new

> boyfriend] last night [heart

> symbol] I have therapy today in 45 minutes. . . . I

> love Chingy [a rap

> artist]. i need to wash. "

>

> She and her new boyfriend watched a movie together

> that night. Some time

> after he left, her old boyfriend stopped over.

> Around 11, she stopped by her

> parents' bedroom to say goodnight, Kathleen Kennedy

> recalled.

>

> ''Goodnight, Kate, see you in the morning, " her

> mother replied.

>

> Carey Goldberg is reachable at goldberg

>

> © Copyright 2004 Globe Newspaper Company.

>

>

http://www.boston.com/yourlife/health/mental/articles/2004/06/27/behind_kaitlyns\

_suicide/

>

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