Depressed over Prozac - Deseret News/Aug 22/04

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> [sSRI-Research] Depressed over Prozac -

> Deseret News/Aug 22/04

>

>

http://deseretnews.com/dn/view/0,1249,595085602,00.html

>

> Sunday, August 22, 2004

>

> Close monitoring urged for antidepressants

>

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>

>

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> Depressed over Prozac

>

> Antidepressants dangerous and should be banned,

> crusader says

>

> By Elaine Jarvik

> Deseret Morning News

>

> Ann Tracy knows hundreds of grisly stories: the

> professor on Prozac who bit her mother to death; the

> Stanford graduate on Paxil who stabbed herself in

> the kitchen while her parents slept; the mother who

> bludgeoned her son and then drank a can of Drano;

> the 12-year-old girl who strangled herself with a

> bungee cord she attached to a plant hanger on the

> wall.

>

> Sit with Tracy for an hour and pretty soon your

> head is swimming in details: the shooting at

> Columbine, a study of violent mice, the conversation

> she had with Rusty Yates, whose wife drowned their

> five children in a bathtub. Andrea Yates was on

> maximum doses of Effexor and Remeron, she reminds

> you. The world according to Ann Tracy is a place

> full of people who were put on antidepressants and

> then went on to do horrible things.

>

> Tracy is executive director of the

> International Coalition for Drug Awareness, which

> she operates out of her home office in West Jordan,

> a home she has mortgaged twice to pay for her

> 15-year crusade against antidepressants and the

> pharmaceutical companies who make them.

>

> She is heartened by recent scrutiny of the

> drugs. Last year, the British version of the FDA

> banned all antidepressants other than Prozac for use

> in children under 18. In March, the Food and Drug

> Administration issued a Public Health Advisory about

> antidepressants ­ urging doctors and families to

> monitor adult and child patients on the drugs ­ and

> then appointed a panel of experts to reanalyze the

> incidence of suicide attempts during clinical trials

> of teens.

>

> In June, New York Attorney General Eliot Spitzer

> sued the makers of Paxil for consumer fraud, and 30

> Utahns joined a nationwide class-action suit

> charging that GlaxoSmithKline " concealed, suppressed

> and downplayed " severe withdrawal reactions in

> people trying to go off the antidepressant.

>

> But Tracy won't be happy until the drugs are

> banned altogether. They cause people to become

> violently suicidal and homicidal, she argues. They

> cause cancer, she says, and heart disease and

> diabetes and divorce.

>

> Some people call her a visionary. Others roll

> their eyes and call her misinformed ­ and worry that

> she is hurting the very people she wants to help.

>

> Panacea or Pandora?

>

> In 1991, Tracy wrote an 80-page pamphlet called

> " Prozac: Panacea or Pandora? " Three years later she

> expanded it into a 424-page book that she published

> herself. She wrote a lot of it longhand, while

> sitting in the Salt Lake LDS Temple: the one place,

> she says, where she was sure Satan didn't have a

> foothold.

>

> Hers was one of the first books to criticize

> antidepressants, but others followed: Dr. Peter

> Breggin's 1995 " Talking Back to Prozac, " Dr. Joseph

> Glenmullen's 2000 " Prozac Backlash, " Dr. David

> Healy's 2004 " Let Them Eat Prozac. " As the titles

> suggest, Prozac has become shorthand for

> antidepressant, the way Kleenex is shorthand for

> tissue, because Prozac was the first of a new class

> of antidepressants called SSRIs (selective serotonin

> reuptake inhibitors). But there are now plenty of

> others, including Paxil, Effexor, Zoloft and Luvox.

>

> According to IMS Health, a market research

> company for the pharmaceutical industry, sales of

> antidepressants worldwide in 2003 reached $19.5

> billion, up 10 percent from 2002. Some of this

> growth, according to the IMS Web site, can be

> attributed to the use of antidepressants in

> " lifestyle disorders, " which now include or could

> feasibly include, according to IMS, premenstrual

> dysphoric disorder, smoking cessation, weight loss

> and shyness ­ a list that causes some people, like

> Jim Harper of prozactruth.com, to complain that

> antidepressants are now prescribed " if you bite your

> nails. "

>

> Tracy started the International Coalition for

> Drug Awareness in 1997. The coalition has a Web

> site, www.drugawareness.org, volunteer directors in

> 30 states and board members in Bulgaria and

> Singapore. The most celebrated member of her board

> is Dr. Candace Pert, the Georgetown University

> School of Medicine neuroscientist who a generation

> ago helped discover and map the kind of receptors

> that regulate mood and health.

>

> On the case

>

> Distraught parents of suicidal teens, and the

> relatives and attorneys of people accused of murder,

> call Tracy asking for her help. But Tracy also keeps

> her antennae up for stories about violent deaths

> that might possibly be linked to antidepressants. If

> she reads a newspaper account about a man, say, who

> has gone on a shooting rampage at work ­ as happened

> in July at a ConAgra Foods plant in Kansas ­ she

> will immediately get on the phone to flesh out the

> details, trying to find out if the assailant had

> been on an antidepressant.

>

> Occasionally the victims are famous, and sometimes

> the assailants become famous for their horrific

> crimes, but either way Tracy is not afraid to insert

> herself into their lives or their deaths.

>

> The day after she heard that Brynn Hartman had

> shot her husband, comedian Phil Hartman, and then

> herself, Tracy called up Phil Hartman's brother,

> whose number she found on the Internet. Tracy had

> just returned from being an expert witness at the

> trial of a Wyoming woman on Paxil who had shot her

> husband and later reported that she didn't remember

> anything about the murder except standing there with

> the smoking gun. So Tracy told the Hartmans: " Don't

> you stop till you find one of these drugs. " Brynn

> Hartman, it turned out, had been on Zoloft;

> drugmaker Pfizer settled an eventual wrongful death

> case for an undisclosed amount.

>

> After reading about Mark Barton, the Atlanta

> day trader who killed his family and then drove to

> work and killed nine more people before also turning

> the gun on himself, Tracy phoned his mother. It

> wasn't until six months later that Atlanta police

> reported that Prozac had been found in Barton's car,

> so Tracy was operating on instinct when she urged

> Barton's mother to have his body tested for

> antidepressants. " Not all coroners check for these

> drugs, " Tracy explains. " It requires a few extra

> tests, and not all states will pay for it. That's

> why you need to get to the families right away. "

>

> But things don't always work out the way Tracy

> would hope. In the Atlanta day trader case, she

> says, she had his body ready to be shipped to an

> independent forensic toxicologist in Oklahoma City,

> but Barton's mother changed her mind. Maybe, Tracy

> says, the coroner told Mrs. Barton that Tracy was a

> Scientologist.

>

> The Scientology charge still surfaces

> occasionally, because Scientologists are famous for

> their opposition to psychotropic drugs and in fact

> to psychiatry in general. ( " Psychiatry is seeking to

> create a world where man is reduced to a robotized

> or drugged, vegetablelike state so that he can be

> controlled, " Church of Scientology founder L. Ron

> Hubbard once wrote.)

>

> Vicki Cottrell, executive director of the Utah

> chapter of the National Alliance for the Mentally

> Ill (NAMI), is sure Tracy has Scientology ties. " She

> says she's not a Scientologist, but she has the same

> philosophy, " says Cottrell. " Of course I don't have

> the thing on paper, in writing, but I believe they

> finance her. " Tracy denies any connection to

> Scientology and says in fact that Scientologists

> don't like her because she won't go after

> psychiatrists. She says her war against

> antidepressants has put her $100,000 in debt (mostly

> from phone bills and publishing her book). Tracy

> accuses NAMI of getting money from drug companies.

>

> Cause and effect

>

> Emotions run high because, on both sides, there

> is a belief that lives are at stake. Mental-health

> advocates argue that antidepressants have helped

> millions of people, and they worry that crusades

> like Tracy's will convince the very people who need

> drugs to go off them. The stories of people who have

> committed suicide or crimes while on antidepressants

> are sad and regrettable, they agree, but anecdotes

> aren't scientific proof.

>

> Did Mark Barton, for example, kill his family

> and co-workers because he was on Prozac or while he

> was on Prozac?

>

> " It's a cause-and-effect issue, " says Dr.

> Meredith Alden, president of the Utah Psychiatric

> Association. " People make assumptions about cause

> and effect when there is only an association. "

>

> Yes, sometimes people on antidepressants kill

> themselves or act violently, she says, but that's

> because " you're already dealing with people who are

> prone to violent behavior. " And, she says, " people

> who are depressed are going to be at greater risk of

> hurting themselves. "

>

> Sometimes, concedes University of Utah

> psychiatry professor Dr. David Tomb, " some people

> will briefly feel more suicidal " when they're first

> put on antidepressants, but that happens when they

> first go into psychotherapy, too, he argues, " or

> just because they're getting better by tincture of

> time. " Tomb, like a lot of people in the field,

> offers this explanation: A really depressed person

> may not have the energy to kill himself; then he

> starts taking medication, still feels depressed, but

> suddenly has enough energy to follow through with

> his suicidal thoughts.

>

> But what about the people who weren't suicidal

> until they took the drugs, Tracy asks. What about

> the people who had no history of violence but then

> killed their own children?

>

> FDA weighs in

>

> The FDA, in its Health Advisory issued in

> March, asked drug companies to add stronger warnings

> to their package inserts, cautioning physicians and

> families to " closely monitor " both adults and

> children for suicidal thinking, and " certain

> behaviors that are known to be associated with these

> drugs, " including mania and hostility, especially at

> the beginning of treatment, or when the doses are

> increased or decreased. The FDA stopped short of

> requiring the companies to issue these warnings,

> though, and made it clear that the matter of cause

> and effect has not been settled yet.

>

> The FDA appointed a panel of independent

> experts to review clinical trials of antidepressant

> use in children and teens, trying to determine if

> these studies report more suicide attempts in

> patients prescribed the drugs compared to those

> given a placebo pill. The review follows allegations

> that GlaxoSmithKline failed to report trials that

> showed an increase in suicide attempts, as well as

> those trials that showed that Paxil was no more

> effective than a placebo for younger patients.

> According to the Wall Street Journal, which obtained

> a draft of the panel's review last week, the

> clinical trials show children and teens on the drugs

> were indeed more likely to have thoughts that

> appeared to be suicidal.

>

> Earlier this month, Health Canada, the Canadian

> version of the FDA, issued a warning that newborns

> may suffer withdrawal and other possible symptoms

> (seizures, constant crying, etc.) when pregnant

> women take SSRIs during the third trimester of their

> pregnancies.

>

> In June, the National Association for the

> Mentally Ill (NAMI) Policy Research Institute issued

> a report urging that psychotropic drugs should be

> prescribed for children " only when the anticipated

> benefits outweigh the risks. " Next month, a

> congressional committee will hold hearings about the

> safety of antidepressants and the FDA's alleged

> censoring last winter of a staff member who argued

> that the drugs are dangerous for young people.

>

> " From those who have seen the internal company

> documents, " says Tracy, " we know that there is no

> distinction in age groups with these suicidal

> reactions. These reactions are the same across the

> board, no matter the age. "

>

> Utah cases

>

> Tracy argues that the perpetrators of some of

> Utah's famous violent crimes ­ Margaret Kastanis,

> who stabbed herself and her three children in 1991;

> Sergei Babarin, who shot five people at the LDS

> Family History Library in 1999; Lenny Gall, who

> killed his mother with an axe in 2001 ­ were violent

> because they were either on antidepressants or had

> gone off them too abruptly.

>

> Lenny Gall's father, Len, contacted Tracy six

> months ago, before his son's sentencing hearing.

> Tracy then went through Lenny's medical records,

> Gall says, and found that " he had a very significant

> reaction to Paxil when he was 16 " and was put on the

> antipsychotic drug Zyprexa " shortly before " the

> murder. " He's never had a shred of violence in him, "

> Gall says.

>

> Tracy has served as an expert witness in a

> dozen criminal cases ­ most recently a Maryland case

> against a teenage boy who fatally laced his best

> friend's soda with cyanide ­ and has been hired as a

> consultant in several civil cases against drug

> companies, including one that tried to implicate

> Luvox as the reason why Eric Harris shot students at

> Columbine High School. She estimates that the number

> of people she has consulted with about

> antidepressants ­ how to safely get off them, how to

> find alternative methods for treating depression,

> what to do when a family member is suicidal or manic

> ­ is now in the thousands.

>

> Jason Atwood, who will be a senior this year at

> Copper Hills High School, credits Tracy with helping

> him get off antidepressants, first prescribed for

> him when he was 12. He tried suicide at least 15

> times before reading Tracy's book and listening to

> her tape. It was then, he says, that he discovered

> that odd symptoms ­ persistent dreams of gouging his

> eyes out, for example ­ might be side effects of the

> drugs that were supposed to be making him feel

> normal.

> Following Tracy's advice, he slowly tapered off

> Remeron and now tries to avoid sugar, meat and dairy

> products. " I still have my moments of depression, "

> he says. " But I haven't attempted suicide for over a

> year. "

>

> Ann Blake Tracy, according to the International

> Coalition for Drug Awareness web site, has a

> doctorate in health sciences with an emphasis on

> psychology. There is no mention of the institution

> that awarded her this degree ­ George Wythe College,

> in Cedar City. Tracy explains that the Ph.D. was

> awarded for " lifetime experience, " specifically for

> the writing of " Prozac: Panacea or Pandora? " which

> she says she has been told is the equivalent of, or

> " far beyond, " a dissertation.

>

> Self-published, the book contains spelling and

> punctuation errors and incomplete sentences

> (although Tracy says an edited version will be

> published in the next few weeks). It also contains

> page after page of references to studies that seem

> to cast a cloud over the safety of antidepressants.

>

> Tracy argues that the whole hypothesis of SSRIs

> is " backwards. " She maintains that the drugs

> increase serotonin while decreasing the metabolism

> of serotonin, especially in the 7 to 10 percent of

> the population she says that studies have shown

> don't have the proper enzyme to metabolize SSRIs in

> the first place. The drugs, she charges, can also

> cause REM sleep behavior disorder (RBD), which can

> cause people to act out their vivid, violent dreams

> while in a dreamlike state.

>

> Deconstructing Tracy

>

> " It's hard to know where to begin to detail the

> cognitive errors she's making, " says psychiatrist

> Tomb about Tracy's book. " She is really taking

> license with the scientific method. " Yes, Tracy is

> passionate about the evils of antidepressants, Tomb

> says, " but passion has very little place in the

> scientific method in terms of deciding what is

> accurate and truthful. " The book is full of

> vignettes, but vignettes don't tell the whole story,

> he argues. " You could take aspirin and do the same

> thing: comb the literature and find horrible things

> that have occurred with aspirin. "

>

> But Dr. Donald Marks, an internal medicine

> physician from Alabama who was director of research

> at two large drug companies and now often testifies

> as an expert witness against the drugs, calls Tracy

> " in many ways a visionary. " She " has observed a

> phenomenon that is now being validated, " he says.

>

> " I do think there are some people who don't

> understand Dr. Tracy and don't understand her

> passion and don't understand how smart she is, " says

> Jennifer Tierney, a North Carolina mother whose

> teenage daughter was put on Effexor to treat her

> migraine headaches.

>

> In her darkest hours ­ when her cheerful,

> straight-A daughter first became " a monster " and

> later, in an effort to wean herself from Effexor,

> had withdrawal symptoms that left her unable even to

> walk ­ Tierney called every antidepressant expert

> she could find on the Internet. Only Tracy called

> her back.

>

> " Dr. Tracy never got one dime from me. She

> never mentioned money to me at all. When she first

> called me back and I said, 'What can I pay you?' she

> said, 'No. No.' You have to think that's pretty

> pure. And she helped me more than anyone else. "

>

> " An unsung hero, " says Cassandra Dawn Casey, a

> Utah County woman who started an antidepressant

> group called Aspire after her son's death two years

> ago. " None of us would have known what was causing

> these problems in our lives if it hadn't been for

> trailblazers like Ann. "

>

> The beginning

>

> Tracy's interest in antidepressants began in

> 1989 when, she says, she watched two LDS friends

> turn into alcoholics after being put on Prozac.

> After that she started reading about the drugs, and

> soon she was hunting down scientific studies, and

> then she got a button made that said " Just Say No to

> Prozac. " After that she'd be at the grocery store or

> church and people would come up to her and start

> telling her their stories.

>

> " There's great power in those stories, " says

> Texas trial attorney Andy Vickery, who has been

> involved in more than 50 cases related to

> antidepressants. " They have a power to persuade and

> even change the bureaucratic forces of our country. "

>

> And that's just what Tracy expects to

> eventually happen. " I think these drugs are

> history, " she says. Eventually, the stories told by

> parents, and the investigations into the clinical

> trials that the drug companies have suppressed, will

> add up to public outrage ­ and then antidepressants

> will be pulled from the market, she predicts.

>

> " What is sad, " she says, " is that so many have

> had to die or have their lives ruined while we have

> learned that this was yet another terrible mistake

> in our hope of 'Better Living Through Chemistry.' "

--

>

> E-mail: jarvik

>