Lubitz 'on highest dose of Mirtazapine'

Andreas Lubitz, the Germanwings pilot who killed 149 people when he flew a plane into a French mountainside, was taking Mirtazapine at the time of his death, French investigators have revealed.

Regular visitors to this and other websites that warn of the dangers of antidepressants will have come across Mirtazapine before. The NaSSA antidepressant is sold as Remeron in the USA and, like most antidepressants, is associated with causing suicidal and/or violent impulses in some patients.

As usual, however, the focus of investigations into the Germanwings murder–suicide has been on Lubitz’s depression and not the role of the antidepressants he was taking. And it’s not the first time Mirtazapine has been linked to a murder–suicide. Dellwyn Jones stabbed his ex-girlfriend in East Sussex in 2003 while taking the drug and Darren Weatherley stabbed his mother in Norfolk in 2010, to name but two Mirtazapine-inspired homicides.

In an email from Lubitz to his doctor, published by German newspaper
Bild, the pilot said he was taking the highest dose of Mirtazapine and admitted that it was making him restless.

On 24 March 2015, Lubitz deliberately crashed the plane in the French Alps on a flight from Barcelona to Dusseldorf. He had waited until his colleague, the more senior pilot on the flight, had left the cockpit to go to the toilet, before locking the cockpit door and bringing down the Airbus A320.

Sadly, it seems that even the murder of 149 people cannot provoke the medical community into pausing in their relentless prescribing of antidepressants to individuals who would be so much better off without them.

Katie Silvester

Lives destroyed by pills for depression

A middle-aged man who loved his family is found hanging by his only brother. A mother of two who embraced life kills herself by standing in front of a train.

What do the two people have in common? They have both been prescribed anti-depressants, after which they acted out of character. Something in their heads after taking the drugs told them that they must kill themselves and they must do it violently.

How common is their reaction to anti-depressants? We don’t know because no one is collecting the information. No one is doing the research. Investigations into drugs are carried out before they go on the market – not afterwards. 

The warning on the Patient Information Leaflet inside the packet of pills may say that certain side-effects are “uncommon”. They may give the figure of how many people per thousand are affected. But the truth is that no one knows how common any side effect is once the drug is in general use. There is too little feedback and what there is not scientifically recorded. It is not collated as “evidence” and medics will take notice of observations only if they are “evidence-based”.

So you and I, and the woman next door may know that there is an alarming number of cases of people who have destroyed themselves while on anti-depressants, but officially it isn’t happening.

Few patients who have ill effects from a drug will report back to their doctors. And if they do, the doctor will usually just prescribe them a similar drug instead.

And that makes things worse because the danger times with anti-depressants are when you go on them, when you come off them and when the dose or the brand is changed.

There is a Yellow Card Reporting System which the general public can use to report the side effects of drugs. This was set up for medical professional some years ago by the medical regulator, the MHRA (originally called the Medicines and Healthcare Products Regulatory Agency). It has now been extended to the general public. 
Unfortunately, the cards are not generally available at pharmacies or GP practices (the receptionist at my GP practice in Cambridge had not heard of them and when she went to consult colleagues she drew a blank) and the system is not mentioned on the Patient Information Leaflet in the packets of pills. However it is possible to report side effects on line if you put in: “MHRA Yellow Card Reporting System”.
When people jump off bridges, throw themselves under lorries or shoot their wives and children, three questions should be asked: “Was this person on medication?  How long had they been on medication? Was the medication changed?”
This information needs to be recorded on death certificates for suicide cases and on court records when anyone is convicted of any violent crime. Then we would have “the evidence” one way or the other.

So often what families say when someone has killed themselves is how out of character the action was. The families are not just shocked at what happened, they are astonished. The person has been taken over by a force so strong, they are actually “out of their minds”. 

That is how powerful these drugs are. Yet they are often prescribed without counselling or monitoring and with a frightening lack of caution.

Ironically, neither the man who hanged himself nor the woman who stood in front of a train was actually depressed when the drugs were prescribed. They were worried. But worry is not depression. The man had become anxious while waiting nine months for a hernia operation and was upset that he was unable to work. For the last year of his life, he was put on a cocktail of drugs including Venlafaxine, Respiradone and Citalapral.

The woman felt unwell and was afraid that she might be developing ME. She was prescribed Mirtazpine, which was switched for Prozac two weeks later.

When most people are upset, it is for a good reason that would upset anyone and they need time, advice, and loving care to feel better, not a chemical cosh. They need someone to do what GPs seem to be so very bad at – they need someone to listen.

It is too easy to hand out pills and too much money is made out of it. That anti-depressants can cause suicide and violence seems to be acknowledged by everyone except the people who could do something about it, the doctors who prescribe the pills and the coroners who preside over the inquests. It is as if because anti-depressants do help some people, the others must pay this high price.

Campaigner Janice Simmons who founded the Seroxat Users Group says she has hundreds of examples of people whose lives have been destroyed by anti-depressants.  She looks for connections between drugs and all violent incidents. Her website is linked to another called Seroxat Stories. She believes that the school shootings in America, for example, are carried out by people on, or who have recently come off psychiatric drugs.

The connection between mind-changing drugs and violence has been known for decades.  As a young journalist on The Yorkshire Post, I wrote about the connection between what were then called “battered babies” and tranquilisers. The first paragraph of my article read:

“Tranquilisers, taken by thousands of women every day, are a direct cause of baby-battering. The drugs, thought to make people more tranquil, produce aggression and violence. According to a team of doctors in Oxford, this has been common knowledge among doctors for 25 years, though GPs continue to prescribe them.”

I wrote that article in July 1975.
Article by Angela Singer, a journalist for 40 years, whose work has been published in both national and provincial newspapers.

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The proven dangers of antidepressants

by Peter R Breggin MD

On 22 March 2004, the FDA issued an extraordinary ‘Public Health Advisory’ that cautioned about the risks associated with the whole new generation of antidepressants including Prozac and its knock offs, Zoloft, Paxil, Luvox, Celexa, and Lexapro, as well as Wellbutrin, Effexor, Serzone, and Remeron. The warning followed a public hearing where dozens of family members and victims testified about suicide and violence committed by individuals taking these medications.

While stopping short of concluding that antidepressants definitely cause suicide, the FDA warned that they might do so in a small percentage of children and adults. In the debate over drug-induced suicide, little attention has been given to the FDA’s additional warning that certain behaviours are ‘known to be associated with these drugs’, including ‘anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (severe restlessness), hypomania, and mania’.

From agitation and hostility to impulsivity and mania, the FDA’s litany of antidepressant-induced behaviours is identical to that of PCP, methamphetamine and cocaine – drugs known to cause aggression and violence. These older stimulants, and most of the newer antidepressants, cause similar effects as a result of their impact on a neurotransmitter in the brain called serotonin. For more than a decade, I have documented in books and scientific reports how this stimulation or activation profile can lead to out-of-control behavior, including violence. Indeed, the FDA’s conclusions seem drawn from my recent detailed review of Breggin Antidepressant Column, p. 2 studies pertaining to abnormal behaviour produced by the newer antidepressants: ‘Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs): A review and analysis’ published in the I
nternational Journal of Risk and Safety in Medicine, 16: 31-49, 2003/2004 (The complete text of the peer-reviewed article appears on my website). I made a similar analysis in my most recent book on the subject, The Antidepressant Fact Book (2002, Perseus Books).

As a psychiatrist and as a medical expert, I have examined dozens of cases of individuals who have committed suicide or violent crimes while under the influence of the newer antidepressants such as Prozac, Zoloft, Paxil, Luvox and Celexa. In June 2004 in South Carolina, Christopher Pittman went on trial for shooting his grandparents to death while they slept. Chris was 12 when his family doctor started him on Zoloft.

Three weeks later the doctor doubled his dose and one week later Chris committed the violent acts. In other cases, a 14-year-old girl on Prozac fired a pistol pointblank at a friend but the gun failed to go off, and a teenage boy on Zoloft beat to death an elderly woman who complained to him about his loud music. A greater number of cases involve adults who lost control of themselves while taking antidepressants. In at least two cases, judges have found individuals not guilty on the basis of involuntary intoxication with psychiatric drugs and other cases have resulted in reduced charges, lesser convictions or shortened sentences.

The FDA includes mania in its list of known antidepressant effects. Manic individuals can become violent, especially when they are thwarted, and they can also ‘crash’ into depression and suicidal states. They can carry out elaborate but grandiose and doomed plans. One clinical trial showed a rate of six per cent manic reactions for depressed children on Prozac. None developed mania on a sugar pill.

Even in short-term clinical trials, one per cent or more of depressed adults develop mania compared to a small fraction on the sugar pill.

Although it is difficult to determine the rate at which the antidepressants cause relatively uncommon tragedies such as suicide and violence, we do know that they cause stimulant effects such as irritability and agitation in a large percentage of patients, often a third or more. Doctors who fail to recognise these reactions as drug-induced may mistakenly increase the dose of the antidepressant with disastrous results. Little will be lost by minimising the use of the newer antidepressants. While there is strong evidence that they cause suicide, there is no convincing evidence that they can prevent it. Many older antidepressants cause less stimulation and are equally or more effective in head-to-head clinical trials.

Beyond that, a number of meta-analyses drawing data from multiple studies have shown that antidepressants are no better than a sugar pill. People who are depressed often respond to placebo because it gives them hope. Severe depression is essentially a feeling of profound hopelessness and despair that can best be addressed by a variety of psychotherapeutic, educational and spiritual or religious interventions.

Unfortunately, there are also risks involved with stopping antidepressants. Many can cause withdrawal reactions that last days and sometimes longer, causing some patients to feel depressed, suicidal or even violent. Stopping antidepressants should be done carefully and with experienced clinical supervision.

As a first step in responding to this public health threat, we should follow the example of Great Britain whose drug safety agency recently banned the use of many of these drugs in children. Beyond that, the FDA and the medical profession must forthrightly educate potential patients and the public about the sometimes life-threatening risks associated with the use of antidepressant medications.

Article first published in 2004

Peter Breggin is an American psychiatrist. In the early 1990s, Dr Breggin was appointed and approved by the court as the single scientific expert for more than 100 combined Prozac product liability concerning violence, suicide and other behavioural aberrations caused by the antidepressant. He continues to practice psychiatry in New York.