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Re: prozac/suicide

Posted by JohnL on October 31, 2000, at 17:50:16

In reply to prozac/suicide, posted by cindyh on October 31, 2000, at 6:33:33

I'm so very sorry. My heart just crumbles when I see or hear of these things. I'm not sure there's anything that pains me more. I feel stupid commenting on your question, as if it is so minute in importance compared to what you've been through. I don't want to go into details, but depression related suicide is no stranger to what my eyes have seen. There are no words.

As far as I know there has never been a relation between Prozac and suicide. The supposed relation was started up in Prozac's early days, primarily by the media. At the time, and still today, Prozac is more frequently used than its competitors, so logically any adverse events also seem to be more frequent.

Any psychiatric drug can cause a worsening of depression, including antidepressants. Any of them. It's not Prozac specific. I myself have experienced this, and it can be dramatic and swift. If you look through the PDR book which doctors use, every drug listed that has any psychiatric effects whatsoever also states that suicide risk exists and patients should be monitored closely when starting treatment.

With myself I know if I increase my serotonin levels too much too fast, I become nearly suicidally depressed. Real fast. Like in hours. And it continues to build momentum with each passing day. I know for a fact if I wanted to feel suicidal (just for the sake of example) I could take 80mg Prozac instead of my usual 10mg. That would do it. Or 100mg of 5HTP. Or 200mg Zoloft. Or 300mg Serzone. A mere 100mg Moclobemide. Doesn't matter. Too much serotonin too fast and I'm a goner. All of these doses I mentioned are within therapeutic ranges, but they are all capable of making me feel very very depressed. With antidepressants, I have come to learn more is not always better, is actually sometimes worse, and slow and low is the way to get started.

I think too often doctors think that somehow the depressed patient has the endurance to wait 6 weeks to feel better. No. In my opinion, someone who is very depressed needs to feel better now. Why? Because maybe they can't wait 6 weeks. Maybe they can't one day. Maybe they might commit suicide. Starting antidepressant treatment is good. But it's only half the game. I think doctors should also give the patient something to feel better immediately, to buy some time while waiting for the antidepressant to work. Stimulants can do that. Benzodiazepines can do that. These are in my opinion grossly underutilized in psychiatry. Just my opinion. But in Dr Bob's Tips there is mention of using stimulants for quick relief while waiting for the antidepressant to kick in. Also verified in clinical studies. In other studies, Clonazepam served a dual purpose of allowing the depressed patient to sleep and rest and simultaneously have their Prozac start working in just one week instead of six.

Adverse reactions such as suicide occur with all psychiatric drugs, not just Prozac. All of them. One other thing I think doctors hardly ever do, but should do all the time, is give the patient an antidote for a bad reaction. A couple doses of a benzo, or a couple doses of a tranquilizing antipsychotic like Stelazine are marvelous antidotes for adverse reactions. If a stimulant had been given to your husband along with only half the dose of Prozac he was given, and some antidotes on the side for an emergency, he would likely be alive and well today. It isn't Prozac's fault. As advanced as our medical doctors are, they are also often ignorant when it comes to treating severe depression. Six weeks? Get real.

I know I want to, and you probably want to, point a finger at Prozac. I just don't think that is the case. People get worse with any of them sometimes. As well as our doctors are trained, they often aren't trained in ways that are immediatley helpful to the suffering patient. I still ask myself the same thing today that I did ten years ago when I started antidepressants. That is, "4 to 6 weeks? You gotta be kidding?" You know, anyone who says just wait it out a few more weeks is naive as can be. As you've seen, the worst case scenarios do happen. They don't need to. They can be prevented. I want to bury my head in my knees and cry over your loss. I would like to wring that doctor by the neck. But it's not his/her fault. It's the entire medical training system. Somehow they have students duped into thinking everyone can wait 6 weeks. And no, antidepressants help people feel better, not worse. Right? Maybe. Not always. Any doctor who likewise didn't warn the patient to call if he feels worse right away also in my opinion is a lousy example of a doctor. Didn't do anything wrong, but still a crumb of doctor.

So so sorry,




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