Posted by med_empowered on July 19, 2005, at 3:51:28
hey! From what I understand, the college student didn't have a history of particularly serious depression--i.e. depression accompanied by functional impairment, psychosis, hospitalization, suicide attempts, self-mutilation, etc. Eli Lilly's PR people kind of spun her suicide to make it seem like a tragic incident that would have happened with OR without the medication. In all likelihood, this is a completely inaccurate interpretation without any real merit. Interestingly enough, Cymbalta hit the market right before the FDA decided to require ADs to warn patients about the risk of increased suicidality in those treated with anti-depressants vs. those not given ADs. My guess is that had Cymbalta been released during or after that period, the suicide would have been definitely labelled *medication related*. Oh, BTW--the antidepressant+suicide relationship has apparently been noticed for a long time; until recently, no one found it all that important to let patients know what was going on. Tricyclic antidepressants were often considered risky both because they could be used to commit suicide AND because sometimes patients turned suicidal (and sometimes psychotic, hypomanic, manic, or strangely aggressive). And, if you look at the SSRIs, the effect is noted as early as the famous "Listening to Prozac" by Peter Kramer. At some point in the book, Dr.Kramer points out that there is a bump in suicide rates amongst those treated with Prozac versus those not using Prozac. His explanation? The burst of energy following Prozac's kick-start in the brain preceedes any antidepressant effect, so you sometimes have a deeply depressed, lethargic, potentially suicidal patient who suddenly has pep and vigor, but still wishes to die; they use their newfound energy to kill themselves. When I read it way back when, it made sense to me; then, the more I thought about it, and the more horror stories I saw and heard, the more I realized that something was terribly, terribly wrong in a number of cases with people treated with ADs. I've had friends with mild depression or anxiety go CRAZY under Prozac, Paxil, etc....and it isn't bipolar; once the offending med was withdrawn, the symptoms went away, without the need for any long-term use of mood-stabilizing/anti-manic medications. (Although in the "crazy" phase, some docs dosed the patients up with benzos like Klonopin to keep them calm). Anyway, believe whom you want for whatever reasons you want, but my own interpretation is that this death is somehow deeply associated with, if not caused by, the use of Cymbalta.
poster:med_empowered
thread:530027
URL: http://www.dr-bob.org/babble/20050718/msgs/530027.html