![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 143. Go back in thread:
Posted by Devastated Mother on January 24, 2006, at 2:57:14
In reply to Re: Suicide on Effexor, posted by summerflowers on January 23, 2006, at 5:38:49
summerflowers,
Thank you for the link to the summaries of the studies on psychiatric drugs. I checked it out and find it absolutely reasonable and helpful in some ways. I suspect that there are many instances that do not get reported. Do you have any idea how one would go about finding out if adverse effects of drugs have been reported to the FDA?
Devastated Mother
Posted by summerflowers on January 24, 2006, at 3:39:20
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 24, 2006, at 2:57:14
> summerflowers,
>
> Thank you for the link to the summaries of the studies on psychiatric drugs. I checked it out and find it absolutely reasonable and helpful in some ways. I suspect that there are many instances that do not get reported. Do you have any idea how one would go about finding out if adverse effects of drugs have been reported to the FDA?
>
> Devastated Mother
>Im so sorry for your loss.It angers me .Coverups,lies,neglect,its all there.It is estimated more people have died in psychiatry than in all the wars put together.It is also estimated psyciatry only helps 1% of people.I sent a report in on a near fatal severe reaction.But I allways wonder how many others-in our neighborhood,town,city,country have been reported,or just swept under the carpet.Maybe a true investigation would reveal something shocking.Its devestating.
Posted by nicky847 on January 24, 2006, at 10:44:32
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 23, 2006, at 15:42:56
i think that there needs to be MUCH closer monitoring of patients on antidepressants for the first month they are on them...the period that the body adjusts to the meds can be very scary..
i think after a while they are helpful, and they have helped me.. but in the short term they are dangerous
but it's not feasible to hospitalize every person that goes on a/d's until they adjust to the meds..so there has to be some other solution that can provide closer monitoring and counseling during the adjustment period
Posted by nicky847 on January 24, 2006, at 10:49:55
In reply to Re: Suicide on Effexor » Devastated Mother, posted by summerflowers on January 24, 2006, at 3:39:20
> > summerflowers,
> >
> > Thank you for the link to the summaries of the studies on psychiatric drugs. I checked it out and find it absolutely reasonable and helpful in some ways. I suspect that there are many instances that do not get reported. Do you have any idea how one would go about finding out if adverse effects of drugs have been reported to the FDA?
> >
> > Devastated Mother
> >Im so sorry for your loss.It angers me .Coverups,lies,neglect,its all there.It is estimated more people have died in psychiatry than in all the wars put together.It is also estimated psyciatry only helps 1% of people.I sent a report in on a near fatal severe reaction.But I allways wonder how many others-in our neighborhood,town,city,country have been reported,or just swept under the carpet.Maybe a true investigation would reveal something shocking.Its devestating.
>people do die in psychiatry...but you have to remember that in alot of those cases its the disease that kills and not the cure....people die in oncology too but its not because of the chemo in most cases, its because of the cancer..depression is a serious illness! and the worst part is that people who suffer from it are ashamed of it and dont want to talk about how they are feeling..
in my opinion, the problem is that we desperately need to improve our research of mental health issues..advances have been made but we as a society need to drag this disease into the light, remove the stigma, and begin finding more effective and less dangerous treatments...antidepressants are a start but we can do much, much better!
Posted by Racer on January 24, 2006, at 12:59:46
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 23, 2006, at 7:07:59
>
>
> However, I wonder if I have possibly misunderstood the black box. Is the patient expected to warn his/her family about the potential problems? Is this a reasonable expectation from someone who is depressed?And therein lies the rub...
I think the theory is that doctors monitor their most vulnerable patients closely enough to ensure their safety, and let parents or caregivers know that there is some danger during the adjustment phase.
And pigs fly through the air on great multicolored wings.
All I meant is that the FDA has *very* limited means to ensure the safety of people taking these drugs. The Black Box is the strongest thing they have. Beyond that, the doctors who prescribe these drugs are the ones who really have to step in to ensure the safety of their patients.
In a perfect world, there would be a therapist monitoring the patient and coordinating care with the psychiatrist. In the world of HMOs, of course, this doesn't always happen, and pdocs often don't see patients frequently enough during the adjustment phase, and in many cases GPs are prescribing these drugs rather than pdocs. All of those contribute to the problem.
As for why Effexor is not the last resort drug -- and it's not, because there are much more problematic ADs out there -- it's partly because it's generally well tolerated, and it's different from SSRIs. Doctors prescribing antidepressants go through a sort of protocol that starts with SSRIs because they're pretty benign drugs from a medical viewpoint. From there, they'll usually go to the SNRIs, of which there are two: Cymbalta, which is a bit of a disappointment, and Effexor. Effexoer has been around a while, Cymbalta has been out for about a year and a half. Most doctors will go for what they know a bit better first -- hence, Effexor is often a second choice, rather than last choice. How can I call them benign drugs? From a medical viewpoint, they are: no cardiotoxicity, no hypertensive crisis, no hypotension, no known LD50 in many cases, etc. And they tend to be effective for many people, and generally with far fewer side effects than the TCAs or MAOIs. The other newer drugs, Remeron, Wellbutrin, etc, have their own drawbacks, which make them somewhat less popular. So, most doctors will start with SSRIs and go on to Effexor.
I am sorry about your experience.
Posted by Devastated Mother on January 24, 2006, at 18:29:32
In reply to Re: Suicide on Effexor, posted by nicky847 on January 24, 2006, at 10:49:55
I guess I could accept this if my son had had depression issues for years. He did not. He had a couple of things happen in his life that would have depressed anyone, and a bad doctor decided effexor would help. Just a bad choice on her part not to assume that there would be a need for someone else to know about her decision and it's potential effects.
Posted by Smeegle on January 24, 2006, at 19:23:38
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 24, 2006, at 18:29:32
Sorry to hear about your loss. Your post struck a chord with me because I attempted suicide while weaning off Effexor. Fortunately for me, I just ended up in the psych hospital for a couple of weeks while it cleared my system and my new meds started working. I don't blame my pdoc even though he didn't warn me. I was taking it before we started reading about the "possible" suicide potential in children but not once did I ever read that it was a strong possibility for adults as well. I am 42 and never had a suicidal thought before then. Effexor seemed like a miracle drug when I first started taking it. I thought I had my life back. But then we started having to increase my dose about ever six months until I reached the maximum dose my dr would prescribe and my bp was high. It was only when I stopped taking it that there just didn't seem to be any other options. Looking back I can see how irrational my thinking was, but at the time it was so vivid and painful. It was no longer a matter of 'would I', but rather a matter of 'when'. I am now on Lexapro and though I still have depression, my thinking is rational and I fully believe in my current state of mind I would have the courage to ask for help. I would never recommend Effexor to anyone for any reason. It's not worth the risk.
Posted by summerflowers on January 25, 2006, at 0:24:37
In reply to Re: Suicide on Effexor » Devastated Mother, posted by Racer on January 24, 2006, at 12:59:46
> >
> >
> > However, I wonder if I have possibly misunderstood the black box. Is the patient expected to warn his/her family about the potential problems? The Black Box is the strongest thing they have. Beyond that, the doctors who prescribe these drugs are the ones who really have to step in to ensure the safety of their patients.>EXACTLY! Its like if you have an electrical problem say,in your house,you call in an electrician.You expect them to do their job safely,because it could be dangerous or lethal if it isnt.They get payd for their electrical expertise,Just like psychiatrists do.If the electrician causes a fire,they are liable for that,because they didnt do the job properly.People are warned about the dangers of electricity just as patients are warned of the dangers of these medications,but it is up to the experts to do their job-thoroughly!Just as an electrician or what have you.Man,I cant believe half of what goes on.
Posted by gardenergirl on January 25, 2006, at 22:57:53
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 24, 2006, at 18:29:32
> Just a bad choice on her part not to assume that there would be a need for someone else to know about her decision and it's potential effects.
Unless your son signed a consent for release of information, the doctor was not legally allowed to inform anyone about your son's being on psychotropic medications unless he directly expressed his intent to immediately harm himself to the doctor.
I'm sorry for your loss. I just wanted to clarify why a doctor might not inform an adult's parent about his care.
gg
Posted by Devastated Mother on January 26, 2006, at 1:47:52
In reply to Re: Suicide on Effexor » Devastated Mother, posted by gardenergirl on January 25, 2006, at 22:57:53
Yes, I know about the forms. Every other doctor he had, when he was asked, he willingly signed the form for us to be told. I don't think she asked him, because he would have signed it.
Yeah, just a mistake on her part. And it only cost him his life. Oh well...
Posted by summerflowers on January 26, 2006, at 2:37:38
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 1:47:52
> Yes, I know about the forms. Every other doctor he had, when he was asked, he willingly signed the form for us to be told. I don't think she asked him, because he would have signed it.
>
> Yeah, just a mistake on her part. And it only cost him his life. Oh well...
>Two years ago,my partner of 16 years who I love and are so close to,(and the father of our 5 children) went through a rougth patch.Nothing he couldnt usually deal with.In the past,he had tackled problems,got through them,he also spent time in a rehab,a place where he came out stronger,so much healing went on.They didnt just deal with the alcaholism,they also dealt with everything deeper,including a chilhood of severe abuse.For 6 years he held onto the strength they gave him,and the skills taught,in how to survive in life.So,this time,he was advised by someone to see a therepist.When he went to the place he was given a psychiatrist,we didnt know the difference.This lady started bringing up his past,the past which he had dealt with allready in rehab.It all got dragged up again,and all the emotions with it.She diagnosed him PTSD,and gave him drugs to help,aropax and epilim.Each day went by and his whole character seemed to become possesed,rage came into the picture,character changes where he started acting really narrsistic.I told him I was scared,told him he had to stop taking the drugs,4 weeks he was on them,then he attempted suicide.He tried 4 ways but he amazingly survived.He has permanant damage to his brain,liver,and emotions.They dont seem to care.They also didnt involve me in anything,I was just nothing to this woman,she thought she knew him better than me for some reason.My heart goes out to you.I dont know if I should submit this,because the words you said above should be the last said,it is that sad.
Posted by Devastated Mother on January 26, 2006, at 5:55:35
In reply to Re: Suicide on Effexor, posted by summerflowers on January 26, 2006, at 2:37:38
summerflowers, and all of you here,
It does help to know I am not crazy, so your sharing here is helping me. I am grateful, especially since I can see you are sharing times that were incredibly difficult for you as well. For me, life will go on, as I know it must, but I am driven to try to do something to change our system that allows these sorts of things to happen to people. This is so wrong.
Posted by shasling on January 26, 2006, at 7:08:21
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 5:55:35
> summerflowers, and all of you here,
>
> It does help to know I am not crazy, so your sharing here is helping me. I am grateful, especially since I can see you are sharing times that were incredibly difficult for you as well. For me, life will go on, as I know it must, but I am driven to try to do something to change our system that allows these sorts of things to happen to people. This is so wrong.--Mom,
As someone who has never faced anything like this, I found that I had little to offer other than my deepest condolences and wishes for your healing. I wished I could do more to make it better. However, as a mom of a son the same age, who can't even process the the horror, I had to recognize that I very well might only make it worse by inadvertently dragging you back to a place you have already travelled through.
When I see this morning that you have received a measure of comfort and relief from talking with the others I am so grateful. It brought surprise tears to my eyes. I just want so badly for you to find some comfort, and was frustrated that it wasn't something I could do. Thanks to the others, and I am sorry for all of your experiences and losses.
With hope for your continued healing,
Suzie
>
>
Posted by Racer on January 26, 2006, at 13:24:45
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 5:55:35
> but I am driven to try to do something to change our system that allows these sorts of things to happen to people. This is so wrong.
>
>Believe me, I can relate to that sentiment.
If you really do want to do something to improve the system, I highly recommend that you report the doctor involved to your state's medical board. You can get all the forms online, and it's not that difficult to get through the whole process. The benefit of doing this is that it's free -- AND, if the doctor gets any sort of consequence at all, it's a whole lot easier if you choose to sue at a later date.
The medical boards are an often overlooked resource, and the more reports they get, the better the chance that things will change.
Another thing to do is to contact your local representatives -- although it shouldn't be, health care is a political issue. Especially mental health care.
Also, you can contact your local chapter of NAMI -- the National Alliance of the Mentally Ill. They have a lot of information about how to get through the maze of getting help in this sort of situation -- whether that help is getting the doctor involved investigated to make sure she did everything she was required to do, or getting you counseling, or adding you to a list of people the legislators should know about for the next time something about this comes up.
I realize that I'm suggesting that you DO things at a time in your life when I very much doubt you feel up to it, and I regret that. Maybe you'd find the process therapeutic, but regardless of that I very much hope that you have found grief counseling for yourself.
Posted by Devastated Mother on January 26, 2006, at 13:42:53
In reply to Re: Suicide on Effexor » Devastated Mother, posted by Racer on January 26, 2006, at 13:24:45
Actually, it has been a little more than six months, and I am at a point where I do want to DO something. I will probably never need counseling in my life--I will probably never trust another shrink in my life. If I had been less trusting, this wouldn't have happened.
I will start the process of trying to contact the medical board. Thanks for the suggestion.
Posted by summerflowers on January 26, 2006, at 15:32:29
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 13:42:53
> Actually, it has been a little more than six months, and I am at a point where I do want to DO something. I will probably never need counseling in my life--I will probably never trust another shrink in my life. If I had been less trusting, this wouldn't have happened.
>
> I will start the process of trying to contact the medical board. Thanks for the suggestion.
> You have all of our deepest sympathy,and I really think people all over the world who have been through this should stand together,and let the truth be told,for those that we loved.
Posted by simon levane on January 31, 2006, at 8:52:20
In reply to Suicide on Effexor, posted by Devastated Mother on January 21, 2006, at 2:23:04
I lost my 20 year old daughter in May 2004 under very similar circumstances. She had been prescribed effexor by a highly rated specialist in a Mental Health and Addiction Foundation for Obsessive Compulsive Disorder and General Anxiety Disorder. I had no idea that the drug had risk. She had a long history of personality disorder "acting out" and some previous attempts with overdoses of tylenol, but never a "final act". Neither the specialist, nor a psychiatrist she was seeing, nor our family doctor who was prescribing the drug advised us of the risk. I had let the family doctor know that she was abusing her use of ritalin by stealing extra doses from me, but he was clueless about the real risks of ritalin addiction, and the potentially deadly combination of tranquilizers and ritalin and the effexor. My daughter killed herself in the subway the day after her dose of effexor was increased.
This whole ridiculous aspect of medical confidentiality is so stupid when facing an at risk young person whose judgement was completely questionable due to her illness. Doctors are supposed to provide information if there is a serious risk of safety. When we later saw her medical records and I understood the total picture which I did not when she was alive from emotional exhaustion (not uncommon with troubled kids) and because I could not have imagined the stupidity and lackadaisical attitude of doctors about prescribing mind influencing drugs.
The pain of losing a child is just beyond comprehension. I wish that my daughter's medical caregivers could experience my pain for one day -- they would never ever forget to look after their patients. My daughter was full of life in spite of her illness and had so much to look forward to. Now I live in an agony that she could never have imagined being inflicted on me. It is a wonder I have not actually killed myself.
Many parent survivors of loss of their children to suicide feel just like that.
Doctors simply do not want to be accountable for this unbelievable kind of disaster. They would rather rationalize that "depressed people kill themselves", instead of accepting their own failure to duly inform family members of risk of medications.
Posted by Devastated Mother on January 31, 2006, at 9:25:16
In reply to Re: Suicide on Effexor » Devastated Mother, posted by simon levane on January 31, 2006, at 8:52:20
I am incredibly sorry for your loss. It has indeed been a long uphill battle with my own feelings in the face of this loss. I am sure it is not over.
Did you report the doctor to anyone or take any other steps?
Posted by simon levane on January 31, 2006, at 12:36:21
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 31, 2006, at 9:25:16
> I am incredibly sorry for your loss. It has indeed been a long uphill battle with my own feelings in the face of this loss. I am sure it is not over.
>
> Did you report the doctor to anyone or take any other steps?We lodged a complaint against my daughter's last psychiatrist as he had refused to see parents. He actually told my daughter (paraphrased) "I am not a child psychiatrist, so I only see adults, not parents of children"
Had he seen us, we could have given him so much more information. The sharing of medical records between doctors is terribly flawed. Our family doctor hardly sent very accurate medical history to other doctors and the doctors we saw were truly ignorant about how to involve parents in my daughter's care.
I have lived in the most terrible guilt because I believe that I failed my daughter... but I had not understood how my mistakes could contribute to such a terrible outcome. Personal flaws like being a book addict, and not very good at housekeeping, as well as just getting so frustated at her behaviour that I had become reactive to her as a mode of relationship rather than loving. This was part of her illness -- avoiding school, and she became addicted to prescription drugs. It is a long story. I wish I had researched her illness myself, but as she was seeing doctors, I thought that I didn't need to do this.. and I was seeing a psychiatrist for support as well as attending a parent support group, but now I realize that none of the doctors had a very good understanding of her illness other than this common characterization of "being difficult".. And I just did not get the information about risk that should have been there as a front line reality.
The doctors basically excuse themselves by saying " depressed people kill themselves" but the fact is that my daughter was anxious and unhappy but not necessarily depressed, and one of the risk factors for her illness is impulsivity, so the combination of the effect of the effexor with my daughter's use of prescription drugs took her to an impulsive act in the subway. A friend told me that he knew a man on Effexor who was in the subway and was actually thinking of jumping, but when the thought of getting a coke crossed his mind, he went to get the coke instead of killing himself.
I have since read so much about risks and realize that our doctors simply did not put two and two together in keeping us informed - and her last psychiatrist blocked our input and in doing so he lost valuable information that could have saved her life.
When I told one doctor about the risks of ritalin as kiddie cocaine, he told me that he had never heard of that.. Imagine, a doctor prescribing a drug to an adolescent/young adult without realizing a very serious risk.
I was a single parent. Neither my daughter's mother, nor I were perfect parents, but we loved her dearly and struggled to try to help her with her behaviour, but we failed because neither of us really understood what was wrong with her. No one really explained it in a way that could have helped us keep her safe. At end, the risk factors of her illness and our failure to understand cost her her life..
It should not have happened. It could have been prevented. The tragic stories are in the background for a lot of people -- sad news that does not touch too close to home, but when it happens to self -- and my daughter's room is now empty of her forever, and I long for the sound of her voice and her smile, and laughter, and miss her knowing I will miss her for as long as I live, then the anger inside for failure of medical caregivers with their vaunted egoes and so-called intelligence -- to help... I wish they could experience my agony for one day.
Posted by simon levane on January 31, 2006, at 12:42:27
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 31, 2006, at 9:25:16
> I am incredibly sorry for your loss. It has indeed been a long uphill battle with my own feelings in the face of this loss. I am sure it is not over.
>
> Did you report the doctor to anyone or take any other steps?Dear DM...
here is a website for suicide survivors that you may find helps. Nothing helps much for long. It is a terrible agonizing process to somehow live through the unfathomable tragedy..
I found that this site has some very good thoughts and resources..
http://members.tripod.com/~LifeGard/index.htmlI do hope that this helps...
SL
Posted by Devastated Mother on January 31, 2006, at 13:07:00
In reply to Re: Suicide on Effexor, posted by simon levane on January 31, 2006, at 12:42:27
Simon,
Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
--DM
Posted by Devastated Mother on January 31, 2006, at 14:19:09
In reply to Re: Suicide on Effexor, posted by simon levane on January 31, 2006, at 12:36:21
> > I am incredibly sorry for your loss. It has indeed been a long uphill battle with my own feelings in the face of this loss. I am sure it is not over.
> >
> > Did you report the doctor to anyone or take any other steps?
>
> We lodged a complaint against my daughter's last psychiatrist as he had refused to see parents. He actually told my daughter (paraphrased) "I am not a child psychiatrist, so I only see adults, not parents of children"
> Had he seen us, we could have given him so much more information. The sharing of medical records between doctors is terribly flawed. Our family doctor hardly sent very accurate medical history to other doctors and the doctors we saw were truly ignorant about how to involve parents in my daughter's care.
> I have lived in the most terrible guilt because I believe that I failed my daughter... but I had not understood how my mistakes could contribute to such a terrible outcome. Personal flaws like being a book addict, and not very good at housekeeping, as well as just getting so frustated at her behaviour that I had become reactive to her as a mode of relationship rather than loving. This was part of her illness -- avoiding school, and she became addicted to prescription drugs. It is a long story. I wish I had researched her illness myself, but as she was seeing doctors, I thought that I didn't need to do this.. and I was seeing a psychiatrist for support as well as attending a parent support group, but now I realize that none of the doctors had a very good understanding of her illness other than this common characterization of "being difficult".. And I just did not get the information about risk that should have been there as a front line reality.
> The doctors basically excuse themselves by saying " depressed people kill themselves" but the fact is that my daughter was anxious and unhappy but not necessarily depressed, and one of the risk factors for her illness is impulsivity, so the combination of the effect of the effexor with my daughter's use of prescription drugs took her to an impulsive act in the subway. A friend told me that he knew a man on Effexor who was in the subway and was actually thinking of jumping, but when the thought of getting a coke crossed his mind, he went to get the coke instead of killing himself.
> I have since read so much about risks and realize that our doctors simply did not put two and two together in keeping us informed - and her last psychiatrist blocked our input and in doing so he lost valuable information that could have saved her life.
> When I told one doctor about the risks of ritalin as kiddie cocaine, he told me that he had never heard of that.. Imagine, a doctor prescribing a drug to an adolescent/young adult without realizing a very serious risk.
> I was a single parent. Neither my daughter's mother, nor I were perfect parents, but we loved her dearly and struggled to try to help her with her behaviour, but we failed because neither of us really understood what was wrong with her. No one really explained it in a way that could have helped us keep her safe. At end, the risk factors of her illness and our failure to understand cost her her life..
> It should not have happened. It could have been prevented. The tragic stories are in the background for a lot of people -- sad news that does not touch too close to home, but when it happens to self -- and my daughter's room is now empty of her forever, and I long for the sound of her voice and her smile, and laughter, and miss her knowing I will miss her for as long as I live, then the anger inside for failure of medical caregivers with their vaunted egoes and so-called intelligence -- to help... I wish they could experience my agony for one day.
>Did you complain to the Medical Board?
I wish them much longer than one day of our agony.
I must believe, however, that one day, their behavior will come back to haunt them.
Since we lost our son, several people around us have experienced other equally tragic losses. My husband at this point says that tragedy is waiting to come into every life.
dm
Posted by simon levane on January 31, 2006, at 15:41:27
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 31, 2006, at 13:07:00
> Simon,
>
> Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
>
> --DMDear DM...
if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
I still feel more guilty than anyone..SL
Posted by Devastated Mother on January 31, 2006, at 16:08:31
In reply to Re: Suicide on Effexor, posted by simon levane on January 31, 2006, at 15:41:27
> > Simon,
> >
> > Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
> >
> > --DM
>
> Dear DM...
> if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
> In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
> I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
> I still feel more guilty than anyone..
>
> SL
>Medical Boards should be told when doctors do not live up to the "do no harm" that they are sworn to uphold. Talking to a doctor is impossible for a lay person, since doctors always think they know more than we do. Medical Boards are their peers, and should at least investigate this. Even at this point, I do not think it is too late to make that report. I urge you to do so. Doctors should have to be answerable to someone when they do something that takes a life.
--dm
Posted by simon levane on January 31, 2006, at 16:43:07
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 31, 2006, at 16:08:31
> > > Simon,
> > >
> > > Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
> > >
> > > --DM
> >
> > Dear DM...
> > if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
> > In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
> > I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
> > I still feel more guilty than anyone..
> >
> > SL
> >
>
> Medical Boards should be told when doctors do not live up to the "do no harm" that they are sworn to uphold. Talking to a doctor is impossible for a lay person, since doctors always think they know more than we do. Medical Boards are their peers, and should at least investigate this. Even at this point, I do not think it is too late to make that report. I urge you to do so. Doctors should have to be answerable to someone when they do something that takes a life.
> --dmDear DM
the fact is that when there are a multiplicity of factors such as diagnosis of Borderline Personality Disorder, previous suicide attempts in history, known drug abuse, then the doctor is basically off the hook in a flash. The best we could do was have our complaint on his record. And in fairness, he was not the only doctor who failed, but his selfish attitude and his personal space of not wanting to deal with parents were not best for our daughter, but only suited his needs. I know from reading about best practices for patients with this disorder that working with parents is CRUCIAL to helping them. I was struggling with the manifestations of my daughter's illness frustrated that my bright and beautiful daughter could not somehow get her act together. I just did not see the depth of her pain because she was so "up" and could be demanding, and self-serving and somehow disregarded the feelings of others in how she acted to get what she wanted. What I didn't see was that she had actually become an addict. The behaviour was driven by her illness. It is not as if I was not seeing doctors for help, but the scale of her illness was not explained to me in a way that I really understood... and I am not uneducated, but this was so close to the skin and I was in the middle of it for many years. I needed help to help her.
If this last doctor or another doctor had just looked at the situation clinically, they should have been blowing whistles and alarms at the risk. Instead they either had limited information or were simply ignorant of the situation - in the way a doctor forgets about the patient when they put that file back on the shelf.. Out of sight, out of mind... but prescribing is a quick.. sure go ahead it's ok..
There have been cases of medical disasters causing the death of children -- two cases in Toronto about 15 or so years apart, and in both cases the lawyers for the institution and for the doctors or others who had clearly failed in their medical roles resisted admitting to this. One woman who lost her son because he was complaining of stomach aches and one of the residents was "sure" that it was psychosomatic because she couldn't diagnose what was wrong with him and even forced him to clean up his own vomit.. he died on the operating table when they finally realized he had a twisted bowel and had been telling the truth from day one. The mother fought for about 10 years till they finally admitted that the doctor was clearly at fault. She got an apology and her costs I believe as well as a settlement, but it was not the money... She fought for her son after his deat h so that this would not happen to other children. This happened in the most famous Children's Hospital in Canada, and the best hospital in spite of this.. Imagine.. ten years of fighting in the courts without the resources of a huge institution.
It is very difficult in cases of psychotrophic drugs to have a direct cause and effect. After all, "she was depressed, and depressed people kill themselves."..
There is a survivor advocacy group on Yahoo, (Canadian) that strives to educate both the public and professionals to help prevent suicides. OH, so tragically, suicide is the second cause of death of young people from 16 - 24, the first one being auto accidents.
I wish I had known so much when my daughter was alive, but the thought of her suicide was so horrific that I could not bear to think it was possible. If only I had dared to face this as a reality. I think for many parents taking that leap to facing the real possibility of it happening must be excruciatingly difficult. I could not face it when my daughter was alive. Now I face it every day, and I know from talking to other parents, that they could not imagine it happening. Not my child. How could they do this to us (as we are still alive and they are gone). When we ask "how could they do it to themselves?" the answer is that we should have been able to protect them.. but we failed.
that is how I feel.
SL
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