Notes on a Scandal

In 1996 Zoe Heller, the author of Notes on a Scandal, took part in a widely reported debate with Roy Porter about Prozac. She defended the drug. It had restored her to life. He said today’s miracle invariably ended up in tomorrow’s tragedy and asked, Why is it that we never learn?

In 2003, Notes on a Scandal came out. It was made into a stunning movie in 2006 starring Cate Blanchett. This was the story of a schoolteacher who had seduced and was having continuing sexual relations with one of her male pupils.

In 2006, Rosie Meysenburg started up SSRI Stories, a website for cases of violence triggered by SSRI drugs (see The story of SSRI Stories). To collect the material she posted, Rosie had to review reports of criminal and other legal cases in which media reports mentioned SSRIs. To her astonishment, she began to notice that she had a series of cases involving women teachers convicted for inappropriate sexual behavior toward male pupils — with the women typically taking an SSRI. For one woman, the Courts decided her drug had caused the problem. This was the plot of Notes on a Scandal.

The most obvious thing SSRIs do is change sexual functioning — almost all people on an SSRI will notice some change within hours of having had it. Ian Hindmarch’s women volunteers in Leeds in 1983 almost certainly all had changes in their sexuality or sexual behavior. Delayed orgasm is extraordinarily common to begin with; reduced libido comes later. In many cases, things return to normal when the drug is stopped. In a not inconsiderable number of cases the changes are permanent — we don’t know how often this happens.

At the start of the antidepressant story, Roland Kuhn celebrated the fact that imipramine, an SSRI, had cured some homosexuals he had seen (discussed in greater length in The Antidepressant Era). Thirty years later Peter Kramer celebrated in the same way for Prozac. No one argued this was impossible. There are good grounds to accept that SSRIs can shift some of us along the axis of our sexual orientation.

But it’s not reasonable to think the shifts are likely to be only one way — in the direction some would view as normalizing. For every one whose change in orientation the Catholic Church might celebrate, there is likely to be another whose change would pose problems for the bastions of morality. There won’t be one without the other.

In 1999, 13-year-old Matt Miller was taken by his parents to see a doctor, as he was unsettled in a new school. The doctor, who was on Pfizer’s speakers’ bureau, put him on Zoloft. Matt became restless on Zoloft. A week later he hung himself in the bathroom between his and his parents’ bedroom.

Pfizer argued Matt’s death wasn’t caused by Zoloft; it was a case of auto-erotic asphyxiation gone wrong. To argue their case, they wheeled in Parke Dietz, an expert who had offered the view that Anita Hill’s views that she had been harassed by Supreme Court Judge Clarence Thomas were just fantasy. But Dietz didn’t come up with this idea of auto-erotic aphyxiation first — Pfizer did. Where did they get it from?

The idea almost certainly came from their studies, whether healthy volunteer trials like the Leeds study (see Mystery in Leeds), or in one of their trials for other purposes or in convincing reports to the company. This idea didn’t come from anyone’s understanding of what 13-year-old boys normally do.

Would Zoloft-induced impulses to auto-erotic asphyxiation be more or less plausible than a 13 year old spontaneously turning to this sexual expression? If it seems more plausible that Zoloft had induced auto-erotic asphyxiation, then whose fault would this death have been given the volume of data on Zoloft and sex that Pfizer had?

If Matt had practiced auto-erotic asphyxiation regularly (before starting Zoloft), another set of complications opens up. Zoloft inhibits orgasm. Could Zoloft have changed things, leading him to go too far? If so, whose fault would his death have been then, given that Pfizer had not warned about this? Knowing what they knew, Pfizer should have been honor-bound to warn anyone else who engages in auto-erotic sexual play or any form of sexual play, about this possibility.

It was one thing for Pfizer to argue for auto-erotic asphyxiation gone wrong, but they really should have told the court of the range of sexual changes they knew about.

In the Miller case, Pfizer flew Ian Hindmarch over to a pre-trial hearing. At this he claimed that the volunteers in his Zoloft study in Leeds (see Mystery in Leeds) were just suggestible. Nothing much had happened to any of these women. But the study remained unpublished, and its full details have probably never been seen by any regulator.

Four years later, the FDA put a Black Box warning of the risk of suicide in children taking Zoloft and other SSRIs. It’s difficult to believe that many people will have ever thought that Matt Miller died because of auto-erotic asphyxiation rather than a straightforward Zoloft-induced suicide. This warning should drive a stake through the heart of Pfizer’s argument.

For most people, the only remaining unanswered question of interest is likely to be where Pfizer got the auto-erotic asphyxiation idea from in the first place. The only remaining question for most people, that is, except the American Psychiatric Association, who after the Black Box warning rushed out a statement that the APA believes Antidepressants save lives. As outlined in Professional Suicide, this is an extraordinary example of a professional suicide note.

But perhaps what the APA, and more recently the Irish College of Psychiatrists, has been doing is not suicide after all — perhaps it is auto-erotic asphyxiation?  Let’s hope it doesn’t go wrong.


  1. On another post under Dr. David Healy I pointed out that despite his contributions to the reform movement, The noble, ethical, courageous all too believable Dr. Peter Breggin questions Dr. Healy’s place in the psychiatric reform movement since Dr. Healy is the major advocate of Electroshock, which Dr. Breggin and many others consider another form of lobotomy brain damage. Here is an article by Dr. Peter Breggin about Dr. Healy being a stealth psychiatrist in the psychiatric reform movement by attacking SSRI’S for the purpose of pushing the more dangerous ECT!!

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    • This is a very interesting article by essentially one of the fathers, if not the father, of the modern psychiatric reform movement. Breggin could have cashed out big time given his connections at Harvard but instead followed his conscience to the detriment of his professional career and personal life. My respect for Mr. Breggin is immense and he should have his own column on this forum. If you notice every couple of years or so Congress brings him back to find out about the latest horrors coming from psychiatry. They never do anything, but i doubt they would keep bringing him back if his damning assessments were wrong. Breggin at one time WAS the reform movement and his contributions cannot be overstated. As for shock, my understanding of shock is that it 100% gives brain damage but some rather be brain damaged than severely depressed. Nevertheless, given psychiatry’s past and present, shock just seems like another inhumane procedure that has caused much more harm than good. I am very surprised that David Healy would be so pro shock given how critical he is of SSRI’s which cause enough brain damage.

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  2. I think hairs are being pulled in this so called argument. The point that is being lost here is that there is mainstream biological psychiatry pushing ALL of its toxic treatments including bogus stigmas to push lethal drugs, ECT and new experimental brain stimulation, etc. Sorry, but given that I have read tons about the mental death profession, I am all too well aware of their deadly treatments in the guise of medicine.

    Then, there is the so called reform movement of psychiatry that consisted of Dr. Thomas Szasz, Dr. Ron Lieffer and others in this group after the R.D Laing group and then Dr. Peter Breggin, who for some time was the entire reform, protest movement as the concience of the new biological psychiatry. Others have included Dr. Loren Mosher, Dr. Joanna Montcrieff and others in the Critical Psychiatry Network and others posting on this site, Dr. Grace Jackson, etc. None of the well known and respected reformers advocated for any dangerous brain damaging treatments like ECT. I think you need to learn more about ECT rather than the typical corporate ad ploys stated by those psychiatrists bought out by the $5 billion dollar ECT industry along with so called standards of care and claims of safety and efficacy based on huge conflicts of interest as is most typical of psychiatry. See latest article posted on on this site about the huge financial conflicts of interest for the DSM5, the junk science bible of psychiatry created in bed with BIG PHARMA.

    I have commended you in other comments since I was filled with admiration for your firm stance in fighting against lethal psych drugs/treatments on Dr. Steinberg’s web site and others, so I think we share many of the same views. I think we have gotten into a silly argument with us pitting Dr. Breggin and Dr. Healy against each other with each seeming to take one side when I really don’t see it that way.

    Dr. Breggin is frustrated because when he criticized ECT, Dr. Healy VERY FALSELY CLAIMED that nobody had fought against dangerous SSRI’s and antipsychotics, which was totally false. Dr. Breggin had attacked these lethal drugs from the start as well as ECT and other brain damaging treatments. The fight was not against Dr. Healy perse, but rather brain damaging ECT as is true with my own concerns. It is true that Dr. Breggin is a died in the wool reformer who wants no part of biological psychiatry’s current lethal treatments while Dr. Healy has made a great contribution helping to expose the dangers of SSRI’s, but the truth is that this had already been done by Dr. Breggin and Dr. Joseph Glenmuller on the suicide, mania and violence risks for which they paid dearly with nasty attacks from mainstream psychiatry and BIG PHARMA to discredit and destroy them.

    Though it may be true that Dr. Healy did not deliberately attack SSRI’s to push ECT, I guess my point is that why bother going after SSRI’s lethal effects if you are only going to push ECT and other equally or more lethal treatments? This is what separates full scaled reform psychiatrists versus one who may reject one harmful drug or treatment, but still practices harmful, mainstream psychiatry, which I now believe is true of Dr. Peter Breggin and Dr. David Healy respectively. And as you say, I make no secret of my loathing of all the toxic, bogus life destroying stigmas and deadly “treatments” for social control in the guise of medicine perpetrated by mainstream psychiatry since I’ve seen the harm firsthand.

    It is Dr. Breggin and Dr. Healy who choose which camp they wish to be in per the above. But, I think Dr. Breggin also feels loyalty to the many psychiatric survivors of psychiatry and felt that they should be warned that though Dr. Healy may appear to be a total reform psychiatrist, he is actually pretty much still mainsteam especially since he still uses ECT as a major advocate of it and probably other toxic psych drugs along with their bogus stigmas. I must say that I saw Dr. Healy more on the reformed side and tended to quote him liberally, making me feel rather betrayed to find out he is such a leading staunch advocate of the deadly ECT that killed Ernest Hemingway and destroyed many other lives. Once I get over this shock, I will probably still quote Dr. Healy where we agree, but I will be sure to also point out where we don’t agree as with his mainstream push for ECT.

    I cannot force my opinions on you , so you have to make up your own mind, but I don’t think this should be a fight between you and me or Breggin and Healy, but rather the medical claims in question based on science and evidence. You might want to check the book, DOCTORS OF DECEPTION, and its reviews by a woman whose life was destroyed by ECT and provides the truth hidden by psychiatry, which seems to be the case with Dr. Healy’s ECT book per the reviews you might also check out on AMAZON.

    I would trust Dr. Breggin any day of the week with my own or my child’s care rather than Dr. Healy given the very different psoitions of these two doctors. I know of no reform psychiatrist pushing ECT and all that Dr. Breggin is asking of one trying to wear the mantle of reformed psychiatrist is to be at least against all types of lobotomy including surgical, chemical and electrical Frankly, I don’t think that is too much to ask or an unreasonable standard by any means. You can have your own opinions but you can’t have your own facts per Winston Churchill and he wasn’t big on appeasement when it came to evil, deadly threats like all too many others, which saved the world from Hitler.

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  3. I failed to comment on the outrageous arrogance here inferring that this great professional dialog should only take place among the doctor gods while nonmedical peons are too stupid to read the books, studies and evidence not to mention their own or loved ones’ horrific experiences making them the real experts.

    Psychiatry has nothing to do with health or recovery but rather, robbing those they stigmatize for their power elite masters of all democratic rights to torture, silence and destroy them with impunity as agents of social control just like Soviet Russia.

    You are no longer addressing uneducated peasants and serfs of the Middle Ages that are willing to swallow anything you say as so called medical experts.

    I easily found some articles by Dr. Healy promoting ECT in a big way online as well as his book on ECT whereby he extolls all the so called virtues of it while burying all the negative studies proving it is even worse than the drugs he condemns while performing his own character assassinations on those in psychiatry and BIG PHARMA promoting these drugs. Do we have a case of narcissism whereby different standards apply to you and Dr. Healy than those you force on others with such condescending disdain as you are doing to me now? So, why are you so angry that Dr Breggin has merely stated the truth and I have shared it here other than the fact you and Dr. Healy wanted to hide the truth you knew would probably not be any better received than the views of drug pushers by psych survivors and reform advocates. Sounds like a trojan horse to me!!

    Anyway, thanks for showing your true ECT colors and your patronizing attitude toward Dr. Breggin and me is well noted.

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  4. Dr. Healy,

    I’m a quite offput about how you frame discussions of sexuality, treatment, and SSRIs. You claim SSRIs “cure” homosexuals, not even saying what of, presumeably being attracted to people of the same gender. This implies that people who identify as gay are somehow in need of treatment to not be gay (and need help being straight.) If SSRIs were used to cure straight people of heterosexual attraction (they certainly do affect many people’s ability to experience desire and arousal), then they would never be popular. Similarly, if SSRIs were shown to have similar effects on male teachers’ sexual behavior I think there would be great outrage against them. Embedding a pathologizing of queer sexualities (which brave queer folk had to fight the psychiatric community to at least superficially stop doing), avoiding gendered and sexual politics in a discussion about how SSRIs may affect sexual attraction and behavior is pretty loaded, and exposes quite a bit a sexist and heterosexist notions underpinning your understanding.

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    • SSRI’s don’t “cure” homosexuals as much as they destroy libido, aka the life force. On SSRI’s your sexual attraction to ANYTHING is diminished gay, straight, bi, whatever. Plus, they make concentrating and learning a lot harder. SSRI’s have been the power elite’s wet dream by both sterilizing and lobotomizing the users. Any wonder why 11%, that is right, 11%, of Americans over the age of 12 are taking these KNOWN poisons. We must start looking at psychiatry not through the lens of a medical profession gone astray, but as a phrma attachment which also acts as a means of societal and population control.

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  5. I can’t help but be taken aback by the implicit and explicit homophobia in Dr. Healy’s essay. It’s sad to hear that despite motivations to reform psychiatry, Dr. Healy still holds fast to Socarides era Freudian views of being not heterosexual as being abnormal. I myself have experienced overmedication on SSRIs by psychiatrists who I believe were attempting to repress my sexuality through chemical means and ignoring my very real depression complaints.

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  6. I dont think so, homosexuality is abnormal, as abnormal is the incapacity of any living being to reproduce. I can confirm that indeed increasing serotonin levels can changes sexual orientation. I used to be a bisexual suffered also of depression and anxiety as many gays do. Well so interesting many medications fail to treat my depression but after many trials I found one that help me: Hydergine. Hydergine made disappeared all my homosexual atractions but by libido is still OK. Chinese scientists have shown that low serotonin levels in rats make them homosexuals and I read this after have tried Hydergine!! so no placebo here!

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