Not so Black: Ablixa and Homicidal Side Effects

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If you don’t want to know what happens in the movie Side Effects – do not read further. The post does not reveal all but does reveal important details.

So now we know Soderbergh’s movie Side Effects is not so Black/Noir after all – more Fifty Shades of Grey. Emily Hawkins (Rooney Mara) is put on Ablixa by her psychiatrist Jonathan Banks (Jude Law) and while on it kills her husband. She apparently murders him while sleep-walking triggered by Ablixa and sleep walking being a perfect defense against murder she is acquitted.

The first part of the movie is an expose of the pharmaceutical industry and greedy doctors. But in fact the industry and greedy doctors are the victims of wicked lesbians Hawkins and her former shrink, Victoria Siebert (Catherine Zeta Jones), who helps construct her alibi while both make a killing in the stock market by investing against Ablixa.

Do they get away with it – I’m not telling you. Their attempt to do so though is a twist in the tale that’s supposed to be Noir.

One of the best definitions of Noir comes from the humorist Tom Sharpe, who describes an incident in the South African navy when he and colleagues were scrubbing a ship, and one of their colleagues fell overboard just as an Admiral walked up the gang plank. Everyone had to stand-to for an inspection by the Admiral, and while they did so the sailor who had fallen overboard drowned.

In real life suicides and homicides on the SSRIs have almost certainly boosted the sales of these drugs. Far from a verdict against Ablixa leading to a collapse in its share price, the publicity would have increased sales, not least among women who might want to murder their husbands.

In real life mass homicides such as school shootings even when the press in the best traditions of pantomime try to draw the attention of the cast and politicians to the drugs in the background, produce more mental health screening programs, leading to more drugs being prescribed and more school shootings. That’s Noir.

So why should an investor worry? In real life the “girls” would have lost their shirts on this one – their play should have been on the share price going up.

Side Effects launched in a week that saw a Dutch court hear evidence that paroxetine (aka Aropax, Paxil, Pexeva, Seroxat, Sereupin) can cause violent behavior.

“The suspect bashed in his girlfriend’s head using a fire extinguisher and then shot a police officer. Other law enforcement officers then shot the suspect 5 times, but they still had a lot of trouble trying to restrain the suspect.

“The officers stated that they shot the suspect in the chest but it did not seem to have any effect. After the suspect had also been shot in the leg and shoulder, the suspect was still able to resist arrest. He still managed to hit another officer in the head using his gun. Officers even used pepper spray but that too did not yield any results. The officers stated that the suspect acted like a zombie.

“Court experts stated that it was highly likely that the behavior of the suspect had been caused by the use of Paroxetine”.

In some jurisdictions such as Canada companies are legally obliged to say their drug can cause violence, a recent article in Psychopharmacology by Dutch academics Paul Bouvy and Marieke Liem denied the possibility of a link.

Bouvy and Liem correlated data on lethal violence in Holland between 1994 and 2008 against sales of antidepressants. The drug sales went steadily up and the number of episodes of lethal violence fell, leading the authors to claim that “these data lend no support for a role of antidepressant use in lethal violence”.

This is a marvelous example of an ecological fallacy, which is when someone claims that if an increase in the number of storks parallels an increase in the number of births that storks must be responsible for births.

The best known example of storkology in recent years were the graphs produced by tobacco companies showing rising life expectancies and even reduced deaths from respiratory illnesses in line with rising cigarette consumption. These were produced as part of a Doubt is our Product strategy to deny the risks of smoking.

Recent sightings of storks include claims that increased SSRI use is linked to falling national suicide rates. The articles making these claims offer data from the late 1980s but disingenuously omit some key facts. One is the fact that suicide rates in most Western countries were falling before the SSRIs were launched. Another is the fact that both suicide rates and antidepressant use rose during the 1960s and 1970s when antidepressants were being given to the most severely ill people at the greatest risk of suicide. This was when suicide rates should have fallen if antidepressants have any effects on national suicide rates (Reseland et al 2008).

Autopsy (post mortem) rates are also left out. The more autopsies done the more suicides and homicides are detected. Autopsy rates rose in the 1960s and 1970s and fell from 1980 before antidepressant consumption began to escalate dramatically. The rise and fall in autopsy rates perfectly mirrors the rise and fall in suicide rates (See Reseland et al 2008).

Why would Psychopharmacology, a prestigious journal, take an article like this?  Alcohol use has increased in Holland during this period but no-one is making the argument that increased alcohol use has led to a decline in acts of lethal violence or the further Bouvy and Liem argument that this means alcohol cannot cause violence.

SSRIs slow growth in children. During this period SSRI consumption among children has increased in Holland but the Dutch have become the tallest people in the world and are getting taller. Where is the article saying that the increasing height of the Dutch proves that SSRIs don’t retard growth?

In the case of violence, the published trials show antidepressants cause it, at a greater rate than alcohol, cannabis, cocaine or speed would be linked to violence if put through the same trial protocols that brought the antidepressants on the market.

And there is at least one clear and well-known factor, just like autopsy rates that can account for the findings – young men. Violence is linked to young men, and episodes of lethal violence are falling in all countries where the numbers of young men are declining.

School shootings were almost unheard of before the SSRIs appeared on the scene. Correlation is not causation but in between this and the next blog post I will be laying out the evidence that antidepressants cause violence up to and including homicide at two lectures in Chicago – including the evidence that real life antidepressants as opposed to Ablixa can in fact cause sleep walking and murder. A video of the lecture will be posted on RxISK.org as soon as possible afterwards.

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David Healy, MD
David Healy is a founder of Data Based Medicine and RxISK.org and has authored of over 240 peer reviewed articles, 300 other pieces, and 25 books. His main areas of research are adverse effects of treatment, clinical trials in psychopharmacology, the history of psychopharmacology, and the impact of both trials and psychotropic drugs on our culture.

18 COMMENTS

  1. I was waiting for some coverage on this because I suspected it was going to be another Soderbergh pharma/public health public service announcement.

    The heads up that the film was going to double back on the teaser regarding “violent side effects” is that Soderberg has certain ideological affiliations with the “Skeptics”– the ideological-cum-astroturf front group which worships Richard Dawkins, the late Hitchens and psychotic “scientism” fundamentalists like Sam Harris.

    To understand any of it, it would help to backtrack on the history of the collective. Journalist Chris Hedges, currently the lead plaintiff with Watergate Whistleblower Daniel Ellsberg in suing against the “indefinite detention” provision of the National Defense Authorization Act, called it in 2007 with his book, “When Atheism Becomes Religion: America’s New Fundamentalists.” Regarding the Skeptic’s pseudo-rationalist movement, Hedges warned that this was not merely a politically disinterested group of mainstream atheists or agnostics lobbying for freedom of non-religion but a rabid ideological and para-religious “scientism” front acting as a precise reverse parallel to the radical right. It’s only natural that the group ultimately sought funding from commercial science industries and aligned itself with the power of industry-captured institutional public health. From the moment affiliated Skeptic groups began receiving Anonymous Schedule B donations in the millions, they’ve been hysterically defending pharmaceutical products, GMO’s and a long list of dicey industry platforms. Michael Shermer, editor of Skeptic Magazine, sits on the board of the multi-industry front group American Council of Science and Health. Fellow ACSHoles include Breggin-stalker Stephen Barrett of Quackwatch and a long alumni list of pharmaceutical operatives including Sally Satel and Fred Goodwin. ACSH board members come and go but there are screenshots in circulation of membership lists going back to several years and all the usual industry henchmen appear.

    Soderbergh’s ego would probably preclude him being a “follower” per se, more a de facto trendsetter for members of the front group which, due to some “stealth” edicts by Skeptic leaders like Harris, have been advised to obscure affiliations the better to promote their “message.” Still, it’s easy enough to see the lines of influence by picking over Soderbergh’s interviews and recent projects.

    It all sounds very cloak and dagger and even silly on the surface, but when Peter Breggin warned that the pharma front had become a “religion,” he wasn’t being fanciful. Chris Hedges also warned in his book that it only takes a tiny minority of fanatics to perform a cultural coup– and now the nuts are forming factions within “progressive” news sources like The New York Times, Slate, Wired, Vanity Fair, Mother Jones, NPR, etc., many of whom come out of Bill Gates’ “science journalism” training seminars, often through his sponsored program at MIT. The Bill and Melinda Gates Foundation, which is increasingly invested in the pharmaceutical industry, funded Participant Media which produced Soderbergh’s “Contagion.” All the “population reduction” conspiracy nonsense about Gates aside, Gates is clearly a radical utopian “true believer” in the wonders of modern tech and frankly more than a little unhinged.

    It’s funny that one of the chief ploys of Skeptics and other astroturf fronts is to accuse consumer rights advocates and corporate critics of irrational belief in “conspiracy theories”– meanwhile pundits like Harris act like 12 year-olds playing “enemy camp invasion” and are begging to be viewed as “legion.” The disconcerting thing is that, due to the money pouring in, this ideological front is gaining a real foothold and is now branching out into creative culture capture. Soderbergh thinks he’s very clever playing culture jammer by teasing his current film as consumer criticism only to do astroturf jujitsu and flip it into commercial science propaganda, but he’s not that subtle. The title of Soderbergh’s “Contagion” wasn’t a very well veiled either—obvious reference to Gladwell’s and Dawkins’ respective versions of the “meme” theory regarding supposedly “beneficial” propaganda meant to capture the culture through a “contagion” of beliefs and ideas (which Dawkins and followers purport have the power to impact human DNA and guide evolution, but best to leave the fine points of their crock hypotheses for another discussion).

    Any prescription reform advocate who happened to see certain earlier films co-produced or directed by Soderbergh such as “We Need to Talk About Kevin” would probably have detected an emerging industry-friendly pattern in Soderbergh’s recent cinematic work. “Kevin” had the same premise as “Side Effects”– a teenager fakes a Prozac reaction as an alibi to commit mass murder in his high school, though apparently the film didn’t “capture the culture” quite enough for Soderbergh’s liking and so he took another crack at inoculating the public against criticism of commercial science agendas. Soderbergh’s “Contagion” was also another case in point– a sort of hagiography of the vaccine industry and public health which depicted safety advocates as profiteering Luddites (never mind that the vaccine industry has turned into Haliburton and that the hallowed days of Salk are over).

    All told, there may be a silver lining to the fact that Soderbergh tipped his hand a bit more regarding psych drug promotion. Pharmaceutical front groups specialize in creating strawman constructs (e.g. “anti-psychiatry”) by trying to align independent industry critics with fanatical “anti-progressive” special interest groups to create one big flammable target. By the same token, industry tries to avoid overly centralized flak operations which take on too many consumer rights platforms at once, since industry PR mavens obviously know the danger of this. But now it’s all starting to come together.

    Since the Skeptics went astroturf, they’ve focused on genetic industry, vaccine industry and Big Ag GMO defense and have been relatively quiet regarding psychopharmaceuticals. The group’s defenses of drugs have been visible, though not very loud or frequent. But growing public awareness of the link between modern mass violence and meds no doubt poses such a viable threat to industry that the Skeptics have been forced to take a clearer stand on behalf of sponsors.

    I’m going to take this film as a cue that the Skeptics are now going full frontal after psychiatric reform, which probably means Gates is in the picture somewhere. Expect a familiar resurgence of equivocations comparing psychopharmaceutical critics with fanatical followers of cults and the usual industry sponsored anthropological and social research putting this into “science speak.” You’ll be seeing more than the usual number of paid trolls spouting Latin legalese, discussing “low cognitive processing,” and “logical fallacy.” Skeptic pundits in the New York Times and on NPR are going to start peppering their “rationalist” arguments with analogies between people believe prescription drugs play a role in mass murder and fanatical proponents of “Intelligent Design.”

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  2. Not being a neurologist, let me ask: Are the mechanisms of action between certain psych drugs and violence clearly established? If so, what are they and how were they established?

    There seems to be more and more reporting of the relationship (causal? or correlational?) between these drugs and violence and as a non-medical person, I’m just curious of what the mechanism is and where I can read about it. Thanks.

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  3. David– Peter Breggin’s “Medication Madness,” “Talking Back to Ritalin” and “Your Drug May Be Your Problem” include a lot of discussions and study citations regarding drug-induced akathisia, dementia and violence along with Healy’s more current “Pharmageddon” and Grace Jackson’s very technical “Drug-Induced Dementia: The Perfect Crime.”

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    • The leap from restless agitation side effect to well planned murder, is ludicrous crap, and Healy and his acolytes embarrass themselves every time they try it on. Every school shooting has been expertly carried out with paramilitary precision, it is foolish to believe the molecules in a pill are causing such well planned crimes. Drug blaming is the reverse side of the coin of brain blaming, neither side can prove their assertions, and drug blaming is the greatest cancer growing on our movement. Anybody who would type the words ‘drugs caused’ instead of ‘drugs may have contributed to’, is irresponsible. Healy does this, and I label him irresponsible.

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  4. I’m so glad you posted this. I was recently very annoyed by an article in the Finnish press with graphs showing a correlation between rising SSRI prescriptions and falling suicides. It just seemed so idiotic. My initial thoughts were to draw up some graphs demonstrating equally compelling correlations between changing patterns of alcohol use, falling Body mass index averages, meat consumption etc. Nor did they stratify the data in anyway so we were unable to see if suicide was actually on the increase in the young, but dropping in other groups for instance. This is a country remebemer which has had its fair share of school shootings and other violent incidents. I think the debate about the safety of SSRIs needs to intensify here too.

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  5. Weird that the Kirsh work has come out and research psychiatrists are agreeing that the overall effectiveness of antidepressants is very mild at best, and yet we’re trying to correlate reduction in suicide rates with antidepressant use. A competent scientist would have to compare those taking and not taking antidepressants, and when that’s been done, suicide rates have increased in the drugged samples, hence the Black Box Warning.

    I plan to see the movie so didn’t read the article, but I’m glad a mainstream movie is taking on this issue, however sensationally it is presented. I hope it can promote the conversation about the connection between violence and psych drugs, because that conversation is long overdue.

    — Steve

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  6. This is a bit off topic, but it falls roughly under “madness in the media”, and it comes from David’s side of the pond: chimps on anti-depressants

    http://www.bbc.co.uk/news/world-asia-india-21464474

    Why bother with scientific studies, peer review or clinical trials when you can just advertise for free on the BBC? And everybody loves chimps.

    Although I wonder what psychiatrists will make of the fact that the apes were “depressed” after a lifetime of trauma and abuse. Or perhaps they had an inborn chemical imbalance? Oh well, I suppose it’s only fitting that they bring out the chimps to complete the circus.

    (BTW, Steve Soderbergh directed a very interesting film called “Schizopolis” in 1996, which not many people have seen. Worth watching.)

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  7. ATG’s response is insightful BUT he refers to “growing public awareness of the link between modern mass violence and meds [which] no doubt poses … a viable threat to industry.” ATG you’ve been reading Mad in America too thoroughly. You need to diversify our sources. Of course ifs the awareness grows from .01 % of population to .3% it’s tripled. Even left of liberals (The Nation) made no link between betweeen massacre at Sandy Hook and psych drugs.No one on the left did. Nor mainstream corporate media. Only a few Libertarians dared to speak out. And the usual suspects here–and Breggin. Of course poor Alexander Cockburn was turning in his grave mourning his premature departure.

    Will this movie backfire for the industry? Is there a chance it can increase public awareness so it DOES pose a threat?

    I agree with ATG that the right and pro-psych forces will attempt to depict critics of Psychitry as “conspiracy theorists.”

    AS a leftist and dissident psychologist (and a theist, I might add) I have long been infuriated by the left’s refusal to criticize Psychiatry. It’s the mental health partners of the drug industry that immunizes it. (Michael Zirin is a recent example of a puzzlingly uncritical supporter of “mental health.”) We must relentlessly expose the psychiatric-pharmaceutical industrial complex for what it is. We must make every effort to sunder the Left’s sentimental ties to “mental health.” It’s possible that in spite of the auteur’s intentions the movie could be a blessing for those of us opposed to corporate captivity of the state and colonization of everyday life.

    On behalf of those who are not enamored of scientism I take this opportunity—as I always do–to recommend my new book,The Spiritual Gift of Madnesss:The Failure of Psychiatry and the Rise of the Mad Pride Movementhttp://www.amazon.com/Spiritual-Gift-Madness-Psychiatry-Movement/dp/159477448X/ref=sr_1_1?s=books&ie=UTF8&qid=1360855174&sr=1-1&keywords=farber+gift
    For those baffled by the title my neo-Laingian quasi-Jungian theory is that madness is often not only a “breakdown” but also a breakTHROUGH into the realm beyond reason, of ineffable love,the non-local redemptive realm of the Not-Yet (Bloch)which beckons to us from beyond the horizon of the enfeebled imagination that reigns now in the name of reality. The obstacles are formidable, but not insurmountable–as long as we maintain hope. Seth Farber, Ph.D. [email protected]

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  8. I know how childish this question sounds, but how can people, especially educated doctors,do these things to another person? We are back to the government flirting with the idea of involuntary treatment and forced medications, and I watch Torrey state rather flippantly, that these past side effects and disasters, that psychiatry wasn’t to blame. They had not known about the side effects. shouldn’t that be a matter of interest when advocating to drug people against their will? The lying, fear mongering, and the pompous refusal to even explain their opinion….. The sad thing is that I’m the one who is mentally ill and “dangerous” but I could never treat another living thing with this level of disregard. And honestly, I’m afraid of them.

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  9. I am lucky. I did not end up dead or in prison on the side effects of SSRIs. I always stopped taking them because of how negative and especially agitated they made me feel. If I had just blindly followed prescribing doctor instructions…I don’t know what would have happened but I assure you it could not have been good. They made me apathetic too, which is probably the worst thing for someone extremely agitated. The old expression “a ticking time bomb waiting to go off” that is what those drugs were like for me. Zoloft was the worst and fastest with the agitation factor. I cut myself on Prozac. They are all just horrible drugs for those experiencing adverse reactions. People need to share their stories of the potential for harm and adverse effects if they’ve experienced them. Maybe people will understand. Maybe even care. Thanks for providing a place to comment.

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