Robin Williams On Antidepressant at Time of Suicide

Rob Wipond
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Robin Williams had “therapeutic” levels of the tetra-cyclic antidepressant mirtazapine in his blood at the time of his suicide, according to the coroner’s report on his death, posted in its entirety by TMZ.

Williams also possessed a partially-used prescription for the antipsychotic quetiapine, although this drug was not detected in his blood at the time of death. Williams was also being treated for Parkinson’s motor dysfunction, but it is not clarified if the condition was genetic or instead induced by use of antipsychotic drugs. In addition, Williams was being prescribed various drugs for urinary problems.

TMZ reported that Williams had two antidepressants in his body, but the coroner’s report listed only one — the apparent second one was actually desmethylmirtazapine, which is metabolized in the body from mirtazapine.

According to the black box warning on its label, mirtazapine has been shown to increase suicidal tendencies in adults up to 24 years of age.

Robin Williams Suicide Triggered By Depression, Parkinson’s, Paranoia (TMZ, November 7, 2014)

Coroner Investigative Report In the Matter of the Death of Robin Williams (Marin County Sheriff’s Office Coroner Report posted by TMZ)

Remeron (Mirtazapine) – Drug Description (RxList)

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Rob Wipond
Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.

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39 COMMENTS

  1. Mr. Williams was quite a bit older than 24 years of age. I also find your suggestion that anti psychotic medications are somehow correlated with the onset of Parkinson’s disease to be rather unfounded. The man had a long history of illicit drug use, was suffering from depression and anxiety and was informed he had Parkinson’s disease. These three factors have far more impetus on one’s decision to terminate their lives than antidepressant use.

    • “Antipsychotics” cause a range of well studied and documented “changes”/damage to the dopaminergic system and the basal ganglia, resulting in what is often much worse than parkinsons disease (tardive dyskinesia, dystonia). I don’t think it is the slightest bit unreasonable to assume that a drug that is so well known at causing one damage/dysfunction of the dopaminergic system could also cause or contribute to another.

      Also, neuroleptics have been found time and time again, in many different types of studies, from all across the world, spanning generations — an amount of replicability that is truly astounding — to cause BRAIN SHRINKAGE as well. Brain shrinkage could certainly be responsible as a cause or contributor for just about any brain disease or impairment somebody goes on to develop afterward. With what neuroscience knows about how the brain works, brain shrinkage would be expected to cause GLOBAL dysfunctions in the brain — everything becomes compromised! But I’m sure by the tone of your comment that you probably believe otherwise, as psychiatry is busy trying to convince people that this shrinkage is somehow therapeutic to people diagnosed with mental illness. Just as an ice pick to the frontal lobes was once hailed as a miracle breakthrough treatment — its inventor even won the nobel prize!

    • The connection between motor dysfunction and anti-psychotics is well known:
      https://en.wikipedia.org/wiki/Parkinsonism
      “Drug-induced parkinsonism (“pseudoparkinsonism”) due to drugs such as antipsychotics, metoclopramide, MPTP”
      There is no established biological reason why the suicidal tendencies from these drugs should be restricted to people below 25yrs of age. The fact there is no data on it does not mean that the problem does not exist and in fact many people (I can include myself in this category) experienced such problems even when older that that arbitrary boundary.

    • candreae,

      Many people way older than 24 have experienced suicidal ideation on psych meds and were fine once they got off of them.

      To be honest, I haven’t kept with with the Williams case to have an opinion one way or another as to whether meds were an issue or not so I will pass on commenting. But judging from your posts, you seem to think that meds never cause any horrific side effects and that just isn’t the case.

    • On the other hand, his psychiatric treatment doesn’t seem to have helped very much, does it?

      I’m sick and tired of hearing people blame “the disease” (secret code for blaming the “patient”) for bad outcomes. We’re paying psychiatrists to help people with these ostensible “diseases.” If their “help” leads to misery and suicide, then they need to find another way to help. It’s the only profession where you can blame the subject of your profession for not cooperating in allowing itself to be fixed. If I take my car to a mechanic, and he can’t fix it, he doesn’t blame the car and charge me to come in for weekly “treatments” for the rest of my life. He says, “I am sorry – I can’t help you with this. I don’t know how to fix it.” It’s past time for psychiatrists to learn a little humility and start admitting when they don’t know how to help someone. The antidepressants don’t have to have been the cause of death for this to represent a colossal failure of psychiatric intervention. He was receiving the best psychiatric help money could buy, was compliant with “treatment,” and yet was still so miserable he ended his life. That’s a failure by any estimation.

      — Steve

      • I agree. Unfortunately, I don’t think we’ll ever know whether or not these drugs may have caused/worsened suicidal impulses for Robin Williams, although it is certainly possible. At best, psychiatry failed to help him, as it fails to help a remarkable portion of the people it claims to serve, and at worst, this was yet another iatrogenic tragedy.

    • @Candreae

      Yeah, I also was a lot older than 24 when I was on a huge dose of Effexor and began trying to walk out into traffic as I walked to work every day. Give me a break! I experienced this overwhelming urge to kill myself in all kinds of bizarre ways and I’d never been suicidal in my entire earlier life. Wake up and smell the coffee. Just because the black box warning sets a certain age limit doesn’t mean that these dangerous drugs don’t have the same effects on older people. I think that being older makes one even more susceptible to the horrible effects of these dangerous drugs.

      You yourself may like them just fine, but I will never swallow another one of those disgusting pills till the day that I die. And by the way, the drug never, ever helped with my feelings of great sadness caused from overwhelming losses experienced in a very short time. They did make me into a zombie who couldn’t feel his emotions and who didn’t care if the entire world blew up in his face. All they do is numb people so that they can’t feel anything at all. They don’t make the sadness go away. Defend them if you want but I know what they made me not feel. I couldn’t cope with the real world and only wanted to kill myself. Great medicine huh?!!!!

    • All psychiatric drugs cause compulsive behaviors. Stimulants, “antidepressants” and neuroleptics. As a child I developed OCD on those drugs, and any drug of any type from any class of theirs would make it worse. Fast forward twenty years and compulsive disorders are so common in mental patients that it’s becoming a scourge all its own.

      • Yeah, but it’s called co-morbidity. Same with diabetes type II, Parkinson’s, dementia etc. All miraculously co-occur with mental illness. Never because of the drugs even though they’re listed as side effect on many of them and are frequently reported by people.

  3. And yet his death has already been used to great affect for pushing “early screening” and “antidepressant” prescriptions. Just like when there’s a mass shooting, and 90+% the time the shooter is wacked out on drugs, the response becomes trying to loosen forced drugging laws and increase tax payer funding for it.

    The times we live in are truly insane, and will go down in history as such.

  4. But if there was more of psychiatry it would have surely helped… Maybe if he was on 8 more drugs he might not have killed himself (presumably by being to drugged to be able to move) and died of heart disease, diabetes and other iatrogenic illness instead.
    When are people going to get the memo that these drugs don’t help?

  5. I love how the drug companies always say that suicidality is only for children, adolescents and young adults. I was in my 40’s when I experienced terrible akathisia and a strong compulsion to end my life while taking an SSRI antidepressant. I called my doctor to tell him I was considering ending my life–of course left a message, and nobody ever called me back. Fortunately, I realized by Day 4 that it was an additional effect of the meds–and stopped taking them. I spent another four or so days white-knuckled alone in my home, trying desperately not to hurt myself or anyone else. As for the assertion that suicidality can be caused by depression, it had not occurred to me prior to taking this drug, and once it left my system the compulsion left with it. I know how it feels to have that drug-induced compulsion, and I would do anything in my power not to take any of those drugs ever again.

    • I belive Healy conducted an experiment in which healthy volunteers with no history of depression were given SSRI’s. One of them had to be put on suicide watch and was so shaken he took months to recover.

      I really should try to find the report, it’s just a memory so this may not be reliable.

      • John,

        I haven’t read the study but Peter Gotzsche in ‘Deadly Medicines…’ states:

        David Healy performed a study in 20 healthy volunteers – all with no history of depression or other mental illness – and to his big surprise two of them became suicidal when they received sertraline.(13) One of them was on her way out the door to kill herself in front of a train or a car when a phone call saved her. Both volunteers remained disturbed several months later and seriously questioned the stability of their personalities. Pfizer’s own studies in healthy volunteers had shown similar deleterious effects, but most of these data are hidden in company files.

        (13). Healy D. Let Them Eat Prozac. New York: New York University Press; 2004.

        • I have mixed reactions when I read about these reports. One the one hand, I am glad that I have reports to cite that demonstrate what the drugs to people . On the other, I do not feel at all good about people being subjected to these experiments that we have every reason to believe will do them harm, and once we already have evidence of harm, the case could certainly be made that they should not be allowed.

      • Hi John,

        Are you talking about the study cited in Healy’s “Let Them Eat Prozac?” (or is my brain equally foggy). If we’re thinking of the same study – antipsychotics given to clinical researchers and physicians – here’s an anecdotal account:

        https://invinciblesummers.wordpress.com/2009/04/16/a-doctor-voluntarily-took-an-antipsychotic-drug/

        Alternately, here’s a report off Healy’s website, regarding SSRI healthy patient studies:

        http://davidhealy.org/mystery-in-leeds/

        Best,

        MB

        • MB,
          Please take a moment to visit Daivid Healy’s blog-

          http://davidhealy.org/persecution-sui-cide-or-homicide/

          It is of crucial importance to contemplate the fate awaiting those who speak out the strongest and the most directly against the dangers of psych drugs– and the corruption in academic psychiatry that is perpetuating the lies–

          It is crucial to reflect on how best to support those to whom we owe the greatest debt of gratitude– ultimately, we are the ones who will suffer the most IF the few academic psychiatrists with conscience and courage are
          silenced—

      • Hi John! I’ve been out of the Chat here lately but anyway:

        The study is described in Chapter 7 of Healy’s book Let Them Eat Prozac. His original goal was to figure out if personality types (extrovert-introvert, novelty-seeker v. risk-avoider etc.) could predict who would respond well to different antidepressants and who would have trouble. All twenty “normals” (mostly doctors and nurses) took Zoloft for two weeks and Reboxetine, a non-SSRI AD, for two weeks.

        His theory was largely borne out: everyone had one pill they kind of liked to some degree, and one they didn’t — and Zoloft actually got more “likes” than Reboxetine. But that was overshadowed by the big finding: Two women became suicidal on Zoloft. Both of them were pretty badly rattled by the experience; even though they knew it was really the drug, it still shook up their view of themselves. Both also got more “disinhibited” and reckless in their overall behavior.

        Healy himself was pretty rattled; both from concerns about the two women, and because he didn’t expect this finding. He undertook the study mainly out of interest in Reboxetine as a possible alternative for people who weren’t helped by SSRI’s or felt worse on them. He was already learning about suicidality on SSRI’s but had thought it was rare enough that there was little or no chance of it showing up once in a group of 20 people. In fact it showed up twice, a 10% rate — pretty shocking.

        Two people felt depressed while on Reboxetine as well — but not suicidal. It was more that they felt lethargic and had a case of the blues.

        • Jim Coyne wrote a nasty paper about David Healy. Underlying his beef with David is his inability to believe that antidepressants are dangerous. If he knew what David knows, I’d join forces. Did you see him take up the cause of the ME/CFS patients vs Simon Wessely this year?

          In this anti-Healy rant, he calls out the result — that 2/10 became suicidal on an antidepressant. He was incredulous. His comment was something like “How is that we wouldn’t know about this, if it’s true?” LOL LOL ROTFLOL.

          Most of us don’t have the media’s ear, most of us don’t want publicity, scant few doctors will listen, and pharma is in the business of not listening. Those doctors who do listen are pilloried (even by you, Jim!)

          There are those of us who want to talk about this, far and wide. But we don’t get very far on our world tours. (No one believes us, Jim. And you’re not helping.)

    • It’s not only SSRIs, benzos and anti-psychotics are a hell too. I have not taken a single psychiatric drug that did not have a strong and negative effect on my mental well-being:
      Prozac -> horrible anxiety
      benzos -> full blown paradoxical reaction (agitation, aggression, suicidality)
      other anti-depressant I don’t remember the name of -> suicidality and total emotional hole
      Zyprexa -> I was suicidal and umotionally unstable for at least a week after a single small dose (2.5mg or less)
      Seroquel -> total zombification with bouts of crazy anger and panic attacks
      That’s only ones I remember, there was more (got switched with every visit, also because of other pleasant side effects like vomiting, sleepiness bordering on narcolepsy, binge-eating, restless leg syndrome… I could go on).
      I think taking arsenic is better – at least it kills you fast.

  6. Aside from all the details about what drugs he was taking, the simplest bottom line regarding his suicide is that he had a great deal of psychiatric “help,” whatever it might have been, and that was uncontested. How this terrible tragedy gets twisted into an argument for more psychiatric “help” is unbelievable.

    We have to find a way to get this message to the public. The almost complete blackout of our point of view in the media is very scary. Meanwhile, there is a powerful attempt by our politicians to completely strip people like me of our constitutional rights and lock us up and drug us at will.

    This crisis has happened because, instead of fighting for our rights as all other movements of oppressed people have done, too many of us have accepted jobs and money from the system. The desperate situation we are in now is the result.

    Do the people who benefit from these jobs and this money really think it will continue once the Murphy bill and other moves of this sort have us officially declared as non-human?

  7. Too often in the press the assertion is made that a suicide is the consequence of simply not seeking treatment because of stigma or one’s discontinuing his or her medication, “If only he or she had reached out….,” “If only he or she had not ceased taking his or her medication.” I doubt any reporter will ask, “If treatment with antidepressants is so effective how could Robin Williams have taken his life?”

  8. ” The almost complete blackout of our point of view in the media is very scary”

    The reality of harm caused by *psychiatric drugs/treatment” is the message not reported and explored by our media…

    Therefore, when the *best* treatment does not work, or causes the *patient* more suffering, the conclusion is that the *patient* is a hopeless case. When the *patient* agrees—- for lack of sound reasonable information regarding the risks of the treatment….

    The reporting of the truth by Shelley Jofre was a good start…
    http://youtu.be/_0ffzsrDkSQ

    However, it must be noted that reporting the truth of harmful effects of SSRIs and antipsychotics AND the corruption behind maintaing the lies about these drugs– is in itself a risky business:
    David Healy.org

    There are more reliable means for informing the public than waiting for mainstream media to develop integrity–

    ACT locally—

  9. I was 50 with no history of psychosis…yes I had experienced “depression” during some difficult times (ie a reasonable reaction to a bad situation), but the psych meds changed all that. Ambien…didn’t know whether I was awake or asleep, extremely paranoid, slightly psychotic and was told it was all just my imagination and labelled non-compliant, because the doctor KNEW the drug had NO side effects and was the safest sleep med ever made.

    Mirtazapine and olanzapine (forced in a locked ward) – psychosis, suicidality, anxiety, confusion, insomnia, massive weight gain because of uncontrollable food cravings, eating disorder etc etc etc….truly awful.
    Prozac – constant suicidal thoughts, alternating between emotionally numb, supersensitivity, disappearing into pits of blackness, anger, insomnia, parasthesia, loss of balance etc etc etc.

    Effexor and a few others vomiting, dizziness, passing out.

    Funny how those things have all significantly improved now I have been medication-free for a couple of years. I had just thought and been told that these were illnesses that had been there all along and that had been “unmasked” by the drugs. There were a lot more side effects that I didn’t dare mention because I didn’t want anyone to know how extremely “mentally ill” I was.

    I still need to be very careful with my environment and the people and situations I am exposed to, but it is mostly manageable. With the psych meds it wasn’t, and I have no doubt that had I stayed on them or been given long acting forms by injection, I’d be dead by now.

  10. It looks like Robin Williams was suffering from an early case of “Lewy body dementia” — a nasty piece of luck, as it can cause both movement difficulties that resemble Parkinson’s, as well as hallucinations and paranoid feelings. People with LB dementia are often mis-diagnosed with Parkinson’s — another nasty piece of luck, because LevoDopa and other drugs for Parkinson’s can cause hallucinations too, as well as compulsive gambling, spending, sexual behavior etc.

    He was also on Seroquel and Remeron (mirtazapine) — which makes me think he was almost certainly diagnosed “bipolar.” There was certainly a lot of loose talk in the media insisting he was bipolar and even scolding him to some degree for not being more open about it. Finally he did struggle with alcohol and cocaine abuse for years. If you’re naive about street drugs (like most shrinks) and inclined to see brain disease everywhere, I’m sure a Hollywood actor whacked out on coke and whiskey looks like an obvious manic to you.

    Seroquel and other antipsychotics can absolutely induce Parkinson’s-like symptoms. The “new” antipsychotics don’t do it quite as much as the old ones, but they can do it. Even if you had such symptoms to begin with, taking Seroquel was likely to make them worse. In addition, the Seroquel would have been working against the LevoDopa: one increasing dopamine levels, one decreasing them. Must have felt like a horrible seesaw.

    The poor man. Based on what I see of American medicine lately, I’m betting he had one doctor treating his “Parkinson’s”, another doctor treating his “Bipolar”, and the two never talked. And in the end it looks like he didn’t have either one. If this is the treatment you get when you’re rich and famous, and can see only the top specialists, you don’t want to think how the average person is faring.

    It also teaches us a sad lesson: Psych drugs aren’t the only drugs that can mess with your mind.

    • “Seroquel and other antipsychotics can absolutely induce Parkinson’s-like symptoms. The “new” antipsychotics don’t do it quite as much as the old ones, but they can do it”
      I didn’t get to the level of Parkinsonism but both Seroquel and Zyprexa induced a very nasty case of restless leg syndrome, which is also due to completely screwed up dopamine controls. Your dopamine is low so your brain can’t properly control your movements – in case of RLS you can’t relax your legs and they keep twitching, spasming and giving you all kinds of really nasty sensations. Combine it with terrible tiredness that comes with this drugs and you’ve got inability to fall asleep plus horrible sleepiness -> you go absolutely nuts.
      Drug induced torture.

    • I’m not convinced that he was being treated for the bipolar disorder label. Seroquel, with FDA approved approval, is being used in the treatment of so-called treatment resistant depression now, too.

      My feeling though is that much of this celebrity bipolar disorder is actually a drug problem. Former Senator Patrick Kennedy, for example, after his alcohol and drug addicted antics, presently has the mental illness excuse, a bipolar label, to boot. Rather than effectively kicking the substance abuse habit, you’ve got the effects of long term stimulant and depressant use to contend with, and the solution obviously involves getting a “mental health” quick fix alternative to complete and total psychoactive substance withdrawal.

      Given a toxic drug regimen, both prescription and illicit, Robin William’s Lewy Body Dementia should not come as such a big surprise. My understanding is that, given widespread use of psychiatric drugs, we are seeing a corresponding increase in Alzheimer’s and dementia diagnoses later in life.

  11. Antidepressant drugs are hypnotics and antipsychotic drugs act essentially on two neurotransmitters : Dopamine and serotonin. As much as Mr. Robin Williams is victim of a disease that is maybe not fundamentally related to neurology… I would say : Doctors should never touch to neurotransmitters ! Cheers ? Cheers !