From Witt-Doerring Psychiatry:
Dr. Peter Gordon: “Over 25 years ago, my son had just been born, I was sitting my membership exam for the Royal College of Psychiatrists . . . and I wasn’t sleeping well — young baby, disturbed nights, I’ve always been a little on the anxious side, I was distressed. I went to my GP in rural Aberdeenshire, which is quite remote in Scotland, and my GP recommended that I start an antidepressant for what, she explained to me — and I knew this, because I was studying psychiatry at the time — was social anxiety disorder.
And a new drug was being widely marketed at that time, widely promoted, really across the Western world, and that drug was paroxetine — Paxil, Seroxat. At this time in Scotland we had what was called a ‘Defeat Depression’ campaign — and it later transpired this five-year campaign was almost entirely sponsored by the pharmaceutical industry — and it was to try and tackle ‘low rates of diagnosis of depression’ and ‘make sure a treatable condition was treated.’ And a major part of that, and what I told my patients and what I was taught on a daily basis — and some senior psychiatrists today try and make out this wasn’t the case — but certainly in Scotland every single week that I went to education I was taught about the chemical imbalance, and the drug reps that came along to those meetings — it was all about 5-HT. So I thought it was perfectly safe for me to take an antidepressant for anxiety. And I took it and I probably felt a little bit better, not hugely — I wasn’t depressed, I was just anxious and not sleeping. But probably about three or four months in . . . I just stopped it because I thought it wasn’t making much difference. And the next day I felt hellish. I felt nausea, flooding, I’d slept poorly, I felt flu-like, I had buzzing in my head, I’m a keen gardener and I couldn’t work in the garden, I couldn’t sit down, I was restless. I thought, What’s going on here? And I said to my wife, I wonder, why am I feeling like this? Do you think it could have a relationship to the fact that I’ve just stopped my Seroxat, my Paxil? And that was the beginning of my discovery.
And to cut a long story short, it’s been absolute hell ever since then trying to get off this medication that I was told I wouldn’t find dependence-forming. And not only was it hell, over probably the vast majority of my career right up until the end, many of my psychiatrist colleagues — good folk, nice folk that liked me — they didn’t believe me. They wouldn’t say it outright, but they would say things [like], ‘Oh, this is recurrence of Peter’s illness,’ and I would say to them, ‘Well I started this for anxiety, I didn’t have these states of mind and physical symptoms before this.’ These states were brought about from protracted withdrawal, however slowly I tried to get off this damn stuff . . . I tried everything . . . I must have tried about four or five times to come off it gradually, and eventually I got off it using liquid. It probably took me at least a year; I felt hellish but I got off the stuff.
But in the course of the last few months, physically, I was feeling terrible, mentally, I was feeling terrible and I was getting lower and lower mood . . . So in 2005, this changed my life for good. My children were then wee — a wee daughter at kindergarten, a son at primary school. And I knew my mood was slipping, and I became suicidal. I wasn’t sleeping, I wasn’t eating, I was restless, I was agitated, I felt flu-like, I thought I was never going to get better. And then I became suicidal [and] ended up in a psychiatric hospital . . . [for] about three or four months. I tried to end my life. I was given multiple different psychiatric drugs to treat my depression, which — I was depressed, but — you can ask my wife, everybody who knows me — I’ve never had anything like this, it was directly related to the withdrawal from paroxetine.
And then eventually I was getting ECT . . . the ECT, it was like a sledgehammer. So it certainly got rid of some of my worst feelings at the time. But as a result of the ECT I really don’t remember anything of — very little of — 2005, and that’s a mixed blessing. It’s good I don’t remember what I put my family through, but it’s also sad because my children were then wee, and you don’t really relive your family life again. So eventually with ECT I got to a sort of level state; it took me another seven or eight months before I got back to work. Eventually as an outpatient I insisted to my psychiatrist, ‘Look, I think the only thing you can do is’ — because at that time they tried me on different antidepressants, I can’t even remember which ones in combination — but eventually I said, ‘I think you should put me back on my Seroxat.’
And that’s 2005. So here I am 17 years later, I’m still on the stuff. And people have said, Oh Peter, why don’t you just try and withdraw slowly with tapering strips, and I have very seriously thought about that. And I’ve even heard some people say, Oh Peter, you don’t have balls, you know, you can get off this stuff. And well maybe they’re right, but I kind of believe life is — I only live life once, it’s fairly short, and I’m terrified, absolutely terrified — I can cope with much heartache myself, [but] I’m terrified of putting my family through what I put them through before. So to cut a long story short, here I am in 2023 still on this paroxetine that I was told was not dependent-forming and I shouldn’t be ashamed of taking.
20:19 The narrative in psychiatry has been very powerfully controlled by a fairly small group that’s had a wide influence on the rest of us. And here I’m not just blaming the pharmaceutical industry, certainly not. I actually blame more the medical, the healthcare system for just slavish — for rather not questioning enough of what we’re doing here, and not explaining to people that — people look for quick fixes, we all do, for suffering; nobody wants to suffer, so we want a quick fix . . . But in any intervention there could be a range from positive outcomes to negative outcomes and usually a whole host of in-between. So why has — antidepressants in particular, but not just them, antipsychotics and other drugs — why has it become so polarized? And I think partly that’s because these narrative controllers are very defensive.
22:25 I think there is plenty of evidence out there to show that the investment of money, the relationship of the pharmaceutical industry and medical prescribing — not just in psychiatry — can lead to worse outcomes because the interests of the company are put before the interests of the patient.
33:03 There is a small group of what I call the narrative controllers who have been career-long paid opinion leaders for the pharmaceutical industry and have been there ten, 20, 30, 40 years. Many of them are coming up to their retirement and they are still ‘educating.’ And there is no way of finding out how much they may have been paid in recent weeks, in previous months, previous years, or as a career. And I think the scale of payments could be massive.
46:23 What I saw on social media… I was briefly on it, probably 2014 for about six months, and at first I thought it’s great because it’s a leveler, it levels out people who are in high positions of power and you can say things that they don’t want you to ask them. [But] I quickly realized how nasty it can be . . . there’s some very senior members of the Royal College of Psychiatrists for example, and I’m sure it’s the same in America and Canada and Australia, who are extremely nasty, and get away with some of what if it was in the clinic would be the most unprofessional behavior. And it goes with a blind eye by the Royal College of Psychiatrists.”
Dr. Josef Witt-Doerring: “There seems to be very little appetite for a conversation that doesn’t say ‘Antidepressant save lives,’ you know. As soon as you start talking about the risks of them I see people labeled as being ‘dangerous’ or ‘harmful’ or ‘pill shaming’ or, you know, ‘dissuading people from getting the help that they seek’ and . . . there’s this intimidation. And it was definitely something that I felt kind of subtly throughout my training, and then maybe a little bit more loudly when I saw people I really admired talk about these things, people like David Healy, and I look at what happened to him…”
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