year 2001 & Mark Harvey says he is still shaking the tree (truth will out!)

June 14, 2004

" Towards the end of last year (2001) she (Stanaway) saw a newspaper

advertisement soliciting for victims of medical negligence. The

person she called referred her on to Mark Harvey at the Cardiff firm

of Hugh Ford Simey, who was then unaware of the full extent of

the problems linked to Seroxat. But now he is, for he has since

heard more than 100 other stories......... "

" Mark Harvey says he is still 'shaking the tree' to see how many

people are suffering from the sort of severe withdrawal symptoms

afflicting Stanaway. People are learning of his interest at

the rate of about two a week. The most common story he hears is that

the drug initially worked, but then the difficulties really started.

At present he has 120 people on his books, and he has commenced

applications for legal aid ............... "

***** People are learning of his (Mark Harvey's)interest

***** and he (Harvey) has commenced applications for legal

aid ............... "

http://society.guardian.co.uk/mentalhealth/story/0,8150,707016,00.htm

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The chemistry of happiness

Seroxat is set to overtake Prozac as the world's favourite

antidepressant. With 100m prescriptions in more than 100 countries,

it is aggressively marketed as the addiction-free answer to our

anxieties. But thousands of patients are now saying their dependence

on the dream drug has all but destroyed their lives

Simon Garfield

Sunday April 28, 2002

For some unfathomable reason, the key episodes often occur in

supermarkets. Two years ago, Stanaway returned home from her

work as a cleaner and went for her big weekly shop in Swindon. Not

long in the busy aisles, she was struck by a panic attack and an

urgent desire to flee. She abandoned her shopping but the attacks

persisted.

After three or four, she went to her doctor and was told that for a

woman of her age, in the midst of her menopause, such events were

not unheard of. She was prescribed a drug called Seroxat. 'That was

the beginning of the end,' she says. 'If I'd have known what it was,

there is no way I would have taken it.'

Ian was in a supermarket in Gloucester when he decided to buy

150 tablets of paracetamol. The sales assistant told him, quite

properly, that he was not allowed to sell him anything like that

amount. 'But I live miles away,' explained. 'I can't come

running here every few days.'

Eventually , who is an eloquent 38-year-old wildlife

photographer, persuaded the assistant that he should sell him as

much as he wanted.

'Don't tell anyone,' the employee said. 'And don't do anything

stupid with them.'

'This was rather ironic,' says now. 'Because that was exactly

what I was about to do.'

The brain remains the great unconquered organ of scientific and

medical knowledge. Ian is fond of saying that if we knew as

little about the workings of the heart as we do about the brain,

then nobody would dare to perform open-heart surgery. When the brain

malfunctions we are often at a loss to detect why, and we are still

groping towards effective treatments. Paracetamol is a blunt tool

most often used in the masking of headaches, but 's intended

use was for suicide. He believes that this was a side effect of his

doctor prescribing him a drug known as an SSRI - selective serotonin

re-uptake inhibitor - a family of medications once recognised only

by the tradename of Prozac, but now also marketed as Seroxat,

Cipramil, Lustral, Efexor, Dutonin and Faverin. They are most

commonly prescribed as treatments for depression, but each year new

applications are being found for them.

The molecular shape of the drugs is designed to be highly specific,

but they are often prescribed for the most unspecific of symptoms:

anxiety, insomnia, shyness, natural sadness following bereavement.

The drugs are now so widely used that it is difficult to find any

community or large organisation without members who are taking them.

In 2000, just under 12m prescriptions of SSRIs were dispensed by the

NHS in England alone, almost 4m more than in 1997. An interesting

pattern is emerging regarding their use, quite aside from the

question of why we appear to be getting more depressed and anxious.

The majority of those on the drugs believe their lives have

benefitted from their complex but still unrefined chemistry, but

there is also a growing band of desperately unhappy and angry people

who claim the medications have all but destroyed them. Inevitably,

many solicitors are now involved, and there is the possibility of

class actions directed against the pharmaceutical companies who have

made the invention of drugs of the mind one of the top priorities of

the new century.

Ian says he was given his SSRI for acute insomnia. 'I was a

normal person who very rarely visited my doctor. Within a day of

taking the drug I was overcome with what I can only describe as an

intense disquiet - the most unpleasant thing that I have ever

experienced in my life. Many of my friends said they just didn't

recognise me.' He says he went back to his GP the next day and told

him that the pills were having devastating effects, and his doctor

replied that it was unlikely to be the drug.

SSRIs are designed to enhance the brain's levels of serotonin, a

substance involved in the transmission of nerve impulses and widely

thought to be a key element in the maintenance of a balanced mood.

They do not generally take effect for two or three weeks, so Ian

carried on taking them. He lost almost three stone in three

weeks. After a while his employer sat him down and told him he did

not consider him well enough to continue working.

'A lot of time on the drugs you feel nothing, but then suddenly the

most minor of things can drive you to the most catastrophic actions.

In three months I tried to kill myself on six separate occasions,

always with lethal intent. The paracetamol tablets. I tried to gas

myself in a car, I tried hemlock. Paracetamol is an extremely

unpleasant way to kill yourself. It doesn't kill you instantly, and

I was found by someone. I ended up in hospital with liver and renal

failure.' The strangest thing is, he says, when he woke up in

hospital he really couldn't understand why he'd done it.

's recovery began a few weeks after he came off Prozac last

August, and he began a lengthy complaints procedure which has yet to

yield him any satisfaction. He claims the medical profession and the

NHS have brushed him off, blaming his own underlying psychological

imbalance rather than the effects of a drug upon it. This is a

dilemma encountered by many of those who have bad experiences with

SSRIs: because it is so difficult to measure emotional and other

mental states, it is almost impossible to show that a worsening

condition would not have occurred without interference. The same, of

course, applies to an improvement.

What is clear is that by their very nature, anti-depressants tend to

be given to people who are in a vulnerable situation. Stanaway

remembers her doctor telling her that she 'needed a little

something' to help her through her menopause. She is 52, and used to

enjoy a reasonably active life.

She used to work as a cleaner for 20 hours a week, but has not done

so since July 2000, which was when she stopped taking her daily

morning dose of 20mg of Seroxat.

Stanaway's problem on the drug - severe headaches - was nothing to

the predicament she faced when she came off it. 'After 11 months of

it I was still getting very bad headaches and I felt the drug wasn't

right. My doctor agreed, and she said to come off it by taking one

every other day and then stop, which is what I did. After four days

I went into withdrawal. It started with leg spasms. I had

nightmares. Muscle weakness. My balance went.'

She saw the duty doctor, who told her to go back on Seroxat. She did

this, but the symptoms continued. After a further month, she says

her regular doctor said she was very sorry about the adverse

reaction, and that the withdrawal now seemed impossible to stop. She

came off the drug completely. 'The past 20 months have been

unbearable,' she says. Her husband asks her to try to remember what

she was like before that episode in the supermarket. She has been on

incapacity benefit since January, but only wants to get back to

work. 'No one knows how to do this. People tell me I'll get my

balance back eventually, but I'm yet to see it. I feel I need a

miracle.'

Towards the end of last year she saw a newspaper advertisement

soliciting for victims of medical negligence. The person she called

referred her on to Mark Harvey at the Cardiff firm of Hugh

Ford Simey, who was then unaware of the full extent of the problems

linked to Seroxat. But now he is, for he has since heard more than

100 other stories.

Harvey has conducted many class action medical negligence cases

during his career, beginning with the claims against Eli Lilley, the

makers of the occasionally fatal anti-arthritic Opren in the early

80s. He is currently seeking compensation for users of

Lipobay/Baycol, the anti-cholesterol drug pulled off the market by

Bayer after adverse reactions with other drugs resulted in a number

of deaths. The case of Seroxat is not unexpected, he believes. 'The

drugs are all trying to fill that huge gap in the market - covering

anything from mild to serious depression - and if you can produce

something that alleviates the problems and isn't addictive, then you

have a huge winner. People now go to their doctor and say, " But will

I be addicted? " because they've all heard the Valium stories.'

The data sheet that accompanies each packet of Seroxat has a bold

claim: 'These tablets are not addictive.' A little later in the

patient instructions, after information about not taking it with the

popular blood-thinning drug warfarin and other medications, the

reassuring message appears again: 'Remember that you cannot become

addicted to Seroxat.' Many patients now regard this claim as

unacceptable.

Mark Harvey says he is still 'shaking the tree' to see how many

people are suffering from the sort of severe withdrawal symptoms

afflicting Stanaway. People are learning of his interest at

the rate of about two a week. The most common story he hears is that

the drug initially worked, but then the difficulties really started.

At present he has 120 people on his books, and he has commenced

applications for legal aid.

The data sheet supplied to doctors by manufacturers GlaxoKline

(GSK) does inform them that withdrawal should be gradual, but Harvey

believes that the language employed deliberately downplays the

potential problems. 'However you dress it up,' he says, 'they're

trying to suggest that it's not a major issue. But I've got people

who have been trying to get off it for four or five years and

say, " My life is a misery. " I've heard this argument about [it not

being addictive], but I think it's mischievous. What they're saying

is that the body doesn't become so absorbent to the drug that you

have to keep prescribing larger and larger amounts. That may well be

right. But I have to say that if you're a patient and you read your

information sheet that says " These tablets are not addictive, " then

they understand that as meaning: " If I want to come off this drug

then I should be able to do so without any problems, like coming off

penicillin. " But to say that there's a technical definition

to " addiction " is wrong. It's bad enough doing it to a doctor, but

you certainly shouldn't do it to a member of the public.'

Harvey is not the sort of hot-headed litigator we may be familiar

with from the movies; he does not distrust Big Medicine per se. He

acknowledges that a lot of people benefit from Seroxat, and he has a

moderate suggestion that falls well short of any grandiose attempt

to have the drug withdrawn. 'If [GSK] were sensible, they would sit

down and go, " We don't accept any legal liability but we recognise

that we could improve the information that we give to the patient

and the doctor. " '

People become aware of Harvey's involvement principally through the

internet, which has recently developed into a vast arena of anti-

SSRI campaigning and sad stories from depressives. Websites cater

for all types of anxiety and melancholy, and they provide a self-

help community for those troubled by their treatments. On the

popular 'HealingWell' site, which caters for all ailments, the

diabetes message board had recently attracted 406 postings, and the

one for multiple sclerosis 261. By the same day in mid-April, the

message board for anxiety and panic disorders had received 8,208 and

the depression board 9,392.

The postings have titles like 'In A Deep Hole and I'm Sinking

Again'. Some consider how to withdraw from SSRIs, but others have

gone beyond that. One recent message from Sally186 said: 'I've had a

horrible weekend. Been more and more anxious lately - pending

divorce and my mother-in-law is dying and I love her and it's too

much like when my dad died two years ago. Started feeling horrible

suicidal urges late last week and only stayed out of the hospital

when my therapist agreed to call me twice a day to make sure I was

OK. I don't want to hurt my children. God help me. If I'm not in

chat tonight you'll know where I am. Sally.'

There was an immediate response: 'Dear Sally, Your thinking is all

negative. You've been handed your fate - you can turn it into

something good. It really doesn't have to be as bad as you are

making it.'

Depression is not a modern affliction; indeed, it was recognised as

a treatable illness by Hippocrates. But only recently have we begun

to diagnose the scale of the problem, and only in our lifetime has

medical science been able to approximate its biological causes. The

World Health Organisation estimates that depression is soon to

become the second leading cause of disability - behind ischaemic

heart disease and ahead of road traffic accidents. Extensive surveys

report that major depressive illness occurs in 3-10 per cent of the

adult population, with the prevalence in women two to three times

higher than in men. A report published in 1997 suggests that major

depression is prevalent in 2.3 per cent of the UK population, and

mild depression in 7.7 per cent. Thirty to 50 per cent of cases are

believed to go undetected.

By themselves, these figures mean little, particularly to those who

are not depressives themselves. In the past decade a few graphic

memoirs have thrown light on the true nature of severe illness, and

the one thing they make plain from the start is that they are not

suffering with a bad, common case of the blues. The American

novelist Styron ventured that 'depression' has been

devalued, a word that has 'slithered through the language like a

slug, leaving little trace of its intrinsic malevolence'. In his

peerless book The Noonday Demon, gives an unnerving

description of being unable to raise himself from his bed to answer

the phone; even a journey to the bathroom becomes a multi-step

struggle. On a broader plain, 'the first thing that goes is

happiness', explains. 'You cannot gain pleasure from

anything... Your mind is leached until you seem dim-witted even to

yourself. If you hair has always been thin, it seems thinner; if you

have always had bad skin it gets worse. You smell sour even to

yourself. You lose the ability to trust anyone, to be touched, to

grieve. Eventually, you are simply absent from yourself.'

Even the best literary descriptions do not help the best scientific

minds, nor can they explain the ideal balance in treatment between

the several types of psychotherapy and the many types of chemical

medications. As with all psychiatric disorders, each case of

depression must be judged by its own manifestations and causes.

Should we, therefore, be suspicious of the voracious marketing of

drugs that claim to cure depression, anxiety, panic and post-

traumatic stress in one tiny pill? And what should we make of the

news that Seroxat has taken over from Prozac as the bestselling anti-

depressant on the market, or that the NHS is currently dispensing 60

per cent more SSRI compounds in England than it was four years ago?

Should we be worried, or should we be grateful?

June 14, 2004