Jul 01, 2006 03:00 AM

I’m a suicide survivor. My soulmate of 17 years, Tooker Gomberg, committed suicide March 3, 2004. I lost my best friend and the world lost a warrior.

The pain around suicide is unfathomable and indescribable for those left behind, but especially for the person driven to take his/her life. Unless you’ve been there, you just can’t know this darkest torture of the soul. I saw Tooker’s anguish, one so deep and riveting that he saw no choice but to end the suffering through death.

What could possibly have driven him to such despair?

The world lost a warrior

Tooker Gomberg, internationally renowned for his environmental, peace and justice activism, gave up the ghost at age 48. We had an excellent relationship. He had skills and friends. He was kind, humorous, courageous, a fighter, a leader, and he had fame and respect around the world. What went wrong?

His first depression hit in 2001 and continued into 2002, following the Quebec City free trade protests, police clampdown and horrific mass tear gas poisoning. Tooker was discouraged and exhausted and his depression zapped the spark out of him for nine months. He tried many holistic alternatives to pharmaceutical drugs before turning to an SSRI antidepressant. Nothing seemed to help but, in time, he climbed out of his despair.

When his second depression hit a year later, unemployed after moving to a new city, he sought help through counselling and pharmaceutical drugs, as this was the only option our health care system would pay for. Psychiatrists and their drugs are covered, but naturopathic doctors and their medicines are not, nor are cognitive behavioural therapists, massage therapists or other helpful treatments.

When Tooker’s psychiatrist prescribed the antidepressant Remeron, his anxiety and agitation went through the roof – clearly an adverse reaction. However, his psychiatrist didn’t see it as such and instead, encouraged him to stick with the drug, repeatedly increasing the dosages to the maximum. Then he prescribed a tranquilizer to counter the agitation. After just five weeks on the drug, Tooker’s agitation sent him over the railing of Halifax’s MacDonald Bridge.

He wrote in his suicide note that he was anxious, felt like a zombie and couldn’t think.

Let’s look at the facts.

Three weeks after Tooker died, the US Food and Drug Administration (FDA) publicly associated antidepressant drugs with worsened depression and suicidal ideation. I was dumbfounded and immediately immersed myself in this field, reading everything I could.

What I learned is that, typically, one in four patients feel worse when beginning any antidepressant drug and quit it within the first month. Almost half quit within three months. So while these drugs may help some people, they are not reliable, not even close.

If only drug companies were straight up about this. But that wouldn’t be good for sales. On the contrary, doctors are instructed through industry propaganda to “reduce patient dropout” by “managing” the side effects and encouraging patients to stick with the program rather than to listen to their patients’ experiences.

Agitation is a very common side effect of antidepressant drugs, especially during early stages of treatment or after a change in dosage (up or down). Extreme agitation is known as akathisia, an internal unrest or turmoil.

In clinical trials for SSRIs, the most commonly prescribed antidepressants, this reaction has been recognized and documented since the early ‘80s. Prozac’s clinical trials, both prior to and after its launch in 1988, recorded rates of agitation and akathisia of between five and 25 percent.

Conservatively speaking then, at least one (and as many as five) in 20 patients become agitated on antidepressant drugs – a significant adverse reaction that doctors should be informed about and patients warned about. However, generally, they are not informed. Agitation is a very potent predictor of suicide and violence.

By extrapolating from clinical trial data and multiplying by numbers of users, Dr. David Healy from the UK claims that one in 500 users of antidepressant drugs will complete suicide because of the drug. That’s 100,000 tragic and unnecessary deaths among the 40 to 50 million people on antidepressant drugs worldwide.

Clearly, drug companies have a lot to lose if this information becomes well understood. And user numbers are growing quickly: there was an 80 percent increase in antidepressant prescriptions in Canada from 1999 to 2004.

In February 2005, Dr. Dean Fergusson of the Ottawa Health Research Institute and faculty of medicine at the University of Ottawa published a shocking finding in the British Medical Journal. His meta-analysis reviewed data on 90,000 patients from some 700 clinical trials and found that patients were twice as likely to attempt suicide on antidepressants as on sugar pills.

Huh? Patients are put on antidepressant drugs to lower suicide risk, not to double it!

Just how effective are antidepressants in relieving symptoms of depression? Incredibly, there is little evidence that antidepressant drugs actually produce benefits. We know that they may help some people in the short term, but over the long term, we find a worsening of depression or anxiety compared to placebo-treated patients. Too often, more severe psychiatric symptoms are triggered by the drug itself, such as drug-induced manic or psychotic attacks, often treated with more drugs. For everyone helped by a drug treatment, there may be another harmed.

There is also the disturbing and very real issue of dependence on antidepressants. When you try to stop taking them, you can suffer an emotionally distressing withdrawal that includes “crashing” with depression, fatigue and feelings of hopelessness, which also often involves painful physical symptoms, such as flu-like symptoms, muscle cramps and shock-like headaches.

What are the alternatives?

Leaving pharmaceutical drugs aside, there’s much we can do to treat depression and anxiety, especially of the mild and moderate sort, where it all starts.

Proper diet, exercise, talk therapy and hobbies keep your mind and body strong. Spiritual practice, meaningful work and community keep you connected and centred. But it all comes down to self-awareness and self-love.

We all need to support those in our life who are suffering, especially during their crisis periods. Depression is cyclical. It comes and goes. When people are in the depth of despair, they may not think rationally. They need you to give them a reality check, to remind them that they’re worthy of love and life. Get them beyond their valley of darkness, and when you’re going through your own dark night of the soul, someone will be there for you, to pull you back from the brink.

It’s better to light a candle than curse the darkness. With intelligence and integrity, and with the intention of patient safety rather than profit, we can save lives. With compassion and skill and a dose of generosity, each of us can reach out to those we love during their dark times. We must. We’re all connected, and we’re all making a difference.

Reprinted from Depression Expression: Raising Questions About Antidepressants, a project of Healthy Mind Body Planet.

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Our recommendations to reduce harm

by Angela Bischoff

We believe Health Canada should support a public health framework that reduces the use of psychoactive drugs through health promotion, rehabilitation and prevention.

Health Canada should actively discourage physicians from prescribing SSRIs to adolescents and women of childbearing age.

Health Canada should make all clinical trial data available to the public, including all serious adverse events.

Health Canada should require that clinical trials last long enough to study long term outcomes, including withdrawal, to reflect the time period that patients normally take antidepressants.

We call upon Health Canada to immediately issue safety advisories for all antidepressant drugs, which would include the risks of suicidal ideation and violence as well as other reactions

We believe that reporting of all serious adverse reactions to Health

Canada’s adverse drug reaction monitoring program should be mandatory for all physicians, and promoted and expanded for public use.

All provincial colleges of physicians and surgeons should develop standard practice guidelines on suicide assessment, to ensure patients are monitored for suicidal ideation.

The provincial ministries of education, in concert with ministries of health, should monitor closely the growing trend toward pharmaceutically sponsored speakers presenting to students about depression and suicide, talks that frequently conclude with pro-prescription drug solutions.

We implore the media and the justice system to take note of the serious, ongoing role of antidepressants in violence and suicide.

We call for Parliamentary hearings on antidepressant drugs to explore the nature and extent of harm many Canadians have suffered as a result of their prescription, with the aim of preventing harm.

From _Common Ground_

http://www.commonground.ca/iss/0607180/cg180_tooker.shtml