This post was first published by Mad In America on 24th October 2024
People who consider themselves suicide experts are usually just the opposite. They are biased towards drug use and cherry-pick the studies they quote even when they call their reviews systematic,[1] and suicide prevention strategies always seem to incorporate depression pills.[2]
A 2015 “State of the Art review” in the BMJ claimed that “Evidence supports specific psychotropic drugs to reduce the risk of suicide.”[3] I explained why none of the references supported this.[4] There is no such drug.
In 2017, suicide experts wrote in the Swedish medical journal that antidepressants, lithium, and clozapine prevent suicides, but several of their references were seriously misleading, and I noted that there is no reliable evidence that any drug can prevent suicide.[5]
In 2017, Norwegian Professor Heidi Hjelmeland et al. noted that it is a myth that mental disorders play a significant role in at least 90% of suicides.[6] In most cases, there is no preexisting mental disorder. Their article was very difficult to publish. Hostile reviewers did not debate the science but accused them of being polemical, climate change deniers, extreme, unbalanced, not trained as psychiatrists (the “you are not one of us argument”), or just expressing opinions. When the article was published and the editor invited comments, none arrived. This is also typical. If you can’t win, you keep quiet.
In 2017, 29 suicide prevention experts from 17 countries published a report with the authoritative title, Evidence-based national suicide prevention taskforce in Europe: A consensus position paper,[7] which quoted a “systematic review” conducted by 18 experts. However, the review did not include the numerous studies or reviews that went against the authors’ dangerous recommendation of drug therapy as suicide prevention.
It was exceedingly difficult for Hjelmeland et al. to publish a criticism of the report.[8] Their paper was rejected by six journals, for political reasons.
In 2020, Hjelmeland et al. published an article online with interviews of professionals about their experiences of working with the implementation of the Norwegian action plans and guidelines for suicide prevention.[9] The professionals were highly critical of the monopolisation of “the truth” within the suicide prevention community. One month after the article was published, the researchers received a letter from the editors stating that they had received a complaint about defamatory content. They wanted to republish the article but would give the researchers the opportunity to withdraw it first. This was a trap, which I have also been exposed to. You should NEVER accept such an “offer” from an editor who will undoubtedly use the opportunity to reject your paper after additional peer review.
The complaint seemed to have come from the National Centre for Suicide Research and Prevention. The authors refused to withdraw the article, which resulted in a five-month battle where they needed legal assistance from their university and from Germany where the publisher is located. There was nothing defamatory in the content. In fact, the content was protected in legislation on freedom of speech.
Next, the editors wanted to investigate if there was any basis in the data for what they called “strong allegations” and demanded that the interview transcripts be handed over. This would have been a serious breach of confidentiality. Instead, the researchers sent material to the editors showing that the national suicide centre had publicly confirmed their findings in several professional journals.
Then, the editors asked the university to investigate the researchers for scientific misconduct. The university gave in to this silly demand and its investigation fully supported the researchers. Only then did the editors accept that the article would remain in the journal.
I corresponded with Hjelmeland about this saga, which made me search on the Internet to find out what the “experts” opine today about using drugs for suicide prevention. A systematic review from 2021 in the psychiatrists’ flag-ship journal, American Journal of Psychiatry, entitled Improving suicide prevention through evidence-based strategies was shocking.[10] The abstract claimed that “Meta-analyses find that antidepressants prevent suicide attempts.” The psychiatrists even had the audacity to call their lethal advice “evidence-based strategies.” However, meta-analyses of the randomised trials have found that depression pills double not only the risk of suicide; they also double suicides, with no age limits.[11]
A 2022 Lancet seminar was yet another proof that psychiatry has degenerated to a point of no return. The seminar, Suicide and self-harm,[12] was very long, 14 pages, but is one of the worst articles about suicide I have ever seen, which I explained on the Mad in America website.[13] The authors tried to resurrect the myth about a chemical imbalance in the brain being the cause of psychiatric disorders,[14] but the two references they cited were gobbledygook.
Among risk factors for suicide, they mentioned substance use but not depression pills, antiepileptics (which double the risk of suicide[15]), or the psychiatric profession itself.[16]
It was also dishonest to say that there is a “possibility of exacerbating suicidal thoughts, particularly in young people.” We know that depression pills double suicide rates, but none of the 142 references were to any of the many meta-analyses of placebo-controlled trials showing that depression pills increase the suicide risk. Instead, the authors quoted a book written by one of them and by Robert D Goldney who has published a review that is a classic example of how one should not do a review.[17] He cherry-picked observational studies that supported his idea that depression pills protect against suicide including studies conducted in the Nordic countries that are scientifically dishonest.[18] Goldney had received “gold” “from a number of pharmaceutical companies.” No surprise there.
The authors claimed, with no references, that drug treatment can reduce the suicide risk. What are the miraculous drugs that can do this? They only exist in the delusional world of the psychiatrists. A little later, the authors spoke about observational studies suggesting that antidepressants might reduce the risk of suicide. This is the UFO trick: If you use a fuzzy photo to “prove” you have seen a UFO when a photo taken with a strong lens has clearly shown that the object is an airplane,[19] you are a cheat. They claimed that randomised trials were underpowered, which is not true if we combine them in meta-analyses.
Sadly, one of the most important studies I have come across in my whole career is virtually unknown. Studies of people that have not been randomised but have chosen themselves what to do, e.g. to exercise or not, are called observational studies. Such people differ in many other respects, and it is therefore common to adjust for baseline differences with statistical methods. However, statistician Jon Deeks showed that it is not possible to adjust reliably for baseline differences. Ingeniously, he used raw data from two randomised multi-centre trials as the basis for observational studies that could have been carried out. He found that the more baseline variables we include in a logistic regression, the further we are likely to get from the truth.[20] He also found that comparisons may sometimes be more biased when the groups appear comparable than when they do not. He warned that no empirical studies have ever shown that adjustment, on average, reduces bias.
Many false claims in psychiatry are derived from observational studies, which is why it is important to know about Deek’s research.
The authors claimed that the evidence base is incomplete, since many trials excluded people at high risk of suicide and they noted that some research has found an association with increased risk of suicide-related outcomes in young people. This is dishonest. When the FDA looked at all the randomised trials, they found a causal relation and not just an “association.”
The Lancet is the extended marketing arm of the pharmaceutical industry,[21] just like the New England Journal of Medicine, which has also published articles denying that depression pills cause suicide.[22]
In 2023, the “experts” failed us badly again. In a long article (6,425 words) in BMJ, Suicide in young people: screening, risk assessment, and intervention, Hughes et al. mention some risk factors, e.g. living in a home with firearms,[23] but not depression drugs, which they recommend for young people, with “increased monitoring by the prescribing physician.” This is a fake fix, as people can kill themselves suddenly and unexpectedly.[24]
Hughes et al. believe a risk difference of 0.7% for suicidal ideation or suicide attempt between drug and placebo is small, and they immediately dismiss it by saying that “Data from more recent pediatric antidepressant trials have not shown differences between drug and placebo.” The review they quote cannot be used to such effect. And when studying rare events, it is unacceptable to lose statistical power by including only “recent” trials. Moreover, the review only included published trial reports, which have omitted many suicide attempts and suicides. It is irresponsible of the BMJ to publish such dangerous nonsense.
In September 2023, I did a Google search in Danish on suicide and antidepressants, which confirmed that the public is being massively and systematically misinformed.[25] Here are the top 10 posts:
- The Danish Centre for Suicide Research reported that antidepressants increase the risk of repeated suicide attempts by 50%.[26] The research was supported by Lundbeck, and after the researchers had adjusted their analyses for many factors including psychiatric contact and use of various psychiatric drugs, they concluded that the pills do not increase the risk of another suicide attempt. It is plain wrong to adjust for something that is part of the causal chain. It can remove a true association totally.
- In a message addressed to Danish citizens, Risk of suicide and violence is not affected by antidepressant therapy,[27] Psychiatry in the Capital Region used the UFO trick when referring to a Danish registry study.
- In another message, the same institution claimed that antidepressants do not increase the risk of suicide in young people and protect against suicide in adults.[28] They referred to a meta-analysis by Gibbons from 2012. Gibbons uses statistical modelling, and his studies are so dishonest that it is not a question of errors, but of deliberate cheating.[29]
- An article[30] from an industry-funded magazine misquoted our study, which found that, in adult healthy volunteers, depression drugs double the risk of suicide and violence compared with placebo.[31]
- Text from the Danish Drug Agency for the package inserts for antidepressants,[32] gives people the impression that the pills reduce the risk of suicide.
- Psychiatrist Marianne Breds Geoffroy’s article in our medical journal:[33] Youth suicide and antidepressants: Peter Gøtzsche claims that antidepressants have driven young people to suicide. But how can he know that? Well, when a drug increases the risk of suicide, some will succeed. Geoffroy begins her article this way: “Peter Gøtzsche writes that it is antidepressants that have ‘driven young people to suicide.’ If that is correct, then why are not all children and young people who have depression and are given antidepressants driven to suicide?” Well, some people die in traffic accidents, but we don’t all die. Geoffroy had received fees from Lundbeck, Eli Lilly and Novartis.
Eight years earlier, in the article, No one above Gøtzsche,[34] Geoffroy called my governmental funding into question and called it bizarre “to extrapolate from the few unfortunate cases to the many … That’s how bad things can go when a statistician leaves the desk and strays into real life.” She called my book about organised crime in the drug industry,[35] which has two chapters about psychiatry, “The first dark book.” My book about psychiatry[36] was obviously the second dark book. Stupidity has no limits.
A year later, Geoffroy was on the warpath again.[37] She claimed it was an ideology and a conflict of interest that we had suggested we should demedicalise the population because psychiatric drugs are the third leading cause of death.[38] I thought all doctors were interested in helping their patients to survive. She complained about me to my management, my boss at the university, the Board of Health, the Minister, and the committee at the university that handles alleged cases of scientific misconduct. I noted that anyone can report their neighbour to the police, but sometimes it is the complainant who is the problem, and not the one complained about.
- Our medical journal announced psychiatrist Lars Søndergård’s PhD thesis.[39] It was based on Danish registries and found that antidepressants reduced the risk of suicide. The UFO trick is popular in psychiatry.
- The comment I made in 2015 on the Board of Health’s website.[40] Videbech had claimed in the Board’s journal, Rational Pharmacotherapy, that undertreatment with antidepressants is dangerous because of the suicide risk. I noted that this cannot be correct because the drugs increase the risk of suicide, and I pointed out other errors.
- A science site mentioned[41] my research group’s meta-analysis demonstrating that duloxetine increases the risk of suicide and violence 4-5 times in middle-aged women with urinary incontinence, as judged by FDA defined precursor events.[42] Furthermore, twice as many women experienced a core or potential psychotic event. Psychiatrists have criticised our use of precursor events for suicide and violence, but this is similar to using prognostic factors for heart disease. As smoking and inactivity increase the risk of heart attacks, we recommend people to stop smoking and start exercising.
- My article about Rasmus Burchardt’s suicide.[43] His parents had asked me to write about it to warn other parents. Their 19-year-old son had hanged himself in their bathroom 18 days after the family physician had prescribed mirtazapine for sleep problems and school fatigue.
In April 2024, award-winning British documentary filmmaker Katinka Blackford Newman launched a petition, “Get suicide prevention services to ask callers if they are taking meds that cause suicide,” to the Samaritans, which is a suicide prevention service.[44] It got over 25,000 signatures in just two months.[45] Experts she had talked to had suggested that medical professionals and helpline staff should ask people with suicidal thoughts: “Have you become suicidal since going on, changing dose, or coming off a drug that lists suicidal thoughts as a potential side-effect?”[46]
When she contacted the Samaritans, a spokesperson said that their volunteers were not medically trained and did not offer advice on prescription medication, which the patients should get from their doctor. In David Healy’s view, while suicide prevention services cannot be expected to offer medical advice, “they could raise the possibility with callers that their problems may be caused by medication.”
It is taboo that depression drugs cause suicide and homicide. This taboo kills people. Katinka is herself a victim of horrible medical malpractice. While going through a divorce in 2012, she was prescribed escitalopram (Cipralex or Lexapro, from Lundbeck) even though she was not depressed, only distressed.
Katinka invited me to the launch of her book, The pill that steals lives.[47] She told the audience that she was very lucky to be alive, and not serving a life sentence if she had killed her two children after the pills made her psychotic.[48] She has made a very moving 8-minute film[49] about her story and has a homepage,[50] with links to documentaries and with stories about people who killed themselves or others or were seriously harmed in other ways.
Katinka ended up in the private Florence Nightingale psychiatric hospital in London. The psychiatrists didn’t realise it was the pill that had made her ill. They diagnosed psychotic depression and forced her to stay and take a dangerous cocktail of drugs. But her 11-year-old son Oscar knew it was the pills. What saved her was that her private insurance ran out.
As an introduction to her book, I wrote: “This book describes in vivid detail how ordinary people can become murderers if they take antidepressant drugs and how psychiatry can destroy people. It is a catching personal testimony about what is wrong with psychiatry, its love affair with unscientific diagnoses and harmful drugs, and its blindness towards the fact that what look like psychiatric diseases are often side effects of psychiatric drugs.”
In my book about organised crime in the drug industry, one of the chapters is, Pushing children into suicide with happy pills.[51] Can anything be worse than this in healthcare? Telling children and their parents that the pills are helpful when they don’t work and drive some children to suicide?
I don’t know of any other medical specialty whose practitioners systematically lie to the public in matters of life and death. Several psychiatrists have told me that their leaders suffer from cognitive dissonance, as what they see and hear doesn’t influence them.
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References
[1] Hjelmeland H, Jaworski K, Knizek BL, Ian M. Problematic advice from suicide prevention experts. Ethical Human Psychology and Psychiatry 2018;20:79-85.
[2] Whitaker R, Blumke D. Screening + drug treatment = increase in veteran suicides. Mad in America 2019;Nov 10.
[3] Bolton JM, Gunnell D, Turecki G. Suicide risk assessment and intervention in people with mental illness. BMJ 2015;351:h4978.
[4] Gøtzsche PC. No psychiatric drugs have been convincingly shown to decrease suicides. BMJ 2015;Dec 10 and Gøtzsche PC. Is psychiatry a crime against humanity? Copenhagen: Institute for Scientific Freedom; 2024 (freely available).
[5] Gøtzsche PC. Ingen pålitlig evidens visar att läkemedel kan förebygga självmord. Läkartidningen 2017;May 1.
[6] Hjelmeland H, Knizek BL. Suicide and mental disorders: A discourse of politics, power, and vested interests. Death Stud 2017;41:481-92.
[7] Zalsman G, Hawton K, Wasserman D, et al. Evidence-based national suicide prevention taskforce in Europe: A consensus position paper. Eur Neuropsychopharmacol 2017;27:418-21.
[8] Hjelmeland H, Jaworski K, Knizek BL, et al. Problematic advice from suicide prevention experts. Ethical Human Psychology and Psychiatry 2018;20:79-85.
[9] Espeland K, Knizek BL, Hjelmeland H. “Time to try something new” – professionals’ experiences and reflections on suicide prevention in Norway. Crisis 2021;42:434-40.
[10] Mann JJ, Michel CA, Auerbach RP. Improving suicide prevention through evidence-based strategies: a systematic review. Am J Psychiatry 2021;178:611-24.
[11] Hengartner MP, Plöderl M. Newer-generation antidepressants and suicide risk in randomized controlled trials: a re-analysis of the FDA database. Psychother Psychosom 2019;88:247-8 and Hengartner MP, Plöderl M. Reply to the Letter to the Editor: “Newer-Generation Antidepressants and Suicide Risk: Thoughts on Hengartner and Plöderl’s ReAnalysis.” Psychother Psychosom 2019;88:373-4.
[12] Knipe D, Padmanathan P, Newton-Howes G, et al. Suicide and self-harm. Lancet 2022;399:1903-16.
[13] Gøtzsche PC. A hopelessly flawed seminar in “The Lancet” about suicide. Mad in America 2022;June 1.
[14] Moncrieff J, Cooper RE, Stockmann T, et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry 2023;28:3243-56.
[15] FDA package insert for Lyrica (pregabalin).
[16] Hjorthøj CR, Madsen T, Agerbo E, et al. Risk of suicide according to level of psychiatric treatment: a nationwide nested case-control study. Soc Psychiatry Psychiatr Epidemiol 2014;49:1357–65.
[17] Goldney RD. Suicide and antidepressants: what is the evidence? Aust N Z J Psychiatry 2006;40:381-5.
[18] Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015, page 97.
[19] Sagan C. The demon-haunted world: science as a candle in the dark. New York: Ballantine Books; 1996.
[20] Deeks JJ, Dinnes J, D’Amico R, et al. Evaluating non-randomised intervention studies. Health Technol Assess 2003;7:1–173.
[21] Smith R. Medical journals are an extension of the marketing arm of pharmaceutical companies. PLoS Med 2005;2:e138.
[22] Friedman RA. Antidepressants’ black-box warning – 10 years later. N Engl J Med 2014;371:1666-8.
[23] Hughes JL, Horowitz LM, Ackerman JP, et al. Suicide in young people: screening, risk assessment, and intervention. BMJ 2023;381:e070630.
[24] Gøtzsche PC. Depression drugs have been shown to double the risk of suicide in young people and should not be used. BMJ 2023;April 26.
[25] Gøtzsche PC. The lie that antidepressants protect against suicide is deadly. Mad in America 2023;Nov 28.
[26] Jakobsen SG, Christiansen E. Selvmordsforsøg og antidepressiva. Center for Selvmordsforskning 2019;Dec.
[27] Risiko for selvmord og vold påvirkes ikke af antidepressiv behandling. Region Hovedstadens Psykiatri 2023.
[28] Antidepressiva øger ikke risikoen for selvmord. Fluoxetin og venlafaxin øger ikke risikoen for selvmord blandt unge. Blandt voksne og ældre, beskytter præparaterne mod selvmord. Region Hovedstadens Psykiatri 2023.
[29] Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015, page 96.
[30] Antidepressiva øger risikofaktorer for selvmord. Psykiatrisk Tidsskrift 2016;Nov 20.
[31] Bielefeldt AØ, Danborg PB, Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109:381-92.
[32] PhVWP/CMD(H) vedtaget SPC ordlyd for alle antidepressiva: selvmordstanker og selvmordsadfærd. Danish Drug Agency, undated.
[33] Geoffroy MB. Unges selvmord og antidepressiva. Peter Gøtzsche hævder, at antidepressiva har drevet unge til selvmord. Men hvordan kan han vide det? Ugeskr Læger 2023;July 10.
[34] Geoffroy MB. Ingen over Gøtzsche. Dagens Medicin 2015;Oct 23.
[35] Gøtzsche PC. Deadly medicines and organised crime: How big pharma has corrupted health care. London: Radcliffe Publishing; 2013.
[36] Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.
[37] Geoffroy MB. Interessekonflikter – mere end ussel mammon. Ugeskr Læger 2016;178:1838-9.
[38] Gøtzsche PC. Begrebet interessekonflikter bør ikke udvandes. Ugeskr Læger 2016;178:1840.
[39] Sammenhængen mellem antidepressiv/stemnings-stabiliserende medicin og selvmord. Ugeskr Læger 2007;June 8.
[40] Gøtzsche PC. Misinformation om antidepressiva og selvmord. www.irf.dk 2015;March 5.
[41] Barse M. Forskere: ‘Lykkepiller’ giver bivirkninger, som kan føre til selvmordsadfærd. Videnskab.dk 2017;Feb 11.
[42] Maund E, Guski LS, Gøtzsche PC. Considering benefits and harms of duloxetine for treatment of stress urinary incontinence: a meta-analysis of clinical study reports. CMAJ 2017;189:E194-203.
[43] Gøtzsche PC. Endnu et tragisk selvmord på depressionspiller. Jyllands-Postens Kronik 2018;Feb 3.
[44] https://www.samaritans.org/?currency=EUR
[45] Newman KB. Get suicide prevention services to ask callers if they are taking meds that cause suicide. Petition launched 2024;Apr 21.
[46] Newman KB. I was sectioned after being given a tranquiliser for anxiety that triggered a frightening slide into psychosis. But the worst part of my ordeal was how doctors tried to cure me. Daily Mail 2024;Apr 23.
[47] Newman KB. The pill that steals lives. London: John Blake; 2016.
[48] Gøtzsche PC. On the brink of murder because of an antidepressant. Mad in America 2024;Mar 28.
[49] https://www.antidepressantrisks.org/films?wix-vod-video-id=73528fa5f3da48bf9bfe77889f453cad&wix-vod-comp-id=comp-kme2lksu
[50] https://www.antidepressantrisks.org/
[51] Gøtzsche PC. Deadly medicines and organised crime: How big pharma has corrupted health care. London: Radcliffe Publishing; 2013.
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