About 6 months ago I became aware of Sundance Diagnostics, a company who have, for some time, been investigating the link between popular antidepressants and suicide. Convinced there is a link Sundance now hope to try and tackle this problem by giving patients and their carers a warning that many doctor's fail to do.
Sundance are a diagnostics development company based in Boulder, Colarado.
In an interview with Sundance CEO, Kim Bechthold, I asked her what the Sundance goal was, she told me:
"We hope to curb the risk of suicidality and potentially the risk of violence when people take antidepressant drugs.
"Second, we hope that the availability of a test for risk causes the doctor to have to explain to every patient and every family member that taking an antidepressant drug carries with it a serious risk (medical liability insurers in the United States may require the doctor to order the test).
"Last we hope to foster a major patient information initiative so that the patient will know to ask for the test, if the doctor does not offer it.
"All of this depends on our research resulting in a very sound and predictive set of genetic markers that are very helpful clinically for the physician and very informative for the patient and his or her family."
Peter Tolias, Scientific Advisor to Sundance Diagnostics, told me:
"Sundance will be using whole genome sequencing of patients who experienced suicidal ideation and controls – that is patients who did not. This technology allows Sundance to identify the entire 3 billion base pairs in every person’s genome."There's many advocates who would suggest that SSRi type medication be pulled from the shelves, studies have showed that SSRi's show little or no benefit over placebo and even when an SSRi has shown efficacy in clinical trials, it's effectiveness has been 'minimal'.
The proposed genetic test isn't just about identifying the risk of suicide whilst on antidepressants. Tolias told me, "Many other factors should always be considered – other illnesses, other medications, social stress, diet, nutrition and infectious diseases, to name only a few."
I asked Sundance if a test came back showing the patient had a high risk of suicide [when taking an SSRi] would it mean that they would be safe from harm if a doctor prescribed an alternative such as an antipsychotic?, they told me:
“No. Nothing in the medical world that we know of is showing any data that a drug in the antidepressant or antipsychotic class of drugs is completely safe."So high risk means only to use judgment, clinical information, family knowledge and support, and, taking all into account, to consider whether antidepressant drugs, of any kind, for that patient, may not be worth the risk.
"Depending on our research, the report to the doctor and patient will say that the patient has a genetic prediction of risk for treatment-emergent suicide and the risk is in the lower, medium or higher category (or some similar designation of degree of risk). We would explain completely the markers and the reason for the prediction of lower, medium or higher risk."We may say that the patient carries none of the markers that would predict risk, according to our study, but caution still needs to be taken for all of the possible conditions that could still lead to suicide risk."
There will be many who would suggest that Sundance are putting all their efforts into screening for a possible link when it's been shown that the efficacy of SSRi's has only been shown to be minimal. Surely, we need to target the pharmaceutical companies and key opinion leaders?
This has been done for years.
I've been criticising medicine regulators, pharmaceutical companies and key opinion leaders for the last seven years. There are many others that have gone before me, many more who continue to write about the dangers of these drugs. We all play a part but do pharmaceutical companies really care about people shouting from rooftops about the dangers of their wares?
We've all been witnesses to see how they have worked around the black box warnings [FDA] and recommendations [MHRA].
Point is, SSRis are still being prescribed and there is nothing in place that can tell a patient how dangerous it may be for him/her if they were to start taking them.
Pharmaceutical companies have known about the risk of suicide for poor and intermediate metabolizers for many years. What's a small percentage of suicide to them?
The pharmaceutical industry is a well oiled machine. They monitor websites, blogs, forums. They like to know what is being said about their products. They and I know that the general public will always lean toward the guy with the white coat and stethoscope so a couple of hundred people writing about the lack of efficacy and suicide links causes them a minor itch.
When faced with litigation the pharmaceutical industry will make huge settlements because they really don't want the truth exposed.
Lawyers for plaintiffs will discover evidence that is damning. They'll deposition pharmaceutical executives who will be told by their own personal attorneys to say nothing that implicates any individuals.
So, here we have Sundance Diagnostics. A company that don't tell us they are searching for a suicide link in antidepressants - they've already done their homework on that issue. They know there is a link. What, it appears, they are trying to achieve here is to put the antidepressant/suicide link in front of doctors and patients with science.
For years I have been frustrated by the lack of courage that regulators of these drugs have shown. SSRi's are dangerous, not only for children but for adults too. Children have been targeted by pharmaceutical companies because new brain disorders have miraculously appeared. They offer no science behind these disorders. I've yet to see an MRI scan image of a child with ADHD or anxiety disorder.
Sundance, if successful, will have the science to show the prescribing doctor and individuals. They have estimated that over half a million of these individuals per year are at significant risk of developing drug-induced suicidal thoughts.
Part of the Sundance press release today states the following:
"If successful, the new tests will be available for each patient before a drug is prescribed. The physician can then take action appropriate for the patient throughout the course of therapy.
"Family members, who before now may not have been advised of antidepressant medications’ side effects, can be informed of the patient’s specific risk and can actively participate in ensuring the safety of the patient during treatment, helping to determine the level of monitoring that is warranted and making decisions on complementary therapies and alternatives to medication."
Although Sundance will be centering their research on SSRi induced suicide they will, if successful, branch out to include those who may be susceptible to withdrawal reactions. SSRi medications are at the tip of a very big iceberg. Smoking cessation, statins, acne, anti-biotics, painkillers, hay fever medications, in fact any drug that may cause anxiety and, ultimately, lead to suicide, may well be on the Sundance radar soon.
Ask any of the following surviving family members if they would use a genetic test if their loved ones were still alive today.
Sundance Diagnostics, a Genetic Test Pre-Suicide [Leonie Fennell]
Genetic Testing for Suicide Risk [Maria Bradshaw]