A post appeared on the WZZM 13 website a few days ago that caught my attention and caused yet another deep sigh.
78 year-old Bob Farthing [Pictured] was found dead in the back of his car on Friday 17th January. Farthing was reported missing by his family on Wednesday, Jan. 15.
Details are emerging that show Farthing was having difficulty withdrawing from the antidepressant Seroxat, better known in the US by the brand name Paxil.
Farthing's daughter, Denise Shaheen, said there is only one explanation for the disappearance. "He is struggling with the withdrawal from the drug Paxil."
After using the antidepressant for 15 years, his family says doctors were weaning Farthing off of the powerful drug and putting him on other medicine. But it was a difficult process.
"He would have a couple good days, he would have a couple bad days. His bad days were very bad days," said Shaheen. "He became very depressed, very confused."
A video report of Farthing's disappearence and death is below.
Having experienced severe Seroxat withdrawal myself I really feel for this guy.
Of course, those who defend Seroxat, namely GSK and their attorneys, will argue that Farthing had been taking Seroxat for 15 years and the withdrawal he was going through was possibly his original depression returning.
Another article from M Live reports...
Witnesses told police Farthing appeared confused when he was spotted later Wednesday afternoon at Blodgett Hospital. He had asked for help with directions.
Farthing was also reportedly seen Thursday in East Grand Rapids' Gaslight Village, where he stopped in Edward Jones to ask for directions to Blodgett Hospital.
His daughter, Denise Shaheen, earlier said Farthing was recently taken off a medication and may have been confused or suffering from medical problems. He reported not feeling well on Wednesday, she said.
Cause of death is unknown and is currently under investigation.
The withdrawal issue surrounding Seroxat has been debated many times. There are a number of people who suffer mild or no withdrawal problems at all.
So, what is being done to help those at the other end of the scale, those who suffer severe Seroxat withdrawal?
In a word, nothing!
The British drug regulator, the MHRA, have played down the issue of withdrawal time and time again, not only with Seroxat but with other SSRis too.
In fact, I personally met with the Chief Executive of the MHRA, Kent Woods, back in 2008, some 6 years ago, to discuss the withdrawal issue regarding Seroxat and other SSRi's.
Here's a summary of the minutes from that meeting.
Robert (Bob) Fiddaman (RF), Campaigner, Author of Seroxat Sufferers Blog
Prof. Kent Woods (KW), Chief Executive, MHRA
Sarah Morgan (SM), Head of Pharmacovigilance Risk Management, MHRA
John Watkins (JW), Communication Manager, MHRA, acting as secretary
1. RF said he would like to discuss problems of withdrawing from Seroxat. He said that though his concerns centred around Seroxat, he recognised that other SSRIs posed similar problems which ought also to be addressed.
2. He produced copies of the Patient Information Leaflet (PIL) for Seroxat in which he had highlighted the 32 places where patients were told to talk with their doctor about various issues. He felt that too much of an onus was put on doctors, many of whom did not know enough about withdrawal problems and their management.
3. In answer to a question from KW, RF agreed that the focus of the meeting should be on the information going to doctors and perhaps also on their training.
4. KW noted that doctors do not generally refer to the PILs, nor indeed to the similar but more technical Summaries of Product Characteristics (SPCs). Instead, they use the British National Formulary (BNF), revised twice each year, and guidance produced by NICE. The NICE guidance on the management of depression was currently being revised; a draft is due to go out for public consultation in December 2008 with a view to publication in June 2009.
5. He emphasised that MHRA controls neither the BNF nor NICE in any of the matters they cover, but the Agency can and does make suggestions to both organisations about the information they provide.
9. KW said he was aware that RF had had some very good support from his doctor and wondered how widespread such support would be. RF believed that many doctors would not be able to provide that level of help, due to not knowing how to manage withdrawal. RF had sent the Agency a very large number of personal testimonies about difficulties that others had experienced during withdrawal.
10. RF pointed to guidance on withdrawal produced by Dr David Healy; KW said he had seen it but his concern about any guidance would be whether “one size fits all”, given the range and diversity of withdrawal experiences. That should not however prevent the development of authoritative guidance.
11. RF asked what authority MHRA had to issue warnings. Could it for example require warnings to be put on packaging like those on packets of cigarettes?
12. KW replied that the place for warnings to patients is within the PIL. If they were very prominent on the packaging then that might well deter patients who really needed the medicine from taking it. The Agency has control over PILs. KW outlined the improvements to PILs in recent years, largely due to testing them with users; a programme which will end very soon has been reviewing and revising the PILs for all medicines. RF acknowledged that there had been significant recent improvements in the Seroxat PIL. KW noted that there is still room for improvement in PILs but the Agency is now starting to explore other initiatives relating to PILs. It might for example become feasible to ensure that PILs are available to patients beforehand rather than at the time they start to take their medicines.
13. RF wondered whether MHRA had thought of including Yellow Cards with or in the PILs. SM replied that we had considered asking pharmacists to include them in the bag holding the package. KW noted that every edition of the BNF had a Yellow Card at the back but there was no obvious place for making it available to patients other than placing them in pharmacies and GP surgeries. Reports from patients were still relatively new. So far only about 10% of all reports come from them, but the quality of the information they contain is every bit as good as that from healthcare professionals.
14. KW asked RF what he thought of the Seroxat PIL’s Section 5, “Stopping Seroxat”. Early in the section it says “When stopping Seroxat your doctor will help you to reduce the does slowly …”. RF felt that this was over-optimistic. He also felt that the advice about dosage reductions of 10mg a week (which SM noted was based on clinical trials) was too large an increment in view of his own experience – he needed to reduce by 1mg a week, only practicable with the liquid – and the experiences of others. And he felt that the signposting to the liquid form, “It may be easier for you to take Seroxat liquid during the time that you are coming off the medicine” was inadequate. SM agreed that steering patients towards the liquid could be made more obvious; and it could be helpful if such a steer was also given to doctors, in some document such as the NICE guidance.
15. Referring again to the management of withdrawal in relation to benzodiazepines, KW read out the advice on management of withdrawal for that class of drugs that is in the current edition of the BNF. RF said he would have found it very helpful if that kind of advice, but about Seroxat / SSRIs had been available to him at the time he started to withdraw. He wondered how many doctors used the BNF. KW reckoned that almost every doctor will use it, with many of them referring to it frequently. When he was a clinician, he always carried around a copy of the BNF in his coat pocket.
16. KW thought that the inclusion of similar advice in relation to SSRIs could be suggested to the BNF. It might also be suggested to NICE for their guidance. And a potentially useful way of drawing prescribers attention to any new advice that emerged would be MHRA’s monthly Drug Safety Update. KW again stressed that though we might make suggestions about this to the BNF and to NICE, it would be for them to decide. While MHRA’s primary role is to regulate industry – with no jurisdiction over doctors, it is within the remit of both the BNF and NICE to inform and indeed to influence doctors.
17. RF asked whether MHRA would talk with David Healy. KW said he would be happy to have that happen. But it would be useful if others with experience of managing withdrawal were also consulted. Those present at the meeting could not immediately identify anybody else in the UK but MHRA would try to do that, perhaps with the help of one of its Board members.
18. RF asked whether the management of withdrawal could be covered in the training of doctors. KW explained the difficulty any organisation would have in influencing medical schools when each school determines its own curriculum.
19. RF enquired how the Agency kept up to date on research and indeed legal issues surrounding Seroxat. Had the Agency for example been aware of the “Glenmullen report” before he drew attention to it at a time when the Agency was still investigating GSK? KW could not recall at exactly what stage he personally became aware of the document but assured RF that the Agency kept track of developments generally, not just in the context of a particular investigation. SM described how her group undertake a weekly review of the literature in respect of all drugs, covering all the major journals. And pharmacovigilance also takes account of clinical trials and trends in Yellow Card reports.
20. The meeting concluded by recognising that though the focus had been on Seroxat, there were other SSRIs that posed similar problems, and that changes in prescribing practices, such as a reduction in prescriptions for Seroxat in recent years and increases for other drugs, for example Venflaxine, mean that some of the issues deserve to be dealt with in terms of the class of drugs rather than in relation to individual members of that class.
To my knowledge the MHRA have not kept in contact with David Healy.
I severed ties with my communications with them in 2009. I had brought the Lyam Kilker trial to their attention. Lyam was born with heart defects. His mother had taken Seroxat during her pregnancy. A jury found Seroxat to be the cause of his heart defects.
After many emails back and forth to the MHRA I decided that I was flogging a dead horse. The MHRA were just never going to acknowledge that Seroxat was a teratogen.
On May 6, 2007, Neil Carlin found his 18-year-old daughter, Sara, hanging from an electrical cord in the basement of the family’s Oakville, Ontario. A bottle of Seroxat, which her family doctor had prescribed to her 14 months earlier, was found at the scene.
The inquest into Sara's death was high profile and was covered extensively by the Canadian media. I covered the inquest myself, reporting what the media failed to report through fear of lawsuits from GlaxoSmithKline.
After a gruelling 10 day inquest a jury issued 16 recommendations on June 28, 2010.
To date not one of the 16 recommendations have been implemented.
“We realized it’s a bullsh–t process,” Neil Carlin said. “They go through the motions to give the public a sense of confidence they’re on top of it. Nobody really cares or follows up.”
Hey, what's a few deaths here and there.
I'll leave you with an email I sent to Hudson on Nov 8 2013. He never replied.
Dear Mr Hudson,
As I understand you are now Chief Executive of the MHRA. I'd congratulate you but we both know that I'd be lying with those congratulations given your past links to GlaxoSmithKline and Seroxat.
That aside, I have to remain professional.
My question to you is one of great concern and one that I shall be making public on my blog http://fiddaman.blogspot.com
Are you, or do the MHRA plan to reevaluate the current recommendations that pediatrics should not be prescribed SSRi's?
I ask as it has come to light that MHRA consultant, Stephen J W Evans, has recently co-authored a study where he and the other authors call for a re-evaluation of the current prescription of SSRIs in young people - Back story here.
This email, along with your answer, if you are brave enough to answer that is, will be published on my blog.