Patricia Casey is an Irish psychiatrist who also writes opinion pieces for the Irish media. She, it would appear, is adamant that antidepressants do not induce suicide and, judging by her latest opinion, "Mind and meaning: Antidepressants work," it seems that she feels that the black box warnings on antidepressants have no place, at least I think that's what she is trying to say?
Her opinion piece, published in the Irish Independent (Tuesday 2 June 2015) is a mish-mash of references from various studies where she tries to make her opinion valid - when in actual fact, in my opinion, it makes her look rather silly and, dare I say it, desperate.
I'm unsure of Casey's agenda here? Is she concerned that people with suicidal tendencies aren't taking antidepressants or is she concerned that the black box warning is scaring people from taking antidepressants?
The Irish Independent, it would seem, are not allowing any opposing comments to Casey's viewpoint. One has to ask why?
So, if an opinion piece, written by a psychiatrist, is unbalanced and comments are vetted then, I guess, the only way to respond is via personal blogs. However, one has to tread carefully when writing, nae opposing the views of Casey.
Back in 2011, Irish blogger, Leonie Fennell, received a letter from Casey's solicitors for comments she had made regarding Patricia Casey's ties to pharmaceutical company, Lundbeck. Casey had previously attended the inquest of Fennell's son, Shane, and had publicly made comments about certain aspects of it. Shane killed himself and another young man whilst under the influence of citalopram, a drug marketed and manufactured by Lundbeck.
Fennell posted the letter from Brophy Solicitors on her blog here.
That was four years ago and, it seems, that Casey is still speaking out regarding antidepressant use and suicide, although she has differing opinions than many of the patient advocates who have experienced the negative side of antidepressants.
Her latest opinion piece starts with...
"I have written on many occasions about the over use of medication in psychiatry, particularly for those with "depression". This stems from the fact that "depression" is such a broad church. It is an emotional state that occurs in everybody - the word is used interchangeably with "sadness". It is a symptom that features in many psychiatric illnesses and it is an illness. The fairly crude description of the illness in modern textbooks lacks the nuance to distinguish this from normal sadness in many cases. Yet, every doctor knows that when antidepressants are correctly used in depressive illness, their impact is remarkable and I make no apology for prescribing them in these circumstances."
It, to me at least, is quite confusing. I cannot fathom if Casey believes that sadness is an illness? She also claims that, "...every doctor knows that when antidepressants are correctly used in depressive illness, their impact is remarkable..." - That's quite a statement to make. I mean, has she spoken with "every doctor" or does she just mean that every doctor she has spoken to? Maybe she should speak to the patients who have had negative side effects when prescribed these medications, after all, it's really the patients who are best positioned to offer feedback and not the doctor's (at least the ones she's spoken with)
To back up her beliefs, her latest opinion piece, quotes a study from fellow psychiatrist, Robert Gibbons. It's a study that has, over the years, been quoted time and time again by healthcare professionals who believe in the efficacy of antidepressant use. It's also a study that has been carefully scrutinized and been shown to be deeply flawed. It's a published paper that has "simple mathematical errors", writes retired psychiatrist, Micky Nardo (Source)
Nardo even had his response submitted for publication in the Archives of General Psychiatry, where he wrote...
"This meta-analysis has been widely publicized as disproving both the FDA “black box” warning about potential suicidality and the questionable efficacy of antidepressants in children with MDD. And yet it is marred by inappropriate data selection kept in the shadows, an opaque methodology, obvious arithmetic errors, and an outcome that was greater than the sum of the parts. This is a flawed study, hardly supporting any broad conclusions about the safety or efficacy of antidepressants in youth." (Source)
So, in Casey and Nardo we have differing opinions. Why is it that Casey can't see what Nardo can? Maybe Casey cannot grasp mathematics or maybe she hasn't bothered to look at the discrepancies? These really are questions that need asking and also need answering, be it by Casey herself or by the Irish Independent who publish her opinions.
I don't know why Casey is, in my opinion, so headstrong when it comes to her belief that antidepressants are safe, effective and reduce suicide. I don't know why she is still debating this issue when medicine regulators around the world issued warnings to pharmaceutical companies to update the wording on antidepressants regarding their propensity to induce suicide.
If Casey believes she is right then there really is nothing we, as patients who have suffered at the hands of these drugs, can do. Yes, we can offer our own opinion, yes, we can show Casey that the studies she references are flawed but, at the end of the day, we will always have differing views.
My only problem with Casey's views is that they are published to a wide audience who see her as an expert in the field of mental health and antidepressant use. These same people don't get to see or hear the other side of the debate and the Irish Independent really should investigate any studies that Casey quotes in her one-sided opinion pieces.
So, that's my opinion piece written.
Bob Fiddaman.
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