It's not often one comes across a coroner who goes against the grain.
It's not often coroners come up against surviving family members armed with knowledge about drugs used to treat apparent mental illnesses.
Yesterday, at Dublin Coroner’s Court, Coroner Dr Brian Farrell ruled against suicide as being the cause of Jake McGill Lynch's death on 20 March, 2013.
Jake was just 14 years-old when he took a .22 rifle and placed it in his mouth and pulled the trigger. One year previously he had been diagnosed with Aspergers and, after a 15 minute consultation with psychiatrist,Dr Maria Migone, he was prescribed Prozac (fluoxetine) and was told that it would help him get through his exams at school - something that Jake had been worrying over.
Six days after starting his medication, Jake walked out of his first exam halfway through - later that night he cried for three hours. A day later his Prozac dose was doubled,
On day 46, Jake killed himself.
During the 18 month long inquest evidence showed that there were links to Prozac and suicide related deaths, in particular the black box warning on Prozac in the US. No such black box warning exists in either the UK or Ireland (Jake's place of birth)
In fact some years ago after meeting with the Irish Medicines Board (the equivalent of the FDA and MHRA) Jake's parents were told that, "nobody would take Prozac if such a black box warning was put into place."
Some informed consent that is, huh?
So, what is an open verdict?
In a nutshell it means that there is insufficient evidence that somebody had intended to kill themselves. In other words, Jake may not have intended to kill himself were it not for a third party, that party being Prozac.
The coroner's verdict is kinda vague in as much that he cannot say for certain why Jake did what he did but with Prozac on the table one only has to read between the lines. It leaves open the question as to whether or not Prozac induced Jake's death.
One fifth of adolescents experience suicidal thoughts, according to Dr Houlihan, a consultant Paediatric Psychiatrist at Temple Street Children’s Hospital.
Yesterday's open verdict was welcomed by Jake's parents, Steffini McGill Lynch and John Lynch from Clondalkin.
“It’s a huge relief. It allows us to grieve now. You can’t let go of that night but this allows another chapter to close. This is the verdict he deserved because in our eyes it was drug induced,” Steffini said after the inquest concluded.
One thing is certain. Jake should never have been prescribed Prozac for 'exam jitters'. He was a normal child made to feel abnormal the minute he walked into his psychiatrist's office. He was a child, who through no fault of his own, that had to deal with two things.
1. The worry of pending exams.
2. The chemical imbalance caused by the Prozac he was prescribed.
Earlier this year "Jake's Amendment" was tabled in the Dail of the Coroner's Amendment Bill 2015, a bill that calls for coroners to widen the scope so they are able to deliver a finding of Iatrogenic Suicide. Iatrogenic Suicide is the ending of one's own life where the effect of medical treatment undertaken by the deceased, including any prescribed medication.
Although no such verdict was delivered yesterday, the open verdict certainly points to the fact that Jake did not intend to kill himself - something pushed him. You'd have to be from the plant Zog to rule out Prozac.
Eli Lilly, who market and manufacture Prozac, have placed the following warning on the package insert for Prozac in the United States.
"Suicidal Thoughts and Behaviors in Children, Adolescents, and Young Adults: Monitor for clinical worsening and suicidal thinking and behavior."
The Irish Medicines Board should follow suit. I doubt if they will. The whole medicine regulatory system is run by limp-wristed buffoons who, it appears, merely shrug their shoulders when people die as a result of medications they have granted licence to.
Jake's voice has been heard. Hopefully the pro-antidepressant brigade in Ireland will cease writing column inches in the Irish media bigging up the use of these types of medications in children and young adults - I doubt that will happen too. Psychiatrists who write for the national press are, in my opinion, egotistical and bear all the hallmarks of narcissism.
Godspeed little man.
Bob Fiddaman.
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