CAN PILLS FOR DEPRESSION TURN YOU INTO A KILLER?
In a shocking interview, a man who calls himself a loving father tells how he killed his son during a psychotic episode caused, he says, by medication. As some experts warn his case is far from unique . . .
DAVID CARMICHAEL, 59, calmly and methodically describes the events leading up to the day he killed his 11-year-old son Ian.
He maintains his composure right up to the point when he describes his boy: ‘Oh man, he was the most loving child.’
His face clouds and he rocks with pain. ‘We spent so much time together and we got along great. He was a beautiful boy, a beautiful gift. I miss him so much.’
Ian had epilepsy and very mild dyslexia, but had no problems other than being a little behind with his reading. David was a nurturing and devoted dad, a sports coach from Toronto, Canada, who’d spent his entire professional life working with children.
But when David took Ian’s life during a psychotic episode, he was convinced that his wife Beth and daughter Gillian would thank him for getting rid of the ‘intolerable’ burden Ian had become.
David was tried for first-degree murder, but the judge ruled he was ‘not criminally responsible on account of a mental disorder’. Two forensic psychiatrists diagnosed him as being in a ‘major depression with psychotic episodes’ when he killed Ian.
David was sent to a psychiatric hospital where he spent four years. On December 4, 2009, he received an absolute discharge: a finding of guilt, but with no criminal record.
It is a truly shocking and bitterly tragic story, and one that will divide opinion. David has always believed that his psychosis was caused by a type of antidepressant known as a selective serotonin re-uptake inhibitor (SSRI). But it has not yet been proven that SSRIs were to blame.
David was taking paroxetine (sold as Paxil in the U.S. and called Seroxat in the UK). While the drugs appear to work for some people, SSRIs, like all medicines, can cause side- effects. Drowsiness, nausea, insomnia and loss of libido are some of the recognised ones. HOWEVER,
as Good Health has previously highlighted, there is growing concern about other SSRI side-effects such as anxiety, agitation, hallucinations and paranoid delusions, which, although more rare, can have a devastating impact.
In these pages filmmaker Katinka Blackford Newman, a previously super-fit mother of two, has described her terrifying experiences. Hours after taking her first SSRI dose she became psychotic.
‘I didn’t harm my kids, Lily, now 15, and Oscar, now 14, but it still terrifies me that I might have done,’ she says.
Katinka has since investigated other adverse reactions, meeting David Carmichael and others affected, ‘who made me realise it was pure luck I didn’t kill my children. I was determined to make this issue public, and so took my research to BBC Panorama.’
Tomorrow, Panorama takes up the story, asking: is it possible that a pill prescribed by your doctor can turn you into a killer?
More than 60 million prescriptions for antidepressants were written in the UK in 2015.
Clearly very few people on them become suicidal or homicidal, but according to David Healy, a professor of psychiatry at Bangor University and a leading critic of SSRIs, as many as one in 1,000 people taking the medication is severely affected.
‘There are probably up to an extra 2,500 suicides in europe triggered by an SSRI antidepressant,’ claims Professor Healy, who founded rxisk.org, a website that helps identify potential drug risks. Chillingly, he believes the figures are similar for episodes of violence, including mass killings.
In March 2012, 28 Belgian and Dutch schoolchildren and teachers were killed when the coach they were travelling in drove into the wall of a tunnel.
Investigators hired by the parents found that the driver was withdrawing from Seroxat. They believe he killed himself while suffering delirium caused by fluctuating levels of the drug.
In the same year, at the premiere of a Batman film in Aurora, Colorado, James Holmes, a 24-year- old PhD student with no record of violence, murdered 12 people and injured 70.
He is serving multiple life sentences in jail, but questions have been asked as to whether the SSRI he’d been prescribed played a part.
Andreas Lubitz, the German pilot who on March 24, 2015, deliberately crashed a Germanwings flight into the French Alps, killing all 150 people on board, was taking antidepressants, including the SSRI mirtazapine.
While no one knows for sure why SSRIs may adversely affect some people and not others, Professor Healy believes David Carmichael was ‘almost certainly’ in the grip of SSRI psychosis when he killed Ian.
At the time, David was running sports camps while his wife stayed at home to look after their children.
‘I wanted to be the best worker, the best provider, the best father, and I stressed myself out to provide for my family,’ he tells me.
‘I got into the shower one morning and I started to shake. Over the next few weeks, I was conscious that my heart was racing and I lost confidence in things I’d always been able to do.’
His doctor diagnosed depression and prescribed 40mg of Paxil. ‘Right from the outset, I experienced akathisia — a compulsion to be in constant motion.’
This is a recognised sideeffect of antidepressants and antipsychotics: statistics from clinical trials suggest that as many as one in 20 patients stops taking SSRI drugs because of agitation, with one in 100 experiencing hallucinations.
‘I felt like I was coming out of my skin,’ David says. ‘I was so agitated, I’d be pacing the floor in the middle of the night.’
But the agitation died down after ten days and David began to feel better within six weeks.
‘I started to feel great. I thought I was recovered.’
But there were side-effects David didn’t like: excessive sweating, weight gain and sexual dysfunction. ‘These got me down, so I began to wean myself off,’ he says.
He doesn’t know why he didn’t go back to the doctor. Nor does he know why he didn’t consult his doctor before taking them again a year later. ‘I felt the symptoms coming on again: I was anxious and I could feel my confidence drain away.
‘I had a full three-month prescription left over from the year before, so on July 8, 2004, I put myself back on 40mg a day.’ ALMOST
immediately, David began to feel agitated again. ‘I started to feel incredibly negative, and suicidal thoughts raced through my mind,’ he says.
Thinking his depression was getting worse, he increased the dose to 60mg.
‘I believed it would help me recover more quickly, like taking two aspirin instead of one for a headache,’ he says.
Over the next few days the akathisia subsided and, outwardly, David appeared to be functioning normally.
‘I’d get up, go to work. But inside, I was disintegrating. I became detached, unemotional and fixated on ending my life.’
David became convinced that he should end Ian’s life, too. ‘I felt strongly that it was my role as his dad to send him to a better place with me,’ he says.
David describes a chilling state of calm as he worked his plan through. He decided to take Ian to the family’s
weekend cottage where he would drown them both by going out in the family boat.
But when he found he’d forgotten to pack his own bathing shorts, he changed his mind.
‘I’ve never been spiritual, and I don’t go to church, but I began to think that it was a message from God that I was not supposed to die, just Ian.
‘It’s still hard for me to believe I could have been in that mindset. But I really thought I was doing everyone a favour . I thought they’d understand.
‘In my mind, Ian ’s mild epilepsy had become permanent brain damage; his challenges in school meant he had no future.’
David decided to kill Ian with medication he bought specifically for that purpose from a chemist. The day after buying it, he calmly researched how much time he’d spend in prison for murder , and what jail would be like.
David arranged to take Ian on a trip to an indoor BMX park he knew his son would love, followed by a night in their favourite hotel in London, Ontario.
Three days after buying the medication, David told Ian to kiss his mother goodbye and they headed off. ‘I wasn ’ t worried,’ David recalls. ‘I knew in my wildly distorted mind that killing Ian was the right thing to do.’
The pair checked into the hotel on Saturday , July 30, ordering room service of all Ian ’s favourite food and watching a superhero movie. All the while, David was fixated with the idea that he would sacrifice his freedom and go to prison for 25 years so Ian could go to a better place.
‘Nothing kicked in, no innate sense that I was doing the wrong thing,’ he says.
Just after 10pm, he poured the medica - tion into a glass of orange juice for Ian.
But, instead of becoming sleepy, his son became agitated and began to hallucinate. At 3am David ‘very calmly’ strangled him.
‘I’m a man with no history of violence, a loving father whose life up to that point had been spent working with children,’ he says. ‘To this day, I cannot imagine myself doing it.’
David falters and for the first time during the interview , he breaks down. ‘I remember every detail. It is as unbelievable to me as it is to you,’ he says, shaking his head. ‘But back then, I felt nothing other than a total conviction that everyone was going to thank me for what I’d done.’
When David was sure Ian was dead, he kissed him, told him he loved him and folded his hands over his chest. Then he watched TV ‘without any tears’ for six hours before calling emergency services.
For two weeks, David remained in a psychotic state, with no comprehension of what he had done. CCTV from the police station shows him calmly shaking the hand of the pathologist who had attended the scene, as if nothing untoward had happened.
‘ I didn ’ t feel anything,’ he says. ‘I thought that everyone would understand why I had to do what I’d done.’
When Beth was told that her son was dead and her husband was in custody, she collapsed, screaming.
‘A former boss came to see me and he said: “She will never forgive you.” I remember saying: “What? Of course she will! I did this for all of us,” ’ says David. Three days after this, reality finally filtered through. The pain was so excruciating David cried for ‘whole days. I’d shut my eyes, praying I’d die in my sleep.’
David’s daughter Gillian has never blamed him. He says her unconditional love and forgiveness gave him the motivation to carry on living. Alone in his cell he’d repeat the mantra: ‘I’m a good dad. I’m going to be a good dad again.’
David credits Gillian with saving his marriage ‘by loving us both’.
Did Gillian, then only 14, under - stand? ‘She understands that it wasn’t her dad who killed her brother,’ he says carefully . ‘She understands I was mentally ill.’
Gillian, now 27, explains: ‘ I knew him. I knew that something was terribly wrong and didn ’t make sense. My father would never harm another person, especially his own children.’
The question now, says David, is: ‘What caused my psychosis? That’s what we’re dealing with now.’
David believes akathisia is the key to recognising a potential risk. ‘Anyone who has been prescribed SSRIs who becomes agitated and restless should be monitored closely and, if necessary , taken off the drug,’ he says.
‘If doctors screened patients for akathisia, lives could potentially be saved.’ David, who now volunteers with families dealing with loss, says he feels ‘a duty to speak out about the dangers of prescription drugs’.
He has taken out a $20 million lawsuit against Glaxosmithkline, the maker of Seroxat, on the grounds of personal injury and product liability.
‘I believe there have been many , many deaths associated with Seroxat and I want to see the data on the table,’ says David. When
he was discharged from the psychiatric institution, the com - munity and some family shunned David.
‘People didn’t understand how anyone could take the life of a loved one, even when suffering from a mental illness. They still don’t.’ No one, he says, can punish him harder than he’s already punished himself.
David and Beth now live in a different part of Canada, with Ian’s treasured BMX bike sitting in the hall. ‘Gillian and I have talked about Ian a lot, but Beth and I have only started talking about him,’ he says. ‘Sometimes, we don’t even talk, we just hug.’
David says he has forgiven himself for Ian’s death. ‘I stopped beating myself up a long time ago. I recognise it was the drug and not me that killed my son.’
A spokesman for Glaxosmithkline said: ‘Mr Carmichael’s case is clearly a tragedy , but medicines like paroxetine are an important option for treating depression and have helped many people.
‘Patient safety is our priority and there is no scientific evidence that paroxetine causes homicidal, psychotic, or violent behaviour.
‘We continue to monitor paroxetine’s safety and make our research available. It is important that patients do not change how they take their medicine, or stop taking it altogether, without speaking to their doctor.’