The failure to learn

Yola Lucire

There is an answer to fraud: You fight it with science. We have the science. Pharmacogentics.

As you saw, Generation RX contained first hand accounts, ignored by authorities and psychiatrists, that some people became confused, hallucinated, homicidal and suicidal on antidepressants. And that school massacres are mostly caused by prescription drugs:

These effects were well known 50 years ago. My 1960 undergraduate psychiatry textbook, Mayer-Gross, Slater and Roth, reported them. The US Food and Drug Administration, the FDA, now cites that old text. You saw cases where attention was drawn to it. Underpinning those dramatic ones are people who have become chronically neurotoxic 'organic borderlines' suicidal and using mental health care to no avail.

Drug companies denied these effects until forced, by litigation, to issue warnings. But they have not done so in Australia, where fines for fraudulent promotion are tens of thousand of dollars, not billions as in USA, for their contumelious disregard for human life and well-being that can be remedied. A generation of Australian psychiatrists seems unaware of these problems and it is hard to attract attention to them.

These toxic behaviours reflect a toxic brain state called akathisia, which is what this film was about. Neuroleptic toxicity, like brain fevers, makes some people like that obsessed with death and dying, with killing selves or others. They tell me: I have changed. I am not myself. I can't sit still. I can't sleep. I'm seeing things. I want to hang myself, drive into a tree. I'm aggressive, thinking of killing people. I feel like Martin Bryant.

The New York Times proclaims that "Psychiatry is in Denial". The Wall Street Journal writes about "Akathisiagate". The FDA issues suicide warnings for many drugs. The Australian regulator, the Therapeutic Goods Administration, does nothing. It conducts secret inquiries and does nothing.

Prozac arrived in 1990, followed by nine new serotonin drugs. Costs and demand for mental health services doubled in the next decade and continue to increase by 4 per cent or more annually since. In USA, 400 persons a day join the ranks. These statistics suggest that two out of three service consumers in NSW may have medication-induced symptoms that are not being addressed in their treatment. Adverse drug reactions are in the big four killers and cost generators, with strokes, heart attacks and cancer. Near deaths fill emergency rooms.

The solution to this problem lies in understanding pharmacogenetics. Personalised medicine in Australia is found in policy documents, pharmacies and laboratories. Its practice lags ten years behind textbooks. The basics can be taught in a day. Genes determine if you can take medicine safely. All medicines are gene dependent, not only psychiatric ones. The standard dose does not fit all.

Medicine will change in the twenty-first century. Pharmacogentics will change medicine as Galileo changed astronomy. And medicine like no other discipline resists change. Institutions based on practices resist change. Postgraduate eduction is funded by Big PHARMA, which promotes its own financial interests. Science based public education has to be resourced as a matter of policy. It should start with the important doctors who sit on the Medical Board of NSW because they are charged with protecting the public.

I have now done gene tests on over 100 persons just like those in the film. I thank Healthscope Molecular and Diversity Health Institute at Westmead who have provided tests for my research. The test is done by cheek swab. It costs $200. Overall, 91 of 100 lacked some metabolizing genes. They were Poor Metabolizers of various kinds who could not process antidepressants. Each drug's Product Information warns about Poor Metabolizers. Hardly anyone reads it. Only nine persons (not the majority as expected) had normal genes. They were on huge doses. Eight research subjects had killed loved ones soon after starting antidepressants prescribed for stressful life events. Each lacked several genes. When they stopped taking prescribed drugs, they returned to normal.

My research subjects are the human face of mental health statistics, of financial demands that services make on government, the community and the taxpayer. My research subjects suffered terribly, generated social and dollar costs, hundreds of inpatients, hundreds of admissions, ambulance services, police time, scores of years of jail time, lost relationships with premature death from suicide and homicide. All because of medication induced states, which are reversible. Involuntary intoxications, non-insane automatism or somnambulism based behaviours, They stayed that way until the culprit drug was stopped. Then they got better.

If you cannot metabolise a drug you are effectively overdosed. Toxic states are clinically different from schizophrenia, bipolar and borderline disorder but a generation of doctors seems unable to make this distinction.

I ask our legislators: Is our Trade Practices law sufficiently robust to redress the socialised costs of this public health problem? While profits remain in private hands? Or will Australia be left to face a toxic legacy like asbestos? As we meet in this House, the challenge to parliamentarians and the people is to insist that, as a matter of basic human rights; drug companies and their compradors provide balanced, accessible and accurate information about risks and benefits of prescription drugs.

We should demand clear warnings of catastrophic side effects, about the possibility of personality change, delirium, dementia, homicide and suicide. The relative risk of suicide on these drugs compared to placebo was 2-12. That's right, in some trials as you heard in the film; suicide risk was multiplied by 12. Small wonder that psychiatry has become a public health problem as those incorrectly diagnosed are without possibility of recovery, for those whose genes have got them into these hideous predicaments and where they are unrecognised.

It is a basic human right to be able to give informed consent to what a doctor wants to do to you. That right cannot exist if information is not available I will leave you with a quotation from Sir Liam Donaldson, the Chief Medical Officer of the United Kingdom, and now head of Patient Safety at the World Health Organisation. He says: "To err is human, to cover up is unforgivable, to fail to learn is inexcusable".

Dr Yola Lucire is a forensic psychiatrist, medical anthropologist, and a leading proponent of personalised medicine, of genetic testing, to ensure that drugs do no harm. She has made some 500 reports to the Adverse Drug Reactions Advisory Committee providing detailed medication information about adverse effects of antidepressants. These are the notes for her comments in the panel discussion following Generation RX, a film on the pharmaceutical industry & health care screened as part of the Evatt Foundation's Big Pictures program at NSW Parlimant House on 24 November 2009.

Suggested citation
Lucire, Yola, 'The failure to learn', Evatt Journal, Vol. 9, No. 5, December 2009.<>