“Elusive”

This was the ‘Keynote Lecture’ as given at the International Congress of the Royal College of Psychiatrists, Monday 20 June 2022:

[Please note: the above images come from #RCPSYCHIC22 as openly shared]

As a recently retired NHS psychiatrist, who was peacefully protesting outside this International Congress, I was not at this lecture. The following comments are based on the content of this slide [as shared on #RCPSYCHIC22]

As far as I can see, this summary slide, from the keynote lecture of the RCPsych International Congress 2022, fails to mention AKATHISIA: a widely recognised potential consequence of all psychiatric drugs [particularly when starting , reducing, or changing dose].

Yet another opportunity to “improve safety” seems to have passed by.

World-wide, few have more expertise on the study of suicide than Professor Louis Appleby. He leads the National Suicide Prevention Strategy for England and runs the Centre for Mental Health and Safety at the University of Manchester.

In the latter years of my career as an NHS Psychiatrist I tried to communicate with Professor Appleby in relation to prescribed-drug-induced akathisia. I was never successful in my attempts.

The Wikipedia page for Professor Louis Appleby includes this insight:

Activist Pete Shaughnessy and others in the mental health user/survivor movement reportedly found Appleby, in his role as mental health tsar, "elusive".

As I was standing outside the International Congress I spotted Professor Louis Appleby walking up towards the Conference Centre door. As he got to the entrance, I said “hello” and pointing to my placard asked “do you support Cumberlege?” He looked at me quizzically, and responded with physical gestures that I did not understand. So I asked him again.  He replied “and who are you?” I replied “I am Dr Peter Gordon”. A few seconds later, but it seemed like longer, he said “Oh, gosh! You’re the one that writes”. His tone of voice was dismissive. As he went through the revolving door, I could see that he was throwing his arms up into the air, as if in despair.


This post is for Charlie, Antony, and Ed.


This film presents missed opportunities, in particular the potential role of prescribed medications as risk factors for suicide . The film presents a timeline from 2002 to 2019 in relation to England’s National Suicide Prevention Strategy.

A Timeline of Missed Opportunities:

Since making this film, and it is now several years old, the National Suicide Prevention Strategy has offered no response.

Music credits: [all made free to share under common license by Dexter Britain]
(1) ‘Perfect I am Not’
(2) ‘From Truth’
(3) ‘Chasing Time’

Film credits:
(1) ‘A message from Professor Louis Appleby’ for Zero Suicide Alliance (April 2017)
(2) ‘Remember Amy’ a Presentation by Beverley Thorpe for (AD4E) A disorder for everyone (July 2019)

Thanks to Millie Kieve for kindly agreeing to let me use the recording of her January 2004 phone call to Manchester Coroners Office.

Thanks to Marion Brown and Beverley Thorpe for their help with this film

All correspondence/comments on this film can be read here. These communications would seem to confirm that opportunities to reduce suicide continue to be missed.

This film is for all those affected by suicide.

A definition of Akathisia: “presents people with a tortuous fight to stay alive. It is so uncomfortable, distressing & under-recognised by the medical profession that people often turn to ‘suicide as their only option. They literally think they are losing their minds.”

AKATHISIA:

Are you or someone you know suddenly unable to stop moving or agitated?

If so, and you recently started, stopped or changed the dosage of a medication, you may be suffering from akathisia. This disorder is also characterized by inner restlessness, anxiety, agitation, impulsivity, aggressiveness, insomnia, irritability, and hostility. Akathisia can lead to violence/suicide.

Akathisiais a disorder, induced as a side effect of medications (including SSRIs and antipsychotics), which can cause a person to experience such intense inner restlessness that the sufferer is driven to violence and/or suicide. It has been said, ‘Death can be a welcome result.’ For reasons related to the strong political and lobbying power of pharmaceutical companies, akathisia is rarely explained as a possible side effect of medications, and medical professionals and the general public know very little of the existence of this disorder.” (MISSD)


House of Commons, Suicide Prevention Report, 2016-2017

Anti DepAware archive

Mille and the Tsar, AntiDepAware, 9 Nov 2019

A Word to the Coroner, AntiDepAware, November 15 2019

Problematic Advice From Suicide Prevention Experts, Ethical Human Psychology and Psychiatry, Volume 20, Number 2, 2018. By Heidi Hjelmeland, Katrina Jaworski, Birthe L. Knizek, and Ian Marsh

Centre for Suicide Prevention, Manchester

Working with the government, by Professor Louis Appleby, British Journal of Psychiatry, Volume 193, Issue 3September 2008 , p. 191

RSM Health Matters, Podcast, Episode 1: Antidepressants, Antibiotics and The Gender Pay Gap, April 2018, Professor Sir Simon Wessely and Professor Clare Gerada

Do Antidepressants Save Lives? A Comment On The 2016 Interim Report On Suicide Prevention By The House Of Commons Health Select Committee, by Professor Carmine Pariante, Huffpost, 6 Feb 2017

‘Mental health drug epidemic for children in Scotland’, Herald, by Helen McArdle, 27 October 2019

Suicide risk and the SSRIs, by Wessely S, Kerwin R, JAMA. 2004 Jul 21;292(3):379-81.
[Note: Professor Sir Simon Wessely has made available his extensive publications, though unfortunately he has not included this publication]

Treatment Emergent Violence To Self And Others; A Literature Review of Neuropsychiatric Adverse Reactions For Antidepressant And Neuroleptic Psychiatric Drugs And General Medications. By Clarke C, Evans J, Brogan K. Adv Mind Body Med. 2019 Winter;33(1):4-21.

Letter to the Editor: Newer-Generation Antidepressants and Suicide Risk in Randomized Controlled Trials: A Re-Analysis of the FDA Database. Hengartner M.P., Plöderl M. Psychother Psychosom 2019;88:247–248

Research News: SSRIs double the risk of suicide and violence in healthy adults. BMJ 2016; Ingrid Torjesen, BMJ 2016;355:i5504

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