Letter to the BBC (Panorama TV Show)

Prescription for murder (BBC Panorama) aired last week.

Let’s pretend there’s a medication taken by millions of us daily that turns some of us into murderers. This was the theme of the recent Panorama episode on antidepressant medication ever so kindly called “Prescription for murder”

That’s a very powerful and frightening message, especially when you’re talking about a class of drugs that saves tens of thousands of lives each and every year.

BBC. Let me be frank – your recent crass television show “Prescription for Murder” is going to put people off antidepressants and subsequently cost lives.

Antidepressants aren’t perfect, they have side-effects when you initially take them, it can take a long time for some people to find the one that works best for them and they don’t solve your problems that slid you into a Depression in the first instance. It’s important to be open and honest and say the above regarding initial mild side effects and having to try a second or third anti depressant. I don’t call them magic pills. I’m a fan of anti depressants and I am also a fan of investigative journalism like BBC Panorama because it can be a force for change when needed and I’d love to see more of it, but with any topic it needs to be done well, and when there’s a risk of people stopping a life-saving medication that’s especially true!

Hence I was concerned by the programme! What irked me? I fully believe that antidepressants can change behaviour, and we should be asking whether the side-effects are outweighed by the benefits. To do that, we need to see thorough examination and evidence, not simply be given a case study. The programme focused almost entirely on the case of Mr. James Holmes, known as the “Batman Killer” after opening fire in a cinema showing a film the “Dark Knight Rises”. A study of James Holmes is not a review on the safety of anti depressants!

We need expertise in this field. Professor Seena Fazel is known across the world for knowledge and insight. He has investigated whether antidepressants lead to an increase in violence. I have studied his work previously. Let me be immediately clear:The research doesn’t show any evidence for an increase in people over 25. In younger people, there is evidence of a slight increase but it can’t be confirmed if this is due to antidepressants. (It’s complex with youngsters as young people are often taking considerably more alcohol and also -recreational drugs) Seena’s work is clear : there isn’t a correlation between Anti depressants and violence. Even if there was a correlation and antidepressants caused people to be more violent, that a huge step away from turning someone into a murderer.

It’s not just Seena who doesn’t see the evidence for saying antidepressants turn people into murderers. My study finds the vast majority of researchers with the same opinion : there is no evidence to suggest that antidepressants turn people into murderers. Yet in the show we were presented with one psychiatrist who said he thought the drugs weren’t to blame, one who thought they definitely were and one who thought we should be looking into it. It seemed as though the field is split evenly on this – this isn’t representative of the views of the mainstream science:

The main evidence the programme seemed to be running with was the result of a Freedom of Information request to the Medicines and Healthcare Regulatory Authority. The MHRA is responsible for aspects of healthcare including a “Yellow Card system” that records all the bad side-effects linked to any drugs.
The Panorama team informed us that their investigation had unearthed 28 cases linking antidepressants to murder and 32 to murderous thoughts. I was alarmed until I thought how many instances there are of anti depressant prescription and use in the UK.
The show did point out that these were just reports, not conclusions that the drugs had caused a murder. However what they failed to mention was that these reports to the MHRA can be made by anyone. There’s an equivalent of sorts in Ireland. The reality is – You or I could go on their website right now and make a report, it’s my belief that some reports are vexatious, a report certainly doesn’t necessarily mean it was a medical professional who submitted it or that the report was supported by any evidence whatsoever . Maybe each of these reports was made by a healthcare professional and was supported by good evidence, but Panorama didn’t show it to us.

The programme reminded viewers not to stop taking medication without speaking to a medical professional first, but it also kept repeating time after time that these drugs might be turning people into murderers. Stats!: Over 60 million prescriptions for antidepressants were made in the U.K in 2015 alone, probably more than 500 million during the last three decades. Back to the 60 “Yellow Card reports” and let’s assume (rather morbidly) all 60 were without doubt an instance of a drug turning someone into a murderer that would be around 1 per 800,000 prescriptions, running with best prescription figures available.  If you are taking anti depressants, please do not stop without medical advice. Abrupt cessation can lead to your symptoms returning or some unpleasant effects (Anti depressants should be tapered down)

What I’ll say finally is I do have concerns about anti depressants, the concerns are about under-prescribing and how really useful drugs are still being ignored. I am also interested from a psychology view whether we could learn a lot about how much such drugs do to change people’s personalities, whether using them stops us from investing in psychological therapies. We need a debate though, not a biased show.

Your anti depressant doesn’t make you a murderer..