This paper, worked over on April 26, 2010, was nonofficially
distributed as a contribution to the conference "Coping
with stress and depression related problems in Europe,"
organized by the World Health Organization, the European
Commission and the Federal Ministry of Social Affairs, Public
Health and the Environment (Belgium) in Brussels, October
Published in: Journal
of Critical Psychology, Counselling and Psychotherapy (U.K.),
Vol. 2 (2002), No. 1, pp. 54-58. Deutsche
Übersetzung / Traduzione
Continued version from May 7, 2010: Resisting
Psychiatric Assault: A European initiative to introduce
a suicide register
Treatment-induced Suicide: Suicidality as a Potential
Effect of Psychiatric Drugs
Translation by Pia Kempker
"From this, the selection through suicide
lies in the direction of the strengthening of the population's
and its cheerful temper."
(Lenz , 1923, p. 23)
Depression can have many causes: psychosocial and political conditions,
neurological diseases, metabolic disorders, aging, toxic substances
and drugs. Physicians generally focus on organic or supposed organic
depressions, for which they prescribe psychiatric drugs and electroshocks.
It is hard for them to accept that many psychiatric drugs can
cause or increase depression and suicidality. But in the medical
and pharmacological specialist literature there are many reports
about the depressive effects of psychiatric drugs. In particular
neuroleptics, so-called antipsychotic drugs like haloperidol (one
brand name for which is Haldol; for other trade names click
here) and clozapine (one brand name for which is Leponex;
for other trade names click
here) often initiate depression and suicide. A suicide-register
with special consideration of associated psychiatric drugs, electroshocks,
restraint, and other forms of psychiatric compulsion could be
effective as a form of prevention and lower the occurrence of
depression and suicides.
Drug-associated depression and suicidality
Discussing studies on suicides in patients with the diagnosis
"schizophrenia" and comparing suicide rates in different
time periods, David Healy from the North Wales Department of Psychological
Medicine in Bangor and colleagues plead for an explanation of
the "excess of suicides among patients receiving treatment"
(Healy, et al., 2006, p. 227). If psychiatrists choose
to give the diagnosis "schizophrenia" or similar ones
like "psychoses", their standard treatment is the administration
of neuroleptics. At people with the diagnosis "schizophrenia"
suicidality is found about 50 times more frequent than in the
average society (Müller, 1989).
Neuroleptics have a blockading effect primarily against the transmitter
dopamine resulting in Parkinson's disease. This is a complex of
symptoms, characterized by walking with a stoop, muscle tremor
and blurred speech. Parkinson's disease regularly results from
dopamine blockade. The potency of neuroleptics is defined by their
power to create Parkinson's disease; this is not an unwanted side
effect, this is the therapeutic main-effect as defined by psychiatrists.
Parkinson's disease, primarily a disease of the movement-apparatus,
involves alterations on the psychic level, too. Neurologists define
them as Parkinson-personality. The symptomatology includes apathy,
loss of willpower, depression and suicidality and states of confusion
and delirium (Fünfgeld, 1967, pp. 3-25). In 1955, after the
first administrations of the neuroleptic prototype chlorpromazine
(Largactil, Megaphen and Thorazine; for other trade names click
here), the German psychiatrist Hoimar von Ditfurth pointed
to the parallels between the emotional Parkinsonian deadening
after a brain disease and the emotional deadening after neuroleptic
As we may believe, it looks like as if the psychic alterations
provoked by Megaphen especially on the emotional level are from
the same nature as the "affective deadening and restriction,"
which is registered so often at postencephalitic parkinsonists
(people with Parkinson's disease after subsiding of an acute brain
inflammation, P.L.) (p. 56).
Thus depression and suicidality are normal effects of neuroleptics,
and thus psychiatrists accept them without question.
Frank J. Ayd (1975) from the Psychiatric Department of the Franklin
Square Hospital in Baltimore, USA, wrote:
There is now general agreement that mild to severe depressions
that may lead to suicide may happen during treatment with any
depot neuroleptic, just as they may occur during treatment with
any oral neuroleptic. These depressive mood changes may transpire
at any time during depot neuroleptic therapy. Some clinicians
have noted depressions shortly after the initiation of treatment;
others have observed this months or years after treatment was
started (p. 497).
Otto Benkert and Hanns Hippius (1980), two German psychiatrists,
answered the question, whether suicidality perhaps could be caused
by an excessive dosage: "Depression, suicidality, states
of excitement and delirium under the influence of drugs generally
occur during doses prescribed by the treating physician"
Empirical data about suicides caused by psychiatric drugs are
hard to find for many reasons, as psychiatrists themselves write.
Psychiatrists do not notice or blame their courses of treatment
as the cause of depression (Lehmann, 1996, p. 111). Asmus Finzen
of the Psychiatric Department of the University Berne, Switzerland,
showed that the likely number of suicides in psychiatric institutions
is vast; correct figures are, however, hard to find because
... In illness documents and discharge summaries you
could often find no notice about the patients' suicide or death.
If the suicide happened during a vacation, the patient's discharge
date might be backdated. If the suicide attempt did not lead to
an immediate death, in the illness document and statistics he
would be considered as moved to the inner or surgical clinic"
(1988, p. 45).
R. de Alarcon and M.W.P. Carney, two English psychiatrists, studied
depressive mood changes after administration of neuroleptics with
other variables staying the same. In the British Medical Journal
they reported on suicides under the influence of fluphenazine
(trade name Moditen; for other trade names click
here), administered as part of community treatment, and described
a fluphenazine trial on a 39 old man who already had tried to
kill himself under the influence of this drug. When the psychiatrists
had realized that this man regularly had developed suicidal intensions
some days after the two-week depot-injections, they wanted to
witness the mood-worsening effect of the neuroleptic with their
own eyes. In the psychiatric institution the man was observed
over four weeks, without being treated with neuroleptics, and
without displaying anything remarkable at his mood. Then they
injected him with 25 mg fluphenazine intramuscularly:
During his stay in hospital he was interviewed by one
of us (R. de A.) three times a week. For a week before the injection,
on the days he was not due for an interview. His condition was
discussed with the chief ward nurse and the nursing reports were
perused. He was given the trial injection on a Wednesday at 3
p.m.; by mid-afternoon on the following day he felt low, wanted
to be left on his own, and had no desire to talk to anyone, read,
or watch television. He took to his bed at about 4 p.m. In the
opinion of the charge nurse he was a suicidal risk. When interviewed
on the Friday the change in external appearance was strikinghe
looked gloomy, he did not respond with a smile to a joke, and
there was no spontaneous conversation. His answers were limited
to what was strictly necessary. He denied any paranoid of hypochondriacal
ideas or any feelings of guilt. He simply said that he felt very
low and if he were alone in digs he would take his life. By Friday
evening there was some improvement, and when he was interviewed
again on Saturday he had returned to his usual normal self. (...
de Alarcon and Carney gave a resume of their findings, P.L.) that
some patients my become severely depressed for a short period
after an injection of fluphenazine enanthate or decanoate. So
far no pattern has been established regarding when an in whom
this I likely to occur. The lack of adverse effects in the past
is no indication that these may not appear in the future. In the
trial case, for instance, the patient received fluphenazine enanthate
for more than six months before he begun to react repeatedly to
the injection with severe depression, and the same thing happened
with other cases in the series" (1969, pp. 565-566).
In his placebo-controlled study, psychiatrist Peter Müller
from the Psychiatric Department of the University of Göttingen,
Germany, found that a much higher percentage of people treated
with psychiatric drugs had depressive symptoms than people treated
with placebos. In relation to lessening or withdrawal of the psychiatric
drugs he wrote:
In 47 cases the depressive mood lifted in 41 cases,
in only two cases there was no change, and in four cases the effect
was dubious. It was very surprising to see that in the predominant
number of cases the reduction of the doses (normally to half of
the former dose) alone lead to an improvement of the depressive
symptoms. Often it was only a partial improvement, but even this
brought clear relief to the patient. On the other hand, in other
patients, or in the same ones whose situation improved only slightly
when taking lower doses, complete withdrawal made them feel much
better. Some patients reported that only now did they feel completely
healthy again, as they had long before their depressions. The
depressive symptoms, which were seen to be unchangeable by some
psychiatrists, and which could possibly have been taken to be
a start of organic disorder, vanished completely. The possible
argument that these could be psycho-reactive effects caused by
the patients' relief about the withdrawal of the psychiatric drug
is refutable, because nearly all patients received depot-injections
and were not informed about their doses or got placebo-injections.
(...) Their change was quite impressive to themselves, their relatives
and their medical examiners in some cases. The patients reported
that now they felt completely healthy again. In the group of people
still treated with psychiatric drugs, this was mostly not the
case. These results quite definitely speak for pharmacogene influences
and against psychiatric morbidity developments (1981, pp. 52-53
Depressive syndromes after the remission of the psychoses
and under treatment with psychiatric drugs are not rare, but occur
on about two thirds of the patients, and sometimes even more frequently,
especially when depot-drugs are given. Without treatment with
psychiatric drugs, depressive syndromes after a complete remission
are only found in exceptional cases (ibid., p. 72).
Müller's reports are supported by many of his colleagues
(Lehmann, 1996, pp. 57-87, 109-115). Some examples: Raymond Battegay
and Annemarie Gehring (1968) of the Psychiatric Department of
the University of Basel, Switzerland, warned after a comparison
of treatment courses before and after the era of psychiatric drugs:
During the last years, a shifting of the schizophrenic
syndromes to a depressive syndrome was repeatedly described. More
and more schizophrenias show a depressive-apathetic course. It
became clear that often exactly that develops under psychiatric
drugs, what should be avoided with their help and what is called
a defect (pp. 107-108).
Walther Pöldinger and S. Siebern of the Psychiatric Institution
Wil, Switzerland, wrote: "It is not unusual that depressions
caused by medication are marked by a frequent occurrence of suicidal
ideation" (1983, p. 131).
In 1976, Hans-Joachim Haase of the Psychiatric institution Landeck,
Germany, reported that the number of perilous depressive occurrences
after a treatment with psychiatric drugs increased at least ten
times when compared with before the introduction of psychiatric
drugs. The increase of the suicide rate is "alarming and
worrying," said Bärbel Armbruster of the Psychiatric
Department of the University of Bonn, Germany, in 1986 in the
Nervenarztwithout, nevertheless, alarming the (ex-)
users and survivors of psychiatry and their relatives, or even
Rolf Hessö from the Psychiatric Department of the University
of Oslo, Norway, informed about the development in Finland, Sweden
and Norway in 1977; it seemed to be clear, "…that the increased
incidence of suicide, both absolutely and relatively, started
in the year 1955. This was the year that neuroleptics were introduced
in Scandinavian psychiatric hospitals" (p. 122).
In 1982 Jiri Modestin wrote about his place of employment, the
Psychiatric Department of the University of Berne, as well as
the neighbouring psychiatric institution Münsingen: "Our
results show a dramatic increase of the suicide frequency among
the patients in Berne and Münsingen in the last years"
First hand reports about depression and suicidality
In the book Coming
off Psychiatric Drugs, published originally in German
language in 1998 (in English in 2004), Regina Bellion from Bremen
(Germany) gave a report about her psychic condition under the
treatment in the community:
Alone at home. Three times a day I count my Haldol drops.
I don't do much else. I sit on my chair and stare in the direction
of the window. I have no sense of what is happening outside. I
find it difficult to move. Nonetheless I am able to get up everyday.
I don't notice that the apartment is getting dirty. It doesn't
occur to me that I should cook something. I don't wash myself.
I don't even ask myself if I stink. My misery progressesbut
I don't even notice.
I vegetate behind my neuroleptic wall and I am locked
out of the world and out of life. The real world is further from
me than Pluto is from the sun. My own secret world is also gonemy
last refuge, and I had destroyed it with Haldol.
This is not my life. This is not me. I may as well be
dead. An idea has begun to take shape. Before winter comes I will
But before that I want to try and see if my life would
be different without Haldol. I reduce the number of drops. I take
less and less until I arrive at zero.
After one month I am clean. Then I begin to notice how
unkempt I am. I wash my hair, make the bed, clean the apartment.
I prepare a warm meal. I even enjoy doing this. I can think again
(2002, pp. 311-312).
Another user of psychiatric drugs, living in Bremen too, had
gotten a prescription of Haldol and the antidepressant Aponal
(active ingredient doxepin; for other trade names click
here); under the influence of this combination she triedfortunately
without successto end her suffering by suicide:
When I got out again I would sit in my kitchen in front
of the water-faucet, thirsty but yet unable to pour myself a glass
of water or to bite into the bread that had become stale and hard.
The supermarket was not far away, but I couldn't manage to get
up and so I wished that I were simply dead so that I would have
some peace at last. I was broken by my illness. I saw it as a
punishment for two dark points in my life. Worst of all was the
vicious circle of endlessly recurring psychotic patterns of thought.
I tried again and again to think of something else even just for
a momentbut it didn't work. My thoughts always revolved
in the same circles, a hundred times a day, sometimes at a time-loop
tempo in slow motion, other times constantly accelerating until
my brain was spinning. And that was hell for me, the devil's game.
I felt damned and abandoned by God with no hope of salvation.
I could do nothing but suffer through this film, my life, lying
down. I knew that I had to learn to have faith again, but I couldn't,
and so I tried to end my life (Marmotte, 2004, p. 114).
Even clozapine, the prototype of so-called atypical neuroleptics,
seems to have suicidal effects, as the report of Austrian Ursula
Fröhlich in Brave
New Psychiatry shows:
Since I began taking Leponex (clozapine), I do not want
sex anymore, did not feel like moving and had no joy in life.
A life without joy is, however, worse than death. All that remained
with me is watching TV, where I have watched others living for
seven years. I am still alive biologically, but my senses are
long since dead, everything that I former enjoyed I am not able
to do anymore. In a way, my life does not exist anymore, I feel
so empty and unimportant. In the mornings, the feeling is the
worst. Every day I intend to start a healthy life the following
day, to throw away the drugs, to drink many vitamins and fruit
juices and to start with a daily fitness routine. The psychiatric
drugs cause a feeling as if it was possible for me to start with
a completely different, a new life the following day. But when
I wake up in the morning I feel like smashed, and I never come
out of bed before 9 o'clock, my depressions are so extreme that
I think of suicide every day (cited in Lehmann, 1996, pp. 70-71).
Psychiatrists did not differ in their own experiences of these
drugs. In 1954 and 1955 Hans Heimann and Nikolaus Witt (1955)
of the Psychiatric Department of the University of Berne published
their experiences after once taking Largactil, the prototype of
chlorpromazine. They experimented with spiders and 1080 control
subjects; they had three self-experiences and nine experiments
with as many psychiatrists and pharmacologists. The marked inferior
feeling and the feeling of powerlessness, structural element of
the syndrome of Parkinson's disease caused by psychiatric drugs,
after taking Largactil became very clear in the following excerpts:
I felt physically and mentally ill. Suddenly my whole
situation appeared hopeless and difficult. Above all, the fact
that one can be so miserable and exposed, so empty and superfluous,
neither filled by wishes nor by something else, was torturing.
... (After finishing the examinations): The tasks of life grew
immense in front of me: dinner, go to the other building, come
backand all of that by foot. With that this state reached
its maximum of uncomfortable emotions: The experience of a passive
existence with clear knowledge of the other possibilities... (p.
an instrument of prevention
In February 2000, the German Organization of the (ex-) Users
and Survivors of Psychiatry put forward the demand to the health
minister to introduce a suicide-register with special consideration
of associated psychiatric drugs, electroshocks, restraint and
other forms of psychiatric compulsion (Lehmann, 2001, p. 46).
The missing of a registration of suicides associated with psychiatric
treatment methods, covering all areas of a country, is a serious
evil; such data are a fundamental prerequisite for cause-research
and an important basis for prevention and early detection. An
obligation to notify the authorities of suicides associated with
psychiatry and psychiatric drugs could enable preventive measures
and instigate reliable studies that discover the connection between
suicidality and the effects of psychiatric drugs. Not only neuroleptics,
as shown, but antidepressants (Healy, 2001; Lehmann, 1996, pp.
194-204) and electroshock (Frank, 1990), too, should be watched
very attentively and with a meaningful participation of independent
organisations of users and survivors of psychiatry.
Reports of (ex-) users and survivors of psychiatry who have been
pushed into suicide attempts after traumatizing treatment with
psychiatric drugs, electro- and insulinshocks (see, for example,
Kempker, 2000), must no longer be ignored. Physicians and relatives
have to be informed about the risk of drug-caused depression and
suicidality. The users of psychiatry need to be informed so that
they can make a carefully considered and informed decision about
taking or not-taking an offered psychiatric drug and if necessary
can take less risky measures against their depression.
In 1999, Paul Barreira, M.D. and deputy commissioner from the
Massachusetts Department of Mental Health in Boston, wrote about
patterns in causes of suicides, mortality and reduced life expectancy
of psychiatric patients:
"From the standpoint of public policy, it is essential to
conduct further research with databases from across mental health
systems and different states to explain the differences in life
expectancy and causes of death."
As long as suicide prevention programms are funded by drug companies
earning money by selling these neuroleptics, which could cause
suicidality, and as long as their representatives are in leading
positions and even personally directly involved in suicide prevention
programms, you will not even find a simple remark in such programms
that neuroleptics could be one of the many risk factors of suicidality.
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Copyright by Peter Lehmann 2001 / 2002 / 2010