SSRIs, Lindsay Clancy, and Me

Although there are warnings about the rare, potentially lethal side effects of selective serotonin reuptake inhibitors (SSRIs), which were issued by the FDA and Health Canada in 2004, many North American psychiatrists and doctors still aren’t aware of how to prevent or even recognize rare problems that are caused by the pills. Many don’t acknowledge that there can be deadly adverse reactions to SSRIs.

David Carmichael and his son, Ian.

I can attest to one such lethal side effect.

In July 2004, shortly after starting the SSRI Paxil, I had a psychotic episode and took the life of my 11-year-old son, Ian, in a London, Canada hotel room. I was then charged with first-degree murder, judged not criminally responsible (insane) in October 2005, institutionalized in a mental health centre (forensic psychiatric hospital), and conditionally discharged in December 2007, which allowed me to live with my wife Elizabeth and daughter Gillian again. I received an absolute discharge from the Ontario Review Board in December 2009.

Since 2005, I’ve become familiar with many tragic stories about people who have lost loved ones to SSRIs and other psychiatric drugs, but I’ve never been as immediately heart-stricken as when I read my first newspaper article about the Lindsay Clancy family tragedy in Duxbury, Massachusetts.

Lindsay was the mother of three young children—Cora, 5, Dawson 3, and eight-month-old Callan—when she started taking an antidepressant and other drugs in October 2022. She had been exercising and eating healthy to deal with the challenges of parenting until she started to feel anxious about returning to work as a labor delivery nurse after her maternity leave, so she went to a psychiatrist.

On January 24, 2023, after being prescribed 13 drugs over the previous four months, including the SSRIs Prozac and Zoloft, Lindsay had been transformed into somebody nobody recognized as being psychotic, and took the lives of her young children and then attempted suicide. She has been charged with the first-degree murders of her children, as well as three counts of strangulation and three counts of assault and battery with a dangerous weapon.

There are several similarities with our homicidal psychotic episodes. Sharing these similarities will hopefully help prevent rare SSRI-induced suicides and homicides, including mass shootings.

Since Lindsay’s case is before the Plymouth District Court in Massachusetts, the statements about Lindsay are from what has appeared in the media.

Personal Similarities

Loving Parents

Lindsay

“According to friends, Lindsay was a devoted mom. “There wasn’t anything she loved more than her children,” said Grace McNulty, a longtime friend and colleague, in a letter. “I do not know a better mother than Lindsay Clancy,” nurse Erika Sevieri, who worked with Clancy, wrote in another letter. “She lived and breathed for her children.” (BestLife, March 1, 2023)

“She was always working out and going everywhere with her kids,” says Michelle Connor, 32, who was on the cheerleading team with Lindsay at Quinnipiac College in Hamden, Conn., and kept up with her on Facebook.” (People, February 16, 2023)

Me

Ian Carmichael rides a bike on the ramps built by his father, David.

During an interview for the documentary Letters from Generation Rx, my daughter Gillian said “My dad and I have always been really close. Both my parents did everything for my brother and I. If there was a sport we wanted to pick up, or something that we wanted to do, we did everything. My dad built my brother a halfpipe in our backyard, and it was like a professionally built halfpipe. This thing was phenomenal, and we had kids from all over the neighbourhood come there to ride it because it was huge. My brother got into dirt jumping as well, so my dad built my brother a dirt jump at our cottage. My brother would just spend hours out there, and he loved it. We were the ideal family.” (Letters from Generation Rx, 2017).

Totally Out of Character

Lindsay

“A work colleague described her as a ‘kind, compassionate, patient, empathetic’ nurse and mother devoted to her children. ‘She is a great human being, and it would be hard pressed to hear anything but positive remarks about our dear sweet Lindsay,’ wrote Laura Sanders, a nurse at Massachusetts General Hospital, who worked the night shift with Clancy for seven years. The story continues to shock the nation, especially those who knew the 32-year-old well.” (BestLife, March 1, 2023)

Me

During a BBC Panorama interview for the documentary A Prescription for Murder? about Aurora Theater shooter James Holmes, Gillian told the BBC journalist Shelley Jofre that “I am 100% convinced that the drug played a part in what happened, absolutely. My dad is not the type of person to murder anyone, especially his own child. It (Paxil) completely changed his behaviour. It changed how he viewed the world when he was on those antidepressants. And then when he went off of them, he was back to the man he was. That doesn’t make any sense.” (BBC Panorama interview, 2017)

Similarities Within the Context of Mechanisms for SSRIs Causing Suicide, Violence and Homicide

When I first read about the Clancy family tragedy and found out that Lindsay’s problems started after seeing a psychiatrist for the first time, I immediately thought about Dr. David Healy’s biomedical model to explain how SSRIs cause akathisia, emotional blunting, and delirium-psychosis, which can lead to suicide, violence, and homicide. I’ve explained how my homicidal psychotic episode is aligned with his biomedical model in this 2016 RxISK blog post.

Dr. Healy’s biomedical model applies to many people, without resulting in deaths. SSRIs often cause suicidal ideation (ideas), homicidal ideation, and different type of violence, including physical assaults, verbal abuse, and abrupt behaviour. Only in rare cases will the side effects, within a few weeks of starting an SSRI, changing the dosage, or withdrawing from it, cause suicides and homicides, including mass shootings.

Akathisia

“Akathisia is a neuropsychiatric syndrome and movement disorder that makes it difficult to sit or remain still due to an inner restlessness. A person with akathisia experiences an intense sensation of unease or an inner restlessness. This results in a compulsion to move – usually in their lower limbs. In most cases, the movement is repetitive. This uncontrollable need to move can cause extreme distress.” (Cleveland Clinic)

Lindsay

None of the media reports refer specifically to akathisia but, according to what was published in a People magazine article, it seems reasonable to assume that Lindsay experienced it as an adverse reaction to the antidepressant and other drugs she was first prescribed based on the additional drugs she was prescribed. It’s also likely that she experienced akathisia at other times when her drugs were changed.

“According to Lindsay’s lawyer Kevin Reddington, after the birth of Callan, Lindsay sought help from doctors because she was feeling anxious and depressed. She saw a doctor who prescribed an antidepressant and other drugs, says Reddington. That caused her to have an adverse reaction, she wrote in a social media post last fall. ‘She kept complaining about how she was feeling.’ Between October and January, he says, she was prescribed more drugs, including sedatives, sleep aids, mood stablizers and anti-anxiety pills in various combinations, he says, calling Lindsay ‘overmedicated’ during the time she was being prescribed these medications. ‘They (Lindsay and Patrick) would go back to the doctor, and then they would tell her to get off the medicine and start up something else,’ he says. ‘They didn’t even get her to wean off of it before starting her on something else,’ he says. ‘If that didn’t work, they’d change it. It went like that into January.’ On Jan. 1, Lindsay checked herself into McLean Hospital, a psychiatric facility in Belmont, and was released five days later after being taken off some of the drugs and put on others, he says. When she got out, she felt unwell, and kept going back to doctors to let them know that, Reddington says.” (People, February 16, 2023)

Me

After I started taking Paxil on July 8, 2004, I immediately became agitated and irritated. I remember having to get up and walk because I couldn’t sit still without my legs trembling. I started feeling anxious and incredibly negative thoughts began racing through my mind, which I didn’t have before I started Paxil. I was pacing the floor in the middle of the night because of the anxiety. The pacing did nothing to calm me down. In fact, my anxiety, agitation, and irritation got worse over the next couple of days.

Emotional Blunting

“Emotional blunting means you are numb to both positive and negative emotions. You can’t seem to cry or feel sad about things that normally would make you sad. You also can’t seem to laugh or smile at things that would normally make you happy. People experiencing this side effect often describe themselves as feeling ‘flat’ or ‘detached,’ or having ‘dull’ emotions.” (University of Pittsburgh Medical Center).

Lindsay

Kevin Reddington, Lindsay’s attorney “says she was severely depressed, suffering from post-partum depression and even psychosis, caused by a cocktail of prescription drugs that turned her into a ‘shell’ of herself and robbed her of her personality and ability to feel emotions,” “and that it had turned her into a ‘zombie.’” (DailyMail, February 8, 2023)

Me

As my mind was becoming more delusional towards the end of the second week of July 2004, I stopped worrying and caring about things in my life. I became unemotional. On July 28, three days before I took Ian’s life, I calmly researched how much time I would be spending in prison for first-degree murder and what prison life was going to be like. I wasn’t worried.

Delirium-Psychosis

“Delirium is a mental state in which a person is confused, disoriented, and not able to think or remember clearly. Psychosis occurs when a person loses contact with reality. The person may hallucinate, such as hearing or seeing things that aren’t there, or they may have delusions, which are false beliefs in things that are not true.  People who experience delusional disorders can have more than one unshakeable delusion that everyone else would know is false, and often continue to socialize and function well, apart from the subject of their delusion. Generally, they don’t behave in an odd or unusual manner.” (Cleveland Clinic)

Lindsay

Lindsay “told her husband that after he left the house on Jan. 24, she heard voices and had ‘a “moment of psychosis,”’ prosecutors wrote. He asked her what voices she heard, and she said that she heard a man’s voice telling her to kill the kids and kill herself because it was her last chance.” (Boston Globe, February 8, 2023)

“Police interviewed a close college friend of Patrick Clancy’s named Kyle Carney. Carney said the Clancy’s and their two older children had come to his home for dinner two days earlier, and that Lindsay seemed ‘fairly normal’ and mostly stayed quiet on her phone. Others, too, seemed to notice a change for the better. After Clancy’s parents visited Duxbury just days before the killings, her mother noted her apparent improvement in a text message to her daughter. ‘Nice to see you doing better,’ her mother wrote on Jan. 22.” (Boston Globe, February 8, 2023)

“Duxbury mother Lindsay Clancy started her day on Tuesday, Jan. 24, as any mother would, by taking one of her three young children to the pediatrician for a morning appointment, according to court documents and a local prosecutor. There were no immediate concerns about the demeanor or behavior of the 32-year-old Clancy, who left the pediatrician’s office with her daughter and returned home, where she took her children outside to play in the snow. Clancy texted photographs of the children playing to her mother and to her husband, Patrick Clancy.” (Boston 25 News, February 10, 2023).

A few hours before her homicides, “Lindsay calls CVS pharmacy in Kingston and asks if they have children’s Miralax in stock. A manager tells her they don’t, but have similar medications for children, according to prosecutors. The manager later tells investigators Lindsay did not slur her words or sound impaired during the call.” (Inside Edition, February 28, 2023)

“Patrick maintains that January 24th seemed to be ‘one of her best days.’ She built snowmen with her kids, while her husband worked from home before sending him to CVS to get a prescription for their daughter and takeout food for dinner. ‘She was smiling and happy, and there was no indication that she was going to harm the kids,’ he said, per the prosecution.” (BestLife, March 1, 2023)

Me

I became increasingly psychotic in the last couple of weeks of July 2004, with five delusions towards the end of July that made me think, out of love for my family, it would be best for me to take Ian’s life and spend the next 25 years in prison. On July 27, I started planning a trip with Ian to an indoor BMX park close to London. Although none of these delusions make any sense to me today, they were real towards the end of July and lasted for two more weeks after I stopped taking Paxil while on suicide watch in jail. In the middle of August, my mind was returning to normal.

Two days before our trip to London, I had a meeting with researchers about a project I was developing for a provincial sport organization in Ontario, and none of them made any comments about my behaviour being unusual.

The day of my homicide, I spent the morning at the day camp I was directing in Toronto. In late afternoon, when our bags were packed and in the van, Elizabeth said goodbye. I told Ian to tell his mom that he loved her. He did, and Elizabeth said it back. And then I drove off.

I was calm when I drove away from our house for the two-hour drive to London, and Elizabeth would have had no reason to be concerned without knowing what I was thinking and planning, which I didn’t share with her because I thought it was in the best interest of all of us if I took Ian’s life. In my delusional state, I was convinced that I was saving Ian from living hell, and protecting Gillian, Elizabeth, and other children from Ian. As a loving father who thought I was doing the right thing, I was convinced that taking Ian’s life was worth sacrificing my life by spending the next 25 years in prison.

Preventing SSRI Tragedies

Suicides and homicides, including mass shootings, are rare examples of tragedies that SSRIs can cause. There are, however, many other personal tragedies that can be caused by SSRIs. For example, the common side effect of sexual dysfunction can destroy relationships.

I became familiar with one example during the 2018 Mental Health in Crisis Lecture Tour in Australia and New Zealand that I was part of along with several medical researchers, including Dr. Peter Gøtzsche and Robert Whitaker. When I was being interviewed on a New Zealand radio station, I mentioned that almost everyone taking SSRIs experiences some type of sexual dysfunction. At the lecture that evening, a woman showed up who had heard my interview in the morning and stated emphatically that her marriage was destroyed because of sexual dysfunction issues caused by an SSRI.

In 2022, I toured across Canada to raise public awareness about adverse reactions to prescription drugs, using the sexual dysfunction side effect of SSRIs as an example because of my experience in New Zealand. Several people I talked with on SSRIs were experiencing sexual dysfunction issues but hadn’t made the connection before. Others were skeptical about this adverse reaction, including a young newspaper reporter from Windsor, Ontario. He seemed to be so skeptical that I was concerned about the article that was going to be published the next day, after my evening public discussion about drug safety. Fortunately, the article supported the purpose of my tour.

The article about David Carmichael appearing in the Windsor Star.

My next tour is going to be in the United States. For several reasons, including the significant global increase in the prescribing of antidepressants during the COVID-19 pandemic, I’m going to narrow the focus of my public discussions from prescription drug safety in general to antidepressant safety.

Antidepressant Safety Tour

I’m planning to start my American Antidepressant Safety Tour on November 2, 2023 in Seattle, Washington and end it on June 20, 2024 in Boston, Massachusetts.

In 15 cities, I’ll be holding a four-part Antidepressant Safety Day:

1. 10:30 to 11:30am: Public Discussion about Preventing Antidepressant Tragedies
2. 12 to 1pm: Seminar on Alternatives to Antidepressants
3. 5 to 6pm: Seminar on Tapering Off Antidepressants
4. 7 to 9pm: Screening of Documentary Letters from Generation Rx

An important purpose of my tours is to engage the mainstream media. If I can engage the media, I’ll be able to reach many more people than I can through the actual events. This approach to getting media coverage worked well for my recent cross-Canada tour. For example, I was able to share my story and talk about prescription drug safety on two current affairs shows; CTV W5 in Canada and My Big Story, produced by Channel 7 News in Australia. Both shows promoted my tour and, combined, they reached a few million people.

Based on the minimal media coverage the Mental Health in Crisis Lecture Tour received in Australia and New Zealand, which is the only country in the world other than the United States to allow direct-to-consumer advertising by pharmaceutical companies, I’m expecting it to be difficult to get the mainstream media interested in my American Antidepressant Safety Tour, but I think it’s worth trying. And if the media does get engaged, it will be difficult to know what to expect. At the beginning of my interview with the New Zealand radio station, I was introduced by the host as “killer dad” and the first question was “what does it feel like to kill your own child?” I knew it was going to be a difficult interview, but I didn’t expect that type of opening.

I’m not sure what’s going to happen with the mainstream media as I venture into the United States, but I’m prepared for no interest, some interest or, hopefully, a lot of interest. And some challenging questions.

 

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MIA Reports are supported, in part, by a grant from The Thomas Jobe Fund.

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