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Jury calls for Paxil patients to be more informed about risks Continued from page 1 11 · Wednesday, June 30, 2010 OAKVILLE BEAVER · www.oakvillebeaver.com been taking Paxil, an anti-depressant, which Health Canada warns can increase the risk of suicidal events in children and adolescents under 18. During the inquest the Carlin's lawyer Gary Will argued the side effects of Paxil drove Sara to kill herself while lawyers for Paxil manufacturer GlaxoSmithKline and three doctors associated with treating Sara, made the argument Sara's suicide was a result of depression and drug and alcohol abuse. The Carlin family believes the jury attributed Sara's death to Paxil due to the recommendations they made. However, Teresa Walsh, lawyer for GlaxoSmithKline did not see it that way. While many of the recommendations are aimed at bringing forward greater awareness of the potential side effects of Paxil and other SSRIs, Walsh said the jury did not list Paxil as causing Sara's death in their verdict. Under the cause of death, the jury has listed `hanging by ligature while affected by depression, cocaine and ethanol (alcohol).' "I think the verdict speaks for itself," said Walsh when asked about the role Paxil played in Sara's death. One recommendation called for guidelines to be put in place so that, prior to prescribing an SSRI like Paxil, physicians would be required to give a patient a physical exam, request laboratory investigations, inform patients of the benefits and risks of treatment including rare and serious side effects, inform the patient of reasonable alternative treatments, inform the patient of an SSRI treatment plan and discuss with the patient the impact drugs or alcohol could have on an illness like depression. During the inquest, Sara's family doctor testified that he did not inform Sara about the possible risk of Paxil causing suicidal thoughts and behaviour when he prescribed it because, he said, it is difficult to get a patient to take such a medication after that kind of admission. According to testimony, the appointment where Sara was put on Paxil only lasted 30 minutes. Other recommendations called for physi- cians to monitor patients with weekly visits for the first month after initial introduction to an SSRI, then with biweekly visits for the second month and with one visit in the third month. Sara Carlin The jury said this would effectively monitor the period where a serious adverse reaction to a drug like Paxil is most likely to happen. Still another recommendation called for physicians to try, repeatedly, if necessary, to get a patient prescribed an SSRI to allow for their family members, guardians or trusted friends to be brought into the treatment process, so they can monitor for potential side effects. One of the Carlin family's greatest concerns, which arose during the inquest, was that they were never told that Sara was placed on Paxil and as such they did not know what to look for in the event she had an adverse reaction. Sara's doctor testified Sara had told him she did not want her medical records shared with her parents. Under doctor patient confidentiality he had no choice but to respect that request. Other recommendations called for the creation of an independent drug safety board, the creation of an educational program regarding mental health and substance abuse for the adolescents and youth of Ontario's school system, the creation of a provincial and national suicide prevention strategy and the creation of a Drug Information System that would track and monitor all drugs dispensed in Ontario. This question of how much of a role Paxil did play in Sara's death was hotly debated during the inquest with several of Sara's friends and family members testifying that she went through drastic behavioural changes after she began taking Paxil in February of 2006. These witnesses testified Sara suddenly changed from an academically and athletically focused young woman into an apathet- ic person with alcohol and drug abuse problems. Will argued some of the side effects listed on the Paxil product monograph were increased alcohol consumption, drug dependence, depression and depersonalization to name a few. Walsh countered that these are not side effects, but things that people taking Paxil have reported and have not been conclusively tied to Paxil as the cause. Three expert witnesses testified during the trial with each bringing their views on the impact they felt Paxil had in Sara's death. Dr. David Juurlink, head of the division of pharmacology and toxicology at Toronto's Sunnybrook Hospital and medical toxicologist at the Ontario Regional Poison Information Centre in Toronto's Hospital for Sick Children, testified that Paxil can cause people to commit suicide, but he did not believe this to have happened in Sara Carlin's case. He said most suicides and side effects See Recommendations page 13 · HARDWARE & SOFTWARE SERVICE · NETWORK SECURITY · WEBSITE CREATION & MAINTENANCE · TRAINING (BEGINNER TO ADVANCED)