Sir The Professional Standards Committee (PSC) judgement, said that Ineeded to consult a senior colleague about deficiencies in myknowledge and communication. It concerned 3 patients out of 30whose pharmacological treatment I had reported to the area healthservice and to the NSW Medical Board.Before I saw them, all had displayed suicidal, homicidal, psychotic,violent or otherwise peculiar behaviours both caused and aggravatedby high doses of 'SSRI' antidepressants to which had been added toother medicines which have been well documented interactions withthem. Two were on Aropax which its maker, GSK had admitted, afortnight ago, had increased suicides eightfold in clinical trials over placebo, but they had not disclosed this catastrophic side effect whenAropax was licensed as an 'antidepressant.' The third was on threedrugs together with Luvox, a drug so interactive that it had beenwithdrawn from use in the United States.The NSW Medical Board had declined to investigate my 30 complaintsas prescribing issues. The HCCC used the services of a psychiatristwho was a 'peer' of the prescribers, who found nothing unusual in aseries that soon involved four deaths and several more suicides and

deaths which were not investigated either and a dozen near lethalsuicide attempts and a variety of bizarre behaviours on these drugs.On legal advice, I made the reports prospectively, at a rate of two or so each week, as the doctors of concern continued in their prescribingafter I had issued formal warnings supported by documentation to theSuperintendent. The first deaths occurred very soon after theprescriber had been ‘exonerated’ by the HCCC for the first group of suicide attempts but the reports of the deaths were ‘lost’ for two yearsat the HCCC, then not investigated either, or not by relevant experts. .These same ‘side effects’ have been reported tens or possibly,hundreds of thousands of times to the United States Food and DrugAdministration (US FDA) which issued Public Health Advisory inMarch 2004 and many before and since about worsening depression,suicidality, mania, akathisia, violence, insomnia, agitation, panic andanxiety caused by antidepressants. The Area Health Service, thePSC and the various ‘peers’ all failed to acknowledge the significanceand legal importance of such high level advisories.The PSC was not concerned that one of the three went on to stab aman and attempt suicide when he was given even more of the verydrugs that I had warned (in writing) had already caused a ‘serotonergic

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reaction.’ Nor were they concerned that he had been abandoned byhis treaters and re-diagnosed with an ‘antisocial personality disorder’after he had done that.That complaint was bizarre in that it was I, who had tried to preventsuch a catastrophe by warning in writing, was alleged to be somehowresponsible for causing this behaviour. The PSC was advised that Iwas unethical for making so many unjustified reports and for informinga patient’s mother about her son’s problems, although that informationled to his full recovery.Since 1997, that Area Health Service had increased its mental healthbeds from 30 to 42 and it was promised another 12 in 2006, after yetanother inpatient suicide.Hospitalised suicide attempts have trebled from 55 to 155/100,000.Suicides under mental health care in NSW (a relatively newphenomenon) run at between 100 and 150 annually and violence andhomicides by mental health patients have hugely increased. 194 suchpatients were admitted to one ward during 2003-4, but it took apsychiatrist with 42 years of experience to see that this was apopulation which did not exist before this new batch of serotoninaltering psychiatric drugs came into use, antidepressants and ‘atypical’