When Brokeback Mountain star Heath Ledger was found dead of an overdose on the floor of his SoHo flat, one could have expected a national dialogue to emerge on whether America is suffering from cultural over-medication. ***image1***
But as coroners determined that a combination of antidepressants and prescription-strength painkillers may have caused the 28-year-old Australianï¿½s death, the media instead turned to speculation on Ledgerï¿½s vague relationship with former child star Mary-Kate Olsen.
In New Mexico, however, Ledgerï¿½s name was invoked in the rooms of the Roundhouse as Senate committees debated a bill to study the correlation between antidepressants and suicidal behavior. Specifically, Senate Memorial 9, which passed on Feb. 8, targets cavalier prescription practices among New Mexicoï¿½s medical community.
While Ledgerï¿½s death may have pushed SM 9 past the finish line, the legislative effort began in October 2007 during the days after a 21-year-old Albuquerque woman, Sarina Cuoco, committed suicide. She, too, had been prescribed a cocktail of antidepressants and anti-anxiety
On the memorial Web site (iloveyousarina21.last-memories.com) for Cuoco, her mother, Camille Milke, explains that she found six different pills in her daughterï¿½s home, all of which were allegedly prescribed within the month by a nurse practitioner whose daughter had acted as Cuocoï¿½s therapist.
ï¿½The day after my daughter died, I promised her that Iï¿½d get her voice heard,ï¿½ Milke tells SFR. ï¿½I promised her that I was going to spend my life bringing down everybody who brought her to her demise: the nurse practitioner, her therapist, Walgreens and all the drug companies.ï¿½
Milke is planning a class-action lawsuit and criminal complaints, but almost immediately after Cuocoï¿½s death she identified the 2008 legislative session as a target. She inundated lawmakers and the press with e-mails (since Jan. 1, SFR received 103 unique e-mails) and Sen. Joe Carraro, R-Bernalillo, who carried SM 9, says he had to ask her to step back and let the legislative cycle work. Yet, he adds, by the end of the session, hardly a lawmaker in the Roundhouse wasnï¿½t aware of ï¿½Sarinaï¿½s Voice,ï¿½ the informal organization formed by Milke and her husband, Brian Milke.
ï¿½These drugs certainly do help some people, but clearly, there are too many of these drugs being prescribed,ï¿½ Carraro says. ï¿½The mind is a mysterious and fragile part of our body and we have to be very careful what we do that will affect the emotions and capability to discern reality.ï¿½
SM 9 calls for the New Mexico Health Policy Commission to convene a task force to determine if there is a correlation between antidepressants and suicidal behavior. The task force will ultimately decide whether to recommend changing the law to require mandatory continuing education for anyone who prescribes antidepressants.
For now, Milke says sheï¿½s satisfied with the legislation.
ï¿½Today is 122 days since my daughter took her life,ï¿½ she says. ï¿½I think weï¿½ve gotten a lot done in that time that a lot of other people have done in a matter of years. I mean, itï¿½s absolutely huge, but I will continue working on trying to abolish suicide-causing antidepressants until the day I die.ï¿½
The question of whether antidepressants may cause suicidal behavior has been a matter of controversy for more than 30 years. Some doctors and pharmaceutical companies deny any causality.
In 2005, the Federal Drug Administration decided to require certain antidepressants be packaged with ï¿½black boxï¿½ warnings about suicide risks among children and adolescent patients. Last year the FDA strengthened its position, calling for warnings on all antidepressants.
Suicide-prevention advocate Gail Griffith was living in Santa Fe when she wrote Willï¿½s Choice about her teenage sonï¿½s attempted antidepressant overdose. Sheï¿½s pleased to learn of the legislation but, as a consumer representative on the FDAï¿½s Psychopharmacological Drugs Advisory Committee and a board member of the American Foundation for Suicide Prevention, she says she canï¿½t back Milkeï¿½s call for a full ban on antidepressants. Nor can Griffith support Milkeï¿½s advocacy of ï¿½natural remedies.ï¿½
ï¿½People have this unfounded faith in natural products,ï¿½ Griffith says.
ï¿½Depression is a serious illness. You wouldnï¿½t pooh-pooh chemo or radiation if you were treating cancer, so I donï¿½t think itï¿½s fair to suggest there arenï¿½t pharmacological remedies that are applicable.ï¿½
After her success in New Mexico, Milke says sheï¿½s taking on Congress, particularly Sen. Hillary Clinton, D-NY, and Sen. Barack Obama, D-Ill, who have signed on to legislation that could potentially expand the use of antidepressants to treat postpartum depression.
ï¿½Itï¿½s hard to get people to take us seriously because they instantly say, ï¿½You know what? You should go to therapy,ï¿½ï¿½ Milke says. ï¿½Yeah, OK. Well, that helped my daughter a whole lot, didnï¿½t it? Iï¿½ll go to therapy and theyï¿½ll put me on antidepressants.ï¿½