Andrew Solomon, poster child for psychiatric misdiagnosis

By Alto Strata

Writer Andrew Solomon is one of the most famous psychiatric patients in the world.

Treated for depression since 1994, Solomon based his first nonfiction book, The Noonday Demon: An Atlas of Depression partly on his own experience. The book was a finalist for the 2002 Pulitzer Prize and won the 2001 National Book Award as well as other awards. It is often cited as showing the effectiveness of psychiatric drug treatment.

(Solomon’s highly praised 2012 book, Far From the Tree, is a compassionate look at children who are “different,” including those with autism and schizophrenia.)

Solomon has written and spoken often in great detail about his psychiatric history and psychopharmacology. He is a voluble advocate for aggressive diagnosis of and drug treatment for mental illness. His December 2013 TED talk “Depression, the secret we share,” can be seen on YouTube or the TED site.

As a poster child for psychiatric drug treatment, Solomon has been showered with honors. He received the Society of Biological Psychiatry’s Humanitarian Award in 2008 and is a lecturer in Psychiatry at Weill-Cornell Medical College. He is on the boards of many mental health organizations.

As of March 2013, Solomon was still taking 5 psychiatric drugs a day.

But a closer look at Andrew Solomon’s history suggests that his is a not a triumph of psychiatric drug treatment, but a tragedy. He has been taking a basket of psychiatric drugs every day for 20 years not for depression, but for misdiagnosed iatrogenic symptoms caused by the drugs themselves.

Cold turkey off drug cocktail leads to “agitated depression”

In a January 12, 1998 New Yorker article, Anatomy of Melancholy, Solomon says that in 1994, he “had pretty much solved my problems.” He was seeing success in his writing. He had family money. He was 30, healthy, wealthy, and optimistic in New York City. But sometimes bored, sometimes overwhelmed, and sometimes conflicted about being gay.

He details that after a hospitalization for “agonizing” kidney stones in September 1994, he was taking sleeping pills. That’s when he “sank lower” and “night terrors began.”

Most likely, Solomon had been taking a benzodiazepine. Barbiturates had fallen out of favor by then, partially because of their severe withdrawal difficulties. It’s possible he was taking zopiclone, an early, very powerful “Z -drug” related to Lunesta.

It seems likely his “depression” and “night terrors” were adverse or paradoxical effects of the sleeping pills. “Depression” is a well-known side effect. Sudden surges of intense “terror” are a symptom pattern familiar to anyone who has experienced rebound from benzodiazepines or z-drugs.

At any rate, he was soon thoroughly medicated by Dr. Alfred Wiener, an elite psychopharmacologist still in practice on Madison Avenue, who prescribed a series of antidepressants, plus Xanax.

“….Since that first visit to Dr. Wiener, I have been playing the medicine game. I have been on, in various combinations and doses, Zoloft, Xanax, Paxil, Navane, Valium, BuSpar, and Wellbutrin….”

He experiences the usual unpleasant side effects from all of the drugs, notably sexual dysfunction. He was taking many milligrams of Xanax a day. On occasion, he lost the ability to stand upright — attributed to his “depression.” Whenever he reduced the Xanax, he felt “high anxiety.”

His drugs were being swapped and adjusted. In mid-December 1994, “the terror lifted.” He started to feel better.

“….The spring of 1995, I stopped taking drugs cold turkey. I knew that this was dumb, but I wanted desperately to find out again who I “really” was. At first, all I was conscious of was the awful withdrawal symptoms from the Xanax. I couldn’t sleep for four days, and my eyes and stomach hurt, and my sense of balance was off. Unrelenting nightmares seemed to penetrate my wakefulness, and I kept sitting up abruptly with my heart pounding….

At this point, I entered what is commonly called “agitated depression.” I developed in rapid succession all the typical symptoms — hatred, anguish, guilt, self-loathing. I stopped speaking to at least six people. I took to slamming down the phone when someone said something I didn’t like. I criticized everyone. It was hard to sleep, because my mind was racing with tiny injustices from my past: irritability kept me awake every night, and the lack of sleep made me more irritable still. It is not unusual for really depressed people to have no deep sleep at all…..”

This is his first “breakdown.” Solomon then accepts his diagnosis — he has serious life-long depression and must be constantly medicated. He goes back on a drug cocktail, including Xanax, “a lifesaver,” and, at the end of the article (and ever since), Solomon looks forward to a lifetime on psychiatric drugs.

Withdrawal syndrome misdiagnosed as a psychiatric disorder

Those of us who know what happens when you go off benzos or other psychiatric drugs cold turkey will readily recognize Solomon’s symptoms were not of “agitated depression” but of severe withdrawal. That harsh insomnia, the waves of shame, anger, irritability, even thoughts of suicide — all very familiar.

Solomon’s psychiatrist had no excuse not to know this. By 1995, withdrawal symptoms from tricyclics had been documented for decades, and SSRI withdrawal syndrome had become known. Papers on antidepressant withdrawal-induced akathisia date back to the ’70s.

But, as typical in psychiatric practice, withdrawal symptoms, which are often of an unprecedented severity that causes sufferers to think they are losing their minds, are almost invariably misdiagnosed as profound mental illness. If one is familiar with adverse reactions to psychiatric drugs, Solomon’s psychiatric history — including that recounted in The Noonday Demon” — is readily recognized as iatrogenic — caused by drug treatment.

Being misdiagnosed with a psychiatric disorder and treated inappropriately is a tragedy for each person who experiences it, and Solomon, despite his privileged position, is no exception.

Solomon, who has a tendency to verbose over-rationalization, has embraced the idea that drugs for him are a necessity — although he continues to suffer unpleasant side effects from his drug cocktail — along with his public role as an exemplary psychiatric patient.

And everyone he talked to confirmed he needed to be medicated for a serious psychiatric illness, including his father.

Scion of Forest Laboratories

In a twist of fate that would look contrived in a novel, Andrew Solomon’s father is Howard Solomon, CEO of Forest Labs for 35 years. Forest Labs is the manufacturer of Celexa, Lexapro, Viibryd, Namenda, and Saphris, as well as other drugs.

According to a 2001 interview with Andrew Solomon in the NY Times “Howard Solomon, chairman of Forest Laboratories in New York, a pharmaceutical company valued at $12 billion, introduced antidepressants like Celexa, which now competes in sales with Prozac, because of a sudden urgency to help people like his son.”

“‘….He became interested in antidepressants, in part, because he had seen how effective they were for me,’ said Mr. Solomon.”

This led to Howard Solomon’s downfall. In 2011, the US Office of Inspector General targeted him personally for overly aggressive marketing of Celexa and Lexapro, particularly to treat children. The two antidepressants made tens of billions of dollars for Forest Labs, which could easily afford the $313 million fine to settle criminal and civil charges.

At the end of 2013, at the age of 85, Howard Solomon retired from Forest Labs. Weakened, the company is now being bought by Activis, a large global pharmaceutical company.

So Andrew Solomon appears to be a tragic victim on two counts: Via psychiatric misdiagnosis and mistreatment, and via symbiosis with the pharmaceutical industry. His diagnosis, treatment, and indefatigable proselytizing for psychiatric drug treatment are based on nothing but psychiatric error.

If this could happen to Andrew Solomon, it could happen to anyone — and does, all the time. His truly is the public face of psychiatric treatment, standing in for so many of us who have tripped and fallen down the psychiatric rabbit hole.

More by Alto Strata:

Please do not attempt to discontinue psych drugs without first very carefully educating yourself on the risks involved so that you might minimize the chances of developing grave iatrogenic illness if you decide to withdraw. See: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up