1. Australian Association of Psychologists, Inc. on the suicide death of Robin Williams
The toxicology report from the autopsy of Robin Williams shows that at the time he suicided, he had the
antidepressant (mirtazapine) in his blood. He had also been prescribed an antipsychotic (seroquel) a week
before his suicide- there were 8 pills missing from the bottle, suggesting that he had taken one of those each
day prior to his death. But for some bizarre reason, the media reported that he had 'no drugs' in his system, in
spite of the fact that mirtazapine carries no less than 10 international drug regulatory warnings on causing
suicidal ideation. The manufacturer is forced to include these suicide warnings simply because research shows
that the drug increases the risk of suicide. Along with the increased risk of suicide from antidepressants, side
effects associated with seroquel 'include psychosis, paranoid reactions, delusions, depersonalization and
suicide attempt.'
The question that has to be asked is why the press continues to promote the idea that no drugs were found in
Williams' system? At what point did mind-altering psychiatric drugs, which have side effects consistent with his
cause of death, stop being called drugs?
It would appear that Williams had psychological problems- his battle with alcohol is well documented. But what
is gained by glossing over the possible role which powerful psychiatric drugs played in pushing him over into
agitated-depression (the form of depression most associated with suicide), other than to the drug companies
wanting to avoid bad publicity?
The number of celebrity deaths from prescription drugs continues to rise (as do the deaths of non-celebrities).
Sadly, people take these drugs on the false premise that they are inherently harmless. For a substantial part of
the population, nothing could be further from the truth. Prescribing physicians are also misled by drug
companies who engage in heavy marketing to ensure that their products are fostered on a naive public. The
study of pharmacogenetics explains why psychiatric drugs are not universally safe.
As psychologists, we have a moral responsibility to familiarize ourselves with the science of
pharmacogenetics- many of the people we are seeing are currently adversely affected by the drugs which we
are repeatedly told are helpful; and many of our clients will wind up on a script, with monitoring only by GPs,
who are 'educated' about psych drugs by the drug companies. We need to know what is going on when a
person continues to spiral downwards whilst on psych drugs- the ensuing problems may be more neurological
(drug induced) than psychological.
Pharmacogenetics is the scientific study of people's inherited ability to metabolize and expel from their bodies
the chemicals of substances, including both recreational drugs and prescription drugs. Any substance which
affects the functioning of our central nervous system (eg. alcohol, cannabis, nicotine, caffeine, amphetamines,
antidepressants, minor tranquilizers, mood stabilizers, antipsychotics, etc) needs to be metabolized in order to
be expelled from the body. Such substances are metabolized by a family of liver enzymes called the
CYP450's. We are all born with a particular loading of these enzymes, given to us by our genes. Some people
are born with virtually none of them ('poor metabolizers'), some are born with some of them ('intermediate
metabolizers'), some are born with a full loading ('adequate metabolizers') and some are born with an
abundance of them ('ultra-rapid metabolizers). The first two groups are likely to experience adverse side
effects from antidepressants, sooner or later- these adverse can include:- worsening depression; increasing
agitation, anxiety and panic; increasing suicidal ideation and self-harming behavior; hypomania and mania
(which is usually miss-diagnosed as a symptom of bi-polar), and sometimes even dug induced psychosis.
Antidepressants carry warnings about increased risk of suicide because that is what research has revealed-
the drug companies are legally forced to admit this on the drug information. Unless you know what your
CYP450 profile is, going on to an antidepressant is like playing Russian roulette (well, the odds are actually
worse as there is a 50/50 chance of having an adverse side effect).
It is quite likely that Robin Williams was an intermediate metabolizer of the antidepressant he was on
(Mirtazapine), and/or of the anti-psychotic drug he was on (Seroquel)- poor metabolizers tend to have such
violent adverse reactions that they take themselves off the drug reasonably quickly. As a result, the chemicals

2. in the drug can build up in the blood supply and basically poison the brain, which then results in the known
adverse side effects (including increased suicidality). Depression itself does not carry a huge risk of suicide.
But when depressed mood is combined with agitation (known as 'akathisia' when it occurs as a drug side
effect), the resulting agitated depression is a high risk factor for suicide. The drugs, which some physician or
psychiatrist assured Robin Williams would make him feel better, were probably poorly metabolized and
resulted in agitated depression. Most cases of depression self resolve within a matter of 1-3 months- people
usually make some required changes in their lives. Robin Williams may still be alive today (and may not even
still be depressed) if he was not 'helped' with psychiatric drugs. How many other people in the world is this true
for- the ones only family members and friends get to hear about?