Like so many people, Kim Witczak's call to activism was born of personal heartache. In 2003, her husband, Tim ("Woody") Witczak, sought help for insomnia. His doctor prescribed the antidepressant Zoloft. Five weeks later, Witczak's father found Woody dead, hanging from the rafters of the couple's garage in south Minneapolis. Soon after, the widowed Witczak launched a national drug safety campaign to assure stronger safety measures for psychiatric drugs, including black box suicide warnings to protect those at-risk for devastating side effects.
She has testified before the U.S. Senate and co-organized an international conference in Washington, D.C., which brought together scholars, health care reformers, consumer advocates and health journalists to discuss what she calls the "selling of sickness."
This week, Witczak flew to Washington to begin her appointment as a consumer representative on the FDA's Psychopharmacologic Drugs Advisory Committee — Minnesota's only member.
Witczak, 49, grew up in Bloomington. A freelance advertising executive and co-founder of Free Arts Minnesota, she has never remarried. She travels and enjoys yoga, but her volunteer work with woodymatters.com has been essential to her healing. "I got involved," she said, "to make sure other families didn't have to go through what we learned the hard way."
Q: How did you connect the dots from Woody's death to a prescription drug?
A: From the beginning, his death made no sense to me. Woody wasn't depressed, nor did he have a history of depression or any other mental illness. The only thing that changed in his life was Zoloft. He experienced every known side effect, like diarrhea, night sweats, trembling hands, and his anxiety worsened. He also became easily agitated and kept expressing this feeling of his head being detached from his body. We now know this is a neurological disorder called akathisia. Woody was never told about this potentially deadly side effect and his doctor might not have even been aware of it.
Q: How many people are at risk of similar adverse side effects from Zoloft, Paxil, Prozac and the like?
A: About 3 to 5 percent of the population. That might not sound like a lot, but there are more than 100 million prescriptions for antidepressants written every year, totaling more than $11 billion in sales. Adults and children are being given antidepressants for a growing number of ailments, including depression, obsessive compulsive disorder, panic disorder, anxiety, PMDD [premenstrual dysphoric disorder], menopause, insomnia, pain management and migraines. Do the math and that's a lot of people who potentially can have serious issues with these powerful, mind-altering drugs.
Q: But would you agree that antidepressants — when prescribed appropriately, and in concert with talk therapy, exercise and other healthy habits — also can be lifesavers?
A: Sure, in some cases of severe depression, antidepressants in combination may help. Personally, I think there are a lot of other options that I would try first before medications, such as therapy, exercise, peer support groups, mediation, yoga and faith. At the end of the day, pills do not make the life stressor or issue go away.
Regardless, it's important to remember that antidepressants are serious, mind-altering drugs that need to be closely monitored. The most dangerous times are when a person first goes on them, when dosages change, and when he or she is coming off them.
Q: You've encouraged people to ask their doctors about antidepressants, but what sort of questions?
A: What are the risks and side effects? What clinical trials have been done on this medication? Are there simpler, safer options? What might happen if I don't do anything?
Asking questions forces the doctor to say, "I have a smart patient." I've heard from doctors who say they would love to have patients who are engaged.
Q: What do you hope to accomplish on this new FDA drug advisory committee?
A: I hope to be a non-conflicted, critical consumer voice asking hard questions about potential risks of the drug under review. Drugs often get approved in small clinical trials in controlled settings, with the true risks and benefits not fully realized until the drug gets into the real world. I have a unique perspective of personal experience and a professional background in advertising, where I can see how it all connects.
Q: You say that there are two vulnerable populations — children and the elderly. How so?
A: The elderly and foster kids are often given powerful anti-psychotics off-label. Most of the major drug companies have paid substantial fines for off-label marketing to these populations. In January, researchers from the Nordic Cochrane Centre in Copenhagen released findings from the largest review of antidepressant trials, showing that antidepressants doubled the risk of suicide and aggression in kids under 18. The risks to adults may have been seriously underestimated also. This has been given little media attention in the United States.
Q: What are some life skills you'd like to see taught to children who are struggling, in lieu of, or in addition to, medication?
A: We need to stop labeling children. By labeling children, they see themselves as diseased, sick and permanently broken. We need to teach children about emotional resiliency, compassion and forgiveness, for themselves and others. We need to teach children that it is OK to hurt and feel sad. Life is about ups and downs. It is usually during our down periods that personal growth comes.
Q: I'm guessing you'd like to see those skills practiced by adults, too?
A: Absolutely. I would also add the importance of positive and trusting relationships with others, where you can be vulnerable and openly share about life. This makes you realize that you are not alone. I also found volunteering to be helpful, to connect with others who are less fortunate. There is always something to be thankful for in the midst of our pain. We are a combination of spiritual, mental and physical beings. We need to pay attention to all of these areas of our life.