Paragraph 21 reads:  "Post mortem tests revealed 482 microgrammes of Setraline [Zoloft] in Tommy's body, almost double his prescribed daily dose."

SSRI Stories has attached a different article at the end of this story.  The attached article reads:  "45 Out Of 100 Alcoholics Increased Their Drinking on Zoloft".           

What drink and drugs can do to you
By Hayley Court
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Tommy Counsel, who was a talented musician

THE face of Tommy Counsel should serve as a warning to the families of those embroiled in a life of drink and drugs.

This is the message from Ian Counsel, whose brother died after taking a cocktail of alcohol and prescribed medication.

The talented saxophonist, who had bipolar disorder, died on December 17, 2005, just eight days shy of his 35th birthday.

He was found slumped against the door of his room at The Amethyst Guest House in Shepherds Road, Old Town, having unintentionally overdosed.

One empty two-litre bottle and one partially empty bottle of White Lightning cider were found close to his body as well as large patches of vomit and a box of medication with some pills missing.

Mr Counsel says that while it is too late for Tommy, others can be saved with the constant help and support of their families.

He said: "We thought we were doing all we could for Tommy, but leaving it up to medical professionals is not enough."

Tommy, who had a history of mental illness, had been drinking heavily in the years leading up to his death, often injuring himself in drunken falls and fights.

Mr Counsel said: "I know Tommy wouldn't mind me putting his picture out there for all to see - they need to see what all the drink did to him.

"All the cuts and grazes on him were from drunken falls or fights. Nobody was monitoring what he was spending his benefits on, so he ended up wasting it away.

"Because he was classified as mentally ill he got the maximum benefits, something that usually helps people but for him it was a curse. It just all went on booze."

At the inquest into his death, Coroner David Masters recorded a verdict of misadventure, stating that Tommy had not intentionally taken his own life.

He said the musician had been diagnosed with bipolar disorder, also known as manic depression, and had been taking slightly more than his normal disciplined dose of Setraline anti-depressants to elevate his mood.

During proceedings Mr Counsel asked why his brother was allowed a week's worth of drugs when he was known to take more than the prescribed amount in one go.

He told the inquest his brother had been admitted to hospital in the past after mixing his medication and alcohol.

He said: "He'd been sent to the Great Western Hospital before and had to have charcoal meals or his stomach pumped after overdosing.

"I don't understand why he was given his medication all in one go rather than on a daily basis."

Psychiatric consultant Dr Priya Darshan Sood said that Tommy constantly refused to meet him because he kept reprimanding him over the dangers of mixing his medication with alcohol. Dr Sood said: "I'm sure that if his other health workers had taken this tough line he would have shunned psychiatric assistance altogether.

"Refusing him medication would have been disastrous for him."

Post mortem tests revealed 482 microgrammes of Setraline in Tommy's body, almost double his prescribed daily dose.

Traces of lithium, another prescribed drug, were also found in his bloodstream but these were consistent with a disciplined medicine regime, Mr Masters noted.

Community psychiatric nurse, Sarah Gray, from the community psychiatric team in Old Town, said: "Tom was always very honest about things and he never gave any indication that he would, or had ever, considered suicide."

Mr Counsel added: "Tommy never gave any indication that he'd commit suicide.

"He just wouldn't do it - it's not him. He wasn't always like this, he had his own band and was very happy and successful playing in and around Swindon between 1990 and 1996."

Tommy was found a week before Christmas when another resident at the Amethyst Guest House had tried to enter his room but found something was blocking the door.

The resident asked a cleaner to open the room and once inside the pair discovered Tommy's body slumped against the door.

Mr Masters said: "I do not consider a verdict of suicide would be appropriate, there is no evidence to support that.

"I instead record a verdict of misadventure, that is to say that Thomas Counsel committed a deliberate human act of taking medication and excess alcohol, which unexpectedly and unintentionally led to his death.

"Here is a man who had an extensive career in front of him - who made a deliberate action that went wrong."

Alcohol Craving Zoloft 2004-07-14 Global ++45 Out of 100 Alcoholics Increased Their Drinking on Zoloft

Paragraph nine states: "However, the 45 type B alcoholics who received Zoloft continued to show no benefit from the drug. In fact, heavy drinking increased, he added". 

Zoloft Not for Every Alcoholic
By Steven Reinberg
HealthDay Reporter By Steven Reinberg
HealthDay Reporter,

WEDNESDAY, July 14 (HealthDayNews) -- While not prescribed to treat alcoholism itself, antidepressants are often given to help relieve the depression that often accompanies the problem.

But for some hard-core alcoholics, the common antidepressant Zoloft (sertraline) appears to have no beneficial effect and may even cause increased drinking, a new study finds.

Zoloft is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), which helps maintain optimal levels of serotonin, an important neurotransmitter linked to depression.

"We found that type A alcoholics responded to Zoloft along with 12-step individual therapy," said study author William Dundon, a senior research investigator in the department of psychiatry at the University of Pennsylvania School of Medicine.

However, with type B alcoholics, Zoloft didn't seem to have any effect, Dundon added.

According to Dundon, type B alcoholics are those with the most severe drinking problem. Compared to type A alcoholics, they tend to drink more, have an earlier history of drinking or other drug abuse, and had higher levels of depression.

In their study, Dundon's team did a six-month follow-up of 100 alcoholics who had participated in an earlier trial. In that trial, the subjects were given Zoloft or a dummy drug plus an individual 12-step therapy program. This treatment combination continued for three months.

The research team found that the 55 type A alcoholics who had received Zoloft maintained the positive results they had achieved during treatment, Dundon said.

However, the 45 type B alcoholics who received Zoloft continued to show no benefit from the drug. In fact, heavy drinking increased, he added.

Their report appears in the July issue of Alcoholism: Clinical and Experimental Research.

Why Zoloft is not effective in type B alcoholics is not known, Dundon said.

"This and other studies show that SSRIs may be helpful for the type As, but may not be indicated for the type Bs," Dundon said. Right now, there is no simple way of telling who is a type A and who is a type B, he noted.

"For treating alcoholism, we always recommend that treatment include psychotherapy and medication and involvement in a twelve-step program," Dundon said. This combination is the most effective regardless of whether one is a type A or type B alcoholic, he noted.

"This study suggests that we need to look carefully at people with severe alcohol dependence," said Dr. Darlene H. Moak, an assistant professor of psychiatry at the Medical University of South Carolina.

Moak believes that an easy way to classify patients as type A or type B is to ask when they first started having problems with alcohol. "If it is before [age] 25, that is considered early-onset. If it's after 25, it's later-onset," she said.

For those with early-onset alcohol problems, Moak said she might prescribe Zoloft, but monitor these patients carefully.

There is a concern that an SSRI might increase the desire to drink among type B alcoholics, Moak said. "These patients probably have more serotonin dysfunction. By putting them on an SSRI, it may be too much, too quickly and overload their underused serotonin system," she said.

"We need to be cautious prescribing SSRIs to individuals with early-onset alcohol problems," Moak advised.

"There might be some predictive utility to dividing alcohol dependence into type A and type B," said Dr. Mark S. Gold, chief of the McKnight Brain Institute at the University of Florida. "Identifying types of alcoholics might help predict who could respond to what treatment."

More information

The National Institute on Alcohol Abuse and Alcoholism can tell you about treatments for alcoholism.