Summary:

This article states [paragraph 37, under Prozac]: According to Ronald J Diamond, M.D., of the University of Wisconsin Department of Psychiatry and Medical Director, Mental Health Center of Dane County, WI, "Antidepressant medications can trigger a manic episode in some susceptible people. In addition, some schizophrenic clients are reported to get more disorganized or more paranoid when taking antidepressants."

SSRIs such as Prozac can cause a craving for alcohol.  This is even listed in the insert for Paxil.  Since the liver cannot metabolize the combination of both an SSRI & alcohol, there is a synergistic effect of raised levels of both alcohol and Prozac/SSRIs. 

Many books have stated that Henri Paul was a light to moderate drinker and that he was a quiet, unassuming man.  Seven months before the accident he began taking Prozac due to sadness over the end of a 10 year relationship with his girlfriend.  The night of the crash, this quiet, introverted man was seen in front of the hotel waving and gesticulating to the crowd. He appeared to be in a hypomanic state.  Antidepressants can cause mania and hypomania according to the medical literature.  In the Physicians Desk Reference, it also states that Prozac can cause [as a frequent side effect] the adverse reaction of confusion.

Here is the article from Dr. Ronald J. Diamond:     


http://alcoholism.about.com/health/alcoholism/library/blpaul01.htm


The latest blood test for Henri Paul, driver of the Mercedes in which he, Dodi Fayed, and Princess Diana were killed, shows that he was not only drunk, he was also taking an antidepressant drug and may have stopped taking one prescribed for alcohol abuse. French prosecutors said Wednesday that Henri Paul had traces of two drugs in his blood along with a high alcohol level. A statement by the prosecutor's office said a blood test to determine the driver's alcohol level revealed the presence of two drugs: fluoxetine and tiapride. Latest Updates from FranceThe CNN report said, "Fluoxetine is the generic name for the popular antidepressant drug Prozac while tiapride is a drug which works to calm the central nervous system. It is used for people with psychiatric disorders or to relieve the symptoms of alcohol withdrawal." As more information is becoming available, we are beginning to get a better picture, although still not in complete focus, of the man they asked to drive Princess Diana away from the Ritz Hotel in Paris on that fateful night It is not a very pretty picture, as it continues to develop. Let's take a closer look at the blood content of Henri Paul. This is from the official statement of French prosecutors, reported by Reuters: • The analysis of a sample of blood taken on September 4, 1997, in the presence of an investigating magistrate yielded a level of pure alcohol of 1.75 grams per thousand grams. • The analysis of fluid taken from the eyeball yielded a level of 1.73 grams per thousand. • A search for toxic chemicals in the blood revealed therapeutic levels of a medication whose active ingredient is fluoxetine, and sub-therapeutic levels of a second drug whose active ingredient is tiapride.

Alcohol The above results are from the third blood alcohol test conducted by authorities after Paul's family disputed the first results and got a French judge to order more tests. Obviously, this third test confirms the earlier ones: Paul was more than three times over the legal limit in France, and would have been deemed intoxicated in every country in the world. Prior to the Fourth of July weekend, an article was pubished here on the Alcoholism site which pointed out that someone with a BAC of .15 would be 380 times more likely to have an accident than a sober driver. According to these studies, the likelihood of having an accident doubles with every .02 increase in BAC, so Henri Paul was more than 760 times more likely to have an accident than a non-drinking driver.

Prozac Four weeks ago, I wrote a feature about alcohol and pain, which contained a long list of presciption and over-the-counter drugs which were not supposed to be combined with alcohol. Prozac was one of those drugs.
" ...a few drinks will make a client on these medications more intoxicated than he or she would normally get."
But forgetting about the combination for a moment, let's look at the Prozac alone. According to Internet Mental Health "patients taking Prozac should be cautioned against driving an automobile or performing hazardous tasks until they are reasonably certain that treatment with fluoxetine does not affect them adversely." But the combination of alcohol with any antidepressant is dangerous. According to Ronald J Diamond, M.D., of the University of Wisconsin Department of Psychiatry and Medical Director, Mental Health Center of Dane County, WI, "all antidepressants potentiate the effect of alcohol, and a few drinks will make a client on these medications more intoxicated than he or she would normally get. In addition, alcohol increases the lethality of antidepressants, and a normally non-lethal overdose may become lethal if combined with alcohol." For more information about the interaction of antidepressants with alcohol, see Diane Hunter's examination of the possible dangers and side effects. But perhaps even more startling is this warning from Dr. Diamond: "Antidepressant medications can trigger a manic episode in some susceptible people. In addition, some schizophrenic clients are reported to get more disorganized or more paranoid when taking antidepressants." At this point, we do not know why Paul was taking Prozac, but generally it is prescribed for depression, panic attacks, and bipolar disorder, the condition formerly known as manic depression. It is also used in the treatment of obsessive-compulsive disorder.

Tiapride We are still researching this one, but generally it is listed in medical literature as a treatment for stuttering in youngsters, Tourette's disorder, and for physical "tics." But the CNN report also said that tiapride is used "to relieve the symptoms of alcohol withdrawal." Indeed, the drug has been studied as a pharmacological treatment in the prevention of relapse in recently detoxified alcoholics.
Could this be why everyone in the Fayed camp and in Paul's family is rushing to his defense?
Again, we do not know why Paul had been prescribed tiapride, but the report said that he had "therapeutic levels" of Prozac in his blood, but the level of tiapride was "sub-therapeutic." Since most of these types of medications linger in the blood stream for several days after the patient stops taking them, Paul apparently had previously taken tiapride, but had stopped taking it, since the level was no longer "therapeutic." This brings up some very interesting questions, to say the least. Could it be that Henri Paul had been undergoing treatment for alcohol abuse? Was he drinking heavily because of his depression and his doctor prescribed Prozac for the depression and Tiapride for the alcohol withdrawal? Did he go through detox? Treatment? Could this be why his family was so adamant that the first blood tests were wrong -- because they knew that he was undergoing treatment for his alcohol abuse? Did Paul "fall off the wagon," stop taking his Tiapride, but kept taking his Prozac? Could this be why he appeared to be sober at the Ritz that night after being called back from home to the hotel to drive -- because he was desperately trying to cover up his drinking? Somebody knows the answers to these questions. If Paul had a drinking problem, you can bet that everyone around him, including his parents and employers, knew about it. Could this be why everyone in the Fayed camp and in Paul's family is rushing to his defense -- because the blood tests confirmed their worse fears? He was drinking again and lying about it? As the prosecution investigation continues, I imagine that Paul's medical records will be examined very carefully. Somebody prescribed those drugs for him and did so for a reason. The truth may come out yet, in spite of the denials.

Update: A lawyer for the Al Fayed family admitted Wednesday that Henri Paul should not have been driving the car, according to a CNN report. "Obviously Mr. Paul should not have been at the wheel," lawyer Bernard Dartevelle told reporters. "But he was probably the only one to be aware of his real condition. You may well imagine that if we had known about his condition, we could have stopped him from leaving despite the haste surrounding all this," Dartevelle said. On Wednesday, a Fayed family spokesman called for an independent autopsy on Paul. "We think that there should be one investigation that answers all of the questions," Cole told NBC Television. As of Wednesday afternoon, Paul's body had yet to be turned over to his family. "My Son was Not an Alcoholic"
As Henri Paul's mother continued Thursday to deny that her son was drinking while driving Princess Diana, the Fayed family lawyer suddenly has begun to put distance between the Ritz Hotel and its No. 2 security man by denying any knowledge of a drinking problem. As always, your comments or questions are welcomed. If you would like to receive a very short newsletter about updates to this site and other news, just send a note to Buddy T. Previous Features

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