Suicide Prozac 27/09/2005 Canada 14 Year Old Girl Kills Self Summary:

Paragraphs 6 & 7 read: "Her daughter had recently been prescribed Prozac and so, next morning, a frantic Elaine Millar called her daughter's psychiatrist to relay her concerns."

"'I remember his words as if he had said them yesterday,' she said. 'He told me the benefits far outweighed the risks, and for me not to worry.'"

http://torontosun.com/News/Columnists/Bonokoski_Mark/2005/09/11/1212116-sun.html

By MARK BONOKOSKI

SUICIDE NOTES written -- two to girlfriends, another to her mother and one in which she says "I hate myself" exactly 20 times -- 14-year-old Alison Millar went down to the basement, wrapped an old drapery around her neck, pulled it through the rafters and then stepped off the couch.

Her mother, Elaine, had left their upscale townhouse in south Whitby for work earlier that morning in May knowing that her daughter was feeling depressed, but not to the extent that she would make yet another attempt at ending her young life.

"Promise me you'll keep yourself well," she remembers saying to her only child, consoled somewhat by the knowledge that her daughter's weekly session with a psychologist was scheduled for that very evening.

"I will, Mom," her girl replied. "Love you."

A few months earlier, while watching the CBC evening news, Elaine Millar had listened to a report that the British Medical Journal (BMJ) had given U.S. regulators confidential drug company documents linking a heightened risk of suicide attempts to the antidepressant drug, Prozac.

Her daughter had recently been prescribed Prozac and so, next morning, a frantic Elaine Millar called her daughter's psychiatrist to relay her concerns.

"I remember his words as if he had said them yesterday," she said. "He told me the benefits far outweighed the risks, and for me not to worry."

According to the CBC, the documents obtained by the BMJ had come from an anonymous source, and they indicated that Prozac's manufacturer, Eli Lilly & Co., had been made aware of the drug's potential side effects in the 1980s.

The documents, according to the BMJ, went "missing" in 1994 when victims of a 1989 workplace shooting in Kentucky sued the company after a gunman named Joseph Wesbecker, on Prozac for a month, killed eight people before taking his own life.

Eli Lilly, according to the report, won the case but said it had settled with the plaintiffs during the trial.

In its next edition, the BMJ issued an apology and retraction statement to Eli Lilly for erroneously stating the documents had gone "missing" from Eli Lilly's files and acknowledged that the company had made full and proper disclosure of all its documents during the 1994 lawsuit involving Joseph Wesbecker's rampage.

'OFF-LABEL' PRESCRIBING

The potential link between Prozac and suicide was not addressed in the retraction.

Prozac -- fluoxetine -- is a Selective Serotonin Re-uptake Inhibitor (SSRI) used to treat severe depression, bulimia nervosa and obsessive-compulsive disorder.

While Health Canada has not authorized SSRI drugs for use in patients under the age of 18, it leaves its use in younger patients to the discretion and expertise of medical professionals in a practice known as "off-label" prescribing.

Alison Millar had tried to kill herself 18 months earlier by swallowing an entire bottle of over-the-counter painkillers. Fortunately, her mother had awakened to the sound of her vomiting during the night, and immediately sought medical intervention.

The child spent a week at Scarborough General Hospital and it was here that psychologists and psychiatrists began their journey to drive out whatever mental-illness demons were possessing her -- beginning with counselling, and then moving from one anti-depressant drug to another, ending with Prozac.

Elaine Millar, a personal support worker at a Pickering long-term care facility, separated from her husband four years ago and moved from Mississauga to Whitby to be closer to work.

Her only child, Alison, went with her.

"I know a lot of children are traumatized by their parents' separations," she said. "I know she missed her dad, but I don't believe that was the trigger for her depression.

"She had problems at school, problems with friends. I remember one girl screaming at her over the phone so loudly that I could hear every word," she said.

"And she had problems with boys. She couldn't see past tomorrow. To her, puppy love was the real deal."

On the weekend before she took her last trip to the basement of her house, Alison Millar had gone for an overnight at a nearby friend's house, chaperoned by the friend's parents.

While it is impossible to fit the pieces to this puzzle, it appears she upset a boy who had a crush on her by paying attention to another boy at the party.

That simple; that complex.

As she wrote in one of her suicide notes, "I made a horrible mistake Friday night, and now I have to pay the price. I can't live knowing that (name withheld) hates me."

When she went to work that Monday morning, after hearing her daughter's promise to "keep herself well," Elaine Millar's sixth sense had her unable to concentrate.

She called home, but her daughter didn't answer. Then she called her elementary school -- St. Marguerite d'Youville -- and asked for them to call if she didn't show up.

The school called. Alison Millar, one of their Grade 8 students, had not been on her bus.

Elaine Millar rushed home, screaming her daughter's name from the moment the door opened.

She ran upstairs, praying.

And then, in the basement, she made her discovery.

• You can call Mark Bonokoski at (416) 947-2445 or e-mail at mark.bonokoski@tor.sunpub.com