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Expert believes other problems led to Sara Carlin's suicide Continued from page 1 3 · Thursday, June 17, 2010 OAKVILLE BEAVER · www.oakvillebeaver.com of pharmacology and toxicology at Toronto's Sunnybrook Hospital and a medical toxicologist at the Ontario Regional Poison Information Centre at Toronto's Hospital for Sick Children, was called as an expert by Blain. Juurlink has conducted active research into drug safety and has held presentations on the link between suicide and selective serotonin reuptake inhibitors (SSRIs) like Paxil. Juurlink said that because of his studies into the SSRI/suicide connection he believes SSRIs can provoke suicidal thoughts and suicide. He also pointed out that when a suicide does take place as a result of an SSRI, there is a greater likelihood that it will be violent involving such things as hanging, gunshot wounds or jumping from high places. Despite this stance that SSRIs can cause suicide, Juurlink said this did not happen with Sara. One reason he gave for this conclusion was her Paxil history, which said Sara was prescribed Paxil in February of 2006, but did not kill herself until May of 2007. Juurlink said this is not consistent with other SSRI suicides he has researched where the suicides and suicidal thoughts came within weeks of the patients being introduced to the drug, not more than a year later. "Shortly after the drug was started, not only did she not experience suicidal thoughts and agitation, at several points the writers note she had a good response to the therapy," said Juurlink. "The notion that the drug would be responsible for adverse side effects so far into therapy is a very difficult one to accept." Juurlink said there were a number of other things going on in Sara's life that could have triggered her suicide, including school-related stress, difficulties in relationships with boyfriends and her brother Brendan's tragic death on New Year's Eve 1999. Other witness- es have testified Sara was still having a hard time dealing with her brother's death. "Collectively the impact of all those things, especially combined with alcohol and intoxication, could offer a much more plausible explanation as to why one would take one's life," said Juurlink. During cross-examination, the Carlins' lawyer Gary Will questioned Juurlink about the effect increasing Sara's Paxil prescription may have had on her. Will pointed out that nearly every time Sara's medication was increased she would exhibit disturbing behavioural changes. The Carlins and Sara's friends have testified that while she was on Paxil Sara changed from an academically and athletically-focused young woman to an apathetic person who was abusing drugs and alcohol. Will pointed out that after Sara's Paxil dose was raised from 20 mgs to 30 mgs in late September she wrote a note to herself, which some have characterized as being similar to a suicide note. In the note, she expresses the torment she is going through and calls to her brother Brendan for help. Will also pointed out an increase in Sara's Paxil dose from 30 mgs to 40 mgs in late October was followed by an incident in London in which Sara was hospitalized after mixing sleeping pills, cocaine and alcohol. Juurlink said these incidents were probably brought on by depression, which was not adequately treated by the Paxil. Will also asked about the effects Sara might have experienced when, in the final days of her life, she lost her pills for a couple of days and may have taken several to make up for what she'd missed. Juurlink said patients who suddenly stop taking Paxil might experience SSRI Discontinuation Syndrome, which, in extreme cases, can cause a person to feel as though they See Witness page 10 with its movement containing over 150 actively moving parts, your rolex deserves quality maintenance that only a highly trained and dedicated rolex watchmaker can provide. Monday-Saturday 10am-6pm, Sunday 12pm-4pm SHUTTERS · Customer Satisfaction Guaranteed · Serving Oakville with Shop at Home Service Authorized Eclipse Shutters Dealer CALIFORNIA & PLANTATION · Wood & Vinyl Shutters, Supplied & Installed · High Quality at Affordable Prices FREE Shop at Home Service SHUTTERS ETC. 905.691.4455 www.shuttersetc.ca