Prozac killed my wife

— The Guardian , Wednesday June 4, 2003 —

Alastair Hay is an eminent toxicologist and well-known chemical weapons expert. So when his wife committed suicide, he used his specialist skills to try to find out why. Today, writes Sarah Boseley, he will tell an inquest what he believes happened

Alastair Hay is an environmental toxicologist. He is a chemical weapons expert who is much quoted in newspapers. He advises select committees, lectures, writes papers and travels to conflict zones such as Bosnia to find out which deadly toxins have been released in the name of peace and freedom, or gives evidence in US courtrooms in high-profile proceedings involving the food biotechnology company Monsanto or Vietnam veterans.

He never supposed that at the height of his career he would find himself using his specialised skills and knowledge to investigate the death of his wife.

Wendy Hay was at the centre of his world for 32 years, from the day they met at the Royal Holloway College in London where they were both students. “I just adored her,” he says. “Wendy was so quick and funny. She was such a fun, supportive person to have around.”

The raw emotion in the way he talks of her makes it impossible to doubt the chasm her death has created. They campaigned together. Her formidable librarianship skills helped him in his research. She edited his papers. They made a good life together in the old schoolhouse of a village in the fields eight miles from Leeds university, where he is a professor. They brought up their son together and kept a small menagerie of dogs, cats, chickens, rabbits and two goats. He baked bread. She played the piano and sang and introduced him to Zola.

But in spite of all the good times, Wendy began to be stalked by depression. Hay successfully helped her fight it off once, but it returned. Last September, two weeks after a suicide attempt which scared them both and made her promise never to do it again, Wendy hanged herself in the garage. Hay relives the dreadful day he found her again and again. He sat holding her body, unable to understand how it could have happened. Nearly nine months later, he is preparing to tell a coroner’s court that he thinks he now knows. After researches more distressing than any he has ever conducted, he believes Prozac was responsible.

The Hays arrived in Leeds from London in 1977 when Alastair was offered a postgraduate position, which quickly turned into a lectureship. Wendy worked on adult literacy and library projects for the then Leeds polytechnic. After Tom was born in 1980, she stopped full-time work, but used her research skills to help Alastair. Four years ago, although work was going well, the problems began. In April 1999, after first suffering some inexplicable physical symptoms and dropping to six-and-a-half stone in weight, Wendy was diagnosed with anxiety and depression by a GP who prescribed 20mg daily of Seroxat - one of the SSRI (selective serotonin reuptake inhibitor) class of antidepressants. She suffered a severe reaction to it, shaking so badly that she could not hold a cup and saucer. Hay phoned the poisons unit at the Leeds Royal Infirmary, who said she had been overdosed and should have been weaned gradually on to the drug. They were advised that she should not take another tablet that day. “The next day she was catatonic,” says Hay. She stared at him as if she did not recognise him and seemed unable to speak. “I broke down and sobbed and she said that was what brought her to.”

They agreed it might be best for her to go into hospital for a short while. She was admitted to High Royds in Leeds, where she was put on Prozac, together with Valium. Two weeks later, having gained some weight, she was released into her husband’s care.

Meanwhile, Hay had found out that the best treatment for depression is generally thought to be a form of counselling called cognitive behaviour therapy, but there was a two-year waiting list. So he bought the books and taught himself to do it with Wendy. He stayed at home for 12 weeks and gradually saw her get better. “She was lovely. I just wanted her well and whatever needed to be done, I would do. When she was depressed she used to feel her humour was inappropriate. When that came back it was wonderful,” he says.

Wendy didn’t like being on an antidepressant. She felt it slowed her quick mind. After two years on Prozac, she weaned herself off and all seemed well. Life had returned to normal. They did a lot of travelling. Then things began to go wrong again. Wendy was unable to relax. Her brain was full of feverish activity. One morning she phoned Hay at work in tears. “It’s come back,” she said.

Hay began working from home while Wendy tried to deal with it, but after three weeks it was clear she needed help. Her GP put her back on Prozac. Within 10 to 12 days, says Hay, she began having sleepless nights and the odd suicidal thought. Sometimes Alastair would wake to find her watching him, waiting for him to open his eyes with fear in her face. “I will get better Ali, won’t I?” she would ask.

Three weeks after Wendy had started taking Prozac again, Hay phoned her at the end of his regular Tuesday run with friends. She told him that she was all right and back at home. He didn’t understand. “She met me at the front door and said, ‘I’m so sorry’.” Wendy had tried to drown herself in the River Wharfe. “I saw her wet footprints all the way up the stairs to the shower. We talked late into the night.”

He now beats himself up, he says, for not getting help. To have told the doctor behind Wendy’s back would have been a breach of trust, he says. Nobody had told him that one suicide attempt makes another more likely. “If I’d had the slightest inkling of what it would be like without her, I would have acted,” he says. “It has been so devastating.”

Two weeks after the first attempt, on September 17, Wendy killed herself, leaving a note for her husband and son. It said that Alastair could not look after her forever, that the depression was getting worse and that she could not bear to be institutionalised.

“I didn’t want to carry on either, really,” says Hay. “It was so hard. There’s this person that you have been with so long and you liked so much and loved so much and then they are not there and the idea of carrying on without them is so difficult.”

Late last year, he came across some literature on Prozac that made him feel very, very angry. He found papers by David Healy, director of the North Wales department of psychological medicine, which argue that in a small minority of people, SSRI drugs, including Prozac, can induce extreme agitation and violent, suicidal thoughts. “I just thought, this is something I need to look into. I’m used to looking for evidence because I have given evidence in so many trials. It is a terrible irony to be using those same skills for this,” he says.

He has done toxicological work on the build-up of the drug level in Wendy’s blood and tissue. It was very high, he says, yet he does not believe it could have been a deliberate overdose because there are no tablets unaccountably missing from the packets. He has found a paper by John Cain from the University of Texas in the Journal of Clinical Psychiatry, August 1992, on 23 individuals who were taking Prozac. Four of them began to improve but within a few weeks worsened and had suicidal thoughts which went away when the drug was stopped and then given in a lower dose.

Today, he will tell the inquest that he believes Prozac precipitated Wendy into a suicidal state. She undoubtedly got better on it the first time, but initially took Valium too, which dampens down any agitation. The first time she was given an SSRI - Seroxat - she had a violent reaction to it. He would like to see a clinical study measuring blood levels of the drug alongside changes in mood. “It has to be related to the drug and changing levels of the drug ... Then we may have a tool for saying for the vast majority of people going on Prozac, it is going to be fine, but for this small number it is not.”

The coroner may find that Wendy’s suicide was consistent with her history of depression and that Prozac did not play a significant part in her death. Eli Lilly, manufacturer of Prozac, which is one of the best-selling drugs in the world, denies categorically that there is any link to suicide, citing a meeting held by the American Food and Drugs Administration in 1991 on the subject and a review by the UK’s committee on the safety of medicines in 2000. “There is no credible evidence that establishes a causal link between Prozac and violent and suicidal behaviour,” it says in a statement.

But Hay says that one size may not fit all. Drug levels in the blood are monitored in epilepsy. People on warfarin to thin the blood and digoxin for the heart have their drug levels measured. Antidepressants are handed out by GPs in standard 20mg doses. And there is no guidance for partners on watching for mood changes, or suddenly worsening symptoms.

Alastair Hay is working hard again. When he is not, he reads Spinoza and Richard Dawkins, looking for ways to make some sense of death. He reads Blake, Dylan Thomas and Emily Dickinson because Wendy loved them. He likens himself to a building that has been hit full-on by a blast. Only the metal struts remain, but a bit of the concrete infill is beginning to be laid down.

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