Melrose Place, Billy the Kid, and Zoloft: A Cautionary Tale
I moved to Fayetteville, Arkansas in the autumn of 2001; I was 26. My tiny apartment, about 400 sq. feet, was one of 22 units in two separate buildings facing each other with the parking lot in the middle. That place felt like freedom to me. Soon, I found myself in a community of peers, like-minded people, many who grew to become chosen family. Most of us referred to the complex as Melrose Place, a reference to the hit 1990s TV series. There were certainly enough beautiful people and drama to go around, so the reference stuck.
Billy moved in across the hall from me about six months later. He showed up with a bad attitude, guard up, and a smirk that would eventually become one of my favorite things. He had a baby face but his eyes had such depth, such vulnerability, that he reminded me of Layne Staley. I earned Billy’s trust bit by bit by sharing home cooked meals and he shared his love of music with me via the gigantic speakers in his apartment — loud enough to be heard over both of our vacuums if we left our doors open on cleaning day. Before too long we had standing date nights featuring tapas, loads of wine, too many cigarettes, and Margaret Cho.
As an out gay man in the early 2000s, Billy was one of the first people I knew to use LGBTQ+ specific dating sites. While we were living in the 21st century, it was still Arkansas, so safety was an issue. Billy would come over in his tighty whities to smoke before dates — wouldn’t want those clothes smelling anything less than so fresh and so clean, clean. We would stand at the window together, smoking, scheming and dreaming, while he gave me the rundown: name, address, phone number, and pics of his potential date. “If I’m not home in 24 hours send help!”, he said in jest. Luckily, Billy always came home.
The night I broke my feet outside of a Jimmy John’s on Dickson Street— yes, both feet at the same time — I refused the hospital, insisting they were only sprained. Billy stayed with me. All night. He openly laughed at me as I hobbled on my hands and knees to the bathroom, distracted me with more Margaret Cho, kept my Diet Coke full and icy, and made ramen just the way I like it.
Billy would go outside every morning, coffee in hand, stand in the small patch of grass edging the parking lot, light a smoke, and let Bosley do his business, all in his tighty whities. He did not give a shit! “Put some clothes on!”, I’d yell from my window. “This is my yard!”, he’d yell back, full smirk.
He was at my wedding. He was there the day my first child was born. When my husband was working out of town, when my breasts were swollen with milk and searing with the burning pain of mastitis, Billy snuggled my baby and brought me warm compresses and hot tea. He crashed a bad date for me when I felt unsafe, and I did the same for him. We counted on each other because we could. Eventually, Billy left Arkansas and moved to the land of dreams for any would-be gay international flight attendant: Miami.
He found love. He found a career that fed his passion for travel. Did I mention Billy was fluent in German? He found a friend group and chosen family, and he always came home to visit his precious mom, grandma, brother, cousins, and us. He also found a new doctor.
Billy suffered from time to time with bouts of depression, mostly situational, and had been taking Prozac for years. It worked well for him and he wanted to maintain strong mental health. We talked about the importance of not getting stuck without refills, of finding a local doc in Miami, and so, he did.
Our second child turned two on September 5, 2014. Billy was there. He gave her a stuffed bear and a book, The Very Hungry Caterpillar.
Four days later, September 9, 2014, Billy called me. It was 12:40 p.m. I was in session with a client, so I let it go to voicemail.
On my way to get the girls from preschool I returned Billy’s call. He didn’t answer. It was 3:20 p.m.
At 6:30 that evening I got a text from my brother: What happened to Billy?
Ice cold. That is all I remember, feeling my body turn to ice. My heart seemed to be pounding its way out of my chest while refusing to work all at the same time. Breathing became difficult as I opened Facebook. There, I learned that Billy was gone. He had taken his life less than 20 minutes after he called me that afternoon.
At the funeral home his mother asked, almost pleading, “What did Billy say? Did he leave a message with you? You were the last person he called”.
Her words ringing in my ears — you were the last person he called — all I could say was, “No, there was no message. I didn’t answer the phone. I am so, so sorry.”
I didn’t answer the phone.
I knew Billy had begun a new SSRI, a type of drug (like Prozac) often prescribed to people with a diagnosis of depression and/or anxiety. Despite Billy’s years of success on Prozac, his new physician decided to change it up and put him on another SSRI. Why, we will never know.
Worried Billy’s suicide may have been triggered by a reaction to this new drug, I asked his mother if I could look at his medications. Yes, she said, as soon as we get his belongings back from the police. Several weeks later I received a Facebook message with a picture of a pill bottle, confirming my suspicions: sertraline, also known as Zoloft.
Viatris, the maker of Zoloft (formerly Pfizer), has a page on their site titled Important Safety Information. This is, in part, what it says:
What is the most important information I should know about ZOLOFT?
ZOLOFT may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms, or call 911 if there is an emergency.
- Suicidal thoughts or actions:
- ZOLOFT and other antidepressant medicines may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.
- Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
- Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
- Pay particular attention to such changes when ZOLOFT is started or when the dose is changed.
- Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
2. Call a doctor right away if you or a person you know who is taking ZOLOFT has any of the following symptoms, especially if they are new, worse, or worry you:
- thoughts about suicide or dying, attempts to commit suicide, new or worse depression, new or worse anxiety, feeling very agitated or restless, panic attacks, trouble sleeping (insomnia), new or worse irritability, acting aggressive, being angry, or violent, acting on dangerous impulses, an extreme increase in activity and talking (mania), other unusual changes in behavior or mood
You’ll notice the age-range for this black box warning ends at 24; Billy was 32 when he died.
I. Lost. My. Shit.
I called attorneys. I called the Attorney General of Florida. I called the Attorney General of Arkansas. I called Erin Brockovich! And when a person in one of her offices actually answered the phone, I was told that they were working to challenge the black box warning parameters, but they weren’t making much headway. There just wasn’t enough proof of a connection between adults over the age of 24 experiencing the sudden onset of suicidal ideation secondary to use of the drug sertraline.
While we will never know for sure, I suspect what Billy experienced is something known as activation syndrome. This can be caused by the use of SSRIs and is characterized by the following symptoms: “increased anxiety, restlessness, agitation, irritability, disinhibition, impulsivity, insomnia, and/or a general sense of being unwell” (Mills, 2021, p. 976). But he didn’t know it. He didn’t know that activation syndrome existed. He didn’t know it was temporary. He didn’t know about the black box warning because he had apparently aged out of that risk. He didn’t know his symptoms were a side effect experienced by many people who take SSRIs.
He didn’t know, so he called me. And I didn’t answer the fucking phone.
Zoloft has generated over $30 billion dollars in sales since its release in 1991 even though some research suggests it is not superior to placebo in clinical trials. Pfizer, the original manufacturer of Zoloft, hired ghostwriters, hid information, and paid physicians to make favorable but false statements about the effectiveness of Zoloft. Currently, there is a class action lawsuit against the makers of Zoloft concerning women who took Zoloft while pregnant and gave birth to babies affected by birth defects and other malformations. The black box warning for people under the age of 24 remains, but if you’re 25 or older, I guess you’re just screwed.
While I know clients who have experienced relief from symptoms of depression and anxiety after beginning sertraline, I have seen far too many people in my personal life and in my therapy practice suffer from the side effects Viatris warns about after beginning the drug. I have seen people very nearly lose their precious lives, people who never before experienced suicidality. I have seen people doubt themselves or question their own experience because they were afraid to question their medical or mental health provider. In the worst cases I have heard from clients who experienced gaslighting by providers who discounted their concerns and very real symptomatology.
Why is this drug still being prescribed to adults without a serious warning when there is evidence it is dangerous? Why wasn’t Billy armed with the information he needed to prepare for the possibility that he could experience such scary side effects?
Because the black box warning didn’t apply to him. That’s why.
Billy was my friend, he was an uncle to my girls, he was part of our family.
Billy was a drag racing maniac.
Billy was loyal.
Billy was Bosley the dog’s human.
Billy was a dare devil.
Billy was hilarious.
Billy was a son, a brother, a cousin, a friend.
Billy was loved.
Billy was.
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“I’m sorry, Please forgive me, Thank you, I love you.” Ho’oponopono Prayer
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To report any adverse events related to Zoloft or any Viatris product, you can call 1–877–446–3679 or you may contact the U.S. Food and Drug Administration (FDA) directly at http://www.fda.gov/MedWatch or call the FDA at 1–800-FDA-1088.
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If you are experiencing suicidal thoughts, you are not alone. Help is available. Speak with someone today.
Call 988 to reach the Suicide and Crisis Lifeline
Hours: Available 24 hours. Languages: English, Spanish.
****************************************************************************Mills, J. (2021). Antidepressants and activation syndrome: Decades without definition. Issues in Mental Health Nursing, 42(10), 976–979, DOI: 10.1080/01612840.2021.1972662
