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  • Will Irvine

Jagged Little Pill

What Happens When Pharmac Tries to Murder You?


CW: Mentions of suicide, mental health

Words by Will Irvine (he/him)


I’m awoken by the smell of sweaty balls. My eyes are blotted with gunk. There’s light streaming in through my windows onto my face—I must have passed out before closing my room for the night. More than anything, though, there’s the pain. A deep, throbbing pain at the back of my head that clings onto me, refuses to let go. The skull-pain has become the central deity of my life in the last week—a kind of personal demiurge that, attached to the crown of my skull, bleeds pain into the rest of my body. Yet I keep taking the pills. I have to keep taking the pills.


Between November and April, Pharmac carried out a routine brand change for the nation’s thousands of escitalopram users. For many, nothing changed save for the new glaring pink packaging in our medicine cabinets. For a substantial number of patients, though, the new brand came with a fresh dose of devastating side effects. I was one of these people.


A bit of background on escitalopram—it’s one of the five fully subsidised SSRIs used by the New Zealand health system to treat a range of conditions including depression, addiction, anxiety, and eating disorders. SSRIS, or selective serotonin reuptake inhibitors, work by affecting the body’s circulation of serotonin, one of the many neurotransmitters that impacts mood and energy in the human brain. Since research shows a well-established correlation between depression and low serotonin levels, GPs have become accustomed to using SSRIs as a crutch to treat mental illness where legitimate psychiatric intervention is unavailable. 


Scientists like to call serotonin a “mood regulator” chemical. It keeps things at a nice baseline—you don’t try and kill yourself as often, but you miss out on a lot of the joys of life as well. If this is raising alarm bells, good. On paper, it’s almost absurdly dystopian—a pill that you take to be less extreme, to moderate your behaviour. 


I’m a rare case. I’ve been on SSRIs since I was about 11. I went through puberty, the baptism of fire in high school, and the transition into adult life all whilst on these meds. I don’t have any strong memories from before I started taking them, and I don’t really know what life is like without them. In many ways, they saved my life. Before taking them I was a depressed, suicidal, and physically violent child. 


In 2018, nearly one in ten Kiwis were prescribed some kind of SSRI—a number that only grows, as GPs increasingly try to prescribe their way out of a mental health crisis. In any circumstance where 10% of the population is using a prescription medication, a serious national conversation is needed about how these drugs impact us. 


As for this year’s escitalopram brand transition? Well, for me personally, the side effects only lasted a few weeks. For that period, the head and neck pain was intense—it felt like my body was trying to force out some kind of external pathogen. But, all things considered, I was lucky. One friend of mine is still experiencing the side effects, and is turning to prescription painkillers to treat the serious headaches brought on by her antidepressant usage. 


With very little community input or transparency, changes like these from Pharmac can throw off the life and mental health of a massive chunk of the population. Whilst supply chain issues make these changes often unavoidable, they speak to a real need to confront the growing number of Kiwis who depend on SSRIs to live.


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