History of Romain. Died by suicide, under medication by paroxetine and tercian.

By his father. September 4, 2022.

At the beginning of March 2021, Romain was in perfect physical condition and practiced sport intensely: football and running. At school Romain had good results in maths and physics, and he also took a course in Japanese, his native language. He suffered from intrusive thoughts and obsessive compulsive disorder (OCD). He was aware of his crippling behavior and asked for help. He was willing to get out.

We visited a private psychiatrist who, from the first session, prescribed paroxetine. The psychiatrist never alerted us to the possible side effects of the drug, including the increased risk of suicide in adolescents. Romain first took 10 mg/d then quickly 20 mg/d and 30 mg/d. During the first two months, Romain managed to get rid of some of his most disabling OCDs, especially those related to food. We were all happy with the progress made.

Paradoxically, other problems gradually appeared. Romain became detached. His personality changed. He gave up his sporting activities. He became irritable, and he had an initial anger that didn’t seem normal to me. He had trouble sleeping and often seemed very tired. The psychiatrist increased the dose of paroxetine to 40 mg/d on June 8, 2021. Romain had great difficulty passing his end-of-year exams. From the end of June, sometimes Romain became childish.

During the summer, Romain had an important intellectual activity: he worked intensely on maths and physics to prepare for his return to the final year, he also took an interest in philosophy… However, the previous symptoms worsened and new ones appeared.

In July, after his exams, his sleep cycle was reversed, and he had a few sudden violent outbursts, breaking things. We referred to his psychiatrist, who, at the end of July, added Tercian (cyamemazine) to the medication. Then the psychiatrist went on leave without leaving us any specific instructions.

In August the situation became very difficult. Romain sometimes became uninhibited. He took the subway without a ticket, became very talkative, began to bet on sports, things he did not usually do. He also became manic: so on the 7th he suddenly decided to go on vacation alone, which was unrealistic. We persuaded him to go with an adult and it was his grandfather who accompanied him and took him on a week-long tour of the south of France. On his return on August 15, Romain had a serious crisis of depression. We found him in the shower in the evening, sitting on the floor, unable to utter a word, staring into infinity. We managed to get him on Tercian and he was able to come to. I questioned him then and he understood nothing of his thoughts.

We visited doctors twice, the family doctor (August 18) then the duty (doctor on the 27). They obviously did not apprehend the dangerousness of the situation and advised us to speak to the attending psychiatrist when he returned on September 6.

During the second period of August and early September, Romain had risky or socially incorrect behavior and other violent crises. He swam in a lake far from the shore and had to be brought back by a pedal boat. He borrowed the neighbour’s bike without asking. In a gesture of anger, he broke his cell phone. After one of his violent crises, he came to me and said “dad, help me, I don’t know what’s going on in my head”.

We contacted the psychiatrist as soon as he returned from vacation on September 6 and visited him on the 7th, without Romain, who was at school. After discussion with Romain, we had decided that he would go to class that day, in particular because Romain was scheduled to meet with his psychiatrist on Friday the 10th. During our interview on the 7th with the psychiatrist, we described all the symptoms to him. We asked him for a diagnosis – we had never had one – and whether Romain should be arrested, undergo an MRI, or go to the hospital. He looked worried, then asked us to trust him and said that Romain had to continue school and that he would see Romain’s medication again the following Friday, possibly adding medication for violent attacks. For the diagnosis, the psychiatrist told us that the causes were psychological and related to anxiety. He also suspected a possible personality disorder.

On Wednesday 8 afternoon, Romain had no class, he spent all his time in the swimming pool in the garden. I took the opportunity to try to talk to him. But he had a completely detached demeanor, and it was impossible.

Thursday evening Romain stayed the evening in his bed, in the dark, refusing to take the Tercian. My parents came to help us and finally Romain got up and took his medicine. He seemed physically uncomfortable and mentally confused. Finally, he spent the night with his grandparents, who are neighbors. It was the last time I saw him.

Romain never made it to the Friday meeting. That day, he spent a day at school with his classmates, chatting and joking with them. He even made plans for the weekend with one of them. Around 5 p.m. when he left school, he left his classmates on the station platform to place himself safely and calmly in front of a train that did not stop.