Rx Drugs and Suicidal Ideation

BLACK BOX WARNING LABELS Boxed warnings—or, as they have been popularly called, “black box” warnings—are described in the Code of Federal Regulations (CFR) under “Warnings (21CFR 201.57 (e)).”

Suicidal Ideation in Veterans
April 14, 2025
Arlington, VA

“Labeling shall describe serious adverse reactions and potential safety hazards, limitations in use imposed by them, and steps that should be taken if they occur. The labeling shall be revised to include a warning as soon as there is reasonable evidence of an association of a serious hazard with a drug….”

Veterans with brain wounds will talk about how much relief they get from Hyperbaric Oxygen Therapy, particularly the ability to get off the drugs that seemingly made them worse, not better. This applies directly to the anti-depression drugs prescribed throughout the VA. But there are unintended consequences of the prescribing behavior in the VA that go unreported, even to the Veterans.

It is not uncommon for Veterans to lose track of the drugs they are taking, much less the side effects and, worse, the interactions that can lead to suicide ideation. Among the dozens or drugs being taken by Veterans over time are “atypical antidepressants.” The Food and Drug Administration (FDA) approved these atypical antidepressants to treat depression:

• Bupropion (Wellbutrin SR, Wellbutrin XL, others)
• Mirtazapine (Remeron)
• Nefazodone
• Trazodone
• Vilazodone (Viibryd)
• Vortioxetine (Trintellix)

These drugs are typically prescribed as replacements for, or in addition to, the standard anti-depressants:

• SERTRALINE HCLSSRI (SEL. SEROTONIN REUPTAKE INHIBITOR)
• TRAZODONE HCL NEWER GENERATION ANTI-DEPRESSANTS
• CLONAZEPAM SEIZURE DISORDERS
• FLUOXETINE HCL SSRI (SEL. SEROTONIN REUPTAKE INHIBITOR)
• QUETIAPINE FUMARATE ANTIPSYCHOTICS, OTHERS
• ESCITALOPRAM OXALATE SSRI (SEL. SEROTONIN REUPTAKE INHIBITOR)
• BUSPIRONE HCL ANTIANXIETY, OTHERS
• ALPRAZOLAM BENZODIAZEPINES
• DULOXETINE HCL SNRI (SEROTONIN/NOREPI REUPTAKE INHIBIT)
• HYDROXYZINE HCL ANTIANXIETY, OTHERS
• GABAPENTIN SEIZURE DISORDERS
• VENLAFAXINE HCL ER SNRI (SEROTONIN/NOREPI REUPTAKE INHIBIT)
• CLONIDINE HCL CENTRALLY ACTING AGENTS, ALONE OR COMBOS
• BUPROPION XL NEWER GENERATION ANTI-DEPRESSANTS
• LORAZEPAM BENZODIAZEPINES
• MIRTAZAPINE ANTIDEPRESSANT-TRICYCLICS &TETRACYCLICS
• ARIPIPRAZOLE ANTIPSYCHOTICS, OTHERS
• HYDROXYZINE PAMOATE ANTIANXIETY, OTHERS
• LAMOTRIGINE SEIZURE DISORDERS

Think of a combat Veteran, maybe properly diagnosed, maybe ten years after retirement or medical discharge, faced with worsening physical and mental and behavioral and emotional, maybe financial and marital problems, faced with the onslaught of meds that come with warnings about a myriad of symptoms, only one of which is suicidal ideation.

Now think of that same Veteran trying to get an appointment somewhere in the VA for just a checkup and/or to renew prescriptions. Compound that gauntlet with an emergency, where phone calls may go to an answering machine with a promise to get a callback that may or may not come.

And now think of a decorated Veteran with the following dilemma [this is a true, ongoing story]. The Veteran was separated with a diagnosis of TBI. The VA denied him that diagnosis and the disability rating that he deserved. On his own, he found the Kentucky program that will pay for his HBOT treatment. He told his psychiatric nurse practitioner and is now being threatened with losing his VA privileges for participating in the treatment program. The nurse has verbally threatened the Veteran. She told him in March that she may have to discontinue VA treatments and benefits due him. She went silent after saying she had to consult with her supervisor if the Veteran proceeds with hyperbaric oxygen therapy (HBOT). This is not the first time a Veteran has been threatened and harased and disrespected for seeking healing in a non-VA facility. It happens all over the country.

Now compare the suicide rate (17-22 per day) and total suicides (over 153,000 since 2003), and prescribed drug overdose Veteran deaths of over 109,000, alongside Suicide Prevention budgets (which never mention ending RX suicidal ideation) exceeding $5.375 Billion.

Increasing suicides alongside accelerating Suicide Prevention budgets inside a system shrinking in size and charged with caring for Veterans outside the system when they cannot — or will not — provide the care within the system.

And all this in the face of scientific evidence that Hyperbaric Oxygen therapy is safe, effective, inexpensive, and has saved over 31,000 patients, among them over 12,500 Veterans, among them over 700 Special Operations Warriors.

Does anyone have the phone number of DOGE?

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The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of Concussion, BLAST injury, mild TBI Persistent Post Concussive Syndrome, and polytrauma from AHI and Burn Pits. No Veteran or civilian has ever been killed while undergoing HBOT treatment for TBI/PTSD.

Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made.