It has been more than a year, but her room is still largely the way she left it. Her iPod sits in its charger, her schoolbooks remain on their shelves and her clothes wait on their hangers for an owner who will never return.
This is the room of Sara Allison Carlin, an 18-year-old graduate of St. Ignatius of Loyola Catholic Secondary School.
Sara's parents described her as a beautiful, intelligent young woman of limitless potential, who was looking forward to finishing university so she could pursue a career in dermatology.
Instead, on Sunday, May 6, 2007, Sara, suffering from the side effects of a powerful anti-depressive drug, grabbed a piece of electrical wiring, fashioned a crude noose and hanged herself in the basement of her parents's house.
Today, Sara's parents are speaking out about what happened to their daughter to celebrate her short life and to warn about the possible dangers of anti-depressive drugs known as selective serotonin reuptake inhibitors (SSRIs).
"Sara was beautiful inside and out. She was very very warm hearted and hardworking," said Rhonda Carlin, Sara's grieving mother.
"We talked to the teachers...after...and her math teacher had said that Sara was helping the other kids, even in her own grade with math because she was so good at it."
In addition to being academically strong, Sara had a thirst for athletics, especially hockey and rarely encountered a sport that she did not enjoy or excel at.
"All through high school, she was very active in sports. She played golf, she was an excellent golfer, and she played with the men because she did not know any women her age that could keep up with her," said Neil Carlin, Sara's father.
"She would snowboard. Her uncle taught her how to ski when she was 11 and she was an expert skier by the time she was 18. She liked wakeboarding and soccer and a lot of other things. She really put her heart into this stuff and I think she had a lot of natural ability."
With so many things going for her, Sara was never short of friends in high school. But where some young women might have let this success go to their heads, Sara remained grounded and eager to welcome others into her circle of friends.
"She would go into the cafeteria and if there was someone sitting alone she would sit down with them and then her friends would all come," said Rhonda.
"She had a very kind heart."
The joy in Sara's life only increased as she began her last semester of high school.
Her grades continued to be outstanding, soon earning her the distinction of being an Ontario Scholar, plus she had been accepted at the University of Western Ontario's Health Sciences program.
But it was during this time of happiness that Sara began a dark descent that would eventually claim her life.
With so many changes coming at her so fast, Sara began to experience anxiety and visited a doctor in an effort to alleviate it, explained her mom.
The doctor prescribed Sara, then 17, Paxil (paroxetine), a SSRI anti-depressant. Unbeknownst to Sara's parents, the drug had been slapped with an advisory by Health Canada in 2003 and 2004 stating that the drug should not be given to children and adolescents under 18 years of age due to a possible increased risk of suicidal events.
The 2003 advisory further noted that in pediatric clinical trials into major depressive disorder patients treated with Paxil showed an increased rate of suicidal thinking, suicide attempts and self-harm when compared to those taking placebos.
Her parents noticed a considerable change in Sara's behaviour after she began taking the drug.
"One of the things she said to her sister was, 'It makes you not worry,'" said Rhonda.
"That's the change we found in Sara because she had always been so disciplined and she would be up at 6 a.m. to get out to her hockey practice and her work, which she took so seriously, and she began to just not worry."
Neil noted that Sara got to the point where she just did not care about anything anymore. Eventually, she quit her hockey team and lost her job as the assistant to a local optometrist.
Her parents said alcohol and drug abuse, which had never surfaced in their daughter before, also became a problem.
Sara had trouble sleeping, and when she did sleep, she had terrible nightmares.
Today, flipping through the 2003 and 2004 advisories issued by Health Canada on Paxil, Neil now believes that many of the problems Sara was having are listed as possible side effects of the drug she was taking.
"All the information about self harm and behavioural changes is right there, but we didn't know," he said.
The situation worsened in September 2006 when Sara returned home from Western on medical leave.
Suffering from insomnia, Sara again visited a doctor who, her parents said, prescribed her sleeping pills and increased her dose of Paxil.
Neil pointed to a Health Canada advisory that cautions against sudden shifts in the amount of Paxil being taken.
He believes this event sent his daughter into a spiral from which she would never recover.
Her tortured state of mind during this period becomes clear in a letter she wrote to herself the following month, which was only discovered after her death.
In the letter, Sara calls out for help from her deceased brother Brendan, who also died tragically in 2000.
"I am confused about life. I don't know why I'm here or who I am. This world has stolen a part of me. I'm trying to get it back, but it's hard, sometimes I feel I can't do it. I need strength and I don't know how to find it. Brendan gives me strength. But it is hard. I feel useless and I don't want to let anyone down, but I'm really tired. I'm tired of life. I'm very weak. I've learned that and I know it's true. The world has robbed me of my strength and passion and will to live and survive. I feel you have to numb to survive. Everything seems meaningless. I need to find peace. I need to find purpose. Where do I look? I need answers. I need you, Brendan, to guide me. Please be my savior in my time of despair."
More irregularities in Sara's taking of Paxil followed when her pill bottle was believed stolen in the days leading up to her death.
This caused her to miss several doses, which her parents think she made up for later by taking more of the drug at once, something the literature on Paxil strongly advises against.
"She had no idea what that would do to her, how potent and how dangerous these drugs are," said Rhonda.
"You sort of treat them like penicillin. You shouldn't miss a dose, but it's not going to kill you."
The grim conclusion to these events took place on that fateful Sunday in May.
Sara returned home from dinner at her friend Jenn's house. Jenn's mother remembered Sara as being her happy, normal self.
She had stayed out with her friends late into the evening, but called her mother to let her know that she was coming home.
The following day Sara was nowhere to be found.
She was not in her room. Her parents' frantic calls to her cellphone were not returned.
Around 4:30 p.m., Sara's sister, Meghan, returned from Toronto with her boyfriend and quickly realized something was wrong when she noticed that Sara's purse, shoes and cellphone were still in her room.
"That's when my heart sank. I knew instantly that something was very wrong. I went down stairs and the first door I opened (basement door) she was there," said Neil.
"Her older brother (Joe) and Meghan's boyfriend, we got her down ... 911 was called, but it was obvious she had been dead for some time. We think she did that somewhere between five and six in the morning."
Initially, Neil and Rhonda were unable to accept what their daughter had done to herself believing instead that she had been murdered.
"We thought this has to be murder. This girl would never do that," said Neil.
"How could someone so beautiful and brilliant, who had so much going for her want to end her life?"
Eventually the cruel reality of what had happened began to sink in.
Today, a light is always left on in both Sara's room and in the nearby basement room where she chose to leave this world.
Sara's parents said they receive some comfort from visiting this area of their home. They believe that being there allows them to retain some last form of connection with their daughter.
Despite this, the grief for Sara's parents has been horrific.
The table in the living room is covered with unopened mail and neither parent has been able to return to their jobs.
"I have Joe. I have Meg. I have Neil, but it's hard to get any kind of joy from life after something like this," said Rhonda.
"You can't go back to doing normal things. To just get up and do the things you used to do before is difficult. Even things like putting on makeup, going out, seeing friends, you just don't want to do it anymore."
Neil said he's found some purpose in trying to raise the public's awareness of the potential dangers of Paxil and other SSRI drugs. He hopes no other family will have to endure the pain his is going through.
He is currently working with a reporter from the Toronto Star with the hope of getting a piece about the drugs in the newspaper's back-to-school section.
"It's to remind doctors and campus counsellors that these drugs can be very dangerous and these kids have to be monitored very closely, especially the young ones who are away at university for the first time," he said.
"We all stood and watched this happen and we didn't know what was happening. That's what is so maddening and that's why I'm trying to get this message out because this is unnecessary. If only someone had said something to us, if only someone had warned us."
On Sunday, Sara's parents will take a further step towards healing by celebrating what would have been their daughter's 20th birthday on Monday, July 21.
Around 20 of Sara's closest friends will attend what Rhonda is characterizing as a celebration of her daughter's life.
"Her friends are going to come over and we're going to have some candles for them to light. We've got lots of pictures and they're bringing lots of pictures that we don't have and we're just going to talk about Sara's life and all the great things that she did," said Rhonda.
"We're going to spend that time celebrating her life and try to figure out something good that we can bring from it."
Sara's family would like to thank the countless people who sent cards or wished them well in the wake of this tragedy.
The extreme nature of their grief may have prevented them from writing back, but it has not prevented them from feeling gratitude towards all those who have tried to help them during this terrible time.
Neil noted that anyone who has gone through a similar tragedy or wants more information can e-mail him at ncarlin@cogeco.ca
* * *
MANUFACTURER SAYS DRUG IS SAFE WHEN USED PROPERLY
In response to queries from the Oakville Beaver, Peter Schram, of Corporate Communications, GlaxoSmithKline, the manufacturer of Paxil, issued this statement: "Any suicide is tragic and the greatest risk for suicide is untreated depression.
"Paroxetine has been used by tens of millions of patients and has been proven to be a safe and effective treatment since its launch more than 15 years ago.
"The label contains instructions regarding the use of paroxetine and important safety information about the product.
"If patients have questions regarding the use of paroxetine, or the management of their depression, they should contact their health-care professional.
"Also, it is very important that patients do not stop taking paroxetine without first consulting with their doctor."
My response to Peter Schram:
"Paroxetine has been used by tens of millions of patients and has been proven to be a safe and effective treatment since its launch more than 15 years ago.
Paxil was launched because GlaxoSmithKline chooses the results of their drug trials. False reports were given to the FDA. New prescriptions of paxil should stop all together. Not to worry though, you will still have huge profit because many people are unable to come off paxil at all, the withdrawal so severe. You have paid out huge amounts of damages $ to both children and adults who have suffered severe side-effects, withdrawal, paxil induced brain damage, and suicide. Why are you paying out damages if paxil is so safe and effective?
"If patients have questions regarding the use of paroxetine, or the management of their depression, they should contact their health-care professional.
I agree, if you have questions regarding paxil, don't ask a GlaxoSmithKline representative. They don't tell it like it is in order to save profit. Search the internet and inform yourself, then go to your doctor and ask for assistance to get off of paxil safely.
"Also, it is very important that patients do not stop taking paroxetine without first consulting with their doctor."
Right... as has been proven time and again, it can be deadly to do so. What is unfortunate is those people that are unable to come off of paxil at all and have to live their live with the severe side-effects.
My child wasn't fortunate enough to have this information a few years back. She was taken off paxil abruptly, I've seen first hand the damage that causes. I'm so grateful that GlaxoSmithKline was 'ordered' to provide the public with this information.
