Sara Carlin killed herself at age 18. There is an inquest into her death and the role pharmaceuticals may have played. (Photo courtesy the Carlin family)

Sara Carlin was killed by an electrical cord she wrapped around her neck with her own hands.

That's how the beautiful 18-year-old Oakville teen died May 6, 2007.

But that sad day was only the beginning of a two-year quest by her family to find out if Paxil, the selective serotonin reuptake inhibitor (SSRI) antidepressant she was prescribed, helped open an otherwise closed door to suicide.

Carlin, a straight-A high school student, had started the health sciences program at University of Western Ontario the fall before she died with hopes of becoming a doctor.

She may still make an impact in the medical world.

Depending on the recommendations made by next month's coroner's inquest, her death may change how doctors prescribe drugs, how drugs are regulated in Canada and what warnings are given to parents of teens taking antidepressants.

When contacted by the Sun, Carlin's parents, Neil and Rhonda, asked for privacy in the lead up to the inquest that is set to start Nov. 2.

Preliminary proceedings for the inquest -- applications for standing -- are slated to begin tomorrow.

Amani Oakley, the lawyer representing the family, expressed hope that the four-week inquest will yield answers and save lives.

"There's a lot I think this inquest hopefully can accomplish and look into ... the role of any inquest and the fervent desire of Sara's family is this doesn't happen to another young person in Canada," Oakley said.

It has been a long fight for the inquest.

The family's original request for one was refused by the regional coroner but they successfully appealed to the chief coroner.

"The family is quite concerned about her taking Paxil and initially that seemed to be written off by the coroner's office as an issue," Oakley said.

Carlin had no previous suicide attempts, left no note and ended her life in an uncharacteristic way for a teenage girl, Oakley added.

"A lot of this brings up the concern about what role did Paxil play," she said.

Health Canada issued warnings in 2003 and 2004 about the potential dangers of teenagers using Paxil.

At age 17, Carlin was prescribed the drug for anxiety.

"It's not recommended for teenagers; it's not recommended for anything Sara had," Oakley said. "Our concern is did the Paxil unsettle things, did the Paxil push her over an edge here?"

Dr. Bonita Porter, deputy chief coroner for inquests, said Carlin's inquest will likely be the first time in Ontario the role of SSRI antidepressants and teenage suicide is examined.

"This is a fairly new therapeutic agent so I don't believe we've done an inquest into this kind of issue before," Porter said.

"We certainly have done inquests involving medical treatment before but I believe it is unique in looking at this particular type of medication and the issue of teenage suicide."

Despite controversy in Canada, the U.S. and the U.K, the drug's manufacturer, Glaxo-SmithKline, maintains the drug has been proven to be safe and effective when used according to its label.

Paxil has been at the centre of several court cases including one settled last week in Philadelphia where a jury ordered GlaxoSmithKline to pay $2.5 million over birth defects allegedly caused by the antidepressant.

Back in 2004, GSK agreed to pay New York state $2.5 million to resolve claims that officials suppressed research showing Paxil may increase the risk of a teenager committing suicide.

DON.PEAT@SUNMEDIA.CA