Bernie and Ruth Madoff's alleged suicide attempt on Christmas Eve in 2008, just after their sons had turned over the Ponzi schemer and his wife to federal authorities, appears to have been either half-hearted or ill-planned if true, according to overdose experts.
Of all the drugs they chose for their suicide pact, the sleeping medication Ambien and anti-anxiety pill Klonopin are among the safest drugs around, if not taken in combination with alcohol or other more powerful drugs that could paralyze respiration.
Ambien is a brand name for zolpidem, which is in a group of drugs related to the benzodiazepines and acts in a similar way. Klonopin is a brand name for clonazepam, which is one of the benzodiazepines.
Taken by mouth, alone, by an otherwise-healthy adult who's used them before, neither drug is likely to cause death. No one knows for sure, but the Madoffs may have been naïve about the strength of the drugs -- or they never intended to die.
"We see plenty of people who want attention and maybe are crying for help take overdoses of a pretty wimpy drug and get all the drama around them," said Dr. Marcel J. Casavant, medical director of the Central Ohio Poison Center and clinical professor of toxicology at The Ohio State University Colleges of Medicine and Pharmacy.
"This pattern is very common for somebody to do something they think is suicidal and then to wake up the next day," he said. "Of course, we don't know if they are telling the truth or not."
Ruth Madoff, now 70, told Morely Safer of "60 Minutes" that she and her husband, now 73, made a pact to kill themselves after the scandal that robbed investors of millions broke.
"I don't know whose idea it was, but we decided to kill ourselves because it was so horrendous what was happening," she told CBS. "We had terrible phone calls. Hate mail, just beyond anything and I said, 'I just can't go on anymore.'"
She said she didn't mix the pills with alcohol because she was afraid they would vomit the pills back up.
"I took what we had, he took more," she said. "We took pills and woke up the next day. ... It was very impulsive and I am glad we woke up."
Casavant said had they taken enough drugs with alcohol, they may well have died.
"This is a typical pattern when people feel alone and trapped in a situational crisis where they are publicly humiliated and shamed and desperate and facing incarceration," said John Draper, director of the National Suicide Prevention Lifeline. "Those all add up to feeling suicidal."
Still, Draper said, people in despair can still feel "ambivalent" about killing themselves. "The emergency rooms are filled with stories of people who survive attempts and later are glad they survived, even though they thought at the time they wanted to die."
Judy Kuriansky, a psychologist and professor at Columbia University's Teachers College, said the timing of the Madoff's suicide confession, three years later, was suspicious.
"Why tell now?" she asked. "I think it's a play for sympathy and book sales to reveal it now -- though it makes sense to think of ending it all because of the humiliation and really no way out."
If the Madoffs really wanted to die, they could have succeeded, according to Kuriansky.
"People who are smart enough to con millions of colleagues out of so much money ... are smart enough to know how many sleeping pills to take to insure not waking up."
Ruth Madoff added that she didn't even know if they took the Klonopin or not.
"No doubt the Madoffs are both depressed," said Kuriansky. "Their son Marc committed suicide in his Manhattan loft on the second anniversary of his father's arrest."
The younger Madoff hung himself from a living room beam with a dog leash while his son slept in a nearby room. The first attempt did not work, according to reports, as a broken vacuum cleaner cord was found nearby.
"Narcissistic and powerful people in the high life, like the Madoffs, who fall from grace and their position, suffer tremendous humiliation, which can add to suicidal ideation," said Kuriansky.