Paxil, Zoloft, Xantax - Drug Induced Violence
Categories23 August 2004 - The New York Times reports on the Murder case of Christopher Pittman coming up for trial. The 12-year-old has shot his grandparents and put their house on fire, but he says it was the effect of the drug he was on at the time - the antidepressant Zoloft.
The case comes amid widespread allegations that antidepressant drugs cause many to commit suicide, a charge hotly denied by the pharma companies producing them.
But what's more, a recent "mental health initiative" that includes widespread testing for mental illness in American schools is expected to lead to the prescription of just these kinds of drugs to hundreds of thousands more children like Chris Pittman.
Ann Tracy, an activist who investigates cases of unexplained violence and suicide, argues that antidepressants are dangerous and should be banned. Tracy argues that the perpetrators of some of Utah's famous violent crimes — Margaret Kastanis, who stabbed herself and her three children in 1991; Sergei Babarin, who shot five people at the LDS Family History Library in 1999; Lenny Gall, who killed his mother with an axe in 2001 — were violent because they were either on antidepressants or had gone off them too abruptly.
Tryptophan is an aminoacid that in the body transforms into niacin, also known as vitamin B 3 and into serotonin, both helping to maintain a positive outlook and mood. Dr. Andrew Saul calls tryptophan a prozac alternative. Vitamin D has been found to ease depression if given in supplement form.
With plenty of nutritional alternatives, why do we insist on using drugs as the first line treatment?
Update 15 September: According to an article in the New York Times, "Top officials of the Food and Drug Administration acknowledged for the first time on Monday that antidepressants appeared to lead some children and teenagers to become suicidal."
Boy's Murder Case Entangled in Fight Over Antidepressants
By BARRY MEIER
Published: August 23, 2004
(go to original)
Christopher Pittman said he remembered everything about that night in late 2001 when he killed his grandparents: the blood, the shotgun blasts, the voices urging him on, even the smoke detectors that screamed as he drove away from their rural South Carolina home after setting it on fire.
"Something kept telling me to do it," he later told a forensic psychiatrist.
Now, Christopher, who was 12 years old at the time of the killings, faces charges of first-degree murder. The decision by a local prosecutor to try him as an adult could send him to prison for life. While prosecutors portray him as a troubled killer, his defenders say the killings occurred for a reason beyond the boy's control - a reaction to the antidepressant Zoloft, a drug he had started taking for depression not long before the slayings.
Such defenses, which have been used before, have rarely succeeded. And most medical experts do not believe there is a link between antidepressants and acts of extreme violence.
But the Pittman case has attracted special attention because it is among the first to arise amid a national debate over the safety of antidepressant use in children and teenagers. Depression is a complex condition, and antidepressants like Zoloft have helped countless children and adults.
In recent months, however, the federal Food and Drug Administration has been examining data from clinical trials indicating that some depressed children and adolescents taking antidepressants think more about suicide and attempt it more often than patients given placebos. The findings varied between drugs. The F.D.A. is scheduled to hold an advisory committee meeting on the issue next month.
Against that backdrop, the case of Christopher Pittman - an otherwise obscure small-town murder case that may go to trial this fall - has become a battleground, where the scientific threads of the F.D.A. debate have become entangled with courtroom arguments and a family's tragedy.
Pfizer, the maker of Zoloft, has helped the county solicitor who is prosecuting Christopher Pittman. Plaintiffs' lawyers from Houston and Los Angeles, who between them have brought numerous civil lawsuits against Pfizer and other antidepressant makers, have signed onto the defense team. Groups opposed to pediatric antidepressant use have also championed the boy's case, which is being played out in Chester, S.C., a small town near the North Carolina border.
Locally, some people involved in the Pittman case said they have been stunned by the rush of outsiders. Even a forensic psychiatrist, who testified at a hearing that she believed that Christopher committed the murders while in a psychotic state induced by Zoloft, said she worried that the publicity may frighten parents whose children could benefit from Zoloft and similar drugs.
"I wished it could be staying in Chester, S.C., with this one kid," said the psychiatrist, Dr. Lanette Atkins of nearby Columbia, S.C., who has been retained by Christopher's public defender.
While the pediatric antidepressant debate has focused on potential suicide risks, aggressive behavior can be a side effect of antidepressants. There have also been case reports of adults and children on antidepressants acting violently. But only a handful of psychiatrists have ever argued that such medications can unleash rages so uncontrollable as to overwhelm a person's ability to distinguish between right and wrong and commit murder.
With the Pittman case pending, Pfizer, based in New York, declined to make company executives or lawyers available to be interviewed for this article. The company has previously said that no regulatory agency has ever found a connection between Zoloft and suicidal or homicidal behavior.
Zoloft belongs to a class of medications known as selective serotonin reuptake inhibitors, or S.S.R.I.'s, which also includes other popular drugs like Paxil and Prozac. In the last year, federal drug regulators have issued cautionary statements about most S.S.R.I.'s and similar medications prescribed for the treatment of pediatric depression. The one exception has been Prozac, the only S.S.R.I. formally approved for pediatric use after it was shown to be effective in tests with children and adolescents.
Regulators issued their advisories after a re-examination of drug makers' test data, much of which had not been publicly released. The disclosure of the test results has spurred demands by doctors' groups and others that drug companies be required to list all drug tests publicly, and a few producers have announced plans to do so.
If for some doctors such controversies seemed to have sprung up suddenly, the issues behind them were already stirring about three years ago - right around the time that Christopher Pittman fired four shotgun blasts into his grandparents as they slept.
A Last Chance Goes WrongWhen Christopher Pittman arrived in Chester in October 2001 to live with his paternal grandparents, Joe and Joy Pittman, the move seemed like his last, best chance to find stability.
He felt abandoned by his mother, according to medical reports. And his relationship with his father, who raised him in Florida, was troubled. "I haven't had that good a life; my real mom left when I was 2," Christopher Pittman told a forensic psychiatrist with the South Carolina Department of Juvenile Justice.
Psychiatric reports suggest that Christopher's tailspin began when his parents revived their relationship in 2001, only to end it yet again. After his mother left this time, he threatened to kill himself and was hospitalized. His diagnosis, records show, was mild chronic depression accompanied by defiant and negative behavior. He was put on Paxil.
But after about a week, his father, also named Joe, decided to remove him from the hospital and send him to live with his grandparents. There, a doctor put Christopher on Zoloft, the most widely prescribed S.S.R.I. antidepressant for pediatric patients and adults alike.
Initially, Christopher Pittman appeared to thrive. After a few weeks in Chester, though, he got into a dispute on a school bus and his grandparents threatened to send him back to his father. By the next morning, they were dead.
Dr. Pamela M. Crawford, a forensic psychiatrist who was asked by the case's prosecutor to examine the boy, concluded in her report that Christopher knew what he was doing when he took his grandparents' lives.
He provided "nonpsychotic reasons" for killing his grandparents, setting fire to the house, taking money from his grandparents and then stealing their car, Dr. Crawford's report states. "Following his detention by police, Christopher made self-protective statements to avoid arrest prior to admitting his actions."
Citing the continuing case, both Dr. Crawford and Dr. Atkins, the other forensic psychiatrist, declined to answer questions about their reports or court testimony.
At the time of the murders, questions about the safety of antidepressants were focused on adults, not youngsters. Just a few months earlier, a plaintiff's lawyer, Arnold Vickery, who is known as Andy, had convinced a federal jury hearing a lawsuit in Cheyenne, Wyo., that Paxil had caused a man to go on a murderous rampage.
In June 2001, that jury ordered GlaxoSmithKline, the maker of Paxil, to pay $6.5 million to the relatives of Donald Schell, who, two days after starting on the drug, murdered his wife, his daughter and his granddaughter before killing himself. The company appealed, before settling the case, for undisclosed terms.
It is hard to draw comparisons between civil lawsuits and criminal cases like the one involving Christopher Pittman. Still, the Wyoming verdict was significant because it was the first time, after more than a decade of litigation, that a jury had concluded that an S.S.R.I.-type antidepressant could make users so agitated and unbalanced that they could kill others or themselves.
The Wyoming award has not led to similar verdicts, and drug makers like Pfizer take the position that antidepressants do not cause suicide or homicide.
Contradictory Reports
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