NYT-Boy's Murder Case Entangled in Fight Over Antidepressants

[Guest guest]

Here is the New York Times article by Barry Meier that caught the eye of Dr.

Richard Kapit. And because I feel Barry understood what I was telling him

about the action of antidepressants, I like the quote he took from me -

something

I cannot always say. So, I am going to point that out for you below:

 

Mr. Vickery, the plaintiffs' lawyer who had won the Wyoming trial, was

contacted about the Pittman case by the International Coalition for Drug

Awareness,

a group based in Utah opposed to antidepressant use.

 

Over the past decade, the group's director, Ann Blake Tracy, has become

involved in several murder cases in which a defendant has been on

antidepressants

or other drugs. Ms. Tracy maintains that antidepressants " overstimulate the

brain stem and cause you to go into a sleep-walk state where you can act out

the

nightmares you have. "

 

He also quotes a letter from Christopher that he asked his father to read to

the FDA during the hearing in February of this year:

 

" Through the whole thing, it was like watching your favorite TV show, " wrote

Christopher, who is now 15. " You know what is going to happen but you can't

do

anything to stop it. "

 

Put those two together and you see why so many patients report the same.

These drugs possess the potential to make you act out what is the worst

nightmare

for you. It is referred to as a REM Sleep Behavior Disorder and 86% of the

cases being diagnosed are patients on antidepressants.

 

The chapter devoted to this disorder which explains how serotonergic drugs

produce it is Chapter 7, entitled SLEEP DISORDERS, SEROTONIN, AND THE SSRIs.

It

is the same chapter that has the brain wave patterns in the back of the

chapter of a patient on an SSRI. The brain waves indicate that the patient

is in a

total anesthetic sleep state and dreaming while appearing awake and talking

to

others.

 

 

Ann Blake Tracy, Ph.D.,

Executive Director, International Coalition For Drug Awareness

Author: Prozac: Panacea or Pandora? - Our Serotonin Nightmare

& audio tape on safe withdrawal: " Help! I Can't Get

Off My Antidepressant! "

 

Order Number: 800-280-0730

Website: www.drugawareness.org

 

 

http://nytimes.com/2004/08/23/business/23drug.html?hp

 

August 23, 2004

 

Boy's Murder Case Entangled in Fight Over Antidepressants

 

By BARRY MEIER

 

 

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 Wrong

 

When 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

 

Little is known about Christopher Pittman's response

to Paxil, because he took the drug for only a few

days. And reports about his reactions to Zoloft vary

sharply.

 

He later told a psychiatrist that his mood changed on

the medication, to the extent that he " didn't have any

feelings. "

 

The notes of the local doctor who prescribed the

medication for Christopher paint a different picture,

according to court records.

 

That physician, who saw Christopher just a few days

before the killings, described him this way: " Lots of

energy. No plans to harm self. Not flying off the

handle. "

 

Psychiatrists have long known that adult patients

might experience increased suicidal thinking or

agitation during the first weeks of treatment with

S.S.R.I.-type antidepressants. But in May 2003

GlaxoSmithKline made a disclosure related to pediatric

use of the drug, which would set off a cascade of

events that are still in motion.

 

That month, the drug maker told the federal Food and

Drug Administration and its British counterpart agency

that its re-examination of published and unpublished

test data showed that adolescents who took Paxil

during clinical trials had more suicidal thoughts or

attempted suicide more often than those who received a

placebo. About six months earlier, a curious F.D.A.

analyst had contacted the company seeking more safety

information.

 

Within weeks, British drug regulators told doctors not

to prescribe Paxil to new patients younger than 18. In

June 2003, the F.D.A followed suit, and a month later

the agency asked all antidepressant makers for more

safety data about their pediatric tests. In the weeks

leading up to an emotionally charged F.D.A. hearing

this past February on antidepressant safety, doctors

learned that the drug industry had not published all

the data gathered during pediatric trials of the

medications.

 

Dr. David G. Fassler, a child and adolescent

psychiatrist in Burlington, Vt., who attended the

meeting, recalled being struck by the number of

pediatric studies he had never known about although he

followed medical journals.

 

" This was a lot more data than I knew existed, " said

Dr. Fassler, who is an official of the American

Academy of Child and Adolescent Psychiatry, a

professional group. That hearing also served as a

public forum for grieving parents to testify about

children who had committed suicide soon after they had

started on antidepressants. Joe Pittman, Christopher's

father, was there, reading a letter written by his son

in prison, in which he blamed Zoloft for his

grandparents' deaths.

 

" Through the whole thing, it was like watching your

favorite TV show, " wrote Christopher, who is now 15.

" You know what is going to happen but you can't do

anything to stop it. "

 

A Gathering of Lawyers

 

By then, his case had become the center of a pitched

legal struggle. Mr. Vickery, the plaintiffs' lawyer

who had won the Wyoming trial, was contacted about the

Pittman case by the International Coalition for Drug

Awareness, a group based in Utah opposed to

antidepressant use.

 

Over the past decade, the group's director, Ann Blake

Tracy, has become involved in several murder cases in

which a defendant has been on antidepressants or other

drugs. Ms. Tracy maintains that antidepressants

" overstimulate the brain stem and cause you to go into

a sleep-walk state where you can act out the

nightmares you have. " Mr. Vickery, who has been suing

antidepressant makers since the mid-1990's, soon

joined the defense team, offering his services for

free. So did another plaintiffs' lawyer who has filed

similar lawsuits, Karen Barth Menzies of Los Angeles.

 

Lawyers for Pfizer have also gotten involved. The

case's prosecutor, Chester County Solicitor John R.

Justice, was recently hospitalized with a serious

illness and has not been available to comment. But he

stated at a court hearing that Pfizer had provided

information to him last year to help him prepare for

the trial, according to a published report in The

Herald, a newspaper in Rock Hill, S.C.

 

Christopher Taylor, an assistant country solicitor,

said he thought that Pfizer had contacted Mr. Justice.

The material provided by Pfizer, the article reported,

included F.D.A. reports about Zoloft and previous

court testimony by a psychiatrist, Dr. Peter R.

Breggin, who is scheduled to testify on Christopher

Pittman's behalf. Dr. Breggin, who has campaigned

against the use of psychotropic drugs in children, has

testified in numerous lawsuits and criminal trials

that a link exists between S.S.R.I.-type

antidepressants and both suicide and violence -

positions rejected by drug makers like Pfizer and by

many other experts.

 

" I have been given advice on how to cross Breggin, "

Mr. Justice was quoted as saying, adding that he had

" been schooled on how these drugs are supposed to

work. "

 

The involvement of a drug company like Pfizer in a

criminal proceeding is not unusual. Jennifer Yoder, a

spokeswoman for Eli Lilly & Company, the maker of

Prozac, said that over the years, a " Prozac defense "

had been raised about 75 times in criminal cases and

that the company had worked with prosecutors at times.

She said she was unaware of any case in which the

Prozac defense succeeded.

 

Not long ago, Mr. Vickery and Ms. Menzies asked the

case's presiding judge to order the release of scores

of Pfizer company documents about pediatric trials of

Zoloft, claiming they were critical to their client's

case. Those records were reviewed in the past by Ms.

Menzies, the plaintiffs' lawyer, as part of a 2002

civil lawsuit filed in a Los Angeles federal court

against Pfizer by the widow of a man who committed

suicide a week after starting on Zoloft. The case was

dismissed before trial.

 

According to court filings, the documents include

early drafts of a published positive pediatric report

about Zoloft that was later criticized by researchers

for its methodology. F.D.A. officials also did not

find that the study provided convincing evidence of

Zoloft's efficacy in children and adolescents. Both

Mr. Vickery and Ms. Menzies said they were barred from

speaking specifically about the Pfizer documents

because they were covered by confidentially agreements

they had signed during civil proceedings. But with the

Pittman defense, " I am hopeful that this case is the

one that all of Pfizer's dirty laundry comes out, " Mr.

Vickery said.

 

Pfizer's lawyers have argued in court papers in the

Pittman case that the documents being sought have

nothing to do with the boy's situation, also noting

that a Florida judge struck down a request for company

records in a similar case. In addition, they have

effectively accused Mr. Vickery and Ms. Menzies of

using the case to make a cynical end run in order to

obtain documents they want for other Zoloft-related

lawsuits they are pursuing.

 

A Case in Limbo

 

A Pfizer spokeswoman, Mariann Caprino, said in an

e-mail message that Mr. Vickery had made a business

out of suing antidepressant makers. " In his three

cases against Pfizer that were decided by the court in

which he claimed Zoloft caused suicide, each case was

decided in Pfizer's favor and dismissed by the court, "

she stated.

 

The case's presiding judge has yet to rule on the

document disclosure issue.

 

Christopher Pittman's trial, scheduled to begin this

fall, may be delayed because of the illness of Mr.

Justice, the prosecutor. The teenager's lawyers are

trying to move his case to juvenile court, where if

convicted, he would be released by age 21 from a

juvenile facility.

 

Meanwhile, lawyers like Mr. Vickery have continued to

file lawsuits. Although Mr. Vickery failed earlier

this year in his first attempt use an S.S.R.I. defense

to win an acquittal in a murder case, at a trial in

Detroit, the calculus of such cases may be changing.

 

In April, a time of intense media publicity about the

issue, a man was acquitted of attempted murder after a

state jury in Santa Cruz, Calif., found that he was

not liable for his actions because of a reaction to

Zoloft.

 

The case's prosecutor, Barbara Rizzieri, an assistant

district attorney for Santa Cruz County, said the

growing debate about antidepressants had played a role

in the outcome. " If this had happened a year ago, " she

said " it truly would have been different. "

 

Copyright 2004 The New York Times Company