Guest guest Posted February 22, 2005 Report Share Posted February 22, 2005 atracyphd2 Mon, 21 Feb 2005 19:58:08 EST [drugawareness] Antidepressants: Can they turn kids into killers? Another front page article yesterday out of Binghamton, NY on Kurt Danysh's case. An interesting side bar is that Binghamton is where I lectured at the college about two years ago when friends of mine, a husband/wife team of psychologists, Ben and Elaine Perkus, invited me to speak there. Septemember 13, 2004 as I rushed to attend the FDA hearings in DC on antidepressants and children I got a call from them. Ironically they called about a young man who was having severe reactions to his antidepressant and they were looking for help on how to avoid a fatal reaction. What a shame that few knew enough when Kurt Danysh took Prozac to do the same for him! His father would still be alive and Kurt would be going on with a normal life instead of being behind bars with the pain of knowing he took his father's life. Dr. Tracy _________________ Ann Blake Tracy, Ph.D., Executive Director, International Coalition For Drug Awareness Website: www.drugawareness.org Author: Prozac: Panacea or Pandora? - Our Serotonin Nightmare & CD or audio tape on safe withdrawal: " Help! I Can't Get Off My Antidepressant! " Order Number: 800-280-0730 ________________________ http://www.pressconnects.com/today/news/stories/ne022005s149577.shtml Sunday, February 20, 2005 Antidepressants: Can they turn kids into killers? New cases, evidence to test 'Prozac Defense' BY KARA M. CONNERS Press & Sun-Bulletin Kurt Danysh can't explain why he fired a shotgun blast into his father's head. He only knows he felt the need to shoot him. Kurt Danysh and twin sister Nikol are shown during a 2004 visit Nikol made to Frackville Correctional Facility. Submitted photo Antidepressants in court Here are some highly publicized cases in which murders or suicides were blamed on negative reactions to antidepressants: * 1989: Joseph Wesbecker, 47, shot and killed eight people, injured 12, and shot himself at a Louisville, Ky., printing plant. He had a history of depression and was prescribed Prozac a month before the killings. Wesbecker's relatives sued manufacturer Eli Lilly & Co. in 1994, alleging that Prozac caused him to commit the crimes. The company won, but it was later revealed Lilly struck an agreement with the family during the trial, making the verdict invalid. * February 1998: Donald Schnell, 60, took two Paxil tablets before shooting his wife, daughter, granddaughter and himself in Wyoming. Schnell's family brought a case against GlaxoSmithKline, the producer of the drug. The family won $8 million in damages in 2001. * August 1999: David John Hawkins, 76, strangled his wife at their farm in Australia. The retired mechanic suffered from depression and took five tablets of Zoloft the night before the killing, five times the dose prescribed by his doctor. An Australian court acquitted Hawkins in 2001. * March 2000: Christopher DeAngelo, 28, robbed a Connecticut department store, gas station and two banks four months after being prescribed Prozac and Xanax. A judge determined the drugs impaired DeAngelo's judgment. The 2000 ruling was the first time the " Prozac defense " stood up in an American criminal court as a defense. * June 2002: Amby Cole sued Eli Lilly after her husband hanged himself 13 days after being prescribed Prozac. According to court documents, the drug made Cole's husband " nervous, jittery and aggravated. " Lilly settled the case in 2003 for an undisclosed amount. * January 2004: Christopher Bernaiche, 27, fired at least 20 bullets in a Michigan bar, killing two and injuring three. Bernaiche claimed Prozac sparked his behavior. His dose of Prozac had been doubled two months before the shooting. In February, Bernaiche was convicted of two counts of first-degree murder. * April 2004: Andrew Meyers, 28, struck his friend in the head four times with a brass knuckles-type weapon after a fight over a bicycle. Meyers took Zoloft for two weeks before the fight. The California man was found innocent of attempted murder and assault. * February 2005: Christopher Pittman, now 15, was found guilty of two counts of murder and sentenced to 30 years in a South Carolina prison. Three years earlier, Pittman shot and killed his grandparents while they slept, then set their house on fire and fled in the family car. The defense claimed Zoloft caused his violent behavior. SOURCE: Press & Sun-Bulletin research Nor does Danysh, then 18, remember how he came to steal the gun, or the 8 miles he walked to Wasyel Danish Jr.'s Brooklyn Township, Pa., home on that April 1996 day. But today, 7 1/2 years after pleading guilty to murder and being sentenced to 22 1/2 to 60 years in prison, Kurt Danysh remains certain of one thing: An antidepressant made him pull the trigger. " Prozac killed my dad, " Danysh said last week at the maximum-security Frackville (Pa.) Correctional Facility, an 1,100-inmate prison between Wilkes-Barre and Harrisburg. " But it used my hands to do it. " Danysh's case was one of the first in which lawyers in the United States tried to blame antidepressant medication for a murder. His attorneys claimed that withdrawal from the widely prescribed antidepressant Prozac contributed to the rage that led to the shooting. That strategy has come to be known as " The Prozac Defense. " Since the murder, new evidence has emerged about possible connections between antidepressants and suicidal and violent behavior in children and teenagers; Danysh hopes the recent findings will enable him to appeal. A hearing in April will determine if new evidence regarding his case warrants a new trial. There will be plenty to consider: * Lawyers for 15-year-old Christopher Pittman this month claimed Pittman was impaired by Zoloft -- the nation's most prescribed antidepressant -- when he fatally shot his grandparents and set their house on fire when he was 12. A South Carolina jury didn't buy the argument; jurors convicted Pittman on two counts of murder and sentenced him to 30 years in prison. * The Food and Drug Administration now requires all antidepressant manufacturers to include " black-box " warnings on drugs prescribed to children and teenagers. The warning, one step below a ban, indicates the drugs can cause an increase in suicidal behavior. Still, antidepressants have been prescribed to more than 11 million children each year; 80 percent of those prescriptions are written by primary-care doctors rather than mental-health specialists. * Federal studies also have shown that the drugs can cause increased agitation, anxiety, hostility and violence in a small number of patients -- especially males. All that raises this question: Can antidepressants turn some people into killers? Fighting depression Depression is thought to be linked to the central nervous system's " uptake " of a substance called seratonin. Antidepressants, in a nutshell, are drugs that help some nerve cells in the brain work better. The brain of a nondepressed person has an adequate supply of " neurotransmitters " -- chemicals that help nerve cells send and receive messages that influence mood. The brain of a person who has depression has a low level of neurotransmitters, meaning nerve cells don't communicate effectively. Anti depressants also are used to treat obsessive-compulsive-disorder, eating disorders, panic, social anxiety and stress. More than 18 million Americans suffer from depression, according to the Food and Drug Administration, and Americans take more antidepressants than any other type of drug. In Broome County alone, experts estimate that one in 10 adults are taking or have taken antidepressants. In 1987, Prozac became the first of a family of drugs called selective serotonin re-uptake inhibitors (SSRIs) approved by the FDA for use in adults and children. Prozac, produced by Eli Lilly & Co. of Indianapolis, was launched in the U.S. in 1988 and is prescribed to more than 40 million people worldwide. Within several years of its release, the debate over potential violent effects reached the courts. In a high-profile 1994 case, the family of a Louisville printing-plant worker sued Eli Lilly & Co., claiming his four-week use of Prozac caused the 1989 rampage in which he fatally shot eight people and wounded 12. Lilly won the case, but the verdict was later rendered invalid when it was revealed that Lilly had struck an agreement with the family during the trial. Since 1994, Lilly has faced more than 300 lawsuits over Prozac's alleged side effects. In 2002 alone, the company spent about $13 million in litigation and contingencies. Lilly representatives did not return calls seeking comment for this story. In past court cases, including a 2000 civil suit filed after a man stabbed his wife and hanged himself, the company has insisted that Prozac did not cause the deaths. Manufacturers of other anti depressants also have been targeted in court cases stemming from violent incidents. GlaxoSmithKline, makers of Paxil, lost an $8 million verdict to the relatives of a 60-year-old Wyoming man who gunned down his wife, daughter and granddaughter in 1998. Courts in Australia and California returned innocent verdicts in cases of men charged with murder and attempted murder, respectively, while taking Zoloft. Dr. Ivan Fras, a semi-retired psychiatrist who has practiced for 38 years in Broome County and was identified by several local mental-health professionals as the Tier's expert on child and adolescent depression, said handing out antidepressants with little follow-up is a thing of the past. Diagnosing and treating depressed children and adolescents today, Fras said, requires trial and error to determine the best combination of drugs and therapy. Treating depression, he said, isn't an exact science. " Depression does not equal (automatically prescribing an) antidepressant, " he said. " This is not best-practice anymore. " The U.S. government has helped bring about the change in treatment. In October, the FDA wanted to warn the public of the risk of suicidal behavior associated with antidepressants in some patients. The so-called " black-box " warnings are now required on all antidepressant labels. The warnings -- the government's strongest safety alert -- are one step below a ban. In response to the warning, Lilly issued a statement: " Lilly supports the recent FDA efforts. " However, a " black box warning on antidepressants may have a dangerous effect on appropriate prescribing for patients who urgently need proven treatment options. " Troubled past Kurt Danysh, known to the Commonwealth of Pennsylvania as prisoner No. DL-4879, grew up in New Jersey, saw his parents divorce when he was young, and dropped out of school in eighth grade. He recalled Tuesday, in his first public comments since his conviction, how in 1995 he moved in with his father at his Brooklyn Township home -- about 40 miles southwest of Binghamton -- to " start over. " Danysh later received his GED and attended a semester at Keystone College north of Scranton. Along the way, he said he used marijuana, cocaine and hallucinogens. He said he made several suicide attempts as a teenager, but never sought treatment until he was sent to Susquehanna County Jail in 1996 for an unpaid fine. There, Danysh said, he tried to slit his wrists with an ashtray and choke himself with a sheet. He wrote goodbye letters to his friends and family, and set his cell on fire. In a meeting with the jail physician, Danysh said he was depressed and " needed to feel better. " He had seen an advertisement for an antidepressant in a Reader's Digest while in jail, but had never taken the drugs before. " I had no idea what they were, " he said. " All I knew was that they would make you happy. " Danysh was given a two-week dose of Prozac, which he claimed made him suffer paranoia and violent mood swings. A week before his father's murder, Danysh left jail with four doses of Prozac in a plastic bag. The morning of the killing, he punched out the windows in his truck and drove into a wall. Yet he recalls being calm and emotionally numb -- even when he climbed to the top of the Nicholson Bridge, where he planned to commit suicide. He wanted to jump, he said, but he couldn't be sure that the fall would kill him. Instead, he returned to his truck and wrote obscenities in marker on the windshield. He also wrote " KMD is crazy; broken; I love me and no one else ... don't look back. " Then he walked the eight miles to his father's house with a stolen shotgun. Wasyel Danysh was in the front yard planting a tree. The shotgun was in his son's bag as the pair walked into the house. " I was about to walk out the door and I saw dad looking down, " Kurt Danysh said. " I don't know how the gun got out of the book bag. " Danysh mopped up the blood with towels, took a set of keys from his father's pocket, and drove the dead man's car to a girlfriend's house. There, he told her what he had done. A Montrose psychiatrist who examined Danysh after he was arrested said Danysh had a history of drug abuse. The doctor's report also said the teen suffered from attention deficit hyperactivity disorder, anti-social personality disorder, and intermittent explosive disorder. Prozac, the psychiatrist concluded, did not cause Danysh's violent behavior. In October 1997, two days before jury selection was to begin for his trial, Danysh pleaded guilty to murder. In return, prosecutors agreed not to seek the death penalty. He had just turned 19. A dark world " Major depression " occurs in about 12 percent of children and adolescents. Depressed youngsters, Fras said, hate themselves and live in a world of " dark colors. " Antidepressants, he and another local psychiatrist said, can help bring about wonderful results in patients. But not all those experts agree on how a depressed child or adolescent will respond if medication has a negative effect. Fras said he has seen no violent or suicidal behavior in his patients, though he said antidepressants sometimes can cause suicidal behavior. That normally occurs when a patient is misdiagnosed or given a drug he doesn't need, Fras said. And, he said, some adolescents may harm themselves after initially taking antidepressants because the drug gives them energy and motivation to complete the act. Dr. Leslie Major, an adult psychologist and head of mental health programs at Binghamton General Hospital, said he's never seen an adverse or violent reaction to antidepressants in 17 years with the hospital. Major said all SSRIs like Prozac target the same area of the brain and essentially perform the same task. A patient's behavior, he said, shouldn't drastically change based on an individual drug. Legal defenses such as Danysh's, Major said, don't excuse the behavior. " Is that really any different, " he asked, " than saying 'I was drunk when I did it?' It's the same thing as saying they were impaired by a substance. " And the black-box warnings? " The concern with children and adolescents is that it's a vulnerable population and the FDA wanted to err on the side of caution, " he said. " The risk is extremely small. " Fras said the warnings alarm parents unnecessarily, but he supports the precaution because it promotes dialogue and close follow-up between doctor and patient. The benefits of antidepressants, Fras concluded, greatly outweigh any possible consequences. He said he's seen antidepressants save lives and improve the quality of life for thousands of people. " We hear a lot about the cases that have gone wrong, " he said. " But we don't hear about the majority of cases that have gone right. " 'My guilt' Kurt Danysh is 6-foot-2 and barely 150 pounds. He is sitting on a couch in the prison visiting room, wearing a brown jumpsuit with " DOC " printed in pink on the back, leafing through newspaper reports of his arrest. It is Tuesday, the same day the FDA would announce it is creating an independent Drug Safety Oversight Board to monitor FDA-approved drugs once they are on the market and update doctors and patients of new information on risks and benefits. A day earlier, Broome County's Office of Mental Health began issuing letters from the state explaining the side effects of antidepressants and the black-box warning. Danysh is 27 years old now. His blond hair is thinning and crow's feet are forming around green eyes partially hidden behind tortoise-shell glasses. On his right thigh, he says, is a constant reminder of his crime: a tattoo he burned into his own skin using a staple, cigarette ash and shampoo, the few materials he could find in prison. The message is direct: " I'm sorry dad. " If Danysh is unable to appeal his conviction, his first chance for parole will come in 2018 -- when he's 40. In the meantime, he said he'll continue teaching other prisoners to read, working at the prison library and writing articles for Frackville's newsletter. From his 6-foot by 9-foot cell, Danysh corresponds with other prisoners who have attempted the antidepressant defense, and he has started a grass-roots legal aid fund to help finance his appeal. He's never used the Internet or e-mail, but he can rattle off the addresses of several Web sites for anti depressant research. He completed a paralegal course in prison. And he said he sleeps on the floor in his cell because nine years worth of legal files occupy his bed. Among his paints and books, Danysh keeps a photograph of his father. It used to haunt him, he said. But now, it gives him peace. " Ninety percent of my life is penance, " he said. " Nothing will take away my guilt. " About depression More than 12 percent of all children and teenagers suffer from major depression. In 2003, more than 11 million antidepressant prescriptions were written for children in the United States. In October, the Food and Drug Administration required all antidepressant manufacturers to put " black box " warnings on all drugs given to children and teenagers, indicting the drugs could increase suicidal behavior; the warning is the government's strongest safety alert. The state Office of Mental Health offers tips for parents regarding depressed children. In December, the state issued a letter to parents regarding the black box warnings. Read the letter at www.omh.state.ny.us/ omhweb/advisories/parentltr.htm WHAT TO DO AS A PARENT Tips for parents of children diagnosed as having depression: * Be clear and honest when talking with your child about possible risks and benefits of antidepressants. * Talk to your child about any suicidal thoughts. Let the child know he should tell you immediately if he has suicidal thoughts or other troubling symptoms while taking medication. * Develop a safety and crisis plan with your child's doctor. The plan should identify an adult your child can call if he or she is thinking about suicide. * Monitor your child's behavior, especially during the first few months of treatment. * Any child or adolescent taking antidepressants should visit or speak with the prescribing physician at least bi-monthly during the first months of treatment. * Don't abruptly stop or change your child's antidepressant medication without consulting a doctor. WARNING SIGNS * Watch for behaviors or symptoms that your child exhibits for the first time, that seem to worsen, or that worry you or your child. * Watch for suicidal symptoms -- such as ideas of hurting oneself, thoughts or threats of committing suicide or any self-harming behaviors or attempts. * Watch for signs of new or increased depressed mood or anxiety (nervousness, panic). * Watch for insomnia, irritability, hostility, aggressiveness and impulsivity. * If any of these behaviors or symptoms appear, call your child's doctor imme diately. Sources:U.S. Food and Drug Administration, Eli Lilly & Co., New York Office of Mental Health. Online resources Here are some Web sites that offer information on Prozac and depression. * Depression and Bipolar Support Alliance, www.dbsalliance.org. * Depression and Related Affective Disorders Association, www.drada.org. * Eli Lilly & Co., www.lilly.com. * American Psychiatric Association, www.psych.org. * American Psychological Association, www.apa.org. * National Alliance for the Mentally Ill, www.nami.org. * National Alliance for Research on Schizophrenia and Depression, www.narsad.org. * National Foundation for Depressive Illness Inc., www.depression.org. * National Mental Health Association, www.nmha.org. * To view label revisions of several antidepressants and other drugs, visit www.fda.gov/search/databases.html and click on Drugs (AT) FDA (DOT) * An online community for people who use antidepressant medication and mood stabilizers, www.antidepressantfacts.com. * International Coalition for Drug Awareness, www.drugawareness.org/home.html. 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