[Marxism] Murder asssociated with anti-deperessant use
davidquarter at sympatico.ca
Mon Aug 23 20:21:56 MDT 2004
From: LILITH Finkler
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
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
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
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
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
The Wyoming award has not led to similar verdicts, and drug makers like
Pfizer take the position that antidepressants do not cause suicide or
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
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
"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
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
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."
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