'Zoloft defense' tests whether pills are guilty

Fifteen-year-old Christopher Pittman, peering around a Charleston, S.C., courtroom, is today's poster boy for the "Zoloft defense."

On trial for the 2001 shotgun murders of his grandparents, Jim and Joy Pittman, he is claiming, through his lawyers, that a switch between two antidepressants transformed him into a juvenile Jekyll and Hyde, haunted by and hostage to his nightmares come to life.

On top of growing concerns over the risks of antidepressant use among children, the Pittman trial is testing the public's perception of personal responsibility in the hazy gap between a diagnosed mental affliction and its treatment. Already, antidepressants have been under fire - particularly in their application to children and teens - for increasing the risk of suicidal thoughts and behavior, as some short-term trials have indicated. Now, the Pittman case is offering a lens on an intensifying debate, and a test of how far Americans are willing to go in blaming pills for personal actions.

"I think this is a trial to watch, in part because we're becoming aware that these drugs are not helping all children," says Jack King with the National Association of Criminal Defense Lawyers in Washington. "At the same time, the crime here was particularly horrible, and the defense is really going to have to explain that [Christopher] was not in control of himself."

A similar "Prozac defense" was deployed in some 80 cases in the 1990s. Yet it wasn't until 2000, in Connecticut, that a judge acknowledged an antidepressant's potential role in a crime and acquitted the defendant, Chris DeAngelo, of a robbery three years before.

In the case of Zoloft, which comes from the same family of "selective serotonin reuptake inhibitors" (SSRIs) as Prozac, the defense has gained more legal traction, with two successful cases in the past two years in California and Wyoming. Picking up on the strategy, some defense lawyers are even specializing in Zoloft defenses, leading drug company Pfizer to counter their effort with the "Zoloft Prosecutor's Manual."

The Pittman case, though, is the first criminal trial to test the Zoloft defense, and it touches on an evolving public consciousness of SSRIs' broad use by pediatricians in a country where 1 in 5 children are at some point diagnosed with depression.

The case also comes just a few months after the FDA mandated "black box" warnings for suicide risk - the nation's strongest caution, short of a ban - on Zoloft and 32 other antidepressants, a decision made in light of two Congressional hearings that revealed the FDA has known about problems with the drugs since 1996, but failed to take decisive action. In the last quarter of 2004, the use of such antidepressants dropped 10 percent among children; many attribute the decline to growing awareness of the drugs' potential danger, and to new reluctance in the face of the "black box" label.

To the drugs' critics, Christopher's plight reveals a deeper problem: rampant overprescription of antidepressants for blues that may often be nothing more than the throes of adolescent angst. Taking antidepressants "changes you, and you approach what I call 'learned helplessness,'" a blind faith in the prescribing doctor's advice, says drug-industry critic Jeffrey Wilson, author of "Irrational Medicine."

Page: 1 | 2