Prosecuting for Pharma

Antidepressant manufacturers team up with district attorneys to make sure the Zoloft defense doesn?t fly.

For all of his 12 years, the only constant and reliable figures in Christopher Pittman’s turbulent life were his paternal grandparents. “He loved his grandparents with all his heart,” says his father, Joe Pittman. “They were his life.” But on the night of November 28, 2001, Christopher rose from bed and got the pump-action, .410-gauge shotgun that had been passed down from his grandfather to his father and on to him. He fired it into the sleeping bodies of Joe Frank Pittman, 66, and his wife, Joy, 62; then he set their house on fire and fled.

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Sometime this year, Christopher, now 15, will be tried -- probably as an adult -- in a South Carolina courtroom for first-degree murder. He admits to the killings, but says he acted in a fit of agitation and psychosis caused by the antidepressant he had been taking for just three weeks, Zoloft.

The antidepressant defense has been raised by at least 100 people accused of violence or murder, but it’s not one that Pfizer, the maker of Zoloft, wants to succeed -- particularly now,

when manufacturers and the FDA are under fire for withholding information about dangerous side effects of antidepressants. So the company’s lawyers are doing what they’ve done many times before: assisting the prosecutors by supplying medical information and legal advice.

In the early 1990s, Eli Lilly, the maker of Prozac, started the practice of aiding district attorneys who were prosecuting defendants who blamed the drug for their acts of violence. Lawyers for Pfizer, the world’s largest pharmaceutical company, later created a “prosecutor’s manual” for the same purpose.

The Zoloft manual itself is a closely held secret -- and Pfizer has fought hard to keep it that way. In 2001, a widow sued Pfizer because her husband shot and killed himself after six days on Zoloft. Her lawyers discovered in Pfizer’s records a reference to a document called “prosecutor’s manual,” and requested a copy.

Pfizer fought the request, claiming it was privileged information between the company and its attorneys. The judge allowed the manual to be introduced -- noting it was designed to prevent “harm to Pfizer’s reputation” if a defendant successfully raised “a Zoloft causation defense” -- but he agreed to thereafter seal the manual and keep it out of the public record.

James Hooper, an attorney for Pfizer, says that “in rare cases” the company’s attorneys have provided the manual to prosecutors if a defendant “is attempting to blame some sort of criminal behavior on the medicine. It’s important for the prosecutor to have accurate information. We’re trying to make sure the truth gets told.” He declined to provide a copy of the manual to Mother Jones.

GlaxoSmithKline, the maker of the antidepressant Paxil -- which Christopher also took briefly -- also supplied information to the Pitt- man prosecution. At a court hearing in June, prosecutor John Justice said he’d received a manual from GlaxoSmithKline, and that Pfizer representatives had given him documents and information on a defense psychiatric expert, Peter Breggin. “I have been given advice on how to cross [examine] Breggin ... and have been schooled on how these drugs are supposed to work,” Justice told the court.

Until recently, defendants who’ve blamed violent episodes on antidepressants have rarely succeeded. But as information comes to light that manufacturers have long had indications that the drugs might trigger suicidal or violent urges in some people, the legal argument is gaining traction.

• In 2001, a Wyoming jury found that Paxil had caused 60-year-old Donald Schell to kill his wife, daughter, granddaughter, and himself, and ordered GlaxoSmithKline to pay $6.4 million to surviving family members. Three hours before the killings, Schell took his first two sample tablets of Paxil.

• In April of this year, a jury in Santa Cruz, California, acquitted Andrew Meyers of attempted murder. He had struck a friend with a spiked, brass-knuckles-like weapon, opening a gash in his head. A neuropsychiatrist testified that Zoloft eliminated Meyers’ inhibitions and impulse control, so that he expressed a fleeting emotion -- anger -- with sudden violence.

• And in Florida, the trial of Leslie Demeniuk, accused of killing her four-year-old twin sons in 2001, is on hold while prosecutors appeal a judge’s ruling that two defense experts could testify that Demeniuk was “involuntarily intoxicated” and “psychotic” as a result of taking Zoloft and then Paxil.

One of the prosecutors in the Demeniuk case, Assistant State Attorney Norma Wendt, told Mother Jones that Pfizer lawyers have provided her with advice and documents from other court battles. “I can pick up the line and call Jim Hooper or another Pfizer lawyer,” she said. “They hope like heck we prevail.”

Back in South Carolina, Christopher Pittman could face life in prison. It will be another ordeal in a life that was troubled from the start. His mother, Hazel, left him when he was six weeks old. In the following years, he lived with Hazel’s mother, his father Joe alone, and with Joe and his second and third wives. But mostly, he lived with Joe’s parents.

“My mom and dad -- his Pop-pop and Nanna -- were like parents to him,” says Joe. “He worshiped the ground Pop-pop walked on.”

The trouble began when Christopher’s grandparents retired and moved to South Carolina, leaving Christopher and his sister in Florida with Joe. Soon after, Christopher’s mother briefly initiated, then cut off, contact with her long-estranged children. Christopher threatened to kill himself and was placed in a psychiatric hospital, where he was put on Paxil.

Christopher’s grandparents convinced Joe that they should take the boy to South Carolina, where they enrolled him in school, brought him to church, and took him to a doctor, who switched his prescription to Zoloft. Christopher says the doctor told him to take 100 milligrams a day, but a week later increased the dosage to 200 milligrams.

When Christopher visited Joe at Thanksgiving, he initially seemed “more upbeat,” Joe recalls. “But now I look back at it, it was almost like an adrenaline rush. He was shaking his hands and feet like he was nervous.”

Back in South Carolina, Christopher got into a fight on the school bus and hurt a younger boy. His grandparents told school officials they would discipline him. In the evening, they took him to church choir practice, and then went home. That night, tragedy struck.

“When I was lying in my bed that night, I couldn’t sleep because my voice in my head kept echoing through my mind telling me to kill them,” the boy wrote in a letter his father read early this year to an FDA committee. “I got up, got the gun, and I went upstairs and I pulled the trigger. Through the whole thing, it was like watching your favorite TV show. You know what is going to happen, but you can’t do anything to stop it.”

Civil attorneys who have joined Pittman’s defense team want Pfizer to turn over sealed confidential documents they’ve been allowed to see in civil cases that they say show Zoloft can trigger acts of suicide and violence. Pfizer has resisted releasing the documents, and the two sides continue to skirmish. At stake is the reputation of the top-selling antidepressant in the United States, its $3 billion in annual sales -- and the future of a 15-year-old boy.