Pittman, Zoloft, and akathisia revisited

Christopher PittmanI’ve written about Christopher Pittman, now 19, who confessed to shooting and killing his grandparents when he was on psych meds at the age of 12. He appealed for a Supreme Court hearing but was denied, CNN reported today. He — and his defenders — appealed on the grounds that his 30-year sentence was “excessive for someone that age” and that the dosage of his antidepressants at the time (200 mg) “sent his mind spinning out of control.” Pittman was tried as an adult and, his lawyers argue, “no other inmate in the United States is serving so severe a sentence for a crime committed at such an early age.”

In previous posts here and here, I’ve questioned the link between Zoloft and violence/rage. Pittman, in 2001, had been switched to Zoloft a few days before the murder of his grandparents. However, it sounds like there had been some emotional problems in Pittman’s life that may have given prosecutors a solid case:

At the time of the crime, the boy had bounced around homes for years, experiencing a half dozen family splits and divorces after his mother had twice abandoned him as a child. She has not been in Pittman’s life for years.

Joe Pittman, the boy’s father, raised Christopher Pittman and his sister for much of their lives, but the relationship between father and son deteriorated. A state psychologist later testified this was a “young man who’d had difficulty with the adults in his life.”

On November 28, 2001, Pittman was sent home early for fighting in school and sent to bed by the grandparents. The boy claimed his “Pop-Pop” also beat him with a belt as punishment.

South Carolina prosecutors may easily have set Pittman up as a disturbed young man, which he very well may have been. But there are indications that this disturbance transcended his emotional state into his mental health:

After threatening to harm himself and suffering other emotional incidents, the boy was diagnosed as clinically depressed. His lawyers said Pittman was then given Paxil, a mild antidepressant no longer recommended for those under 18.

Just days before [shooting his grandparents], a doctor had begun prescribing Zoloft, another antidepressant. The family contends the abrupt substitution of drugs caused a bad chemical reaction, triggering violent outbursts.

At trial, a parade of psychiatrists offered conflicting testimony on whether the boy’s emotional problems excused his criminal behavior. Prosecutors called the Zoloft defense a “smokescreen.”

Juror Steven Platt later told CNN the crime appeared deliberate. “It always seemed like the defense was grasping at straws,” he said. “Just because you take prescription medicine doesn’t mean you can’t be held accountable for your actions.”

Platt’s right. I’m not familiar with the specifics of the trial and I don’t know how far an insanity plea might have gone. I don’t think Pittman was “insane,” but for his age and the medication he’d been taking, Pittman really should have been put into an institution for psychiatric care. Let’s review some facts on this:

  • Pittman took Paxil: It is not recommended for those under the age of 18.
  • Pittman was put on Zoloft: “The Food and Drug Administration in 2004 ordered Zoloft and other such medications to carry warnings of an increased risk of suicidal behavior in children.”

It’s also worth mentioning that akathisia (agitation, restlessness) is seen as a possible side effect in nearly all major antidepressants. Zoloft appears to have a high incidence of this problem.

So far, all of the medication that Pittman took before even hitting his teen years isn’t even recommended for someone as old as 17. While people who suffer from adverse effects can report them to drug companies, it sounds like Pfizer did not consider including the Pittman case in their post-marketing side effect data:

Pfizer, the maker of Zoloft, would not comment on the current appeal, but said after the verdict the drug “didn’t cause his [Pittman's] problems, nor did the medication drive him to commit murder. On these two points, both Pfizer and the jury agree.”

I agree. Zoloft didn’t cause his family problems, but his violence and sudden agitation while on the drug leave something to be desired. I grant to you that Pfizer did not report homicide as a post-marketing side effect as a result of the case.

Other Events Observed During the Post marketing Evaluation of ZOLOFT–Reports of adverse events temporally associated with ZOLOFT that have been received since market introduction, that are not listed above and that may have no causal relationship with the drug, include the following: acute renal failure, anaphylactoid reaction, angioedema, blindness, optic neuritis, cataract, increased coagulation times, bradycardia, AV block, atrial arrhythmias, QTinterval prolongation, ventricular tachycardia (including torsade de pointes-type arrhythmias), hypothyroidism, agranulocytosis, aplastic anemia and pancytopenia, leukopenia, thrombocytopenia, lupus-like syndrome, serum sickness, hyperglycemia, galactorrhea, hyperprolactinemia, neuroleptic malignant syndrome-like events, extrapyramidal symptoms, oculogyric crisis, serotonin syndrome, psychosis, pulmonary hypertension, severe skin reactions, which potentially can be fatal, such as Stevens-Johnson syndrome, vasculitis, photosensitivity and other severe cutaneous disorders, rare reports of pancreatitis, and liver events—clinical features (which in the majority of cases appeared to be reversible with discontinuation of ZOLOFT) occurring in one or more patients include: elevated enzymes, increased
bilirubin, hepatomegaly, hepatitis, jaundice, abdominal pain, vomiting, liver failure and death.

(Download uspi_zoloft.pdf)

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3 Comments

  1. Prester John said,

    April 15, 2008 at 8:54 am

    I can’t speak to this case other than to say that in my opinion it’s barbaric to treat children like adults no matter what they’ve done.
    I do know, first hand, that antidepressants changed my predisposition from flight to fight when any challenge, real or imagined, presents itself. I’ve always been a negotiator (coward?) but push me now and it’s on. It’s a visceral thing and quite frankly I don’t like it. I can imagine hurting someone or more likely being hurt, in some sort of altercation that I once almost certainly would have walked away from.
    I just don’t think people’s character/personalities change that dramatically in their late 30s and beyond.

  2. Charlotte said,

    October 28, 2010 at 8:44 am

    I am glad you have addressed this horrible situation with Christopher. Please don’t let go of it. I don’t know him or his family, but I have studied his case and do bring it up often. I am saddened by the canned response that a person is responsible for his actions. When your brain has been altered, you are NOT responsible for what you do. Alcoholics and those who take drugs choose to do so; a child under the care of his grandparents who believe in the doctors, doesn’t and should not be held responsible to this anywhere this extent. His only real choice was whether or not to believe in and obey his grandparents and the medical community.

    He should have been punished, but not to this excess and certainly not after the horror of purposefully waiting until he became old enough to be tried as an adult. He wasn’t an adult when he did it. This decision is unconscionable and the prosecutors should be in jail for their decision.

    Again, thank you and God bless you in your own struggles.

  3. Hatepsychiatrists said,

    July 14, 2013 at 4:30 pm

    Anti depressants are the most dangerous drugs in the world. Psychosis on anti depressants of any type cause depression, anxiety, psychosis and hearing loss. Ban all psychiatric drugs and heal!


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