hristopher 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.