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Christopher Pittman and his grandfather Joe in a family photo that was charred in the fire Christopher is accused of setting.

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A Drug on Trial
Antidepressants and Adolescents


Chester, South Carolina
Map: Chester, South Carolina



Drugs (Pharmaceuticals)

Suits and Litigation

Decisions and Verdicts

Food and Drug Administration

Jim Stratakos/The Herald
Christopher Pittman entering a courtroom in Chester County, S.C. He faces charges of first-degree murder.

Boy's Murder Case Entangled in Fight Over Antidepressants


Published: August 23, 2004

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.

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