March 31, 2008

Judges Reduce Sentences in Latest Paxil and Prozac Criminal Cases

January, 2002

In two recent criminal cases, judges have reduced the sentences for violent crimes committed under influence of antidepressants.  In each case, the judges responded to expert testimony by psychiatrist Peter R. Breggin, M.D. concerning the adverse mental and behavior effects of SSRI antidepressants, specifically Prozac and Paxil.  Both judges concluded that the medications contributed to the crimes and in post-conviction hearings they reduced the sentences of the two men.

Dr. Breggin has been an expert in other criminal and civil cases involving similar SSRI antidepressants, including Zoloft, Celexa and Luvox.

A Case of Paxil-Induced Mania and Aggression

In November 2001 in Charlestown, South Carolina, Dr. Breggin testified at a sentencing hearing before Judge Edward E. Cottinham.  A 27-year-old man with no prior history of violence pleaded guilty to charges of rape.  Dr. Breggin presented evidence that Paxil can cause mania with disinhibition and aggressive sexuality, and that a Paxil-induced Mood Disorder caused or contributed to the defendant’s actions.  Dr. Breggin described the FDA approval process and related topics.  Despite his initial skepticism, the judge concluded that Paxil did contribute to the man’s crime.  Instead of sentencing him to two consecutive life sentences with no hope of parole, he gave him a more limited 21-year sentence with actual release in 19 years.

The hearing was held in the Charleston County General Sessions Court on November 15, 2001.  The attorney for the defendant was Andrew Savage.

A Case of Prozac-Induced Violence

Earlier in 2001 in Abington, Virginia, Dr. Breggin testified in a jury trial presided over by Judge Charles H. Smith, Jr.  The case involved a man who shot his estranged wife and a deputy sheriff who was trying to protect her.  Fortunately, the victims recovered.  However, the defendant was severely wounded in the shoot out.  He faced many charges including kidnapping and malicious wounding.  At the time of the incident, he was being treated with Prozac, Remeron, and BuSpar.  Dr. Breggin testified on adverse drug reactions, drug labeling, FDA procedures, and criminal responsibility, including involuntary intoxication.  The jury found the man guilty.  Judge Smith, however, set a Virginia precedent by giving a jury instruction for involuntary intoxication.  He also expressed appreciation for Dr. Breggin’s testimony.

The sentencing hearing was held before Judge Smith in November 2001 and the judge gave the defendant a reduced sentence.  In his written opinion, Judge Smith specifically cited Dr. Breggin’s original testimony concerning the effect of the prescription drugs on the defendant’s mental condition and behavior.  The attorney for the defendant was Randall Eads.

Background Science

SSRI’s (selective serotonin reuptake inhibitors) include Prozac, Paxil, Zoloft, Luvox and Celexa.  Other antidepressants, such as Effexor, can also block the uptake of serotonin causing similar effects.  These drugs can cause suicide, violence and other criminal acts through several mechanisms, including the following:

(1) SSRI-induced mania, sometimes (but not always) with psychotic features, such as hallucinations or delusions.  During drug-induced mania, the individual can make elaborate plans, including robberies or embezzlement.  However, the plans are often outlandish and doomed to failure due to obviously poor judgment.  Drug-induced mania can cause many expressions of disinhibited or out-of-control behavior, including sexual acting out, road rage, buying sprees and shoplifting.  Drug-induced mania, even when seemingly not intense, can ruin marriages and destroy careers.

All of the features of mania are not required in order to meet the diagnosis of Antidepressant-Induced Mood Disorder with Manic Features.  If the individual’s mood is  “elevated, euphoric, or irritable,” the necessary criteria are met.

(2) SSRI-induced depression or worsening of depression.  In a seemingly paradoxical effect, antidepressants can cause or worsen depression.  In controlled clinical trials for Prozac that were conducted by the manufacturer, Eli Lilly and Company, depressed patients taking Prozac attempted suicide more frequently than depressed patients taking placebo (sugar pill) or older antidepressants.

(3) SSRI-induced severe anxiety and agitation, especially in a patient already suffering from depression with anxiety and agitation.

(4) SSRI-induced obsessions and compulsions that motivate violence toward oneself or others.

(5) SSRI-induced akathisia, an internal sensation of agitation or discomfort that drives a person to move about, and also to lose impulse control.  During akathisia, the inner experience of agitation includes many unusual physical feelings, such as electricity in the head or body.   The person suffering from akathisia typically feels compelled to move the feet when sitting, to stand, or to pace.  Akathisia is known to increase the risk of suicide and violence.

Dr. Breggin has been a medical expert in many malpractice, product liability and criminal cases involving SSRIs (see for a limited selection).  As a medical expert in 1994, Dr. Breggin provided the scientific basis for a large series of product liability cases alleging violence and suicide caused by Prozac.  The court combined the cases in order to allow one organized effort at discovery.  This facilitated the process of evaluating secret documents obtained from the company.  In this lead role as the medical expert for the combined cases, Dr. Breggin reviewed internal documents from Eli Lilly & Company, the manufacturer of Prozac, and also examined FDA materials and the scientific literature.  In a more recent product liability suit against Eli Lilly & Company, Dr. Breggin once again had the opportunity to examine internal documents, this time at the corporate headquarters.  As far as Dr. Breggin is aware, all of the individual Prozac product liability suits in which he has agreed to be an expert have been settled or remain active.

For documentation and further detailed discussion of the above summary, see the following three books by Peter R. Breggin, M.D.:  (1) Talking Back to Prozac (with Ginger Breggin, 1994), Brain-Disabling Treatments in Psychiatry (1997, revised 2008), and (3) The Antidepressant Fact Book (2001).


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