PFPC Daily - March 26, 2005

Family Wonders if Prozac Prompted School Shootings

New York Times, March 26, 2005

By MONICA DAVEY and GARDINER HARRIS

RED LAKE, Minn., March 25 - In their sleepless search for answers, the
family of Jeff Weise, the teenager who killed nine people and then
himself, says it is left wondering about the drugs he was prescribed
for his waves of depression.

On Friday, as Tammy Lussier prepared to bury Mr. Weise, who was her
nephew, and her father, who was among those he killed, she found
herself looking back over the last year, she said, when Mr. Weise
began taking the antidepressant Prozac after a suicide attempt that
Ms. Lussier described as a "cry for help."

"They kept upping the dose for him," she said, "and by the end, he was
taking three of the 20 milligram pills a day. I can't help but think
it was too much, that it must have set him off."

Lee Cook, another relative of Mr. Weise, said his medication had
increased a few weeks before the shootings on Monday.

"I do wonder," Mr. Cook said, "whether on top of everything else he
had going on in his life, on top of all the other problems, whether
the drugs could have been the final straw."

The effects of antidepressants on young people remain a topic of
fierce debate among scientists and doctors.

Last year, a federal panel of drug experts said antidepressants could
cause children and teenagers to become suicidal. The Food and Drug
Administration has since required the makers of antidepressants to
warn of that danger on their labels for the medications.

The suicide risk is particularly acute when therapy starts or a dosage
changes, the drug agency has warned.

Although some studies link the drugs to an increased suicide risk, the
research does not suggest such a connection to violence like Mr.
Weise's rampage through Red Lake High School.

Without knowing Mr. Weise's medical history or precise diagnosis, it
is virtually impossible to speculate on what factors may have affected
him - the drugs, his underlying depression, a gloomy childhood wrapped
in tragedy or something else entirely.

"What I can say is that his physician, I'm sure, made the appropriate
recommendations based on whatever the dosages were," said Morry
Smulevitz, a spokesman for Eli Lilly, which makes Prozac.

The dosage range, Mr. Smulevitz said, runs from 20 milligrams to 80
milligrams a day, so Mr. Weise's 60 milligram dose fell in that
bracket. Mr. Weise, though just 16, was taller than 6 feet and weighed
250 pounds.

Ms. Lussier, who lived with Mr. Weise in her mother's house on the Red
Lake Indian reservation in far northern Minnesota, said she could not
understand what else, aside from drugs, had changed to explain his
sudden violence.

Since his suicide attempt and 72-hour hospitalization a year ago, Mr.
Weise had seemed to be improving, she said, and he was receiving
mental health counseling and a doctor's care at the medical center on
the reservation.

Others in Red Lake said, however, that they had seen few signs of
improvement in the dour, solitary boy.

The driver of a school bus, Lorene Gurneau, said she often saw Mr.
Weise standing outside the middle school, wearing his long black
clothes and strange hairdos, staring off into nothing, in a daze, even
as children raced by or teachers passed him.

Still, in at least one Internet posting last fall, Mr. Weise sounded
determined to improve his life after his suicide attempt, and he noted
that he was taking antidepressants.

"I had went through a lot of things in my life that had driven me to a
darker path than most choose to take," the posting said. "I split the
flesh on my wrist with a box opener, painting the floor of my bedroom
with blood I shouldn't have spilt. After sitting there for what seemed
like hours (which apparently was only minutes), I had the revelation
that this was not the path."

"It was my dicision," he went on, "to seek medical treatment, as on
the other hand I could've chose to sit there until enough blood
drained from my downward lacerations on my wrists to die."

On Monday, in the hours before the shooting, Mr. Weise had seemed
cheerful and normal, Ms. Lussier said. His teacher, who was spending
an hour a day at his house as part of a "homebound" study program that
the school system had created because of his troubles, arrived to give
him his homework assignments, as usual. At 12:30 p.m., less than three
hours before the shootings, another aunt, Shauna, stopped in.

"He was watching a movie on TV," Ms. Lussier said. "There was nothing
out of the ordinary. People keep saying he was depressed, but if you
saw him, he was getting better. All we can think of is, what about the
drugs?"

Though research has not linked antidepressants to acts of violence on
others, several incidents have gained wide publicity.

In 1989, Joseph Wesbecker walked into a printing plant in Louisville,
Ky., with a bag of guns and killed eight co-workers and himself. He
was taking Prozac, which had recently been approved.

In 1999, a student involved in the Columbine High School shootings in
Colorado had reportedly taken Luvox, an antidepressant similar to
Prozac.

In 2001, Christopher Pittman killed his grandparents while taking
Zoloft, another antidepressant similar to Prozac. His lawyers faulted
the drug, but a jury in Charleston, S.C., convicted him of murder in
February.

Still, Katherine S. Newman, a professor at Princeton University who
has studied school killings, said just a small percentage appeared to
have possibly involved psychiatric drugs. Of 27 such killings from
1974 to 2001, fewer than one-fifth of the suspects had been diagnosed
with a mental health disorder before the shootings, Professor Newman
said. Dr. Frank Ochberg, a former associate director of the National
Institute of Mental Health, said he once dismissed any links between
antidepressants and suicides or homicidal acts. The recent research,
however, has changed his mind, Dr. Ochberg said.

"If your intention is shooting the place up and dying as you do it,
you can put the fantasy together," he said. "Suicidal and homicidal
intentions together could theoretically follow the same path."