The August 27 announcement by the National Organization for Women that it will provide financial assistance for the court defense of Andrea Yates - the Houston area mother who drowned her five children in a bath tub - was met with a flurry of national media attention. The Seattle Times ran an Associated Press article about the story the next day. It was a hot topic throughout the day on both KIRO and KVI talk radio stations, with many callers demanding Yates be held responsible for what she did.
The focus of the defense of Andrea Yates has been that she was suffering from insanity induced by post partum depression, or psychiatric symptoms experienced by new mothers, after she gave birth to her fifth child earlier this year. What none of the media or Yates' defenders is focusing on is the fact that the psychiatric drugs she had been prescribed at the time were statistically more likely to cause her to lapse into psychosis, or insanity, and carry out her brutal acts against her own children.
"The chances of a new mother going into a full blown psychosis because of post partum depression is about 1 in 2 out 1,000," said Dr. Ann Blake Tracy of the Coalition for Drug Awareness in West Jordan, Utah. "These are the numbers being used by the psychiatric profession." Tracy's organization provides information for patients who wish to withdraw from psychiatric drugs like Prozac, Paxil and Wellbutrin. Tracy also documents the stories of patients who have experienced adverse reactions to psychiatric drugs in her book Prozac: Pancea or Pandora? She is writing three more books on the experiences of patients prescribed psychiatric drugs. Yates was taking a prescription for two psychiatric drugs when she murdered her children. A prescription for the anti-depressant drug Remeron was added to Yates' existing anti-depressant Effexor prescription after she gave birth to her fifth child, says Tracy.
"Psychiatric drugs are much more likely to induce psychosis in new mothers than post partum depression is," said Tracy. "The drug companies admit that their psychiatric drugs can cause psychosis in 1 out of 100, or at least 10 out of 1,000 patients. Yet one clinical study after another demonstrates that this is an extremely low end estimate, possibly eight to ten times lower. When you add a second drug to a patient's prescription, you are doubling the chances for her to go into psychosis. That's what happened to Andrea Yates after Remeron was added to her prescription. Her psychosis was drug induced. Nobody is paying attention to this."
What about those clinical studies Tracy is referring to? A recent study co-authored by Dr. David Dunner of the Department of Psychiatry at the University of Washington published in the June 2001 Journal of Clinical Psychiatry (JCP) is one example of what Tracy is talking about.
Dr. Dunner conducts clinical trials with psychiatric drugs for pharmaceutical companies. He was one of the lead investigators into the clinical trials that lead to Food and Drug Administration approval for the popular anti-depressant Prozac in December 1987. Dunner's published study in the June JCP involved switching depressed patients who had experienced treatment failure with drugs like Prozac, to Remeron, the same drug that had been added to Yates' Effexor prescription. The study was funded by Remeron manufacturer Organon.
Dunner's Remeron switch study involved 101 subjects at seven academic sites around the United States, including Dunner's department at UW. A total of 43 subjects did not finish the eight week study. Of the total who did not finish the study, 26 experienced adverse reactions to the drug, including 16 who experienced psychiatric symptoms. Of those subjects who experienced psychiatric symptoms, two experienced mania, three aggravated depression and four experienced nervousness.
"These are serious psychiatric symptoms in high numbers for such a small group of subjects," says Tracy. "The terminology being used in the study are euphemisms. Mania and aggravated depression are euphemisms for potential violence and suicide in patients on these drugs. Nervousness mostly likely means the subjects had been experiencing akathisia, or extreme agitation, which can lead to violence and suicide as well." So Dr. Dunner's study confirms Tracy's argument. A total of 9 out of 101 study subjects switched from another anti-depressant drug to Remeron experienced serious psychiatric symptoms that could potentially lead to violence and/or suicide.
What of the potential for patients to commit suicide while on Remeron? Dr. Dunner's study doesn't even consider suicide and there aren't many documented cases of patients becoming violent and/or suicidal while on Remeron, as it is a relatively new anti-depressant drug. However, Dr. Peter Breggin describes such a case in his new book The Anti-Depressant Fact Book.
"Vance was convicted of murder without his defense attorney bringing up the adverse affects of Remeron as a defense or even as a mitigating circumstance," writes Breggin. "Attorney's in criminal cases often have no idea that psychiatric drugs can contribute to abnormal, irrational, bizarre,and destructive behavior." Breggin has written a report in Vance's defense in the hope it will convince the judge in the case to reduce his sentence. Breggin has helped other criminal defendants get lighter sentences when they were on psychiatric drugs while committing their crimes, or what is known as a "Prozac Defense."
Finally, what about the lack of media attention to the fact that Andrea Yates' violent acts against her children was more likely to be drug-induced rather than merely post partum depression induced? Perhaps it is time for the media to start paying attention to the arguments being put forward by Drs. Breggin and Tracy and the clinical studies that back them up, like Dr. Dunner's Remeron switch study.
It couldn't hurt the prospects of Andrea Yates' court room defense either. Her attorneys would probably stand a better chance of convincing a jury that it was Effexor and Remeron that lead her to commit her violent acts against her children.