Pubdate: Fri, 30 Apr 1999
Source: Washington Post (DC)
Copyright: 1999 The Washington Post Company
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Author: Avram Goldstein

SHOOTER USED OFTEN-PRESCRIBED DRUG

The psychiatric drug that Eric Harris had been taking before he went on a
shooting rampage at a Colorado high school last week was prescribed about
1.4 million times last year to people suffering from obsessive-compulsive
disorder and associated depression.

Luvox, which is in the same pharmacological category as the widely used
depression drugs Prozac, Zoloft and Paxil, is praised by health
professionals as an important tool in the treatment of the inherited
disorder.

They agree that while Luvox is not a perfect solution, it does help rein in
the recurrent and irrational thoughts, impulses or images that interfere
with the lives of an estimated 5 million Americans, including many children.
Some children as young as 5 are given such drugs.

The maker of the drug, Solvay Pharmaceuticals, said 6.9 million patients of
all ages worldwide have used the drug, which increases the brain's ability
to use a message-carrying chemical called serotonin.

Although suicide attempts are listed as a possible adverse reaction in
consumer information distributed with the drug, government officials,
private practitioners and the manufacturer said yesterday that such episodes
are rare and likely to be caused by the underlying depression that led the
patient to Luvox.

"It's considered a good and safe drug," said Judith Rapaport, chief of child
psychiatry at the National Institute of Mental Health in Bethesda and a
longtime researcher on obsessive-compulsive disorder. "There is no reason to
think it would have any relationship to any unusual or violent behavior."

Jerry L. Rushton, a University of North Carolina pediatrician who studies
serotonin drugs, said patients who stop taking them typically experience
withdrawal problems, including increased agitation and anxiety. Some reports
say Harris had tried to stop taking Luvox after he was rejected by the
Marine Corps because he was on the drug.

However, Food and Drug Administration officials said that they have seen no
evidence linking Luvox to violence and that its performance has so far been
clinically acceptable. "We see hundreds of people using this family of
medications," said Charles Mansueto, a psychologist who directs the Behavior
Therapy Center in Silver Spring and provides counseling to clients taking
drugs prescribed by psychiatrists. "I'm not aware of any particular problem
with Luvox."

One Washington parent said yesterday that when her 12-year-old daughter, who
has the disorder, stopped taking Luvox for two days recently, she began
having thoughts about suicide. The situation was remedied immediately after
she resumed taking the drug, the mother said. The mother, who did not want
to be named, called it "an absolute miracle drug."

Doctors and patients said it is unfair to associate obsessive-compulsive
patients with an increased tendency toward suicide or violence. If anything,
the nature of their often bizarre symptoms makes that less likely, they
said.

"People with [the disorder] are by definition aware of their irrational
obsessions and virtually never act on those obsessions," said Thomas H.
Styron, a clinical psychologist and executive director of the
Obsessive-Compulsive Foundation in Milford, Conn. "While their impulses are
scary and anxiety-provoking, they are not reality based and virtually never
acted on."

In the 12 months ending in February, Solvay Pharmaceuticals sold $145
million worth of the drug.

Luvox has increasingly been prescribed to adolescents. Some critics say that
more clinical trials on children are needed and that some physicians should
raise the threshold for prescribing such drugs.

A Fairfax County high school senior who has suffered from the disorder since
she was 7 struggled with various drugs until she began taking Luvox in a
clinical trial in 1989, said her father, who did not want to be identified.
The improvement was dramatic, he said, and she never had any side effects or
thoughts of violence or suicide.

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