Pubdate: Fri, 30 Apr 1999 Source: Washington Post (DC) Copyright: 1999 The Washington Post Company Address: 1150 15th Street Northwest, Washington, DC 20071 Feedback: http://washingtonpost.com/wp-srv/edit/letters/letterform.htm Website: http://www.washingtonpost.com/ 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. - --- MAP posted-by: Don Beck