Wonder Drug on Trial
Once regarded as a miracle cure for depression, Prozac will soon be under attack in a Houston courtroom for causing suicides. The sad case of Skye Morris may determine the fate of the nation’s leading antidepressant.
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When the alarm clock went off at seven Saturday morning, Michael Morris wondered why Skye did not reach over and shut it off, the way she usually did. The clock was on his wife’s side of the black-lacquered bed, and as Michael reached over to silence the buzzing he sighed to himself. “Uh-oh. Skye must be really mad,” he thought.
The night before, Michael and his best friend, Eric Miller, had stayed out until three, drinking beer and playing pool at a bar in southwest Houston. Skye, who hated to be left alone, had been uncharacteristically cheerful, sending Michael off with a kiss and an especially long hug. When he got home, she was asleep. Michael feared he had exceeded the limits of her goodwill. He slid his foot across the bed as a peace offering. But when his foot met Skye’s, she did not reciprocate.
Two hours later he awoke again and touched Skye’s shoulder. There was still no response. This time he realized that something was wrong. He sat up in bed and pulled back the covers. Skye’s face was blue. Her hands were clenched. Her pillow was stained with vomit. Wildly, he felt for her pulse. There was none. He bolted into the guest room, where Eric was sleeping, and shrieked, “Eric, get up! I think Skye’s dead!”
Only later did medical technicians and police officers find the suicide note. The note was devoid of emotion, as if it had been written by a calm and detached Japanese geisha. “Dear Michael,” read the note, “please, please keep Miss Clitty and take very good care of her.” Miss Clitty was Skye’s cat. “The little rat loves you,” the note continued. “Just love her, feed her, and bring her a glass of water to bed every night.” She reminded him to pick up his clothes at the cleaners and included a list of items he needed from the store: toilet paper, shaving cream, cat food.
The only paragraph that mentioned Michael offered no explanation for why she had killed herself. “Well, there’s not a whole lot to say except I truly loved you with all my heart and I always will. I already miss you. Please take care of yourself. Your loving wife, Skye!”
The medical technicians also found the empty bottles of antidepressants—two bottles of amitriplyline and one bottle of Prozac—that Skye had used to kill herself. One of the medical technicians made an offhand remark that raised Michael’s suspicions about Prozac. “Oh,” Michael remembers the EMT muttering, “this is another one of those Prozac suicides.”
Skye died on September 8, 1990. Five months later, Michael filed a civil lawsuit in Houston against Eli Lilly, the maker of Prozac, which is prescribed to relieve depression. He claimed that Prozac provoked his 34-year-old wife’s suicide and asked for a maximum of $20 million in punitive and compensatory damages. Skye’s mother and father joined Michael as plaintiffs. The Morris lawsuit is one of many multimillion dollar cases that have been filed against Lilly, but this case may be the first in Texas—perhaps the first in the nation—to go to trial. It is scheduled to be heard this spring in Houston probate court. The twelve Texans who wind up on the jury must decide more than what killed Skye Morris; they must answer a medical question affecting the future of the nation’s most widely used antidepressant.
The unhappy life of Skye Morris is a window into the private world of depressed women. From adolescence through old age, women are two to six times more likely than men to suffer from some form of depression. Moreover, this pattern has remained constant for decades. In the sixties the National Institute of Mental Health found that 70 percent of antidepressants prescribed in the U.S. are prescribed to women. Thirty years later the percentage is exactly the same.
Depression is popularly understood as unrelenting despair. Symptoms include insomnia, persistent sadness, and an inability to work or play. The mystery is, why does it affect so many women? One theory, put forward by feminists, is that men are to blame. Women are depressed because they have to juggle jobs, children, and households with no real help from men. A second theory, offered by critics of pop medicine, blames doctors for being too quick to diagnose depression in women. Most psychiatrists, however, say the problem is biological. Just as males are more likely to stutter than females, women seem biologically predisposed to depression.
For decades, millions of American women have turned to drugs as the antidote to their despair. The introduction of a new drug follows a predictable course: First comes the boom, when it is greeted as a miracle drug. Then comes the bust, when it is condemned as dangerous.
The boom-bust pattern was present in the evolution of Valium, a tranquilizer introduced in 1963. At first Valium was hailed as safe and effective, the new healer. Only years later, when millions were hooked on these happy pills, did the Food and Drug Administration confirm what consumers had long suspected: Valium is habit-forming. The first drug ever to be effective in the treatment of depression was Iproniazid, introduced in the fifties. Iproniazid had spectacular success in relieving anxiety and phobias, but its side effects are equally serious. If take with certain foods, such as red wine and cheese, antidepressants with the same chemical properties as Iproniazid can provoke strokes, even death.
The pattern was more dramatic with Prozac. Even before the drug arrived at pharmacies, Eli Lilly’s stock rose almost eight points in a single day on the basis of reports that Prozac tends to cause weight loss. Most of the older antidepressants such as Elavil, produce dry mouth, blurred vision, constipation, and rapid pulse. The makers of Prozac promised freedom from those side effects—“The first highly specific, highly potent blocker of serotonin uptakes,” promised the company’s early advertisements in trade publications.
Serotonin, a chemical in the brain that is closely associated with depression, was central to Prozac’s magic. Part of the brain is controlled by a chemical messenger called dopamine, which gives us our drive to act. If this system goes to fast, the chemical messenger that functions as a brake is serotonin. If serotonin levels are too high, the brake is too strong, making a person anxious and afraid. If serotonin levels are too low, the brake is too weak, making a person impulsive and unable to think clearly before acting. Prozac regulates serotonin levels.
In Prozac’s boom stage, people embraced it as a lifesaver. Lilly sent out thousands of five-pill sample packages to doctors across the country. Within eighteen months of its release in 1988, Prozac broke all selling records. In 1989 New York magazine touted it as a “wonder drug,” and in March 1990 Newsweek called it a “breakthrough drug for depression.”
Then came the backlash. Del Shannon, a sixties rock star, killed himself while on Prozac, and his widow filed a lawsuit, blaming the drug. Soon after Joseph Wesbecker gunned down eight people in 1989 in Kentucky, it became known that he had been taking Prozac. The families of his victims filed a lawsuit. In the first two years after Prozac was released, the FDA received 5,740 adverse-reaction reports about the drug. Prozac’s prime competitor, Elavil, accumulated half that number in twenty years. Now the number of official complaints to the FDA has reached almost 13,000. Still the FDA defends Prozac on the grounds that the drug has not been proven to provoke suicide. Recently, Eli Lilly acknowledged that a few people who have taken Prozac have had suicidal thoughts, but the company insists those thoughts weren’t related to the drug.
The real blow to Prozac, however, occurred in February 1990, when a Harvard research psychiatrist published a study documenting the cases of six depressed patients who become obsessed with thoughts of suicide two to seven weeks after taking Prozac. The report, written by Dr. Martin Teicher, became a hot item among plaintiff’s lawyers. Teicher’s theory is that Prozac initially raises the amount of serotonin in the brain, causing some patients—particularly those with a history of tremendous anxiety—to develop out-of-the-blue obsessions with suicide and violence. In other words, the brake malfunctions. It is this theory that underlies the Prozac lawsuits.
Now Prozac horror stories are cropping up all over. In Dallas, Susan Stausey, a 42-year-old unemployed legal secretary, went to a doctor of osteopathy and asked for Prozac by name because she was depressed and overweight. “On the sixtieth day of taking Prozac,” said Stausey, “I had a paranoid delusion. I thought I saw blood on my hands.” She stopped taking the drug. Mary Dawson, also of Dallas, took Prozac in January 1991 for relief of depression. After eighteen days, she woke up one morning determined to kill herself and her three-year-old granddaughter. She sought treatment at a psychiatric hospital the next day. Both Stausey and Dawson sought Prozac after hearing it described as a miracle drug by friends and in the media. After their experiences on the drug, they both saw a segment of the Phil Donahue show about people who had had similar experiences.
This is how modern culture handles depression. Psychiatrists earn their living treating misery they can’t explain. Patients diagnose their ailments after listening to TV talk shows. Then, when the longed-for cure eludes them, they or their loved ones turn to the courts for vengeance.
Skye Morris was a creature of this culture. Why was she depressed? The reasons are as elusive as the cure. The roots of her illness lay in her chemistry, her relationship with her parents, and her choice of husbands. Skye’s first instinct was to put her faith in romantic love, and when that failed, she put her faith in prescription drugs. The drugs failed her too. Skye was a brown-eyed, sturdy brunette who had worked all her life, but for some reason she didn’t have the internal means to get what she needed. She tumbled into a black hole that led to her death. Why did she die? Those closest to her have decided to let a jury decide. The irony is that Michael and her parents may have victimized her as much as any drug.
Skye Morris could have been a poster girl for depression. She was born on May 9, 1956 in Lake Charles, Louisiana, to working-class parents. Dean Redford, tall, with dark hair and jug ears, joined the Navy, worked in the oil fields in Louisiana, and ultimately became a long-haul truck driver. He and Skye’s mother, Juanita, separated when Skye was only four.
Thirty years later, Juanita says she hasn’t a clue as to why she and Skye’s father got divorced, nor does she understand what went wrong with her three other husbands. “I was so young when Skye’s daddy left,” says Juanita. “I guess I was just an airhead.” After Redford left, Juanita moved to Port Arthur, where she took a job as a waitress. Later she moved to Austin and worked on an assembly line at Motorola Computer company.
The one thing Juanita gave her daughter that seemed to stick was her name, which Juanita selected from the Sunday comics. Skye was a character in the Mary Worth strip. “She just loved her name,” recalls Juanita. “If anyone ever called her anything other than Skye, she had a real fit.” Around the time her father left, her hands started shaking. Juanita knew about the trembling, but didn’t take her to the doctor. “I wasn’t one to run to doctors very much,” she explains. As an adult, Skye consulted many doctors, but nothing seemed to steady her hands.
When Skye was ten, she decided never to have children. Years later she told a psychiatrist that she had never owned a baby doll, never felt the slightest stirring of maternal instinct. Juanita knew of Skye’s decision but thought nothing of it. “I never thought much about it, because I never did much like small kids either,” Juanita says. Nonetheless, she bore four children—Skye and three boys.
As an adult, Skye told her best friend that her worst fear in life was that she would follow in her mother’s pattern, going from one bad marriage to another. That, of course, is exactly what happened.
She met her first husband in 1975, her senior year of high school. Ralph epitomized stability. After graduation they married, and he went to work at a Safeway in north Austin. After a promotion to assistant manager, Ralph got the chance to manage his own store. He and Skye moved to Bryan. Four years after their wedding, they were divorced. “There seems to be a pattern of her feeling let down by people,” one of her doctors noted in Skye’s medical records, which Michael obtained after she died.
After she left her first husband, Skye moved home to Austin and took a job at the Texas Rehabilitation Commission as a secretary. The work was boring and repetitive, but her $21,000 salary was enough to pay her bills. Besides, she liked the women she worked with. On weekends they often went in groups to country and western bars. One night at the Okey Dokey, a South Austin club, Skye met her second husband. Sam Seelig was a foreman on a ranch southeast of town and seemed emblematic of the country and western way of life. They were married in 1982 and settled into a pattern of working during the week and dancing on weekends.
“Skye was a real private person,” recalls Sam. “If something was bothering her, she didn’t talk about it. She just withdrew.” Her interior life was a mystery to Sam. For instance, she was jealous and insecure about the marriage, but he never knew of her feelings. In 1986, she made good on her childhood promise and had a tubal ligation. “After it was all over, she seemed relieved,” said Sam. “I though she was happy.”
Apparently she wasn’t. In March 1987, she complained to her family doctor in Austin about feeling depressed. He prescribed several different antidepressants, some of which made her constipated and caused her to gain weight. A few months later, shortly before Skye turned 31, her two cats—Whiskers and Squeaky—died. No other event in her life affected her as much as the death of her cats. It provoked what psychiatrists refer to as a serious depressive episode. In 1988 her physician referred her to an Austin psychiatrist, who diagnosed dysthymia, a form of long-term depression that isn’t disabling but keeps people from ever feeling really happy.
She couldn’t sleep, and it became harder to work. The psychiatric survey indicated that she was having trouble remembering things, was afraid of open spaces, and was uneasy in crowds. She said she felt lonely, hopeless, and worthless and admitted she had never felt close to another person. As sad as she felt, she said she had never considered suicide. The psychiatrist noted that she was plagued with low self-esteem, which was not a surprising diagnosis, and that her neediness and jealousy were a result of feeling abandoned.
The doctor prescribed Desyrel, but Skye later complained that it failed to relieve the depression. Then in 1988, when Prozac was hailed as a wonder drug, her family physician gave it to her, but Prozac produced no miracles, only insomnia. Later that year, she alternated between Prozac and Elavil. She never told her mother that she was depressed. But she complained of headaches and general tiredness. “The pills changed her,” says Sam. “They made her nervous and more edgy, but she wouldn’t get off of them.”
In November 1988 Skye and Sam went to a country and western bar called the South Forty. Many of Skye’s friends from work were there. Sam thought they were having a good time, but late that night she confided in her best friend, Di Anna Guinn, that she had been unhappy with Sam for two years and planned to leave him. At midnight, when Sam told her it was time to go home, she refused to go with him. Sam was completely surprised. “Next thing I knew, she wanted a divorce,” says Sam.
A few weeks later Skye confided to her psychiatrist that leaving Sam was a mistake. “The leaving impulsively may have been a misdirected effort for her to take more control of her life,” wrote the doctor in her records. His solution? He took her off Desyrel. He prescribed Xanax to ease her anxiety, and Skye went off in search of a new Sir Galahad.
“Skye was always good and smiles for me,” Michael Morris recalls one evening about nine months after her death. At 38, Michael is a slim sandy-haired man who smokes one cigarette after another. He seemed the personification of the grieving widower. He walked around the apartment he had shared with Skye, picking up Skye’s favorite knickknacks—hand towels imprinted with cat faces, a pair of crystal cocktail stirrers, her address book, in which she had written, “I love him—he is so fine!” by Michael’s name. “Sometimes,” says Michael, “I can still smell her perfume when I walk into this apartment.”
The two of them met in July 1989 at the South Forty, the same Austin bar where she had told Sam she was leaving him. Michael and Eric Miller had moved to Austin and rented a townhouse just around the corner from the South Forty. From the townhouse they tried to sell used cars.
On the night Michael met Skye she was wearing a suede skirt, a silk blouse, and two-inch heels. “She looked so sharp that she stood out,” Michael recalls. He asked her to dance. She refused but eventually followed him to the dance floor, where Michael stepped on her toes. “You can’t dance,” Skye told him and stalked off.
Over the next few nights, they both returned to the South Forty. On one occasion Michael stopped a flower girl, bought every rose in her basket—about $300 worth—and sent them over to Skye’s table. Gestures such as this won her over. She began spending more time at the townhouse.
Skye believed things would be different with Michael. “She told me I changed her whole life,” he says. “All she wanted was to please me.” In his deposition, Michael described their relationship this way: “We were happy. We enjoyed being with each other. She loved me very much, and I loved her.” The two decided to get married. On a Friday afternoon, September 1, 1989, Skye took off early from work, changed into a new black and white print dress, and married Michael at the Travis County courthouse.
By October, Eric and Michael weren’t selling enough cars to support themselves. One night they moved back to Houston, leaving Skye behind with her mother. By then Skye had quit her job. Michael lived with his father until Skye moved to Houston in December. They shared an apartment with Eric, splitting the $425-a-month rent. In early spring, Skye went to work for the Houston office of the Rehabilitation Commission but quit in June 1990 when Michael got a job as the foreman in the body shop of an auto dealership.
Michael never thought of Skye as depressed. “She was happy and outgoing,” says Michael. “When I would come home from work, Skye would be dressed to a tee, ready to go out to eat or something.” He knew that she took prescription drugs, but Skye told him they were to help her sleep and to calm her nerves and her ever-trembling hands. “I recall times she would shake and be real nervous, but not depressed,” recalled Michael. When he would ask Skye why her hands trembled, she told him it was just something that happened to her. “Skye didn’t go on and on about her feelings, and I didn’t press her,” says Michael.
He did, however, press her about the drugs. When she moved to Houston in December, they had a major argument over her medication. “She was acting real erratic,” he says. “We sat down and talked, and I told her to please stop taking the pills.” Skye told her mother that Michael had thrown her medication in the garbage. In April she went to a Houston psychiatrist, Dr. Albert Douglass, and told him that she had tried a variety of antidepressants. He gave her a prescription for amitriptyline, but she went back to him and complained that the drug made her constipated. Later he gave her a prescription for Prozac. She took it for about ten days, until Michael again insisted that she get off the drug. “She started getting real hyper,” insists Michael. “I made fun of people who called it the wonder drug, saying it sounded like something out of a cartoon. It sounds like Batman and Robin.”
In late August she had prescriptions for both Prozac and amitriptyline. Again Michael noticed a change in her behavior. One night she became irate because Michael got home late from work. “She shut the computer off,” said Michael, “and knocked the keyboard on the floor.” Then she threw a glass across the room.
Michael asked her, “What is it that you take that makes you like this?”
She got the pills from the bedroom and handed him the bottle of Prozac.
Did Prozac kill Skye Morris? According to Michael, it did. To prove it, he hired Dan Fontaine and Russ Waddell, both of Houston, as his lawyers. Fontaine has won several large judgments for plaintiffs in the past. In 1989 he won an $8.8 million judgment by proving to a Houston jury that Jeep CJ7’s were defective and prone to rollovers. Now he has set his sights on Eli Lilly’s deep pockets. “Every time Skye got on Prozac, she had to get off of it because it made her jittery,” said Fontaine. “The last time she took it, it killed her.”
Fontaine is also suing all of the doctors who prescribed drugs to Skye. He will try to prove that their diagnoses were imprecise, as was their method for prescribing drugs. For instance, Dr. Mary Garrity, who prescribed amitriptyline, never laid eyes on Skye or even talked to her on the telephone. Garrity authorized a nurse to refill Skye’s prescription. In addition, Fontaine will try to show that Eli Lilly over-promoted Prozac and that the safeguards for drug testing are insufficient. The basic flaw of the process is that it costs so much money for a drug company to develop a promising drug that the company can’t afford for tests to fail. One clinical psychiatrist in Houston who participated in the early testing of Prozac, says, “The drug companies give us the parameters of the tests, and we rarely ever find anything that was not expected.” The doctor said psychiatrists can’t accurately measure a drug’s full performance until they prescribe it to patients and follow the results. By that standard, Skye Morris’ life was not much more than one long drug test and a preparation for a lawsuit.
But there is another version of Skye and Michael Morris’ marriage, as revealed by people who knew them and by Michael’s deposition in his own lawsuit. It is the story of a third troubled marriage, of yet another man in Skye’s life who had let her down and thereby may have contributed to her depression.
In his deposition, Michael reveled himself as an unlikely Sir Galahad. In the early seventies, he was court-martialed in the Army for selling hashish and was given a general discharge. In the early eighties, he was arrested for changing a price tag and was given deferred adjudication, which means the incident was wiped off his record after he served probation. Later he was convicted of being publicly intoxicated in a bar and paid a $100 fine. In March 1989 he was charged with driving while intoxicated and served probation.
In addition, his deposition indicates a checkered employment history. By the time he met Skye, he had lost one job because of the DWI. He was forced to resign from an insurance company after allegations that he had received a $250 kickback from an auto repair shop. He had no job when he went to Austin with Eric Miller to sell used cars. His credit cards had been revoked for nonpayment. Apparently he had saved some money through a profit-sharing plan, but when he met Skye, he wasn’t as flush as he appeared the night he bought her $300 worth of roses.
Michael’s financial troubles became clear to Skye after the two were married. In the first ten months of their marriage, Skye and Michael Morris spent the $10,000 she got from her retirement fund and accumulated another $10,000 in debt. Her friend Di Anna Guinn said that level of spending was uncharacteristic of Skye. “I used to help her balance her checkbook,” recalled Guinn. “She was very particular about every penny and fanatical about paying all of her bills on time.” One Friday night Skye telephoned Di Anna and confided she was upset because her retirement money was gone. “I love Michael,” Skye told Di Anna, “but I’m going to leave him.”
Di Anna said Skye often talked about suicide. She became increasingly worried about her friend, and in February 1990 she went to Houston to visit Skye. Skye told her that Michael went to bars most weekends without her. On Saturday night, the two women went to a bar by themselves, but Michael joined them later. When it was time to leave, Skye and Michael had a major argument in the parking lot over a woman Skye believed Michael was flirting with. Skye continually cursed Michael, and Michael pulled her from the car and she fell to the ground. “I’d never seen Skye like that,” said Di Anna. “She was simply furious.”
It turns out that she had good reason to be jealous. In his deposition, Michael revealed that less than a month after they were married, when he moved to Houston and left Skye in Austin, he had had an affair with an old girlfriend. After Skye moved to Houston, he told her about the affair. Michael denied in the deposition testimony that he ever hit Skye or that the two ever considered divorce. Eric Miller, who witnessed much of what went on in their marriage, has twice failed to show up for depositions.
“These are just straw issues that the defense will use to attempt to discredit Michael,” Fontaine said. As for the money problems, Fontaine explained that poverty was nothing new to Skye Morris. “Besides, she and Michael had pulled themselves out. His job at the auto dealership was good enough that he encouraged her to quit her secretarial job. That doesn’t sound like a man who was taking advantage of her.” As for the affair, Fontaine insists that Skye and Michael had put it behind them and noted that there was nothing in the suicide note to suggest she was angry at Michael. On the other hand, there was nothing in the note to suggest she was drug-crazed either.
Why Skye Morris committed suicide is the unanswerable question that nonetheless will have to be decided by a jury. A lot is riding on the answer—including whether millions of people like Skye will be able to buy Prozac. The jury will have to determine whether Michael Morris is a grieving widower who wants to alert others to the dangers of Prozac or a venal opportunist who took advantage of Skye Morris and now hopes to profit from her death. They will have to make scientific judgments as well about the effects of Prozac on the brain and about the sufficiency of drug testing.
And they will have to make sense of her shaking hands. Her hands were the outward manifestation of her depression and muted rage. She was a woman who never came clean with anyone. “She wasn’t the depressed type,” her mother told me. “She just got the blahs sometimes.” Her father called her frequently and sent Christmas presents. He described their relationship in his deposition as close. She told all three husbands she loved them, and all three thought that meant she was happy. Everyone noticed her hands, but no one—least of all Skye—knew what to do about it. Her hands kept trembling until, at 34, she quieted them with drugs that had not helped her live but that she took to help her die.