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.

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

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