"It's not my first choice, but if someone is dangerous enough and we are afraid of his safety, it's the quickest and most successful treatment we have."
As for the potential for RU-486, which is so highly regulated that the distributor -- Danco Laboratories -- has offices in a secret location so they are not hounded by anti-abortion protesters, Robbins said, "I think we have to keep an open mind."
What interests Robbins is how steroids, which are used to decrease an inflammatory reaction, play a role in depression. And RU-486 is known to decrease the body's steroid system.
"If someone is taking therapeutic doses of steroids for inflammatory problems, like Lupus or any number of things, even poison ivy and asthma, we know that we increase their risk for psychosis and depression," he said. "It's clear that there are significant emotional reactions."
Robbins suspects there may be a correlation between inflammation and depression.
"I personally don't know the answer if [RU-486] works, but I think the theory is worth exploring," he said. "I think it's still premature with this particular drug, but a compelling theory. With the question of inflammation, cortisol and depression, they may be on to something."
Mifepristone was first used to treat psychotic depression in the 1980s in Holland. A doctor in Rotterdam treated a man who thought he was the victim of voodoo rituals, and was nearly catatonic. They discovered the man had cancer of the adrenal gland, which was over-producing the so-called "stress hormone" cortisol.
They gave him RU-486, and in 24 hours, the patient had a dramatic recovery with seemingly no side effects.
Cheryl had a similar reaction to the drug. Her psychosis grew "out of control" over 13 years after the birth of her son.
Looking back, she said the classic triggers for her depression were obvious: a 38-hour labor with a new baby who was colicky, a divorce where her husband joined a cult, and tax problems with her business.
Nine months after her son's birth, she broke down in the doctor's office and was immediately hospitalized for severe depression. "I was a new mother and I wanted to focus on the baby and I was also so ashamed of having those thoughts. I had everything to live for and I didn't understand why I wanted to kill myself," she said.
The doctor recommended a clinical trial after medications failed. In 2002, Cheryl signed up for Phase 2 clinical trials at Stanford University.
"I had a really dramatic reaction," Cheryl said. "After four days, I woke up and had this remarkable feeling, like I had the most restful night sleep, and I couldn't remember sleeping that well in years."
But after the trial ended, the urge to kill herself returned, and Cheryl had that frightening car accident when she swerved with no one was in the road.
She was then allowed two more treatments in trials, and each time her psychoses disappeared. Cheryl searched for a legal way to find RU-486 through a "compassionate use" program, but was turned away.
That's when she decided to seek out the drug on her own. Cheryl travels abroad to bring back the medication that she believes has made life worth living, despite the legal or medical risks.
"I could be dead or I could have some side effects," she said. "Anything else is minor."