Did the Drugs Make Him Do It? The Zoloft Defense

June 4, 2009— -- It all began with the Prozac defense. Then came the Ambien defense. And now the Zoloft defense.

The side effects of certain psychoactive drugs have for years emerged in court cases as the supposed hidden culprits in various crimes, from vehicular homicide to physical assault.

Now, the most recent example of this legal move is being played out in the First District Court in Hempstead in Long Island, N.Y.

According to court documents, 38-year-old Brandon Hampson of Lynbrook, N.Y., is charged with assault against his then-girlfriend, Lisa Essling, 28, of Amlverne, N.Y. on Aug. 25, 2006. Police claim that Hampson tackled Essling to the ground before punching and kicking her in her head, face and back. Hampson is charged with third-degree assault, a misdemeanor crime. The charge is accompanied by four other counts that suggest violent behavior from Hampson.

Eric Bernstein, who is defending Hampson in the case, said that he believes the fact that his client had been taking the anti-depression drug Zoloft, but had been off the medication prior to the incident, strongly suggests that withdrawal from the antidepressant could explain his behavior.

"Our defense is that ... withdrawal from the drug was a contributing factor -- if not directly responsible -- for the event," Bernstein said. "Clearly this is not a joke or gimmick-type defense. This is very serious, very legitimate and is going to get a lot of traction. You're going to be seeing more of this, because it's real."

There are signs that the defense could face an uphill battle. Hampson was convicted of assault against a former girlfriend in 1995; Bernstein would not comment on whether he was taking Zoloft at or near the time of that episode.

Eric Phillips, the prosecuting attorney in the case, said no evidence exists to suggest that Hampson had been taking Zoloft at or near the time of the 1995 assault -- which, if true, could affect how a jury perceives the likelihood that side effects from the drug could be involved in the more recent incident.

Zoloft Data Shows No Increased Violence Risk, Company Says

"We are confident in our prosecution of the defendant in that we will -- and the victim will -- prevail in our case," Phillips said.

Meanwhile, Pfizer, the manufacturer of Zoloft, said in a statement Wednesday that no evidence exists to suggest that their drug would have violence-inducing side effects that could lead to such an episode.

"Zoloft is a safe and effective medication that has been used to treat millions of patients with depression and anxiety disorders," the statement reads. "We continuously monitor the postmarketing safety of our medicines and evaluate all available data to ascertain any signal of increased risk.

"Pfizer's evaluation of Zoloft data never has revealed any signal of an increased risk of violence related to either use or discontinuation of use (withdrawal) of Zoloft."

The case is not the first to throw the popular antidepressant into the legal limelight. One high-profile South Carolina case in February 2005 focused on a teenager who was found guilty of shooting his grandparents to death when he was 12 years old and was subsequently sentenced to 30 years in prison.

In one January 2004 case, defense attorneys argued that in 2002, 27-year-old Christopher Bernaiche of Southgate, Mich., was acting under the influence of Prozac when he got into a fight at a bar -- and then returned with a gun, killing two and injuring three others.

And while it is not an antidepressant like Zoloft or Prozac, Ambien has also entered the realm of the legal system as a defense against reckless driving charges. The drug made national headlines on May 5, 2006, when Rhode Island Rep. Patrick Kennedy smashed his Ford Mustang into a barrier near Capitol Hill. He later released a statement saying that he had been disoriented by two prescription medications he had taken, one of which was Ambien.

As for the so-called Zoloft defense, "There are a lot of cases that have attempted this before," Bernstein said -- though he added that such cases have often been complicated by a jury's unwillingness to accept the argument that violent behavior could be explained away by the effects of a drug.

Questions Surround Antidepressant Side Effects

Yet, there have been instances in the past where such arguments with regard to the class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, have been successful. In February 2000, 28-year-old Christopher DeAngelo was acquitted of a bank robbery charge by a Connecticut judge on the grounds that DeAngelo's judgment was impaired by the antidepressant Prozac and the anxiety medication Xanax.

Whether such a defense is scientifically feasible is still a matter of debate in the medical community. While the U.S. Food and Drug Administration has made additions to labeling on SSRIs to warn of the possibility of suicidal behaviors in children using the drugs, they have not included warnings with regard to other behavioral tendencies, such as aggression.

Bernstein argued that Health Canada -- the Canadian counterpart to the FDA -- since May 2004 has required labeling for SSRIs to warn both adults and children of "severe agitation-type adverse events coupled with self-harm or harm to others" including "hostility" and "aggression."

Dr. Stefan Kruszewski, a Harrisburg, Pa., psychiatrist and expert witness for the defense, said he could only speak generally about SSRIs and not about the Hampson case specifically.

"In a case-by-case basis, all you can do is look at the evidence," he said.

But he said that biologically speaking, the idea that antidepressants could result in unwanted behavioral changes, including violence, is definitely plausible.

"To say that these drugs are incapable of inducing violence is just silly to me," he said.

Dr. John Abramson, clinical instructor at Harvard Medical School in Boston and author of "Overdosed America," agreed.

"Whether or not in this particular case this woman was harmed as a result of side effects of coming off the medication, there are always risks of medications," said Abramson, who is not involved with the Hampson case.

Abramson said that while the verdict should be left up to the courtroom, such cases should draw doctors' attention to the possible side effects of SSRIs.

"There isn't a medicine that's powerful enough to be helpful that isn't powerful enough to cause side effects," said Abramson. "We forget that. We hope that medicines are going to be magic pills and they're not."