Suicidal Impulses: The Mystifying Death Of Marc Pizzuto — (Washington Post)

SSRI Ed note: Talented and popular student, 21, takes Prozac and commits suicide. Parents figure out that the med was responsible. FDA still denies Prozac-suicide link.

Original article no longer available

Washington Post

April 14, 1992

Author: Colman McCarthy; Washington Post Staff Writer

From what his parents and college friends can remember, nothing that Marc Pizzuto said or did in recent months, or even of late, hinted that he had thoughts of taking his life. In mid-March, he did — at home in the basement with his father’s gun, while his mother, a legal secretary, was at work and his father, a freelance commercial artist, was in the kitchen upstairs. Two stories are here: one about Marc’s life, the other about the questions his parents have regarding Prozac, the antidepressant prescribed for him.

In the spring semester of last year, Marc, 21, was one of my students at the University of Maryland. He had qualities that would hearten any teacher: a reflective mind, an appetite for the give-and-take delights of classroom discussion and a writing style that was sensory in tone because he avoided the stiffness of term-paper prose in favor of letting his feelings flow. Marc, in the General Honors program, had the rarest of undergraduate gifts — intellectual openness. He savored exploring new ideas and seeing where they would take him. He spoke of becoming a professor.

At the university, where he was on a partial academic scholarship and kept a 3.8 average, Marc had formed solid friendships. One of his classmates in my course said of him: “We always got into long discussions after the class, and I could never keep up with Marc’s depth of thought. I admired the way Marc seemed so fascinated with every aspect of life. He was the kind of person I wanted to be.”

Marc wrote two papers for class: “The Utility of a Nonviolent Lifestyle” and “Conflict Partnership — A Remarkable New Approach to Managing Conflict.” In the second, a review of a course text, “Conflict Partnership” by Dudley Weeks, he wrote: “I am rather fortunate. I feel my parents have taught me many of the techniques found in ‘Conflict Partnership,’ techniques that are indeed effective. Unknowingly, they have taught me by their example as well as through their interaction with me. Yet I am now more aware of the nature of conflict after reading this book, and I believe that I am better equipped to handle future conflicts with greater skill.”

That Marc was apparently unable to deal nonviolently with the conflict that led to his suicide is perplexing to many of those who knew him, including myself. I went back and reviewed his papers that he wrote for my class for any hints of self-destructiveness. I could find none. He left no suicide note. He never talked about taking his life with his parents.

He was, however, depressed — though I never saw any symptoms of it in my class. But now I know from his medical records, which his father shared with me, that he first went to the university counseling center for treatment of his depression in January of last year. The psychiatrist noted that he was suffering from a major depression — that he had first been depressed in the seventh grade. Marc was given counseling with a psychologist at the university. He was also prescribed the antidepressant drug Prozac by a psychiatrist at the university’s mental health clinic.

At first, he responded well to the therapy. The week after he started Prozac, the doctor noted in his records: “After 3rd or 4th day on Prozac, cloud lifted, started feeling positive, becoming sociable and social, etc. ‘Feel great!’ ”

Marc’s parents knew he was on Prozac but said he told them that it was only a mild depression. When I visited Jim and Carri Pizzuto a few days after their son’s death, they were in deep mourning. This was their only child. Their stories about him confirmed my impressions: a young fellow who glowed with life and had ample self-confidence to handle the routine academic ups-and-downs that periodically come to every college student. At home, he exercised regularly and was careful about his diet.

The Pizzutos are left with questions about their son’s illness — and questions about the drug Prozac. “I didn’t know much about Prozac before Marc’s death,” Jim Pizzuto said, sitting in his living room. “But what I’ve learned since tells me that this is a controversial drug with great risks of terrible side effects.”

The literature on Prozac, the Pizzutos have learned, includes accounts of possible links between the drug and suicidal or homicidal behavior. According to drug liability lawyer Leonard Finz, a former justice of the New York State Supreme Court, some 125 civil suits in state and federal courts are pending against Eli Lilly & Co., the manufacturer. Finz is the lead lawyer in many of the suits.

Last May, the Health Research Group, a Washington advocacy organization, petitioned the Food and Drug Administration to put a warning on the labeling of Prozac “about a risk of suicidal impulses.” The “most frightening side effect in a very small fraction of people taking Prozac,” said the Health Research Group, “is an intense preoccupation with suicide.”

The FDA declined the petition. The review panel concluded that Prozac is safe and effective. An Eli Lilly official, who says Prozac is the world’s largest-selling antidepressant, calls the drug “safe and effective. Every regulatory body that has looked at the data has said that.”

An autopsy found that Marc was on Prozac at the time of his death. For the parents, a hard part of the mourning is struggling with questions that have no definitive answers. Jim Pizzuto believes, “If Marc had never been prescribed Prozac, I’m convinced he’d be alive.” Did Prozac put their son over the edge? What kind of information of Prozac’s side effects is given to those who are advised to take it?

Or was Marc’s depression so severe that he succumbed to a terrible moment of despair? For now, mysteries prevail.

Befitting the way he lived, Marc was generous in death. His heart, liver, pancreas and two kidneys were transplanted to four people — ages 8, 42, 53 and 70. His heart now beats in a man who had been waiting a year and was expected to die soon without a transplant. He is a professor.

1992, Washington Post Writers Group

Record Number:  428973