Robber cleared by drug defence — (The Guardian)

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The Guardian

Jo Revill, health editor, The Observer

Sunday August 10, 2003

Charges dropped after report links Seroxat [Paxil] to threatening behaviour

A man arrested for armed robbery and theft has had charges against him dropped after medical experts concluded that his behaviour could have been altered by the severe withdrawal symptoms he was experiencing from the antidepressant Seroxat.

Mark Douglas-Hamilton, who was facing a prison sentence for holding up a garage, was due to go on trial this week, but the case has been unexpectedly dropped by the Crown Prosecution Service.

The CPS has not given any reason for its decision to discontinue, but it is believed that Douglas-Hamilton was helped by a medical report carried out for the defence which concluded that the drug could have contributed to his threatening behaviour.

Campaigners against Seroxat, whose generic name is paroxetine, say they are aware of at least 10 other families who claim that their relatives committed acts of violence as they withdrew from the medication.  Their cases will be put later this month to the Government’s Medicines and Healthcare Products Regulatory Authority (MHRA), which is reviewing Seroxat.

The move comes as the Department of Health said last night it would examine the unlicensed sale of prescription drugs on the internet following an Observer investigation today exposing the cybernet trade in such drugs, including Seroxat.

The drug’s manufacturer, GlaxoSmithKline, denies violence is a feature of withdrawing from Seroxat arguing that aggression is a feature of anxiety disorders.

However, Douglas-Hamilton’s account of how he suffered serious personality changes while trying to come off the pills has implications for other patients who also reported feeling extremely aggressive and reckless once they stopped taking the drug.

In November last year, two days after coming off the pills, Douglas-Hamilton, 30, used a pair of wire cutters to hold up a garage in Oxford where he walked away with a packet of cigarettes. A CCTV recording of the event shows his bizarre behaviour, where he joked with customers. Two weeks later, the theatre stage manager stole some CDs from a record shop. Douglas-Hamilton says he committed the acts, but claims his personality and behaviour were completely altered by the withdrawal effects of the drug.

‘I’m a fairly timid guy,’ he told The Observer last week. ‘I had only been prescribed [Seroxat] because I suffered from anxiety and some depression. It seemed to destroy my conscience and my fear. I found myself walking out of the house with knives; I had every intention of killing people.’

Douglas-Hamilton, who lives near Hereford, was due to face trial this week in Oxford on two charges of theft. But the case was unexpectedly dropped last Thursday by the CPS, which did not give a reason for the discontinuance .

Had the trial gone ahead, it could have proved a test case. Douglas-Hamilton would have pleaded not guilty, using a defence known as non-insane automatism. This argues that there is some external factor, in this case Seroxat, which was out of the defendant’s control, and caused him to behave irrationally. Dr David Taylor of the Maudsley Hospital had prepared a report for the defence, passed to the CPS, which concluded that the effects of Seroxat could have contributed to his behaviour.

The drug, which is prescribed to thousands of people every year for anxiety and depression, is already the subject of some controversy. Last year, SmithKline Beecham, which became GlaxoSmithKline, was successfully sued by Toby Tobin, after his father-in-law Donald Schell killed himself, his wife, his daughter and daughter-in-law in Wyoming, US. The company was ordered to pay $4.7 million to the family. Schell had taken just two tablets before the murders, and had been depressed, but not suicidal, for the past 10 years.

There have also been claims from families in Britain that it has pushed relatives into suicide, and caused serious withdrawal symptoms. Sarah Venn, spokeswoman for the Seroxat Users’ Group, said: ‘I’m aware of at least 10 families whose children have committed criminal acts on withdrawal, and whose behaviour appears out of character. The MHRA needs to consider this as part of its review.’

A spokeswoman for GlaxoSmithKline said: ‘Violence and aggression are a feature of anxiety and depression disorders. Seroxat will reduce levels of these, and neither violence or aggression are withdrawal symptoms.’