[CTRL] Killer Mom's Meds

[William Shannon]

http://www.dallasnews.com/texas_southwest/400167_drugs_22tex.AR.html Husband says woman changed medications 06/22/2001By Doug Swanson / The Dallas Morning News Andrea Yates had taken a number of anti-depressant and anti-psychotic medications since the birth of her fourth child in 1999, the same year she attempted suicide. They were commonly prescribed medications that work in different – and often not completely understood – ways to alter the brain's chemistry. Mrs. Yates' husband, Russell Yates, said Thursday that his wife began taking Effexor and Remeron earlier this week. She had previously taken Risperdal, Wellbutrin and Haldol, her husband said. Although Mrs. Yates has not said why she drowned her five children, her husband said he believes her depression played a major role. "She wasn't in the right frame of mind," he said. Although the medications she took are widely used, they don't work in all cases, said Dr. Alan Schatzberg, chairman of the psychiatry department at the Stanford University Medical Center. "Unfortunately, not everyone responds to what you put them on," he said. Risperdal is believed to adjust the imbalance of two brain chemicals, the neurotransmitters known as dopamine and serotonin. The chemicals transfer information from nerve to nerve in the brain. Reducing dopamine activity often leads to a lessening of delusions and hallucinations. Reducing serotonin activity may help with lack of emotion and feelings of being disconnected, said Risperdal's maker, Janssen Pharmaceutica of Belgium. The company says it is the most-prescribed anti-psychotic in the United States. Wellbutrin, Remeron and Effexor are anti-depressants that affect neurotransmitters. Remeron, one of the newer anti-depressants, stimulates serotonin release while blocking specific serotonin receptors. All three are commonly prescribed for depression. Haldol, an anti-psychotic manufactured by Ortho-McNeil, is often prescribed for schizophrenia and outbursts of aggression and agitation. It also works by changing the flow of dopamine. Anti-depressants have a number of possible side effects, including dry mouth, blurry vision, nausea, muscle problems, loss of libido and tremors. The drugs may take several weeks to work. There have been some claims that various anti-depressants can produce irrational or aberrant behavior, but these have not been accepted by the medical community at large. "I think this kind of thing is unfortunately part of the illness, not part of the treatment," Dr. Schatzberg said. Depression is the most common mental ailment. The National Institute of Mental Health says that in any given one-year period, about 9.5 percent of U.S. adults suffer from a depressive illness. New medicines to treat depression appear every year. Dosages vary, and are often adjusted according to a patient's reaction to the drug. What works for one person doesn't necessarily work for another, doctors say. Mr. Yates said medication his wife took after the birth of their fourth child did not work as well after the birth of their fifth, six months ago. When her father died, he said, her condition worsened. "She was just primed for that depression," he said. "We were all hopeful she'd respond to the same medication she did the first time. ... She got to maybe 65 percent and sort of stayed there and plateaued."