TAMPA, Fla., Jan. 9 (UPI) -- Tampa police said Wednesday they found a prescription for the acne drug Accutane, which has been linked to depression and suicide, at the home of a 15-year-old boy who killed himself by crashing a plane into a downtown bank building last weekend.
A Harvard Medical School expert on teenage suicide, who has done extensive research on whether Accutane is associated with depression or other psychological side effects, told United Press International Wednesday, however, he rejected the idea the drug played any part in the teen's decision.
The prescription was found during a search of Charles Bishop's home in the investigation of his apparent suicide. It may be two weeks before authorities know if there actually was Accutane in the youth's bloodstream.
"They found a prescription (for Accutane) in his name. We won't know if he was taking it until we get the medical examiner's report," said Jan Reilly of the Tampa police public information unit.
Bishop, a flight school student, climbed into a Cessna 172R at St. Petersburg-Clearwater International Airport Saturday afternoon, took off and flew the single-engine craft into the 28th floor of the Bank of America Building.
For years, there have been anecdotal reports of depression and suicide among Accutane users, including teens.
The Food and Drug Administration has noted these adverse events in various reports, one which said from 1982 to May 2000 it had received notices of 37 U.S. Accutane patients who committed suicide, 24 while on the drug and 13 after stopping the drug. FDA also said 110 U.S. Accutane users were hospitalized for depression, suicidal ideation and suicide attempts during the same time period. As of May 2000, FDA had received reports of 284 Accutane users with non-hospitalized depression.
FDA forced Hoffman LaRoche to change its label warnings in 2001 and required a consent letter be signed before any prescription for the drug is issued. The consent letter has specific references to depression, including the statement, "I understand that some patients, while taking Accutane or soon after stopping Accutane have become depressed or developed other serious mental problems." Patients are to initial that section of the consent form.
FDA said the pharmaceutical company, which defends the drug as safe and effective, also pledged to work with the agency on the issue of the psychological side effects with the drug.
Dr. Douglas Jacobs, associate clinical professor of psychiatry at Harvard Medical School in Cambridge, Mass., has testified before Congress and advised FDA on the issue following comprehensive studies of Accutane reports. He told UPI the science shows there is no "causal link between Accutane and depression and suicide."
"A complete literature review and looking at the elements of causation finds Accutane does not satisfy any of the criteria for depression or suicide," he said. "I've never been referred a patient who had been on Accutane and got depressed and I don't know any of my colleagues who have."
Jacobs said there is no scientific way to look at the suicide and depression cases and find out the mental conditions of patients before they began taking Accutane because few if any had any psychological testing done prior to beginning treatment.
He said there the data show there actually are fewer suicides among Accutane users than among the general population.
U.S. Rep. Bart Stupak, D-Mich., held congressional hearings on the issue following the suicide death in 2000 of his 17-year-old son while on the medication.
In an exclusive interview with UPI last fall, during which he said he would call for new hearings based on evidence he had obtained from the drugmaker Hoffman LaRoche, Stupak said he wants to know why FDA has not done more to ensure that anyone taking the drug is fully informed of the side effects.
He said additional hearings are needed to bring to the public's attention the problem of ensuring warnings and side effect information actually goes out with every prescription. Stupak, who said his son's prescription came without any warning information, claims FDA has not done all it can.
"Everyone thinks the insert is in with the medicine. It's not," he told UPI. "They (FDA) say, 'We're doing a good job,'" Stupak said, characterizing the FDA attitude, but "patients are not getting the information."
Reached at her home by CNN Tuesday night, Bishop's mother, Julia Bishop, said: He was my shining star. He was the light of my life. There is nothing I would not do for that child. Everybody loved him."
A friend and classmate of the youngster at East Lake High School said Bishop had sent him an e-mail warning that something was about to happen.
"He had told me to watch the news on Saturday and he would be on it," Emerson Favreau said. "This was a shock ... There was no indication whatsoever that he was suicidal or that anything was wrong."
Jacobs is director of the not-for-profit "SOS Suicide Intervention Program," which is provided to high schools nationwide free of charge. The program, which he helped develop, is based on evidence that students "tend to talk to other kids (about suicide or depression) and kids don't know what to do with that information," Jacobs said.
He said the program gives students advice on what to do when a friend claims to be depressed or suicidal or talks about the issue.
"This (Bishop case) will obviously be a very delicate matter; it is a tragedy of the greatest proportion," he said. "There is more we don't know than we do know."
In a January 2001 letter to health care providers, Dr. Janet Woodcock, director of FDA's Center for Drug Evaluation and Research said of Accutane: "With respect to psychiatric events, our advisory committee agreed that no clear causal link has been established. However, definitive demonstration of causality for a rare adverse event can be difficult to demonstrate. When there is reasonable suspicion of an association, patients should be informed. We are working diligently with the sponsor on this issue."
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(Reported by Les Kjos in Miami and Ellen Beck in Washington.)
