Friday, June 26, 2009

Where a Man Can Lose His Mind

By Kevin Guilfoile

On an August afternoon in 2007, John Mullarkey sent a text message (by some accounts to his mother) with his blood-splattered cell phone: I stabbed my self at demi.s i love you.

That same instant, Gayle Slomer of suburban Pittsburgh heard a desperate, frantic shriek outside her daughter's window. She ran out the door to find her daughter's 16-year-old neighbor Demi Cuccia bleeding in the front yard from more than a dozen stab wounds. Moments later Mullarkey, Cuccia's on-again-off-again boyfriend, emerged from Cuccia's house, a 10-inch, self-inflicted gash across his own neck. "Get away from me! I hate you!" Demi screamed at Mullarkey.

It was one of the last things she ever said.

Mullarkey confessed to the brutal murder at the scene. Later in the hospital, still unable to speak, Mullarkey wrote on an eraser board and handed it to an Allegheny County homicide detective: If somebody did something bad and they were taking medication, Mullarkey wrote, would that be a defense?

Approximately four months before the murders, Mullarkey began taking the powerful prescription acne medicine Accutane. According to the defense, Mullarkey stopped taking the meds just days before the murder because he was concerned about side effects, which included radical mood swings. Friends of Cuccia's however, paint a picture of Mullarkey as always having been controlling and jealous, and in the days before the murder, Mullarkey sent Cuccia a series of increasingly desperate emails and texts concerning the state of their relationship.

It's a shocking story, but many of the details will sound horrifyingly familiar to Chicagoans, as well as to readers of this site.

On October 24, 2006, respected dermatologist Dr. David Cornbleet, was viciously stabbed to death by Hans Peterson, a former patient for whom Cornbleet had allegedly prescribed Accutane several years earlier. Like Mullarkey, Peterson claimed to have stopped taking the drug after he became concerned about side effects. In fact, Peterson claimed to have taken only a couple of doses. Nevertheless for more than four years afterward Peterson would describe a series of persistent and unbearable side effects that he blamed on the small amount of Accutane he had taken in 2002.

Accutane has had a long history of both success and controversy. Many, including Michigan Congressman Bart Stupak, whose son committed suicide while on the drug, have tried to link it with depression. Roche, the pharmaceutical company that distributes Accutane includes a hefty warning label as required by law, but claims no causal link to depression, suicide or violence has been found.

The Mullarkey case, which has gone to trial this week, appears to be the first time a defendant has claimed his judgment had been impaired by Accutane. The results will be watched very carefully in Chicago, and in Peterson's native Eugene, Oregon, and also in Basel, Switzerland where Roche is headquartered.

If the Accutane defense succeeds, we will no doubt see it again.

Even if it doesn't succeed, I suspect we will see it again.

The story of Dr. Cornbleet and Hans Peterson is just as tragic but far more bizarre than the Mullarkey case. The tale includes a lengthy manhunt across several states, the nuances of international law and extradition, the television show Dexter, online poker, Barack Obama, a strange claim about Asperger's syndrome, and the heroic intervention of an Iraq war veteran. More than anything, though, it's about fathers and sons. I won't repeat all the details here, but if you follow this link and start at the bottom you can get, if not the whole story, a good sense of it.

As John Mullarkey sits before a jury, Hans Peterson sits in a jail cell on the island of Guadaloupe. He has been there for almost two years. The French government refuses to send him back to the US to face judgment, but they also seem reluctant to deal with his crime themselves. No charges have been filed and none seem to be coming in the immediate future. Under French law, Peterson can be held for another two years without trial. Although they serve a different system in a different jurisdiction, Peterson's court-appointed lawyers no doubt will also be watching the outcome of the Mullarkey case with keen interest.

Finally, a meaningless but eerie coincidence: I first wrote about the murder of Dr. Cornbleet 11 months after the crime, on August 15, 2007. The post went up around 9:30 Central Time.

John Mullarkey murdered Dana Cuccia just seven hours later.

UPDATE: A pharmacist testified in the trial yesterday that Accutane likely caused Mullarkey's depression and a mental disorder. On cross examination the pharmacist admitted that his experience with the drug was limited to what he'd read. "I don't think the FDA would (require those warnings) unless there was a problem with the drug," he said.

TOTALLY UNEXPECTED UPDATE: Roche pulls Accutane out of the US Market after an unrelated jury verdict in a class action lawsuit awarding more than $30 million dollars to users who experienced inflammatory bowel disease. More later.

UPDATE: A jury in Pittsburgh took just two hours to convict Mullarkey of first-degree murder.


Barbara D'Amato said...

Kevin, if you're touched on this in earlier posts, I'm sorry, but I'm wondering--has any really large, independent study been done on the psychological effects of accutane? I'm thinking about effects on somebody who is already having psycholgical problems.

Sara Paretsky said...

Kevin, Thank you for staying on top of this case and keeping the rest of us informed.

Kevin Guilfoile said...

Barb, As far as I can tell, none of the studies so far have shown a causal link between Accutane and depression. There is plenty of anecdotal evidence, but the drug's defenders say that the individuals most likely to take the drug--teenagers or young people with very bad skin--are at a greater risk of being depressed in the first place.

It's a powerful medication, and certainly not side-effect free. Women who take it must be on birth control. Most dermatologists I've spoken to consider it something of a miracle drug with benefits that far outweigh the potential for side effects, but I also know of some who have decided to stop prescribing it because of a general skittishness not necessarily related to depression in patients. As is true for a surprising number of medications we take and take for granted (anesthesia for instance), I don't think anyone is certain exactly how Accutane works, or at least about all of the effects it has on the human body.

Various people who have taken it have attributed all sorts of side effects to it. Roche's removal of Accutane from the US market on Friday was the result of a class-action lawsuit from patients suffering from bowel disease. The company might just feel unprotected in the US legal system since there is so much controversy over the drug, warranted or not.

Kevin Guilfoile said...

There is a researcher at Emory who claims to have demonstrated that Accutane can physically and irreversibly alter tissue in the brain. There has been criticism of that study and as far as I know it hasn't been replicated, but it's out there adding fuel to the debate for sure.

Barbara D'Amato said...

Thanks, Kevin. This is very, very interesting stuff. As you say, there are many medications whose method of action is a mystery.

Sara Paretsky said...

The requirement that women be on birth control pills while taking the drug is one of the byways of the abortion wars because the drug can be teratogenic. The regulation was created in a blanket and draconian way that forced parents to put their teenage daughters on birth control pills if they were going to give them acne relief. Some states outlawed sales of the drug altogether because they didn't want to "allow" women easy access to oral contraceptives. We live in a strange world.

nc said...

I’ve created a comprehensive research report on Accutane’s history and pharmacology. Visit the link below to download it.

My research provides insight into why the side effects can persist for a really long time after people stop taking it. Hoffmann-La Roche explicitly states in the Physician’s Desk Reference that they don’t know how Accutane works or how it causes an incredibly long list of side effects, but I believe that they do know. I also believe that through my research I have discovered Accutane’s true mechanism of action that Roche has been keeping secret from the public.

My goal is to expose the truth about Accutane, present the scientific evidence, and enlighten the world about its history/pharmacology and the latent long-term effects it has on the body, which will lead to more independent research being conducted to elucidate the cause of the side effects.

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