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On trial: a man _ or a drug?

Kevin Callahan says he does not remember the day he almost killed his wife just before their first wedding anniversary. When authorities finally found him two days after he attacked her with a butcher knife, Callahan was lying semiconscious on the Gandy Bridge.

Nature had found him first.

Burn marks on Callahan's right hand and left foot showed the path where lightning had enteredand exited his body during a thunderstorm on March 31, 1990. Rescuers took him to Bayfront Medical Center, the same hospital where his wife, Dianne, was recovering from her knife wounds.

Hours, perhaps a day, later, she called his room, he said.

" "I know you didn't mean to do this,' " Callahan said she told him. " "When you were doing it, you had a blank look like you weren't even there. I told you the Prozac was no good.' "

Now, more than one year after the stabbing, that is what Callahan wants a jury to believe. The 33-year-old St. Petersburg man says the anti-depressant drug twisted his mind so badly that he attacked the woman he loves.

Callahan said he remembers nothing until he awoke handcuffed to a hospital bed.

"It was a nightmare," he said in an interview last week. "I kept wondering when I was going to wake up."

Callahan's story is part of a controversy that surrounds Prozac, an anti-depressant first marketed more than three years ago by the Indianapolis pharmaceutical company, Eli Lilly and Co.

Clearwater lawyer Ronnie Crider hopes to convince a jury that Callahan is not guilty of attempted murder. He says Callahan was legally insane at the time of the crime because his perceptions were distorted by the drug.

Callahan is out on bail. The trial is scheduled to begin next week, although Crider said it might be delayed until later this year.

"The defense is not a bulls--- defense," Crider said. "It's not a trumped-up TV defense."

Eli Lilly spokesman Edward West disagrees, noting that Callahan previously had been convicted of fraud and arson in unrelated cases.

"Clearly, Prozac did not cause Kevin Callahan to stab his wife," he said. "Rather, this case is simply one more entry in his already lengthy criminal record."

A wonder drug?

Since the Food and Drug Administration approved Prozac in December 1987, 3.5-million people in 50 countries have been using it to combat mental ailments ranging from depression to obsessive-compulsive disorders.

Psychiatrists touted the drug because their patients seemed to suffer few of the side effects that were typical of similar drugs: weight gain, dizziness or constipation. It is the most commonly prescribed anti-depressant in the United States, according to its manufacturers.

But last year, Dr. Martin Teicher of Harvard Medical School and McClean Hospital published a study in the American Journal of Psychiatry that cast some doubt on the wonder drug. Six of his patients who suffered from depression began to have suicidal thoughts after taking Prozac.

Teicher could not be reached for comment. But Lilly spokesman West said the patients in the study were very ill and had experienced suicidal thoughts before taking Prozac. Furthermore, he said, four of them were taking other drugs at the time of Teicher's observations.

"There is no scientific evidence that Prozac plays a role in suicidal thoughts or aggressive behavior," he said. "To the contrary, Prozac reduces them."

Many psychiatrists agree.

Dr. Richard Restak, a Washington, D.C., neuropsychiatrist, said he has prescribed Prozac to hundreds of patients. Only one had complications.

"It would be a tremendous overreaction to take it off the market," he said.

Nevertheless, lawyers around the country have filed dozens of lawsuits against Lilly, generally claiming that the drug causes suicidal behavior. West said four of the cases have been dismissed. None have been settled before trial.

"These cases need to be tried," he said. "There's no merit to any of them."

In addition to the civil claims, defense attorneys in at least 10 criminal cases around the country have argued that their clients' behavior became violent after using Prozac. Of the 10 cases that have gone to trial, none of the defendants have been acquitted, West said.

But Pinellas lawyer Crider said Callahan's case is different.

"The thing about this case that makes it different from other cases," he said, "is that his history is so clear: the documentation, the background, the history of the effect of the drug."

"He just wasn't himself'

While working for a Clearwater computer cable company in September 1988, Callahan injured his back trying to pick up an 80-pound spool of wire. He said the injury prevented him from working, so he filed a worker's compensation claim. As part of the procedure, Callahan said, he was told to get a psychological evaluation.

Callahan went to Dr. George L. Warren, currently the medical director of Medfield Hospital, for the evaluation.

Callahan was extremely depressed. He argued with his wife and his marriage was failing. He also was discouraged about being unemployed, Warren said in documents filed in Pinellas-Pasco Circuit Court. The psychiatrist told Callahan to take 20 milligrams of Prozac each morning. Callahan already was taking 75 milligrams of Elavil, another anti-depressant.

By March, Callahan's financial situation had gotten worse. He was having trouble sleeping and suffering from a great deal of back pain.

"The patient has deteriorated markedly since I last saw him," Warren wrote on March 7, 1990. "It appears he's under massive tension and is on the verge of exploding."

Warren increased Callahan's dose of Prozac to 40 milligrams.

Callahan's friends were worried. But in some instances, it is difficult to determine whether Callahan's behavioral changes occurred before or after he was placed on Prozac.

"I was concerned with him being depressed," said Brenda Martin, who has known Callahan for 17 years. "He just wasn't himself, irritated. I could tell there was something different."

Another friend, David Olson, said Callahan once came over to his house and just sat silently in a rocking chair. Another time, Olson said, his friend suddenly snapped at him for no apparent reason. And once Callahan threw a set of keys so hard they literally lodged in a wall.

"He definitely had a personality change," Olson said.

Steak, Derby Lane

and a butcher knife

On March 29, 1990, Callahan was elated. A long-awaited worker's compensation check had arrived. He decided to celebrate with his wife.

They grilled a couple of steaks, cooked potatoes and tossed a salad. After smoking some marijuana with a neighbor, they headed for Derby Lane to gamble on the dogs, one of Callahan's favorite hobbies. In a few hours, he won $70 or $80.

After they got home, Callahan drove to a nearby store for sodas, bacon and eggs. On the way back from the store, his car stalled and he walked home in the drizzle.

Meanwhile, Dianne Callahan took a shower, swallowed some Prozac, then climbed in bed. Like her husband, she suffered from depression.

Soon, Callahan returned and put the groceries down.

"I knew by the way he set them down on the counter there was something wrong," Dianne Callahan said later in a court deposition. "I didn't really pay much attention to it again because Kevin had been quite aggressive lately. So I just figured he was mad about this or that and he would get over it."

She drifted back to sleep. Then she felt a pillow over her head, a knife in her neck and back.

"I remember after it was over, after he stopped, he just turned around and walked out of the room with a daze on his face," she said.

As he was walking out, she asked, "What is wrong?"

Callahan did not reply.

Two days later, fishermen found him lying on a catwalk on the Gandy Bridge. When he awoke, Callahan was handcuffed to a bed at the Bayfront Medical Center with lightning burns on his hand and foot. A Pinellas deputy told him he was under arrest for stabbing his wife.

"I was shocked," Callahan said.

He said the last thing he remembers the night of the attack, is walking home in the rain, groceries under his arm.

What happened?

Jurors will have to decide who Kevin Callahan really is.

Crider, the defense attorney, has hired expert witnesses to bolster his case. One of them, Tampa psychiatrist Walter Afield, examined Callahan, reviewed his medical records and gave him a number of tests. He is convinced that Prozac led Callahan to violence.

"I think Prozac was probably the primary responsible agent in this situation," Afield said in a deposition.

Warren, the Medfield psychiatrist, said medical ethics prohibit him even from acknowledging that Callahan was a patient. Generally, he said, Prozac is a useful drug. But he acknowledged that it does not help everyone.

Prosecutor William Loughery would comment only briefly on the case.

He likely will argue that Callahan is prone to violence and crime. Callahan's criminal record includes convictions for arson and defrauding an insurance company. In addition, there is evidence that Callahan was aggressive toward his wife before he ever used Prozac, prosecutors may argue.

"I'm not aware of any scientific evidence that Prozac causes violence," Loughery said. "There is none as far as I'm concerned."

These days, Callahan spends much of his time answering telephone calls from people worried about Prozac. He sends out pamphlets, writes letters and gives interviews. Callahan also is contemplating suing Lilly when his trial is over. If he is successful, he said he will give the money to his wife, whom he is forbidden by a court from seeing.

Callahan said he feels pretty good, except for his back pain. He remains unemployed.

"Now that I'm not taking any drugs," he said, "I'm back to the way I was."