Prednisone connection in Russell Williams’ crimes?

Serial killer Russell Williams at Canadian Forces Base Trenton

At about the time his crime spree began, convicted serial killer Russell Williams was taking a cocktail of medications for chronic pain — including a drug that in some cases causes mind-altering side effects.

One of the drugs, according to an informed source, was prednisone — a corticosteroid used to treat inflammation, arthritis, asthma, lupus and certain cancers. Studies since the 1950s indicate it can cause a range of adverse reactions, including euphoria, mania and bipolar disorder.

The case shocked many last month, when details of Williams’ disturbing crimes were aired in court.

The most important question, however — why did a man with no criminal past suddenly, at 44, embark on a series of ritualistic fetish crimes that quickly escalated to murder — remained unanswered.

Could the drugs be a piece in the puzzle?  Prescription and other drugs can be a factor in violent crimes, says Glenn Woods, former RCMP director of behavioural sciences. But many other factors come into play.

“Everything from personal events, the work life — there’s a whole host of things that go on in our lives every day and we all have different ways of coping,” says Woods. “Some of these offenders cope with these stressors or precipitating factors by acting out on their fantasies.

“So, could medication be part of that? I suppose it could be. But if it was, it’s an accumulative effect — it could be medication, it could be things going on at work, it could be the home life, it could be a host of things. It would be taking a leap to say it would be any one of those things, but it could be a combination.”

Corticosteroid drugs have been cited as a defence or mitigating factor in some U.S. cases involving violence or murder, with very limited success.

Williams, 47, pleaded guilty last month to 82 break-and-enters and thefts, two sexual assaults involving home invasion, and to raping and killing his colleague Cpl. Marie-France Comeau, 38, of Brighton and Jessica Lloyd, 27, of Belleville.

The former air force colonel and commander of Canada’s largest base, in Trenton, Ont., is now serving a mandatory life sentence at Kingston Penitentiary.

His medical history did not come up during his four-day guilty plea and sentencing in Belleville last month. Crown attorney Lee Burgess told the Star in an email that he would not comment on matters that did not come up in court.

Williams’ defence attorneys did not respond to email questions about his medication. The Star also left a message about prednisone at the Ottawa home of Williams’ wife, Mary Elizabeth Harriman, but did not receive a response.

The police investigation looked for anything in Williams’ background that could have triggered his actions, according to a source close to the investigation. Nothing was found.

In April, the Star received an anonymous letter from someone identifying him- or herself as a former co-worker. It said Williams was on a “strong medication” for the past few years, concluding: “I believe this changed him.”

This week, another source, who asked not to be identified, named prednisone. The informed source said Williams was placed on it around the time his string of fetish break-and-enters and thefts began. Prednisone, a generic prescription drug, has been around since the 1950s and is made by a number of drug companies.

Monique Murdoch, who lives next door to the cottage in Tweed that Williams shared with his wife, told the Star Williams began taking medication for chronic pain some time after returning home from a posting to Dubai in 2006.

Williams began breaking into homes, methodically photographing women’s and girls’ underwear, and then posing and masturbating in the items, on Sept. 9, 2007. Shortly after that date, Murdoch says, Williams told her about being on medication.

“One time, we were playing cards and he actually had to get up to stand,” says Murdoch, whose family became close with Williams and his wife. “It was some kind of chronic pain and it was going through his whole body.”

“He did say he was on medication,” recalls Murdoch. “They were trying to find the right combination so that he could function, and obviously they did or he wouldn’t have become base commander.” The pain was so intense that at one point Williams stopped jogging, says Murdoch, adding Williams was also suffering from insomnia.

It’s unclear how long Williams was taking prednisone, or at what dose. In the U.S., pilots taking high doses of prednisone are banned from flying by the Federal Aviation Administration.

In Canada, Williams’ military doctor would have been informed of his medical treatment, even if he had gone to an outside specialist, says a Canadian Forces spokesperson. The military would not comment on Williams’ medical history.

According to Canadian Air Force flight surgeon guidelines: “In general, systemic corticosteroids are not compatible with flight duties for any aircrew . . . Inhaled and topical intranasal corticosteroids are acceptable without requiring an operational flying restriction.”

When asked by police during his taped interrogation and confession why he committed his crimes, Williams provided no explanation. “Dunno,” Williams shrugged. “Have you spent much time thinking about that?” asked Ontario Provincial Police Det. Insp. Jim Smyth. “Yeah, but I don’t know the answers, and I’m pretty sure the answers don’t matter.”

Williams added that he became interested in women’s underwear when he was in his 20s. But there is no evidence of Williams committing criminal acts until his first fetish home invasion in 2007. He is a serial killer the likes of which experts have rarely seen.

A former close friend of Williams told the Star that he noticed numerous medications in Williams’ room in October 2008 and wonders now if they had anything to do with his crimes.

“After it all happened I thought, what on Earth could cause that?” the friend, who asked not to be identified, said in an interview. “I knew he had been taking (the drugs) — but I’m really only grasping at straws because the whole thing is inexplicable.  “But it did strike me that maybe it was all those pills he was taking.”

The friend asked Williams in 2008 about the pills. Williams mentioned arthritis, the friend recalls. “He had to take a combination of at least five or six different pills on a daily basis . . . I thought, wow, that’s a lot.”

A search of Health Canada’s adverse drug reaction database shows there have been 563 reports mentioning prednisone in the past 20 years. The cholesterol drug Lipitor, by comparison, has been reported 1,807 times since it came on the market 13 years ago.

While rare, prednisone side effects cited in the Canadian database include agitation, anxiety, hallucinations and personality and psychotic disorders. In one case, a 28-year-old woman on a 15-milligram dose experienced all of those reactions and was hospitalized.

In another, a 48-year-old woman on a 60-milligram dose experienced insomnia, confusion and a personality disorder. She was also hospitalized.  The drug can also cause slight euphoria and full-blown mania.

In 2003 Quebec psychiatrist François Sirois reviewed studies of corticosteroids since the 1950s. He found side effects in a small number of cases ranging from mild euphoria to “full-blown reversible” psychotic reactions, to “bona fide bipolar disorder.”

In one Toronto case study, a 14-year-old cancer patient with no history of psychiatric illness received 75 milligrams of prednisone a day as part of his treatment. Doctors then noticed a serious psychotic reaction.

“He has multiple grandiose delusions,” said a report co-written by Toronto psychiatrist Dr. Irfan Mian. “He believed that he was God, had created a computer program that could read minds, had billions of dollars, had cured ill people, could revive the dead, and could transport people with his mind. He had visual hallucinations, seeing flames on his hand that he believed were flames from hell.”

In an interview, Mian added that the boy had to be restrained because he was acting aggressively and verbally threatening other children.  Dr. E. Sherwood Brown, who has written extensively about prednisone, says he is “skeptical that prednisone had anything to do with” turning Williams into a serial killer.

“But I’m absolutely fascinated by the story and whether it did all start with him starting prednisone,” adds Brown, an associate professor in the psychiatry department at the University of Texas Southwestern Medical Center.

People being treated for chronic pain, such as that from arthritis, are more likely to be on a lower dose, making psychiatric issues less likely, he adds. High dosages are more likely to trigger severe psychiatric side effects.

“I guess at this point there’s so many unanswered questions,” Brown says. “Was he actually on prednisone continuously for years? Some people are, but it’s usually a pretty low dose.” Going on and off the drug, says Brown, can also cause unwanted side effects.

Brown notes that prednisone is not usually the first choice of treatment for conditions such as lupus and arthritis, due in part to its side effects, which also include “bone loss, weight gain, (and) diabetes.” It is used more often in severe cases of joint pain.

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