Paragraphs 15 & 16 read: "Moreover, the antidepressants Rober had been prescribed were making her symptoms and violent behavior worse."
"'It was like throwing gasoline on fire, exacerbating her irritability and mood swings,' Cutler said. 'When people have bipolar disorder, at times they can become quite irritable, and they can have a lot of trouble getting along with people. Recently, Rhonda has had trouble controlling her irritability, her anger and her emotions and has at times gotten in people's face without meaning to, but that is what happens when your emotions are out of control.' "
Psychiatrist's research feeds bottom line, nourishes homeless
One in an occasional series
By DONNA WRIGHTDr. Richard Cutler, a Bradenton psychiatrist, has made helping the homeless part of his clinical research business.
That partnership, he says, is a win-win relationship.
Cutler gets patients for his clinical drug trials, and the homeless who are mentally ill get access to the latest drugs, treatment and state-of-the-art care.
For those homeless patients who do not fit the eligibility requirements for his clinical trials, Cutler provides a medical evaluation, diagnosis and treatment through referrals to local clinics, other doctors and prescription plans for the needy.
Cutler, who also operates Core Research Inc. in Orlando, opened his Bradenton-based Florida Research Center three years ago.
He began his working partnership with homeless clients at the Salvation Army of Sarasota in January.
Meeting Cutler proved to be a godsend for Rhonda Rober, a middle-aged mother of five, now estranged from her children. Rober's violent behavior and homelessness landed her in Sarasota County Jail in February.
She counts herself lucky that her discharge was delayed by one day.
If Rober had been discharged the evening of March 7, as scheduled, she would have not met Todd Abbott, a Salvation Army counselor.
Had Rober not met Abbott, she wouldn't have met Cutler.
"Todd caught me in the whirlwind of trying to get out," Rober said. "He took me to the Salvation Army Shelter. I don't remember my first night here. I was totally blank."
Recognizing Rober needed help, Abbott introduced her to Kari Goodfriend, Cutler's assistant, who sits in on case management review sessions each week.
Goodfriend immediately recognized that Rober's symptoms made her a good candidate to be examined by Cutler.
After a lengthy evaluation, Cutler diagnosed Rober with bipolar disorder. She had been previously misdiagnosed with depression and borderline personality disorder.
Moreover, the antidepressants Rober had been prescribed were making her symptoms and violent behavior worse.
"It was like throwing gasoline on fire, exacerbating her irritability and mood swings," Cutler said. "When people have bipolar disorder, at times they can become quite irritable, and they can have a lot of trouble getting along with people. Recently, Rhonda has had trouble controlling her irritability, her anger and her emotions and has at times gotten in people's face without meaning to, but that is what happens when your emotions are out of control. "
Cutler placed Rober in one of his studies for a new bipolar drug, but after a short period she was not improving.
"Most likely she was in the group getting the placebo," said Cutler. "I removed her from the study because I wanted her to get help."
He placed her on already-approved medicine to treat her condition. The new meds calmed and stabilized her.
"Things are definitely different," said a relaxed and happy Rober. "I was having a real hard time coping with everything and anything before but for some reason, it seems I have changed."
Rhonda laughs easily now. When something upsets her, she stops and thinks through her responses. Both are signs she is getting better, said Cutler.
"Rhonda is an incredible survivor," he said. "We have been really impressed with her. She has worked quite a bit in her life and held down jobs despite her mental condition and despite her use of alcohol and drugs to try to cope."
The street drugs and alcohol were Rober's way to self-medicate, said Cutler.
Now, Rober is reshaping her life through a counseling program at the Salvation Army that could, in time, help her find work and perhaps reunite with her estranged children.
"Without the Salvation Army and Cutler, none of this would be happening," Rober said. "They saved my life."
Rober is one of 53 homeless individuals Cutler has helped since January.
Eleven of those were enrolled in outpatient clinical trials or in-patient studies at Manatee Glens Hospital. The others were either referred to other clinics or doctors or put on approved medications after a diagnosis by Cutler.
David Sutton, shelter director, said Cutler's help has greatly enhanced the Army's addiction recovery and counseling programs.
"It's a very neat match," said Sutton. "We have had remarkable success. Dr. Cutler's help has changed the dynamic of what we do here."
Cutler sees about 100 patients each month. Eight to 10 are referrals from the Sarasota shelter.
"From my selfish point of view, I get to do the kind of research I love," he said. "I get to be the first kid on the block with a new toy because I have the medicine that isn't out there yet."
And the investment return to the community is immeasurable, he said. People who were once dysfunctional are now productive members of the society.
"I want to be a good neighbor but I also want to be a good scientist," said Cutler. "I very strongly believe in service."
Richard Martin, interim director of the Suncoast Partnership to End Homelessness, praised Cutler for using his expertise to help the destitute.
"Ultimately, homelessness is all about jobs, about housing, about access to good health care and livable wages, but the private sector has traditionally been very quiet on these issues in terms of helping this population," said Martin. "What Cutler is doing is wonderful and a great service to the community."
Donna Wright, health and social services reporter, can be reached at 745-7049.