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----Original Message Follows----
From: [EMAIL PROTECTED] (Rich Winkel)
To: undisclosed-recipients:;
Subject: Prozac: Lilly knew 20 years ago of possible link to violence,
suicide
Date: Mon, 6 Sep 1999 01:24:51 -0500 (CDT)

http://www.newsunlimited.co.uk/uk_news/story/0,3604,79205,00.html

[The Guardian]

Revealed: the danger of taking Prozac

Drug maker knew 20 years ago of possible link to suicide

Sarah Boseley, Health Correspondent Saturday September 4, 1999

Prozac, the anti-depressant taken by millions, was known by its
manufacturers as a possible cause of agitation leading to suicidal
tendencies as long ago as 1978, according to documents released in the
US civil courts.

Internal documents which appear to suggest Eli Lilly, manufacturer of
Prozac, knew 20 years ago there could be a problem, may be relevant to
the first British case concerning the drug, now heading for the
courts.

British hospital Reginald Payne, 63,a teacher from Wadebridge,
Cornwall, suffocated his wife and threw himself off a cliff in March
1996. He had been taking Prozac for just 11 days.  His family blames
the drug and has issued court proceedings against the manufacturers.

The Eli Lilly papers, which chronicle the company's concerns over the
restless state of mind of some patients during clinical trials, were
produced during a case in Hawaii, the first of some 200 in the US
alleging links between Prozac, violence and suicide, to have come to a
verdict.

The case concerned a couple who retired to Hawaii from California in
1989. Finding it hard to adjust to the changes in his life, Bill
Forsyth saw a doctor and was prescribed Prozac for a mixed depressive
anxiety disorder. At first Mr Forsyth said he felt marvellous, but
within two days he was imploring his son and wife to get him into a
psychiatric hospital. Soon after he returned home, he stabbed his wife
June to death and impaled himself on a kitchen knife.

Evidence of violence

The family's lawyers argued in court that Eli Lilly had known for years
that patients on Prozac, which was launched in 1988, could suddenly
become akathisic - a strange, restless and agitated state of mind in
which they can get compulsions to commit violence on other people and
themselves.

The lawyers argued that Eli Lilly should be held responsible for
failing to warn doctors that some patients might respond in this way
and become a danger to others and themselves. Prozac is still a useful
and appropriate drug for some patients, they say, but those who take it
must be closely watched for the signs of akathisia in the first couple
of weeks after beginning a course.

They cited internal minutes from the Prozac development team in August
1978 which ran:  "There have been a fairly large number of reports of
adverse reactions...  Another depressed patient developed psychosis...
Akathisia and restlessness were reported in some patients."

The authorities in Germany, considering Eli Lilly's application for a
licence in 1984, were concerned. "During the treatment with the
preparation [Prozac], 16 suicide attempts were made, two of these with
success. As patients with a risk of suicide were excluded from the
studies, it is probable this high proportion can be attributed to an
action of the preparation." Prozac now carries a warning in Germany of
a risk of suicide. "Therefore for his/her own safety, the patient must
be sufficiently observed until the antidepressive effect of Fluctin
[Prozac] sets in." It adds that the patient may need an additional
sedative in the meantime.

The Hawaii family lost its case, but their counsel, Andy Vickery, said
they would be appealing on a number of grounds, one of which was the
judge's refusal to allow the jury to be told of the German warning. He
said: "I was shocked and disappointed to lose. In my final argument, I
told the jury their verdict could save lives."

Warning rejected

Graham Ross, a personal injury lawyer based in Neston, Wirrall, who has
a number of cases of alleged Prozac-induced suicide on his books, said
he takes issue with Eli Lilly because of its failure to warn of the
risks to some, not by any means all, patients. "It is their refusal to
accept that this is at all possible in any patient, and their
insistence that it would have happened anyway that is dangerous and
irresponsible, in my view. All we are asking them to do is be more
frank in what they say to the medical profession in the first place."

Eli Lilly's spokesmen in the UK and in company headquarters in
Indianapolis insist that the Food and Drug Administration (FDA) which
licenses medicines in the US, and the Committee on the Safety of
Medicines in the UK, had specifically cleared Prozac of inducing
suicide in the early 1990s. "That is more important than an attorney's
selective manipulation of data," said a US spokesman. "You have to take
a look at the patient population.  In people with depression there is
probably a 15% suicide rate. There is no evidence that Prozac causes
suicide."

But although depression is linked to suicide, the rates are highest
among those who have been hospitalised, not among those coping in the
community who may be prescribed Prozac by their GP and some of whom are
anxious rather than depressed.

According to data presented by David Healy, director of the North Wales
Department of Psychological Medicine and author of The Antidepressant
Era, at the British Association for Psychopharmacology annual meeting
in Harrogate in July, the only figures on rates of suicide among
depressed people in the UK taking Prozac are six times higher than the
probable suicide rates for community depression in the UK, which, he
says, "strongly suggests that Prozac may indeed be inducing suicide."

Easing the pain

* Prozac is the world's most widely used brand-name antidepressant,
prescribed to more than 38m people in 100 countries.

* It was the first of a new breed of anti-depressants called SSRIs
(selective serotonin reuptake inhibitors) to be licensed. They are
marketed as having fewer side-effects than older antidepressant drugs.

* It and the other SSRIs work on the assumption that depression is
caused by low levels in the body of the chemical serotonin which
promotes brain activity.

* Prozac, also known as fluoxetine, blocks the reabsorption of 5HT or
serotonin so that an increased amount can stimulate brain cells.

* Prozac is also used to treat obsessive compulsive disorder and
moderate to severe bulimia.

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