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 Day 19

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A Killer Cocktail

Prozac Madness

by FRED GARDNER

The lard-assed cops at Virginia Tech spent two hours interrogating the wrong suspect and failed to prevent the massacre. Now they’re "investigating." What is there to investigate – which brand or brands of anti-depressant Seung Hui Cho was taking?

A lonely, picked-on boy was given Prozac (or one of its chemical analogs) like Kip Kinkel in Oregon, like Eric Harris in Colorado This is not a scoop, America: Prozac causes horrible, bizarre flip-outs. It is a fact that has been known for 20 years and that Eli Lilly and the other manufacturers of "selective" serotonin reuptake inhibitors (SSRIs) have relentlessly denied and are still trying to suppress.

On the very day after the shootings at Virginia Tech, the Journal of the American Medical Association published a study challenging the "black box" warning that the Food and Drug Administration had finally attached to Prozac in October, 2004. "Antidepressants Get a Boost For Use in Teens" read the Wall St. Journal headline. "Despite Warnings on Labels, Study says Benefits Outweigh Risk of Suicidal Tendencies."

The New York Times ran its account of the new pro-Prozac study on the page facing the obituaries of students and faculty members killed at Virginia Tech! "Scales Said to Tip in Favor of Antidepressant Use in Children -A risk of suicidal thoughts is found to be more than offset." You’d think that 33 deaths would more than offset it back.

Evidence that Prozac induces suicidal ideation and actions emerged when the drug was in clinical trials in Germany in the mid-1980s. The German findings were misrepresented to the FDA by a Lilly employee named Joachim Wernicke. U.S. marketing approval was granted in December, 1988, with no warning required. After a drug is marketed here in Guinea Pig Nation, only a very small fraction of the adverse events brought on by the drug get reported. Patients have to tell their doctors who then have to file paperwork with the manufacturers who then have to voluntarily tell the FDA that their products are dangerous.

Among the adverse events brought on by Prozac soon after it hit the market were numerous suicides and homicides, some of which resulted in legal action by the victims or survivors. Lilly’s strategy was to conceal the trend by settling every case out of court. One of the first to capture national attention involved Joseph Wesbecker, a Louisville, Kentucky printing press operator who, on Sept. 14, 1989, killed eight co-workers with an AK-47 and injured a dozen others before committing suicide. Wesbecker had been prescribed Prozac five weeks before and his psychiatrist, noting that Wesbecker had become "very, very agitated," told him to stop taking it on Sept. 11. Victims who survived the shooting, relatives of those who died, and members of Wesbecker’s family subsequently sued Eli Lilly, charging that the company "knew or should have known that users of Prozac can experience intense agitation and preoccupation with suicide, and can harm themselves or others."

In February, 1990 psychiatrists Martin Teicher and Jonathan Cole and nurse Carol Glod published "Emergence of intense suicidal preoccupations during fluoxetine treatment" American Journal of Psychiatry, It described six patients who developed "intense, violent suicidal preoccupations" within two to seven weeks of starting treatment with Prozac. The authors estimated that between 1.9 and 7.7 percent of Prozac users would develop suicidal obsessions. Teicher and his co-workers subsequently reported that Prozac patients were "at least three-fold more likely to develop new suicidal ideation" than patients treated with the older antidepressants, and that patients were also more likely to develop suicidal thoughts for the first time ever while taking Prozac.

Lilly responded, "Our experience does not show a cause and effect relationship between our products and suicidal or violent thoughts or acts. Unfortunately, these thoughts and acts are part of the disease of depression." But the company made its first small concession, noting on the Prozac label in May, 1990, that "suicidal ideation" and "violent behavior" had been reported (as had pancreatitis) as side-effects. This reference appeared in the "Postintroduction Reports" section towards the bottom of the label. No mention of suicidal ideation was added to the "Precautions" section.

The FDA held a hearing in September 1990 at which its Psychotropic Drugs Advisory Committee (most of whose members got funding from antidepressant manufacturers) considered whether SSRIs can induce violent and suicidal thoughts. They voted 9-0 not to recommend a more prominent warning and 6-3 not to recommend a warning in small type that would have read, "In a small number of patients, depressive symptoms have worsened during therapy, including the emergence of suicidal thoughts and attempts. Surveillance throughout treatment is recommended."

Lilly and the other antidepressant manufacturers made more finite, begrudging concessions in the years ahead as evidence linking SSRIs to suicide kept mounting. A turning point came in April 2004, when the British Medical Journal reported that GlaxoSmithKline had concealed data showing that Paxil more than quadrupled suicidal ideation among teenagers. A few months later the FDA acknowledged a study showing that SSRI use induced suicidal thoughts in two out of 100 adolescents and ordered a black box warning. Prozac sales dipped as a result and Lilly et al commissioned the study that JAMA published April 18, showing that SSRI use induces suicidal ideation in only one in 100. Suicidal ideation," "Suicide gesture," "Suicide attempt," and other such terms do not accurately characterize the extremely bizarre flip-outs induced by SSRIs. Carefully planning to annihilate the student body fits the profile. Biting your mother 57 times. Driving your car around in circles until you smash into a tree… Years ago, at a meeting of the Prozac Survivors Support group, I heard Bonnie Leitsch, a flamboyant redhead from Louisville who sounded like Minnie Pearl, try to explain what Prozac did to her thinking:

"It’s hard for people to understand. They say ‘you must know what you’re doing,’ but you do not. You cannot distinguish reality. I could never tell if I was awake or asleep. That was the hardest thing for me to determine. I would lay down in bed and I would think ‘Now am I dreaming this or am I awake and doing this?" My mind constantly ran, it never would stop. I could be having this conversation with you and the whole time if I was drinking coffee, I could be thinking about running it on my hand and wondering what it would feel like. Thinking irrational thoughts. And yet still able to communicate at what would appear to be a rational level. That’s why I think psychiatrists and psychologists and doctors who are dealing with people on Prozac are totally oblivious to what’s going on. These people are the best liars in the whole world in terms of being able to come to you and say ‘I’m fine.’ But the whole time they might be thinking ‘I wonder what it would feel like to stick this knife in my hand?’ And, ‘I can take on a motorcycyle gang and kill ‘em all.’ Most of these people on Prozac like myself lose all natural ability to love. It becomes a spiritual dullness. You cease to know right from wrong. Because there’s no wrong and you’re right 100 percent and the hell with the rest of you."

The media just can’t fathom Seung Hui Cho’s lethal outburst, but Bonnie Leitsch -may she still be going strong- can fathom it all too well.

FRED GARDNER edits O’Shaughnessy’s, the Journal of Cannabis in Clinical Practice (soon to have a presence on the web). He can be reached at fred@plebesite.com