FacebookTwitterGoogle+RedditEmail

It’s the Cymbalta Stupid

by MARTHA ROSENBERG

Many are outraged that Eli Lilly gave nonprofits $3.9 million in grants last year for medical courses to “educate” doctors about the pain-and-fatigue ailment fibromyalgia–more than it spent for diabetes and Alzheimer’s which people already know they have.

But finding new diseases to justify a drug’s existence is the normal way pharma operates.

Especially Lilly who agreed to pay $1.42 billion for illegal marketing of its anti-psychotic Zyprexa last month–$615 million for criminally promoting it for dementia–another $62 million to 32 states for illegal pediatric marketing and agreed to resolve Medicaid fraud investigations into “rebates” at the same time. (And how was your year?)

And whose diabetes treatment Byetta is tanking since reports last summer of six deaths, at least two from pancreatitis.

But Lilly’s fibromyalgia-fighting drug, Cymbalta (duloxetine)–its second best seller after Zyprexa–is anything but normal.

Starting with the death of 19-year-old Cymbalta test subject Traci Johnson in 2004–who hanged herself in the Lilly Clinic in Indianapolis and had no history of mental problems–it has been beset by reports of baffling, rapid, unprovoked, and out of character suicides and suicide attempts.

A 37-year-old man described in the Feb. 2008 Journal of Clinical Psychopharmacology with a stable marriage and employment and no history of mental problems tried to kill himself with carbon monoxide two months after taking Cymbalta for back pain. “The patient was unable to state exactly why he wanted to commit suicide,” write the four physician authors all with the Department of Psychiatry and Behavioral Sciences at the University of Kansas Medical Center who note he returned to normal when the drug was stopped.

A 63-year-old man with no history of suicide attempts or ideation was similarly “unable to explain why he was having thoughts of wanting to die,” say the authors after becoming suicidal two weeks after being put on Cymbalta for fatigue, insomnia and sadness.

Last January, a Texas man prescribed Cymbalta for peripheral neuropathy because of a job that required him to be on his feet all day with no history mental problems “had a normal day at work, drove home, said he was going to grab a sandwich to his wife, and went and shot himself,” his family wrote a reporter.

In Feb. 2007, a 19-year-old Wisconsin college student recently put on Cymbalta “checked out books for a paper he was to write over the weekend,” emailed his resume “to see if he could get a spot on Obama’s team for the summer” and “then hung himself from his loft bed in his dorm,” writes his family. One month earlier, a 21-year old Midwest college student, recently put on Cymbalta, took his own life three minutes after speaking to his family while driving home and sounding fine, the family wrote a reporter.

Nor are incomprehensible and abrupt suicide attempts on Cymbalta a US phenomenon.

Doctors Bilal Salem and Elie Karam of the Saint George Hospital University Medical Center in Beirut, Lebanon write of similar “suicidality in apparently nonsuicidal patients after starting or increasing Duloxetine,” in the June 2008 Clinical Practice and Epidemiology in Mental Health.

Approved as an antidepressant and for diabetic nerve pain in 2004–soon after the Johnson suicide thanks to an unfazed FDA–Cymbalta soon proved to be the “Swiss Army Knife” of Lilly drugs says its hometown paper the Indianapolis Star–approved for general anxiety disorder and maintenance treatment of depression in 2007, for fibromyalgia in 2008 and with approvals for chronic knee and low back pain expected shortly.

In Europe it is in use for stress urinary incontinence but in the US its side effect of urinary retention landed Cymbalta on the FDA’s first Potential Signals of Serious Risks danger list in 2008. (FDA won’t release suicidal rates from stress urinary incontinence trials says reporter Jeanne Lenzer on Slate, who estimates them as 400 per 100,000 person-years for middle aged women.)

But some, like Shannon Brownlee, author of “Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer,” question the revenue-driven prescribothan. Should drugs “that may have a really serious side effect called suicide,” be used for simple knee or back pain, she asks in the Star.

No kidding! Cymbalta is also being studied for binge eating, social phobia, chronic fatigue, restless legs disorder, seasonal affective disorder, migraines, attention deficit disorder and childhood depression–despite known pediatric risks–PMS, menopause, alcoholism, panic disorder, obsessive compulsive disorder, kleptomania and the important medical condition: tennis elbow.

At the American Academy of Pain Medicine Annual Meeting in January, Lilly presented a study by its own doctors finding Cymbalta was superior to placebo in knee pain–in keeping with its penchant to publish studies by Lilly funded and Lilly employed doctors saying Cymbalta is safe.

Cymbalta is also a good use of state and third party payer dollars say Lilly funded doctors in “Differences In Medication Adherence and Healthcare Resource Utilization Patterns: Older Versus Newer Antidepressant Agents In Patients With Depression And/Or Anxiety Disorders” in the 2008-22 CNS Drugs who are fighting the “restrictive reimbursement policies for newer antidepressants,” in which pharmacy benefits managers are saying you want us to spend WHAT?

Getting benefits managers to cover the $200 a month cost for Cymbalta prescriptions for fibromyaglia may also be tough since the ailment has no clear cause, blood test or cure. Maybe Lilly will offer pointers in the medical courses it is funding.

MARTHA ROSENBERG is a columnist/cartoonist who writes about public health. She can be reached at: mrosenberg@evmark.org

 

 

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).

More articles by:

CounterPunch Magazine

minimag-edit

bernie-the-sandernistas-cover-344x550

zen economics

December 06, 2016
Anthony DiMaggio
Post-Fact Politics: Reviewing the History of Fake News and Propaganda
Richard Moser
Standing Rock: Challenge to the Establishment, School for the Social Movements
Norman Solomon
Media Complicity is Key to Blacklisting Websites
Michael J. Sainato
Elizabeth Warren’s Shameful Exploitation of Standing Rock Victory
David Rosen
State Power and Terror: From Wounded Knee to Standing Rock
Kim Ives
Deconstructing Another Right-Wing Victory in Haiti
Nile Bowie
South Korea’s Presidency On A Knife-Edge
Mateo Pimentel
Some Notes and a Song for Standing Rock
Bill Fletcher Jr – Bob Wing
Fighting Back Against the White Revolt of 2016
Peter Lee
Is America Ready for a War on White Privilege?
Pepe Escobar
The Rules of the (Trump) Game
W. T. Whitney
No Peace Yet in Colombia Despite War’s End
Mark Weisbrot
Castro Was Right About US Policy in Latin America
David Swanson
New Rogue Anti-Russia Committee Created in “Intelligence” Act
George Ochenski
Forests of the Future: Local or National Control?
December 05, 2016
Bill Martin
Stalingrad at Standing Rock?
Mark A. Lause
Recounting a Presidential Election: the Backstory
Mel Goodman
Mad Dog Mattis and Trump’s “Seven Days in May”
Matthew Hannah
Standing Rock and the Ideology of Oppressors: Conversations with a Morton County Commissioner
Kevin Zeese - Margaret Flowers
#NoDAPL Scores Major Victory: No Final Permit For Pipeline
Fran Shor
The End of the Indispensable Nation
Michael Yates
Vietnam: the War That Won’t Go Away
Michael Uhl
Notes on a Trip to Cuba
Robert Hunziker
Huge Antarctica Glacier in Serious Trouble
John Steppling
Screen Life
David Macaray
Trump vs. America’s Labor Unions
Yoav Litvin
Break Free and Lead, or Resign: a Letter to Bernie Sanders
Norman Pollack
Taiwan: A Pustule on International Politics
Kevin Martin
Nuclear Weapons Modernization: a New Nuclear Arms Race? Who Voted for it? Who Will Benefit from It?
David Mattson
3% is not Enough: Towards Restoring Grizzly Bears
Howard Lisnoff
The Person Who Deciphered the Order to Shoot at Kent State
Dave Archambault II
Standing Rock Sioux Tribe Statement on Dakota Access Pipeline Decision
Nick Pemberton
Make America Late Again
Weekend Edition
December 02, 2016
Friday - Sunday
John Pilger
The Coming War on China
Jeffrey St. Clair
Roaming Charges: The CIA’s Plots to Kill Castro
Paul Street
The Iron Heel at Home: Force Matters
Pam Martens - Russ Martens
Timberg’s Tale: Washington Post Reporter Spreads Blacklist of Independent Journalist Sites
Andrew Levine
Must We Now Rethink the Hillary Question? Absolutely, Not
Joshua Frank
CounterPunch as Russian Propagandists: the Washington Post’s Shallow Smear
David Rosen
The Return of HUAC?
Rob Urie
Race and Class in Trump’s America
Patrick Cockburn
Why Everything You’ve Read About Syria and Iraq Could be Wrong
Caroline Hurley
Anatomy of a Nationalist
Ayesha Khan
A Muslim Woman’s Reflections on Trump’s Misogyny
Michael Hudson – Steve Keen
Rebel Economists on the Historical Path to a Global Recovery
FacebookTwitterGoogle+RedditEmail