FacebookTwitterGoogle+RedditEmail

It’s the Cymbalta Stupid

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

 

 

More articles by:

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).

January 17, 2019
Stan Cox
That Green Growth at the Heart of the Green New Deal? It’s Malignant
David Schultz
Trump vs the Constitution: Why He Cannot Invoke the Emergencies Act to Build a Wall
Paul Cochrane
Europe’s Strategic Humanitarian Aid: Yemen vs. Syria
Tom Clifford
China: An Ancient Country, Getting Older
Greg Grandin
How Not to Build a “Great, Great Wall”
Ted Rall
Our Pointless, Very American Culture of Shame
John G. Russell
Just Another Brick in the Wall of Lies
Glenn Sacks
LA Teachers Strike: Black Smoke Pouring Out of LAUSD Headquarters
Patrick Walker
Referendum 2020: A Green New Deal vs. Racist, Classist Climate Genocide
Kevin Zeese - Margaret Flowers
Uniting for a Green New Deal
Matt Johnson
The Wall Already Exists — In Our Hearts and Minds
Jesse Jackson
Trump’s Flailing will get More Desperate and More Dangerous
Andrew Stewart
The Green New Deal Must be Centered on African American and Indigenous Workers to Differentiate Itself From the Democratic Party: Part Three
January 16, 2019
Patrick Bond
Jim Yong Kim’s Mixed Messages to the World Bank and the World
John Grant
Joe Biden, Crime Fighter from Hell
Alvaro Huerta
Brief History Notes on Mexican Immigration to the U.S.
Kenneth Surin
A Great Speaker of the UK’s House of Commons
Elizabeth Henderson
Why Sustainable Agriculture Should Support a Green New Deal
Binoy Kampmark
Trump, Bolton and the Syrian Confusion
Jeff Mackler
Trump’s Syria Exit Tweet Provokes Washington Panic
Barbara Nimri Aziz
How Long Can Nepal Blame Others for Its Woes?
Glenn Sacks
LA Teachers’ Strike: When Just One Man Says, “No”
Cesar Chelala
Violence Against Women: A Pandemic No Longer Hidden
Kim C. Domenico
To Make a Vineyard of the Curse: Fate, Fatalism and Freedom
Dave Lindorff
Criminalizing BDS Trashes Free Speech & Association
Thomas Knapp
Now More Than Ever, It’s Clear the FBI Must Go
Binoy Kampmark
Dances of Disinformation: The Partisan Politics of the Integrity Initiative
Andrew Stewart
The Green New Deal Must be Centered on African American and Indigenous Workers to Differentiate Itself From the Democratic Party: Part Two
Edward Curtin
A Gentrified Little Town Goes to Pot
January 15, 2019
Patrick Cockburn
Refugees Are in the English Channel Because of Western Interventions in the Middle East
Howard Lisnoff
The Faux Political System by the Numbers
Lawrence Davidson
Amos Oz and the Real Israel
John W. Whitehead
Beware the Emergency State
John Laforge
Loudmouths against Nuclear Lawlessness
Myles Hoenig
Labor in the Age of Trump
Jeff Cohen
Mainstream Media Bias on 2020 Democratic Race Already in High Gear
Dean Baker
Will Paying for Kidneys Reduce the Transplant Wait List?
George Ochenski
Trump’s Wall and the Montana Senate’s Theater of the Absurd
Binoy Kampmark
Dances of Disinformation: the Partisan Politics of the Integrity Initiative
Glenn Sacks
On the Picket Lines: Los Angeles Teachers Go On Strike for First Time in 30 Years
Jonah Raskin
Love in a Cold War Climate
Andrew Stewart
The Green New Deal Must be Centered on African American and Indigenous Workers to Differentiate Itself From the Democratic Party
January 14, 2019
Kenn Orphan
The Tears of Justin Trudeau
Julia Stein
California Needs a 10-Year Green New Deal
Dean Baker
Declining Birth Rates: Is the US in Danger of Running Out of People?
FacebookTwitterGoogle+RedditEmail