[Reader-list] death, depression and prozac

[Vivek Narayanan]

This could be a nice thing to think through, and argue about: depression 
and its treatment?  Cockburn is his usual provocative self-- I had no 
idea that the suicide rate for psychiatrists is twice the US national 
rate! (From Counterpunch.org)

V



  Death, Depression and Prozac

By ALEXANDER COCKBURN

/New Dehli, India./

Jeff Weise, teen slayer of ten, including himself, at the Red Lake 
Indian reservation in northern Minnesota, was on Prozac, prescribed by 
some doc. How did the consultation go? "Here Jeff, take these, they may 
help you get over life's little problems, like the fact that when you 
were 8 your dad committed suicide and when you were 10 your cousin was 
killed in a car wreck that left your mom with partial paralysis and an 
injured brain. And let's face it, Jeff, most likely you'll never get off 
the res. You're here for the rest of your life." Cut to a shot of the 
doc holding up a Prozac bottle, like the kindly fellow in the white coat 
and mirrored headband in 1950s Lucky Strike ads, telling us that Luckies 
were a fine way to soothe a raspy throat.

The minute the high command at Eli Lilly, manufacturer of Prozac, saw 
those news stories about Weise you can bet they went into crisis mode, 
and only began to relax when Weise's websurfs of neo-Nazi sites took 
over the headlines. Hitler trumps Prozac every time, particularly if 
it's an Injun teen ranting about racial purity. How many times, amid the 
carnage of such homicidal sprees, do investigators find a prescription 
for antidepressants at the murder scene? Luvox at Columbine, Prozac at 
Louisville, Kentucky, where Joseph Wesbecker killed nine, including 
himself. You'll find many such stories in the past fifteen years.

By now the Lilly defense formula is pretty standardized:self-righteous 
handouts about the company's costly research and rigorous screening, 
crowned by the imprimatur of that watchdog for the public interest, the 
FDA. And of course there's the bogus comfort of numbers; if Lilly's pill 
factory had a big sign like MacDonald's, it could boast Prozac: Billions 
Served.

Each burst in the sewage pipe brings a new challenge to Lilly's sales 
force, which has had some heavy hitters down the years, including George 
Herbert Walker Bush (onetime member of the Lilly board of directors); 
former Enron CEO Ken Lay (onetime member of the board); George W. Bush's 
former director of the Office of Management and Budget, Mitch Daniels (a 
former senior vice president); George W. Bush's Homeland Security 
Advisory Council member Sidney Taurel (a Lilly CEO); or the National 
Alliance for the Mentally Ill (a recipient of Lilly funding).

At the turn of this year there was a five-alarm incident when the 
British Medical Journal went back to the 1994 Wesbecker suit against 
Lilly, reminding the world that the company had been involved in some 
shifty footwork involving a back-door payoff to the plaintiffs in a deal 
that successfully excluded from Judge John Potter's courtroom the 
regulatory case history of Oraflex, a highly compromised Lilly product, 
which displayed the company's supposed disclosures to the FDA in an 
unpleasing light.

Lilly rose to the challenge, successfully persuading gullible 
journalists that the real story concerned a lonely freelancer writing 
for BMJ and not a powerful pharmaceutical company with a huge 
advertising budget. The press dutifully shifted its focus from Lilly's 
outrageous efforts to suppress evidence to the narrow question of 
whether a piece of evidence had really been in the public record in the 
years since 1997, when Judge Potter changed his verdict to "dismissed as 
settled with prejudice," very far from the victory Lilly had been claiming.

That's the trouble with time, as Paul Krassner joked about Waldheimer's 
Disease, which is when you get old and forget you were a Nazi. But it's 
never too late to review the origins of the Depression Industry in the 
late 1980s, and the saga of what happened after three Lilly researchers 
concocted a potion in the mid-1970s they christened fluoxetine 
hydrochloride, later known to the world as Prozac.

Long years of rigorous testing? When Fred Gardner and I investigated the 
selling of depression and Prozac in the mid-1990s, we found that 
clinical trials excluded suicidal patients, children and the 
elderlyoalthough once FDA approval was granted, the drug could be 
prescribed for anyone. According to Dr. Peter Breggin, the well-known 
psychiatrist who analyzed the FDA's approval of Prozac, it was based, 
ultimately, on three studies indicating that fluoxetine relieved some 
symptoms of depression more effectively than a placebo, and in the face 
of nine studies indicating no positive effect. Only sixty- three 
patients were on fluoxetine (fluoexetine hydrochloride was branded as 
Prozac in the mid 70s) for a period of more than two years. By 1988 the 
National Institute of Mental Health had not only put the government 
stamp of approval on corporate-funded depression research but had 
created a mechanism whereby government money and personnel could be 
employed to stimulate demand for corporate products.

Psychiatrists--a breed whose adepts, so stated a study published in the 
Journal of Clinical Psychiatry in 1980, commit suicide at twice the 
national rate--have been central to the entire enterprise. The process 
linking their sorcery to the corporate bottom line has a robust 
simplicity to it. As Prozac came off Lilly's research bench and headed 
for the mass production line psychiatrists labored to formulate a 
multitude of bogus pathologies to be installed in the Diagnostic and 
Statistical Manual of Mental Disorders, whose chief editor in the 1980s 
was Robert Spitzer MD, an orgone box veteran and adept copywriter 
skilled at minting new ailments for late twentieth-century America and 
sanctioning treatment, medication, state funding for the requisite pills 
(no expensive consultative therapy) and reimbursement by insurance 
companies.

When detailed research showed likely linkage of Prozac to violent acts. 
Lilly-liveried psychiatrists were there to douse the flames of doubt. In 
1991 the FDA's Psychopharmacologic Drugs Advisory Committee met to 
decide whether Prozac should carry a warning label about links to 
suicide. Five out of the ten panel members (eight of whom were shrinks) 
had active financial interests in the drugs the committee was 
investigating, and all voted against requiring a warning, their obvious 
conflicts duly sanitized by the toothless FDA. Other shrinks in the hire 
of the drug companies urged ever wider application of Prozac to remedy 
social angst, inclcluding plans for compulsory Prozac-dosing of youngsters.

In 2000, when hundreds of farmers in the Indian state of Andhra Pradesh 
were committing suicide because of neoliberal policies that had 
destroyed their livelihoods, the state government announced it was 
sending out a team of shrinks to determine why the farmers were 
depressed. The implication was that these people were mentally unstable. 
But in India credulity about the causes of depression is not so far 
advanced. The plan provoked a storm of ridicule, and in the elections 
that followed the Andhra Pradesh government, darling of Western 
neoliberals, was duly trounced.

No such happy chance in the United States, where government is in the 
pay of drug companies and prescriptions for antidepressants have long 
since taken over from political manifestos that would cure depression by 
collective social action. How they must have cheered at Eli Lilly when 
the Senate wiped out Chapter 7 of the bankruptcy statutes, fostering 
family violence, heightened crime and a vast new potential market for 
Prozac and kindred potions at the stroke of a pen.