Death, Depression, Prozac

by Alexander Cockburn

Jeff Weise, teen slayer of 10, including himself, at the Red Lake Indian reservation in northern Minnesota, was on Prozac, prescribed by some doc.

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, Ky., where Joseph Wesbecker killed nine, including himself. You'll find many such stories in the past 15 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: Millions 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 submissions to the FDA in a disgusting 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 with prejudice as settled," very far from the victory Lilly had been claiming.

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 elderly -- although 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 ultimately based 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 63 patients were on fluoxetine for more than two years (fluoxetine hydrochloride was branded as Prozac in the mid-1970s). 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 expected rate as compared with all physician suicides, 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 M.D., an orgone-box veteran and copywriter skilled at minting new ailments for late twentieth-century America 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, lily-livered 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 10 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, including 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.