Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, March 4, 1991 TAG: 9103020356
SECTION: EXTRA PAGE: E-3 EDITION: METRO
SOURCE: The New York Times
DATELINE: LENGTH: Medium
The new cases were described in a letter in a recent issue of The New England Journal of Medicine.
The physicians said the two cases differed from previous published reports of suicidal behavior linked to Prozac because the two patients had never before shown signs of wanting to kill themselves.
But Eli Lilly and Co. of Indianapolis, the maker of Prozac, as well as many other physicians, vehemently deny that there is any scientific merit to the charge that the medication can prompt suicidal or violent acts.
The company argues that its product is, in fact, less likely to make patients suicidal than other antidepressants.
Prozac, the commercial form of the compound fluoxetine, is already the center of a sharp legal and medical dispute.
More than 50 lawsuits have been filed nationwide against Lilly.
One involves the former rock star Del Shannon, who was taking Prozac when he committed suicide in Los Angeles last year.
Like most of the others, the suit by Shannon's wife, Leanne Westover, charges the pharmaceutical company with "improper testing" of Prozac and "a failure to warn the medical community of the dangerous propensities that Prozac can produce in a small number of cases," said Leonard Finz, a New York lawyer who is the lead counsel in the Shannon case and now the most prominent legal crusaderagainst Prozac.
Other lawsuits blame Prozac In these two cases, it seems to be clear that the Prozac caused the suicidal thoughts. Mantosh Dewan Associate professor of psychiatry State University of New York for driving patients to mutilate themselves and even to commit murder.
Many physicians are dismayed by the lawsuits and bad publicity, and they argue that the medication is being unfairly maligned.
Prozac was introduced only three and a half years ago but is now among the most widely prescribed antidepressant drug, accounting for about 20 percent of the market, or 6.1 million prescriptions, in 1989, the last year for which figures are available.
The vast majority of physicians have said the drug is one of the best medications in its category.
It is able to match the older antidepressants in relieving the symptoms of the mental disease 60 percent to 80 percent of the time, they said, but does not touch off many of the debilitating side effects caused by the traditional antidepressant drugs, like extreme dizziness, weight gain and high blood pressure.
Some doubted that fluoxetine in any way increased a patient's violence or preoccupation with suicide.
They said that depressed people often feel suicidal and that all antidepressant drugs can increase the risk of suicide attempts simply by giving people the energy to act on their impulses before the drugs have had a chance to relieve the mental anguish of the disorder.
But the doctors who wrote the letter said the two patients developed suicidal thoughts less than a week after starting to take Prozac.
Unlike other patients who developed suicidal thoughts after taking the drug, neither patient had considered suicide in the past, the doctors said, and they lost their preoccupation with suicide three to four days after the medication was stopped.
One patient was a 28-year-old woman diagnosed with bulimia and depression; the other, a 58-year-old man suffering from major depression, actually tried to hang himself with a rope.
"In these two cases, it seems to be clear that the Prozac caused the suicidal thoughts," said Dr. Mantosh Dewan, an associate professor of psychiatry at the State University of New York Health Science Center in Syracuse and one of the authors of the letter.
"The question now is whether this very rare side effect is more prevalent with Prozac than with other antidepressants."
by CNB