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Medical flap // Anti-depression drug of Eli Lilly loses sales after attack by sect

Title: Medical flap // Anti-depression drug of Eli Lilly loses sales after attack by sect
Date: Friday, 19 April 1991
Publisher: Wall Street Journal
Author: Thomas M. Burton
Main source: link (303 KiB)

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Scientologists Claim Prozac Induces Murder or Suicide, Though Evidence Is Scant
Campaign Dismays Doctors

INDIANAPOLIS—L. Ron Hubbard, the late founder of the Church of Scientology, long harbored a profound and obsessive hatred for psychiatrists, who, he declared, were "chosen as a vehicle to undermine and destroy the West!"

Five years after Mr. Hubbard's death, Scientologists are still waging war on psychiatry. The quasi-religious/ business/ paramilitary organization's latest target is Prozac, the nation's top-selling medicine for severe depression. The group is calling it a "killer drug" that drives people to murder or suicide. Its tactics include scores of condemnatory mailings and press releases, going on the talk-show circuit and lobbying with Congress and the Food and Drug Administration to ban Prozac.

To the dismay of some doctors and the drug's manufacturer, Indianapolis-based Eli Lilly & Co., the campaign has had some success. Although Prozac's sales are huge, its share of the antidepressant market has slipped to 21% from 25% last July.

'Public-Health Problem'

"The public's fear of Prozac as a result of this campaign has itself become a potentially serious public-health problem as people stay away from treatment," says Jerrold Rosenbaum, a Harvard psychiatry professor.

Moreover, the Scientologists' arguments are being repeated in courts of law. In about a dozen cases pending around the nation, defense lawyers are arguing that their clients shouldn't be held responsible for any crimes because they were taking the drug. In five criminal cases already decided, however, the defendants were convicted. In addition, more than 50 civil suits related to violence allegedly induced by Prozac are pending against Eli Lilly; none have been resolved.

Lilly says it hasn't any evidence that the drug can turn patients either murderous or suicidal, but Prozac, like all antidepressants, does have side effects, including nervousness and sleeplessness. For many people, it is by far the easiest antidepressant to tolerate and doesn't leave the user feeling drugged or sleepy, as other antidepressants tend to do. And it has been known to dramatically relieve depression and improve the lives of some patients.

Going Off the Medicine

Yet at the St. Vincent Stress Center in Indianapolis, severely depressed patients were frightened enough by one Scientology official's remarks on television to stop taking the medication, only to deteriorate rapidly. "I have people coming off Prozac, and some of them are ending up in the hospital," says Paul Riley, the medical director. "I'm very angry about this. Somebody's going to end up dead from coming off the medicine," Dr. Riley says.

For Lilly, the Scientologists' campaign poses special problems. The company is very conservative. Lilly rarely seeks publicity and, with most of its drugs sold by prescription, it isn't used to marketing to the public.

Lilly also is vulnerable because of problems with two earlier products. It was one of several companies that sold DES, a drug blamed for an abnormal incidence of cancer in women whose mothers took it to avoid miscarrying. And in 1985, it pleaded guilty to 25 misdemeanor charges for failing to inform federal officials of four deaths and six illnesses after patients took Oraflex, an anti-arthritis medication.

Company's Position

Nevertheless, Lilly feels strongly that Prozac is safe. Leigh Thompson, the company's top medical official, says: "It's a demoralizing revelation to watch 20 years of solid research by doctors and scientists shouted down in 20-second sound bites by Scientologists and lawyers."

Lilly researchers first synthesized Prozac, known medically as fluoxetine hydrochloride, in 1972. The drug didn't hit the U.S. market until 1988, partly because Lilly had never made an antidepressant before and management didn't push its development. Now, Prozac has become crucial to the company; its sales, despite the late-1990 dropoff, were up 116% to $777 million last year. It is Lilly's No. 2 product, trailing only the antibiotic Ceclor, and many analysts predict that this year Prozac will top $1 billion. Pfizer Inc. and SmithKline Beecham PLC have chemically comparable antidepressants that are on sale in Britain but not yet in the U.S.

The attack on Prozac is only the latest battle in Scientology's war against psychiatry. Mr. Hubbard was a Nebraska-born science-fiction writer who, after a stint in the Navy, took to calling himself "commodore." His best-selling book, "Dianetics," led to creation of the group.

Mr. Hubbard's hatred of psychiatry may have sprung in part from the fact that "the early on rejected" his ideas, suggests Cynthia Kisser, executive director of the Cult Awareness Network. He also realized, she contends, that "the best recruits were people whose problems were not being solved by the mental-health profession. These people might buy into Scientology." Church officials didn't respond to phone calls seeking comment.

Scientologists' central belief is that human beings have a soul-like entity called a "thetan" that is perfect and travels from galaxy to galaxy. Their goal is to help their thetans get rid of something called engrams—essentially, bad memories.

To this end, Scientology developed a lie-detector-like device called an E-meter, which is used to treat mental problems often at hundreds of dollars per session. Psychiatrists consider these "treatments" quackery. In 1984, the Internal Revenue Service successfully challenged the tax-exempt status of the Church of Scientology of California, then the mother church, arguing that it was more business than church. Scientology boasts of having millions of members, but the Cult Awareness Network and former Scientologists put the number closer to 12,000.

In recent years, the Citizens Commission on Human Rights, a Scientology-founded group, lambasted Ritalin, a Ciba-Geigy Corp. drug for hyperactive children. Last year the group, many of whose members have "Psychiatry Kills" stickers on their cars, alerted church members that some favorable press coverage of Prozac was "a declaration of war" that "cannot go unanswered."

"Psychiatrists are in their way," asserts Dennis Erlich, a former Scientologist minister. "Scientology is a serious conspiracy to derail psychiatry, pharmaceutical companies, and so on." He notes the group's paramilitary nature: Some members have military ranks, wear Navy-style uniforms and can be judged for offenses against the church by military-style tribunals.

A Minister's Observations

Sanford Block, a college dropout and Scientologist minister who serves as executive director of the Citizens Commission, says his group isn't run by the church but is mostly staffed by church members. He says he became convinced that psychiatry kills after noticing that "there's an enormously high rate of suicide for people who leave mental institutions" and that "a large portion of mass murderers had been psychiatric failures first."

In attacking Prozac, Scientologists often cite a 1989 mass murder at the Standard Gravure printing plant in Louisville, Ky. They say Joseph Wesbecker, who killed eight co-workers, wounded 12 and then shot himself to death, was "turned psychotic" by Prozac. On a recent Phil Donahue Show on NBC, Dennis Clarke, president of the Citizens Commission, characterized Mr. Wesbecker as a man who before Prozac "had no history of violence" and "didn't have an argument on the job for 32 years." Mr. Block, the Scientology minister, adds in an interview, "There was no evidence about any threats" made by Mr. Wesbecker against co-workers or bosses before taking Prozac.

That is far from the truth. In fact, Mr. Wesbecker was for years a tragically tormented man who tried to commit suicide at least 12 times. During a period when he wasn't taking Prozac, he was diagnosed as a borderline personality, regularly talked about killing his bosses (according to nine separate witnesses who talked to the police ), bought the guns he eventually used—including an AK-47 assault rifle—and went to a gun range to practice. He even bragged about his plans to kill his bosses to a man who came to his house regarding some tile work.

The Scientologists' anti-Prozac material often assumes that any criminal who takes the drug must have committed his crimes because of it. "The numbers of persons who have been driven or are being driven suicidal or homicidal by Prozac is astronomical," one press release says.

Some Suicides Inevitable

But the number of people on Prozac exceeds 3.5 million, more than the population of Chicago, where hundreds of people commit murder or suicide every year. And Frederick K. Goodwin, the U.S. government's top psychiatrist and an authority on depression, says it wouldn't be surprising over time to see thousands of suicides among more than three million depressive patients. "For many," Dr. Goodwin says, "Prozac has truly been a miracle, the first medication to rescue them from the living hell we call depression."

Often, the Scientologists' campaign has involved taking a seed of truth and then stretching it. In February 1990, Martin Teicher, a psychiatry professor at Harvard medical school, wrote that six of his mental patients had "serious" suicidal thoughts while on Prozac. Five had previous suicidal tendencies, but Dr. Teicher said these new "obsessive and violent" notions had strengthened. He estimated that the side effect occurred in 3.5% of his patients on Prozac.

However, he adds in an interview that he doesn't think it fair to extrapolate that percentage to all patients using the drug. Harvard's Dr. Rosenbaum and colleagues surveyed records of more than 1,000 patients on Prozac and found no tendencies such as those described by Dr. Teicher. Yet the Scientology group extrapolated from Dr. Teicher's limited report to conclude that "up to 140,000 people in the United States have become violent and suicidal by Prozac" and "can explode any moment without provocation."

Dr. Teicher says the Scientologists' use of his paper is "absolutely irresponsible." He says they are twisting his research "to advance their purpose, which is to destroy psychiatry." He considers Prozac, used properly, safe and helpful.

Publicity Easily Obtained

Despite their credibility problems, the Scientologists have little trouble obtaining publicity for their cause. For instance, last year, numerous newspapers ran articles saying Scientologists had petitioned the FDA to ban Prozac on the ground that it prompts thoughts of suicide. One such article quoted Mr. Block of the Citizens Commission as saying, "Persons who were never depressed in their lives are going onto Prozac and suddenly wanting to kill themselves."

Likewise, the Smyth County News in Marion, Va., ran an article that appeared to come straight from a Scientologist press release. "A nationwide warning has been issued on the psychiatric antidepressant drug Prozac cautioning that the drug can generate intense, violent suicidal thoughts and can push unsuspecting users of the drug to commit murder," the article said. It contained no response from Lilly or any psychiatrists.

Linda White, the Virginia paper's editor, says such press releases often get printed because small newspapers, including hers, "don't have the resources to check out all press releases."

Psychiatrists say they can't rule out the possibility of a few dangerous side effects with Prozac or any drug. A Yale-New Haven Hospital study in 1990 found some suicidal thoughts among obsessive-compulsive adolescents taking Prozac. But many psychiatrists prescribe it for hundreds of patients without problems, and scattered incidents hardly bear out Scientologists' allegations that "psychiatrists have destroyed thousands of lives" with Prozac.

Far more common are experiences such as those of Jill Silver, a 56-year-old artist and grandmother from Wynnewood, Pa. In the past five years, panic attacks associated with moderate depression forced her to run out of restaurants—and out of her job. In January, she "bottomed out," crying incessantly and constantly needing her husband or a relative with her. "I'd become a baby again," she says.

Her doctor prescribed Prozac. Gradually, over four weeks, with therapy and the support of her family, she improved substantially. Now she is counseling the mentally ill at a crisis hot-line center.

Clinical-Trial Results

To fight the Scientologists, Lilly is taking the unusual step of publishing results from clinical trials conducted before Prozac entered the U.S. market. The results, compiled by doctors unaffiliated with Lilly on 3,065 depressed patients, show a lower tendency toward suicidal thinking with Prozac than with other antidepressants, or with the starch capsules given to a control group. Neither doctors nor patients were told what was in the capsules.

After the Scientologists' attack began, David Wheadon, a Lilly psychiatrist, met with European suicide experts to explore whether the company missed something significant in these tests. Dr. Thompson, Lilly's chief physician, also met with four psychiatrists who scrutinized its findings. Inside and outside the company, psychiatrists concluded that nothing in the clinical trials linked suicidal thinking—common in depression patients—to Prozac.

Lilly also sent out "Dear Doctor" letters about all this. And last January, the company convened its 1,700 U.S. salespeople and urged them to tell any concerned doctors about the clinical-trial results and discuss the Scientologists' campaign.

But that campaign has been effective in frightening Prozac patients. Watching a recent Donahue talk show on which Mr. Clarke and others blamed the Louisville killings on Prozac were 21 severely depressed patients at Oakville-Trafalgar Memorial Hospital near Toronto. Some had been hospitalized after trying to slit their wrists; some were then put on Prozac.

As they heard Mr. Wesbecker described as "your average nice Joe" turned killer by Prozac, the patients became distraught, some hysterically so. Doctors and nurses had to lead them out of the hospital's day room. It took three days for Robbie Thompson, the chief of psychiatry, and his staff to calm many of them.

"I'm all for looking at both sides of the coin," Dr. Thompson says, "but this just isn't right. How this has been allowed to go this far is beyond me."

(c) 1991 Dow Jones & Company, Inc. All Rights Reserved