June 2, 2008

Paxil suicide product liability case resolved

A man with no previous history of violence or suicide drowned himself and his two children in a bathtub after taking two doses of Paxil. Paxil is an antidepressant of the SSRI (selective serotonin reuptake inhibitor) class, which also includes Prozac, Zoloft, Celexa and Luvox.
Psychiatrist Peter R. Breggin, M.D. was a medical expert for the surviving family members who brought a product liability suit brought against the manufacturer, Glaxo SmithKline (GSK). The suit accused the drug company of negligence in testing the drug and in failing to adequately disclose its harmful effects.
In January 2002, GSK resolved the product liability suit. The suit, Lacuzong v. SmithKline Beecham, was brought in California. (Lacuzong v. Davidson et al, Superior Court of the State of California, County of Santa Clara, Case No.: CV 773623).
Dr. Breggin worked closely with plaintiff’s attorney Don Farber of San Jose, California. Before the resolution of the suit, Dr. Breggin and Mr. Farber had the opportunity to examine internal corporate documents at the headquarters of GSK.
Dr. Breggin commented on the similarity between this California tragedy in which a man drowned his children and himself in a bathtub and the more familiar Texas case of Andrea Yates who drowned her four children in a bathtub. The press reported that Mrs. Yates was taking the antidepressants Remeron and Effexor, a combination that can also over-stimulate serotonin.
Severe Adverse Reactions After One or Two Doses
Dr. Breggin stated that physicians and patients are not aware that many severe adverse drug effects can surface after the first or second dose of any SSRI antidepressant. Because the “therapeutic effect” of any antidepressant usually takes several weeks or more to develop, some doctors fail to realize that toxic effects can develop beginning with the first dose. These doctors are not likely to warn patients and their families about adverse events occurring after one or two doses. Furthermore, these doctors may discount the patient’s report when these early reactions occur. They may urge the patient to continue taking the drug so that the patient ends up developing an unnecessarily severe reaction.
Background Science
SSRI’s (selective serotonin reuptake inhibitors) include Prozac, Paxil, Zoloft, Luvox and Celexa. Other antidepressants, such as Effexor, can also block the uptake of serotonin causing similar effects. These drugs can cause suicide, violence and other criminal acts through several mechanisms, including the following:
(1) SSRI-induced mania, sometimes (but not always) with psychotic features, such as hallucinations or delusions. During drug-induced mania, the individual can make elaborate plans, including robberies or embezzlement. However, the plans are often outlandish and doomed to failure due to obviously poor judgment. Drug-induced mania can cause many expressions of disinhibited or out-of-control behavior, including sexual acting out, road rage, buying sprees and shoplifting. Drug-induced mania, even when seemingly not intense, can ruin marriages and destroy careers. All of the features of mania are not required in order to meet the diagnosis of Antidepressant-Induced Mood Disorder with Manic Features. If the individual’s mood is “elevated, euphoric, or irritable,” the necessary criteria are met.
(2) SSRI-induced depression or worsening of depression. In a seemingly paradoxical effect, antidepressants can cause or worsen depression. In controlled clinical trials for Prozac that were conducted by the manufacturer, Eli Lilly and Company, depressed patients taking Prozac attempted suicide more frequently than depressed patients taking placebo (sugar pill) or older antidepressants.
(3) SSRI-induced severe anxiety and agitation, especially in a patient already suffering from depression with anxiety and agitation.
(4) SSRI-induced obsessions and compulsions that motivate violence toward oneself or others.
(5) SSRI-induced akathisia, an internal sensation of agitation or discomfort that drives a person to move about, and also to lose impulse control. During akathisia, the inner experience of agitation includes many unusual physical feelings, such as electricity in the head or body. The person suffering from akathisia typically feels compelled to move the feet when sitting, to stand, or to pace. Akathisia is known to increase the risk of suicide and violence.
Dr. Breggin has written extensively about the adverse effects of the SSRI antidepressants. Harmful mental or psychiatric effects include mania and psychosis, violence, depression, suicidality, agitation and anxiety. As a medical expert in 1994, Dr. Breggin provided the scientific basis for a large series of similar cases related to Prozac. The court combined the cases in order to allow one organized effort at obtaining disclosure from the company. In this lead role as the medical expert for the combined cases, Dr. Breggin reviewed internal documents from Eli Lilly & Company, the manufacturer of Prozac, and also examined FDA materials and the scientific literature. In a more recent suit product liability suit against Eli Lilly & Company, Dr. Breggin once again had the opportunity to examine internal documents, this time at the corporate headquarters. As far as Dr. Breggin is aware, all of the individual Prozac product liability suits in which he has agreed to be an expert have been settled. Others, of course, remain active.
In addition to other sections of this website , see the following books by Dr. Breggin for further information on antidepressants:
Talking Back to Prozac (with Ginger Breggin, 1994)
These books provide documentation and further detailed discussions of issues surrounding the use of antidepressants, including the SSRIs like Prozac, Paxil, Zoloft, Celexa, and Luvox.


Dr. Breggin’s Legal Page