Zyprexa and Quack Psychiatry

Excellent article by Rick Davis. We hope to see more by him.

Since its approval, Zyprexa has been exposed as responsible for a high incidence of stroke, diabetes, endocrine, cardiac problems and movement disorders. And yet, the drug has been routinely prescribed to adults of all ages and to children, despite the fact that the FDA has not approved Zyprexa for pediatric use.

In the July 2002 issue of Pharmacotherapy, P Murali Doraiswamy, the chief of biological psychiatry at Duke University, published a review of adverse events reported to the FDA by Zyprexa patients that found 289 cases of diabetes, 100 patients with ketosis (a serious complication of diabetes), and 22 cases of pancreatitis, a life-threatening condition. The review documented 23 deaths, including a 15-year-old adolescent who died of necrotizing pancreatitis.

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Sales of Zyprexa, dwindled in the last quarter of 2005, as news of the drug's lethal side effects made headlines. In June 2005, word got out that Lilly had agreed to pay $690 million to settle a lawsuit filed on behalf of about 8,000 Zyprexa patients who alleged they had not been warned of the drug's increased risk of diabetes.

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In every state, Zyprexa represents a big line-item expense to Medicaid at a time when most states are facing a budget crisis. US sales of all antipsychotics doubled between 2001 and 2004, largely because of purchases by Medicaid. On September 29, 2005, Bloomberg News reported that Medicaid programs may reduce the $5.5 billion it spends annually on schizophrenia drugs for the poor after a study found a cheaper generic about as effective as nongenerics, including Zyprexa. "The 40-year-old drug perphenazine costs less than $1.50 a day," Bloomberg wrote, "while the newer medicines can cost 10 times as much."

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The state of Georgia has removed Zyprexa from its preferred drug list and any Georgia doctor who wants to start a Medicaid patient on Zyprexa, must now submit a clinical rationale stating why it's the only drug appropriate for the patient, according to the November 28, 2005 Indianapolis Business Journal (IBJ). Illinois, Tennessee, Pennsylvania and Louisiana also require doctors to obtain prior authorization before prescribing Zyprexa, according to the November 2005 Indianapolis Business Journal. Georgia spokeswoman Julie Kerlin told IBJ that removing Zyprexa from the list in 2004 has saved the state nearly $7 million, which means Lilly lost $7 million in one state alone.