Pharma Giant Looking for New Diseases to Treat with Drug Linked to Suicide

By Martha Rosenberg, AlterNet. Posted February 17, 2009.

Bilal Salem and Elie Karam of the Saint George Hospital University Medical Center in Beirut, Lebanon write of similar "suicidality in apparently nonsuicidal patients after starting or increasing Duloxetine," in the June 2008 Clinical Practice and Epidemiology in Mental Health. 

Approved as an antidepressant and for diabetic nerve pain in 2004--soon after the Johnson suicide thanks to an unfazed FDA--Cymbalta soon proved to be the "Swiss Army Knife" of Lilly drugs says its hometown paper the Indianapolis Star--approved for general anxiety disorder and maintenance treatment of depression in 2007, for fibromyalgia in 2008 and with approvals for chronic knee and low back pain expected shortly. 

In Europe it is in use for stress urinary incontinence but in the US its side effect of urinary retention landed Cymbalta on the FDA's first Potential Signals of Serious Risks danger list in 2008.  (FDA won't release suicidal rates from stress urinary incontinence trials says reporter Jeanne Lenzer on Slate, who estimates them as 400 per 100,000 person-years for middle aged women.) 

But some, like Shannon Brownlee, author of "Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer," question the revenue-driven prescribothan. Should drugs  "that may have a really serious side effect called suicide," be used for simple knee or back pain, she asks in the Star. 

No kidding!  Cymbalta is also being studied for binge eating, social phobia, chronic fatigue, restless legs disorder, seasonal affective disorder, migraines, attention deficit disorder and childhood depression--despite known pediatric risks--PMS, menopause, alcoholism, panic disorder, obsessive compulsive disorder, kleptomania and the important medical condition: tennis elbow. 

At the American Academy of Pain Medicine Annual Meeting in January, Lilly presented a study by its own doctors finding Cymbalta was superior to placebo in knee pain--in keeping with its penchant to publish studies by Lilly funded and Lilly employed doctors saying Cymbalta is safe. 

Cymbalta is also a good use of state and third party payer dollars say Lilly funded doctors in "Differences In Medication Adherence and Healthcare Resource Utilization Patterns: Older Versus Newer Antidepressant Agents In Patients With Depression And/Or Anxiety Disorders" in the 2008-22 CNS Drugs who are fighting the "restrictive reimbursement policies for newer antidepressants," in which pharmacy benefits managers are saying you want us to spend WHAT? 

Getting benefits managers to cover the $200 a month cost for Cymbalta prescriptions for fibromyaglia  may also be tough since the ailment has no clear cause, blood test or cure.  Maybe Lilly will offer pointers in the medical courses it is funding.

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Martha Rosenberg is a columnist and cartoonist who frequently writes about the impact of the pharmaceutical, food and gun industries on public health. A former medical copywriter, her work has appeared in the Boston Globe, San Francisco Chronicle, Los Angeles Times and Chicago Tribune, as well as on the BBC and in the original National Lampoon.

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