Drug giant's bid
to block disturbing new research
SECRET campaign was waged by drugs industry giant Eli Lilly to
suppress reports suggesting that Prozac could make some people
Documents seen by The Express show that the company's
executives made "protect Prozac" top priority in the face of
adverse criticism. They feared that the company would go out
of business if there were reports in Britain linking the drug
Prozac is the world's best-selling drug for the treatment
of depression, eating disorders and pre-menstrual tension. It
is used by half a million people in the United Kingdom.
Scientific opinion is divided on whether Prozac can induce
suicidal tendencies in some patients. Eli Lilly has always
argued that there is no credible evidence to support the
theory. But documents released in a US court case earlier this
year reveal that the firm was highly sensitive to reports on
possible dangerous side-effects.
THE young office worker had suffered one of the shocks of
life that nobody could be prepar-ed for. Three weeks before
her wedding, her partner died suddenly and inexplicably of a
It sent Ramo Kabbani, now 32, into a spiral of despair. Ten
months later, still sobbing uncon-trollably in the night, she
sought medical help and was prescrib-ed a number of
anti-depressants. None worked. So eventually she, like
38milli-on people across the world, began taking Prozac. Its
effect was extraordinary.
"I went on an un-natural high. I belie-ved the whole world
should be on Prozac. I was euphoric," said Ms Kabbani, of
Manchester. "I lost my inhibitions and started doing bizarre,
out-of-character things like spending £3,000 on credit,
knowing full well that I couldn't pay it back."
But nobody had warned her of what was to come. After six
weeks she became suicidal, literally overnight. "I was
suddenly obsessed with killing myself and took an overdose of
pain-killers," she said. When this failed, she planned further
attempts and even started to arrange her own funeral.
She said: "I had an inner restlessness. I couldn't settle.
I had no peace. I would go to bed thinking about ending my
life. I'd sleep - sometimes for days - and dream about it,
then wake up still thinking about it."
Her suicide attempts became calculated. "I'd tell the
family I was going away so I would not be found," she said.
"Then I'd take a cocktail of drugs which I thought would kill
"But I would vomit or go into a deep sleep for days. I'd
then feel a complete failure because it had not worked. I
tried taking cocktails of drugs in different ways - even with
milk to line my stomach and stop me being sick."
When drug overdoses failed, she thought of other methods.
She recalls: "I would spend hours working out which
multi-storey car park I could jump from without being seen. I
went into my loft to find rope to hang from the hot-water
tank. I weighed up whether it would be strong enough to take
my weight and decided it wouldn't."
Incredibly, she survived. After realising that her
obsession with suicide may have been connected to Prozac, she
took herself off it. Suicidal thoughts disappeared within a
Her experience is not unusual. Dr David Healy, a
psychiatrist at the University of Wales College of Medicine,
believes hundreds in Britain have committed suicide while on
"The drug affects different people differently," he said.
"Some have restless moods. They can't sleep, sit down or
concentrate. Their minds are constantly racing." Suicide can
be seen as an escape from this agitated state, it is argued.
At the same time, Prozac releases a person's inhibitions and
can make them less likely to pull back from taking their own
S uch possible side-effects have been known by the drug's
manufacturer, giant American pharmaceutical company Eli Lilly,
for more than 20 years but it always dismisses them.
It argues that cases such as that of Ms Kabbani are merely
anecdotes. Its own research has never found strong evidence to
link Prozac with suicide.
Documents revealed by The Express today show that the firm
has spent years attempting to quash debate on the drug's
potentially lethal consequences.
There are no warnings about suicide on the leaflets inside
Prozac packets. In the UK a circular is sent to doctors saying
there have been reports that the drug causes suicidal thoughts
but no "causal" relationship has been established. Earlier
this year Dr Healy presented data claiming that suicide rates
are six times higher among depres-sed people who take Prozac.
He said: "Not only do Eli Lilly fail to warn people
properly, they deny the link between Prozac and suicide. When
anyone draws attention to it they rubbish them in the way
tobacco companies rubbish the link between smoking and
There is no doubt of the importance of Prozac to Lilly.
Last year world sales of the drug were worth almost £2billion.
It has become the universal cure for depression and eating
disorders such as bulimia. It was recently licenced in the UK
for the treatment of pre-menstrual tension.
The company is keen to preserve the drug's reputation as
the anti-depressant with the fewest side-effects but it is
facing some 200 court cases in the US alleging a link between
Prozac, suicide and aggression.
The first case has already been held. It centred on a
Californian who stabbed his wife to death and impaled himself
on a kitchen knife soon after being prescribed Prozac. His
family argued that Lilly was responsible because it failed to
warn patients of such side-effects.
The case failed and the family is appealing. But a number
of disclosed internal documents from Eli Lilly were put into
the public domain for the first time. They show that the
company's executives were aware of a number of reports linking
Prozac to suicidal thoughts and attempts.
When a report linking Prozac to suicide was published in an
American scientific journal in 1990, the company became
de-fensive. In an internal memo that year Lilly's top
scientist, Dr Leigh Thompson, referred to safety worries of UK
It read: "I hope Patrick (head of Lilly's operation in the
UK) realises Lilly can go down the tubes if we lose Prozac and
just one event in the UK can cost us that". In another memo
Thompson wrote: "Anything that happens in the UK can threaten
Prozac worldwide. We are expending enormous efforts fending
off attacks because of (1) relationship to murder and (2)
inducing suicidal ideas."
T he Express has obtained six confidential letters Lilly
sent to its sales representatives. Each refers to research on
the possible association of Prozac and suicidal behaviour. The
letters instruct reps not to mention this research to doctors.
One explains: "These iss-ues (suicide) are not part of our
current marketing plan."
A Lilly scientist in Germany wrote to the head office in
1990 questioning why he was being asked to report cases of
suicidal thoughts as "depression". He added: "I could not
explain to a judge, to a reporter or even my family why we
would do this."
The company line is consistent. Its says the US Food and
Drug Administration and the UK Committee on Safety of
Medicines cleared Prozac of in-ducing suicide in the early
1990s. It says suicides are caused by depression, not the
This will not stop legal action against the company. Graham
Ross, a Liverpool solicitor, is investigating six cases in
which patients or their families believe that Prozac is to
blame for loss of life or a terrible adverse reaction. He
said: "We have expert evidence to show Prozac caused suicide."
Express investigation team: Lucy Johnston, Jonathan
Cal-vert, David Connett and Michael Gillard.
© Express Newspapers Ltd