The Exploitation of the Mentally Ill by Pharma Continues Unpunished

Can you imagine giving people who are already suffering from mental illness a drug that you know will make them worse? Sounds like something out of a sadistic horror movie. Long-term mental illness sufferers experience such torturous states of mind that they might try just about anything to escape them – from the extreme of suicide, to taking just about any drug their doctor says holds the hope of helping them. It takes a particular brand of evil to exploit that condition. But  that’s exactly what Pfizer did with Neurontin (also prescribed as Gabapentin.)

Pfizer’s own studies showed that manic symptoms were significantly worse in bipolar patients on Gabapentin than on a placebo, but that didn’t stop them doing everything they could to get doctors to prescribe it off-label at very high doses for people suffering from bipolar disorder. This included publishing claims they knew were false or misleading, misrepresenting one study, rigging another, and suppressing the results of two more, according to John Abramson, author of Sickening (2022), who was an expert witness in court proceedings against Pfizer. In one leaked email, Pfizer’s own medical director referred to Neurontin as “snake oil.”[1]

Pfizer was eventually found guilty of fraud for the illegal off-label marketing of Neurontin. Foundation Health Plan, America’s largest HMO sued them. But, given that sales of Neurontin had reached $2.1 billion by 2003 in the USA, their total penalty of  a paltry $142 million could hardly serve as much of a deterrent from committing future fraud. No one was jailed, and the trail was barely mentioned in the news. So, guess what? Neurontin is still being prescribed off-label to treat bipolar by doctors who are just used to it.

Is this just a one-off incident of a bad drug slipping through the net?

Hardly. GlaxoSmithKline suppressed negative findings about the effects on suicide and depression caused by their drug paroxetine (Paxil/Seroxat). This only came to light because they were dragged through court and forced to release internal documents! One document gave instructions to “effectively manage the dissemination of these data in order to minimize potential negative potential impact,”[2] which is a really nice way of saying – “make sure no one finds out or we won’t be able to keep making money selling this drug to depressed people that it will make suicidal.” They were fined $3 billion, but that only represented a quarter of the total sales of paroxetine over the years.[3]

When it’s more profitable for pharmaceutical companies to break the law than to follow it, being fined just becomes another expense to take account of. A drug can pass the regulator on flimsy or fraudulent evidence without anyone even noticing, and even if someone notices and sues them, there is no guarantee that your doctor even know they have been sued! They might just keep on prescribing it for no other reason than that they are used to it.

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[1] You can read about the whole Neurontin saga in Abramnson’s book Sickening: How Big Pharma Broke American Health Care and How We Can Repair It (2022) Mariner Books.

[2] Wayne Kondro and Barb Sibbald (2004) “Drug company experts advised staff to withhold data about SSRA use in children,CMAJ.

[3] Katie Thomas and Michael S. Schmidt (2012) “Glaxo Agrees to Pay $3 Billion in Fraud Settlement.”