The Zyprexa and TeenScreen Marketing Ploys:

A Story of Power, Corruption, and Response

By Lloyd Ross, Ph.D., FACAPP.

BACKGROUND:

Over the past ten years, a new group of so called “atypical antipsychotic” psychiatric drugs (read: neuroleptics), have come onto the market to replace the older, “off patent” (read: cheaper) neuroleptics like Thorazine and Haldol. Among these newer drugs are Clozaril, Zyprexa, Risperdal, Seroquel, Abilifly, and Geodon.

These drugs were all marketed as “atypical” because their side effects were not as horrible as the older neuroleptics. However, as these of these drugs became widespread due to extremely aggressive marketing, clinicians began to notice that the side effects were often either similar or much worse than the older neuroleptics.

The largest selling of these “atypical neuroleptics” was Zyprexa, marketed extremely aggressively off label, which is illegal, by Eli Lilly Pharmaceuticals. Since it’s approval in 1996, it has been prescribed to over 20 million people, bringing in revenues of about $4.2 billion per year.

President Bush established the New Freedom Commission on Mental Health (NFC) in April, 2002 to study and make recommendations regarding the mental health delivery system in the U.S. It’s members were highly connected to the nations largest drug companies.

In July, 2004, he announced that the NFC recommended mental health screening of every American from “birth to old age” with particular emphasis upon children, adolescents, and school personnel. In other words, “Universal Mental Health Screening.” These screenings would serve to identify people with symptoms and connect them to treatment programs.

The NFC recommended the Texas Medication Algorithm Project, (TMAP) as the model for treatment. He also instructed more than 25 federal agencies to develop an implementation plan based upon the recommendations. TMAP is a pharmaceutical industry driven treatment plan that mandates the use of specific brand name drugs, and since its inception, has almost bankrupted the State of Texas and has eaten up both the Medicaid and Medicare budgets in that State.

Pharmaceutical company profits have increased astronomically. A New York Times article by Gardiner Harris reported that 70% of Zyprexa sales (which totaled $4.28 Billion in 2003) are paid for by government agencies like Medicare and Medicaid. Journalist Robert Whitaker, author of “Mad In America,” states that the whole TMAP-TeenScreen program could be seen as drug companies and Psychiatry “fishing for customers.” In an April, 2004 report, Carole Keeton Strayhorn, the comptroller for the State of Texas, criticized the foster care agency in the State for giving children drugs, “so doctors and drug companies can make a buck.”

The main instrument used in the schools and agencies to “identify” children in need of psychiatric services is TeenScreen, which is a checklist specifically geared to match criteria from the American Psychiatric Association’s (APA) DSM IV, a manual of “symptoms” and diagnostic categories voted into existence by the APA.

The DSM supposedly identifies at least 6 mental disorders:

• Social Phobia
• Panic Disorder
• General Anxiety Disorder
• Major Depression
• Alcohol and Drug Abuse
• Suicidality

The questions on the test are “loaded.” They are designed to plant the seeds of mental illness criteria and make an adolescent feel that normal, everyday feelings and thoughts are abnormal. For example: “In the past year, has there been any time when you weren’t interested or involved with anything?”* (How many of you were interested for 365 days in a row?) “In the last year, has there been any situation when you had less energy than usual?”* (Who can honestly answer “no” to that?)

TeenScreen’s extremely high false positive rate makes the test virtually useless as a diagnostic instrument. One study, completed by the creators of the test themselves, found an 82% false positive rate, meaning that if 100 adolescents scored in the diagnosable range, 82 of them would be flagged as having some mental illness without having any real problems. A Ouija board would only produce a 50% false positive result.

Dr. David Shaffer, Chairman of Child & Adolescent Psychiatry at Columbia University, the man who developed TeenScreen, found in one study that of 1,729 New York City high school students who were screened, 475 students tested positive for depression and suicide. 262 of the 475 students who tested positive agreed to a follow-up. Of those, 203 had no evidence of depression and suicidality at follow-up, (77%). Shafer also found that when students were retested, the positive predictive value of TeenScreen was 16%. That means that 84% of those designated by the test as mentally ill and were not would have been referred for treatment for every 16 suicidal youths correctly identified.

This makes TeenScreen invalid for screening anything. The test has no more scientific validity or ethical legitimacy than the mass screening for “mental defectives” during the eugenics movement 2 centuries ago in the U.S. That screening resulted in the sterilization of 72,000 Americans, among them children as young as 10 years old.

The New Freedom Commission, TMAP, and TeenScreen appear to be a blatant political/pharmaceutical company alliance that promotes medication, and more precisely, the newer, more expensive antidepressants and antipsychotics which are at best, of questionable benefit and come with deadly side effects.

By creating the NFC, the pharmaceutical industry has taken over control of U.S. public health policy, representing one of the biggest hijackings of public tax dollars in history. Individuals are unable to pay for these high priced psychiatric drugs; Insurance companies are unwilling to pay for high priced psychoactive drugs. Through the NFC recommendations of mental health screenings of all Americans, followed by a TMAP type treatment program, the pharmaceutical industry has arranged that the state and federal governments will pay for their psychiatric drugs in an ever expanding market. Hence, the purpose of all this is “market expansion.”

THE ACTION:

Jim Gottstein, an Alaskan lawyer, while working on a pro bono lawsuit against Eli Lilly regarding Zyprexa in late 2006, came across Eli Lilly’s own suppressed studies which found that the drug caused excessive and rapid weight gain and diabetes in large numbers of people and he felt morally bound to inform the public of these risks.

Apparently, Eli Lilly officials suppressed their own findings in order to get the drug approved, a drug that has possibly killed several thousand people thus far. The drug company went after Mr. Gottstein, attempting to make an example of him to anyone else who might expose the company. They attempted to tie him up financially and physically in legal battles and basically bankrupt him.

In March, 2007, I wrote letters to the Attorney Generals of all fifty states, asking that they both prosecute the Eli Lilly executives for illegal off label marketing practices, for Medicaid fraud, and for criminally negligent homicide. The basis for my letters was Ted Chabasinski, a California attorney who testified before Judge Weinstein, the judge involved in this case.

Ted said: “If executives know they may have long prison terms for their willingness to kill people for profits, they will think more than twice about what they do. If executives can go to prison for stealing their companies’ money, surely those that steal peoples’ lives deserve at least the same fate.” Mr. Chabasinski, who was quite outspoken in his testimony, went on to say that Eli Lilly’s biggest worry was that the documents will be reviewed by state prosecutors and that the real purpose of the injunction against the lawyer is to frighten people into giving up their First Amendment right to petition the government for redress of grievances, which means putting these documents into the hands of as many prosecutors as possible.

These executives continued attacks on the whistle blowers is an ongoing abuse of the legal system which is funded by the profits from this drug. The Zyprexa caused disabilities and diseases are now draining and will continue to drain the public health system for years to come. It is never in the public interest to keep documents secret when to do this will have the effect of making it more difficult to prevent the iatrogenic disabilities of thousands at taxpayer’s expense. From Ted Chabasinski’s perspective, what the executives from Eli Lilly have done amounts to, at a minimum, criminally negligent homicide and depraved indifference. In real terms, it amounts to premeditated murder. What a great idea.

BRINGING THE ZYPREXA CASE AND TEENSCREEN TOGETHER:

The Zyprexa case involves a grand marketing scheme by Big Pharma to aggressively market, off label and on label, their drugs, regardless of the pain and suffering that this may cause, as long as it increases their market share.

The Universal Mental Health Screening Programs and TeenScreen are an advanced form of this marketing scheme in which multiple pharmaceutical companies have merged their resources to multiply the amount of the U.S. population taking expensive psychiatric drugs, regardless of the pain, suffering, and death that this would cause.

Both are part of Big Pharma’s grand snake oil marketing scheme.

CURRENT EVENTS:

The States of Alaska, Arkansas, California, Florida, Illinois, Louisiana, Mississippi, Montana, New Mexico, Ohio, New Jersey, Oregon, Pennsylvania, South Carolina, Texas, Utah, Vermont, and West Virginia have either started lawsuits or are in the process of compiling evidence for lawsuits against Eli Lilly for Medicaid Fraud. Arkansas and South Carolina are the most recent to start suits. Twenty-six additional states have joined together as part of a joint investigation.

Unfortunately, none of these states are currently brave enough to prosecute Eli Lilly executives for criminally negligent homicide. Congressional committees in both the House and the Senate are also investigating these issues. However, keep in mind that both Democrats and Republicans receive significant campaign contributions from Big Pharma, so don’t get your hopes up on the Federal front. On all fronts, the supposed “non-profit” group NAMI continues to advocate for Big Pharma.

On October 13, 14, and 15, 2007, The International Center for the Study of Psychiatry and Psychology, along with MindFreedom International, The Law Project For Psychiatric Rights, Ed Watch, and The Eagle Forum, very divergent groups, is sponsoring a conference on these issues Titled “Universal Mental Health Screening and Drugging of Our Children: Risks and Benefits.” It is a two day multi-disciplinary conference for professionals, psychiatric survivors, students and the general public. David Oaks, Fred Baughman, MD., Jim Gottstein, J.D., Vera Sharav, Grace Jackson, M.D., Peter Breggin, MD., Teresa Rhodes, and many others will be speaking.

On Monday, October 15, 2007, representatives from all these groups will go to Congress and both hold a press conference in the Capitol Building and educate congressional staffs, as we ask for an end to TeenScreen and Universal Mental Health Screening, and encourage further congressional investigation of Big Pharma. Hopefully, this will put a large dent into two particularly unethical and unconscionable drug industry marketing ploys.

Come with us if you can. Information is available on the ICSPP website, www.icspp.org.