1 Boring Old Man

J&J Wins First Risperdal Product Liability Case
Pharmalot
By Ed Silverman
February 17th, 2012

In the first lawsuit to go to trial over personal injuries attributed to the Risperdal antipsychotic, a New Jersey jury decided in a 5-to-1 vote that the Johnson & Johnson drug was not a substantial factor in causing a 56-year-old man to develop diabetes. However, the jury also voted 5-to-1 that the health care giant failed to adequately warn that about the risk that the med could cause the illness, Bloomberg News writes.

Nonetheless, Gary Skala was not awarded damages, handing J&J a welcome victory in what is likely to be closely watched litigation, given the controversy surrounding Risperdal marketing. J&J has reportedly reached a tentative deal to pay up to $1 billion to settle a federal probe into Risperdal marketing and resolve civil charges, and also agreed to a misdemeanor charge over the same issues…

Last month, J&J agreed to pay $158 million to settle a lawsuit filed by the Texas attorney general, who charged the Janssen pharmaceutical unit orchestrated a controversial program called the Texas Medication Algorithm Project, which was allegedly designed to boost the use of the Risperdal antipsychotic in the public sector throughout the country.

Despite the related setbacks, J&J is widely expected to fight the more than 400 product liability lawsuits over Risperdal, at least for now. The drugmaker, in fact, only settled the Texas lawsuit after overwhelmingly damaging testimony was given by various witnesses for the state about marketing practices during the first few days. The move was seen as an attempt to prevent additional evidence from becoming public [read this]…

^{In the latest trial, J&J attorneys convinced the jury that Skala, who is 5′8″ and 240 pounds, developed diabetes because he was an obese “couch potato,” and developed the illness thanks to his weight, heavy drinking, sedentary lifestyle and other risks, according to Bloomberg. Skala, who has chronic major depression, took the pill in 1996 after attempting suicide by taking an overdose of anti-anxiety medicine, and later drank up to 10 beers a day. But J&J lawyers argued that anxiety, stress, sleep problems and family history contributed to his diabetes.}

It’s as easy to over-generalize from court cases as it is to over-generalize from a Clinical Trial – as if either defined the truth. There is plenty of evidence from the Texas Trial that Risperdal can induce Diabetes, that Janssen knew it, and that they actively suppressed the information [see Dr. Glenmullen’s Testimony]. There is ample evidence scattered throughout the testimony that minimizing or denying the Diabetes potential of Risperdal was company policy. Watching the incriminating internal documents dance across the screen and listening to what the Sales Reps were doing, I was kind of surprised that Janssen didn’t settle before that trial even started. Although this may be true,

^{The drugmaker, in fact, only settled the Texas lawsuit after overwhelmingly damaging testimony was given by various witnesses for the state about marketing practices during the first few days. The move was seen as an attempt to prevent additional evidence from becoming public.}

If I may be indulged for a moment and slip into another identity. In working with traumatized patients or people who had been genuine victimized in some way, I learned that the only real solution would be that the trauma had never happened in the first place, which is, of course, impossible – the one sure thing that can never happen. The fantasy that the offending event[s] must be "un-happened" to get better is almost universal. In many traumatized people, repression or dissociation is an "un-happening" that causes innumerable ongoing problems. Others are preoccupied with some kind of revenge – understandable, but it still doesn’t change the past. Thus, part of the treatment of traumatized people is helping them incorporate the truth of what happened to them as a part of the life experience that has made them who they are, has defined them for all times, something that will always be with them even though unwanted. As the bard said, "what might have been is an abstraction remaining a perpetual possibility only in a world of speculation." And the consequence of ongoing "unhappening" is paradoxical. It results in re-experiencing the traumatic event repetatively. As another bard said, "the truth will out," and out it does…

I don’t think this analogy of Psychiatry as traumatized is far fetched [though it’s more often portrayed as traumatizing these days]. Something monumental has happened in the specialty of Psychiatry in the last thirty years. A trauma to Psychiatry. Worse – Psychiatry was indeed involved in its perpetration. We were in a tangle back then. The boundaries between Psychiatry and Psychoanalysis were hopelessly blurred. There had been a massive de-Institutionalization of chronic mental patients largely due to the coming of antipsychotic medications. The Community Mental Health funds to respond to de-Institutionalization were disappearing. Other Mental Health disciplines were on the rise. And there was an anti-psychiatrist of some sort on every corner. Managed Care had arrived, determined to trim the fat [and they considered almost all of Psychiatry as fat]. Training programs were starved for funding as the State and Private placements for trainees rapidly disappeared. Things were a real mess.

We all know what happened – the DSM-III Revision that would redefine Psychiatry in both planned and unanticipated ways. From that time, there emerged a growing collusion between the Pharmaceutical Industry and the upper levels of Psychiatry that would reign to the present – suffused with increasing corruption at many levels lasting for at least the last two decades. And while some of us inside of Psychiatry and even more outside Psychiatry write about this [almost daily], it remains rarely mentioned officially – it’s under a veil of relative secrecy – unspoken. It actually reminds me of a term from the trauma literature – the unforgettable unremembered. It’s not discussed by the people on the DSM-5 Task Force, many of whom were involved in some of the corruption. Dr. Insel of the NIMH barely acknowledges any of it. The Pharmaceutical Companies certainly remain mum ["an attempt to prevent additional evidence from becoming public"]. The APA which should be leading the fight against corruption is silent. Even worse, some of the APA’s top dogs were part of the problem. So if your only sources were from official circles, you would know very little if anything about what happened [is happening].

^{The drugmaker, in fact, only settled the Texas lawsuit after overwhelmingly damaging testimony was given by various witnesses for the state about marketing practices during the first few days. The move was seen as an attempt to prevent additional evidence from becoming public.}