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Drug maker Eli Lilly has settled several lawsuits from various states. Recently, Mississippi, one of thirteen states to sue Eli Lilly over Zyprexa reached an agreement. Alaska, West Virginia, Connecticut, New Mexico, Idaho, Utah and South Carolina are other states that have gotten settlements from Eli Lilly.

Mississippi will receive $18.5 million from drug maker Eli Lilly and Co. as part of a settlement over claims the company promoted the anti-psychotic Zyprexa for ailments it was not federally approved to treat, Attorney General Jim Hood said according to an Associated Press report.

The settlement recovers money the state spent through its Division of Medicaid and the State Insurance Plan, Hood said. The company also will pay $3.7 million in legal fees for the state. Additionally, the company paid a $1.4 billion settlement to the federal government in January 2009 after admitting it had promoted Zyprexa in elderly populations for treatment of dementia between 1999 and 2001.

Zyprexa was approved by the FDA in 1996 to treat symptoms of schizophrenia, bipolar disorder, and psychotic depression.

Recently, the FDA issued a warning to doctors that adolescents using the drug Zyprexa have an “increased potential” in comparison with adults taking the new-generation antipsychotic drug for weight gain and metabolic disturbances that could result in diabetes or elevated blood cholesterol levels, according to a new Los Angeles Times report.

“Clinicians should consider the potential long-term risks when prescribing to adolescents,” the FDA said in a statement released Friday night. “In many cases, this may lead to prescribe other drugs first,” the statement went on.

The FDA has not approved the marketing of Zyprexa by the drug manufacturer Eli Lilly for use in children under 13 who are diagnosed with schizophrenia or bipolar disorder. But the medication, one of a class of psychiatric medications called the “atypical antipsychotics,” is widely prescribed for young patients, despite growing evidence that call its safety profile into question for this population.

The new warning comes in the wake of the October publication in the Journal of the American Medical Assn., in which a study showed that children and adolescents taking their first-ever course of Zyprexa gained, on average, more than 17 pounds over a 12-week period, as well as dramatic increases in triglycerides and cholesterol levels all factors that put them at higher risk of developing cardiovascular disease.

While two other antipsychotic drugs Seroquel and Risperdal were implicated in significant weight gain and metabolic changes, Zyprexa was found to carry the highest risks of all three.

A November 12, 2009 Bloomberg.com story discusses how the use of widely prescribed antipsychotic drugs to combat dementia, actually cause more harm than good. British patients with dementia too often get dangerous antipsychotic drugs, causing as many as 1,800 deaths and 1,620 strokes a year, a report commissioned by the U.K. Department of Health uncovered.

The government announced a plan to curb overuse of the medicines, including Eli Lilly & Co.’s Zyprexa, Johnson & Johnson’s Risperdal, Bristol-Myers Squibb Co.’s Abilify, AstraZeneca Plc’s Seroquel and Pfizer Inc.’s Geodon. The drugs, designed to treat schizophrenia, are often inappropriately used a first-line therapy to quell behavioral problems in people with dementia, according to the report by Sube Banerjee, professor of mental health at King’s College London Institute of Psychiatry.

An estimated 180,000 elderly people with dementia in England are given the antipsychotic drugs each year, and just 20% improve because of the treatment, Banerjee said at a press conference in London. As many as two-thirds of the patients don’t derive any benefit from the pills, which boost the risk of early death and carry a range of side effects including sedation, stiff muscles, and trouble thinking and speaking clearly, the report found.

“We need to be sure that only the people who benefit from these drugs get them, and they get them at the lowest possible dose for the shortest period of time,” Banerjee said. “It is clear that these medications are being prescribed to deal with behavior and psychological symptoms in dementia rather than just for psychosis,” he wrote in the report.

Behavioral Therapies

All of the medications, including older, generic drugs such as Haldol and Thorazine, have the same effect, Banerjee said. As a result, doctors can’t switch patients from one medication to another to solve the problem.

Instead, they need to focus on basic techniques, such as trying to determine the cause of a patient’s agitation, and behavioral therapies to improve the situation, he said. In some cases, simple problems such as lack of sleep or hunger can be the culprit, he said.

“It is unacceptable that antipsychotic drugs are routinely prescribed to people with dementia,” said Health Minister Phil Hope. “I know we’re not going to reduce the use of these drugs overnight, but it can be done.”

The government accepted the recommendations from Banerjee and plans to hire a national clinical director for dementia to oversee efforts to improve care and reduce unnecessary drug use, Hope said at the press conference.

‘Chemical Restraints’

“The use of these chemical restraints really should be a last resort,” said Neil Hunt, chief executive officer of the Alzheimer’s Society. “We’ve got a culture and an ingrained pattern of care to shift here.”

In 2005, the FDA required makers of antipsychotics to include in dosage instructions a prominent warning surrounded by a black box about the increased risk of premature death in elderly patients with dementia. An English study released two years later found patients getting the drugs die six months earlier than those who don’t receive them.