Healthy Skepticism Library item: 8900

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Publication type: news

Mitchell N, Barraud A.
The Zyprexa story (Transcript of 'All in the Mind' programme)
Radio National (Australian Broadcasting Commission) 2007 Mar 3
http://www.abc.net.au/rn/allinthemind/stories/2007/1860792.htm

Full text:

Pharmaceutical company Eli Lilly (makers of Prozac) have agreed to pay upwards of 1.2 billion US dollars to nearly 30,000 patients who claim their bestseller antipsychotic medication, Zyprexa (Olanzapine) has resulted in diabetes, weight gain and other complications and that these risks were downplayed. Secret documents are leaked, the newspaper headlines start screaming, and citizen journalists spread the word – but where is the real advocacy for better drugs with fewer side effects?

Transcript
PLEASE NOTE: A correction has been made in the transcript below to a study figure qouted on-air. See the full details below. .

Natasha Mitchell: And hello, Natasha Mitchell joining you for All in the Mind on ABC Radio National; great to have your company.

Today on the show scandals, secret documents and side effects. Mixed messages about one of the world’s biggest selling medications for the mind.

Philip Dawdy: Many people in the major media also access these same documents the way I access them on the internet and they’ve walked away from the story, even though there are definitely people out there who believe that this is a story on the level of what happened with Viox two years ago.

David Grainger: Well there’s no doubt for anybody with a serious mental illness life is very much about managing the symptoms of the illness which, as you’d appreciate, can be very debilitating at times. Often that balance means weighing up the risk benefit balance I guess with any medication.

Sandy Jeffs: I think society has had a very, very, very fraught relationship with madness and this is shown in how we are treated and how we have been treated. And so doing nothing wasn’t an option you had to do something no matter how barbaric it was.

Natasha Mitchell: With the side effects though, and I guess the persistence of side effects with the medications over years, does it make you feel like a guinea pig?

Sandy Jeffs: Yes it does in one sense, it also makes you feel quite despairing because the only thing that is going to make you OK in a sort of societal way are things that make you feel really horrible physically, or even emotionally sometimes you feel blunted by things. Like the medication I take now if I take it I would be asleep in half an hour’s time because it bombs me out no end.

Natasha Mitchell: Pharmaceutical company Eli Lilly, they’re the name behind the popular antidepressant Prozac.

Reportedly though a third of their revenues and profits comes from another medication called Zyprexa or Olanzapine an antipsychotic drug approved for the treatment of schizophrenia and bipolar disorder. Zyprexa will be the number one neuroscience drug in history, was the company’s claim.

Well in the ten years since its launch around 20 million people have used it and last year it made the company a massive $4.3 billion US dollars. But Zyprexa has now hit the headlines with claims that Eli Lilly downplayed data on known risks of major side effects; amongst them diabetes and weight gain.

So far the company has agreed to pay upwards of 1.2 billion US dollars to nearly 30,000 litigants who claim they’ve developed diabetes or other health problems after using the drug. But as you’ll hear, Eli Lilly doesn’t think the claims have merit. Side effects are a reality of any medication but when they get the better of you and your mental illness has silenced you — who then becomes your advocate?

Sandy Jeffs, author of Poems from the Madhouse is a writer, performer and advocate.

Sandy Jeffs: I’ve had schizophrenia for 30 years so it’s enough to make me have a PhD in psychosis I think and enough to give me a lot of experience of treatments and medications and the paradigm of psychiatry. On the one hand I was diagnosed with this terrible thing called schizophrenia which people were going to find themselves be relentlessly ill, going down, down, down into the dark cave of madness never reappearing again from that dark cave. And the prognosis was really, really dire, it was awful to get that sort of horrible label — schizophrenia, especially at 23.

Natasha Mitchell: At 23 you’re just kicking off with life.

Sandy Jeffs: Exactly, you know your just finding new friends and looking for jobs and trying to consolidate your identity and who you are in the world. And when that’s taken away from you by a psychotic illness you’re left with nothing — except medication. And I remember when I first went to Parkville Psychiatric Hospital there were all these people sort of sitting slumberously in vinyl-clad chairs and you know cigarettes trailing from nicotine-stained fingers and I sort of thought what’s happened to all these people, what’s wrong with them? And much of it was the drugs they were taking, it wasn’t just the illness, their medications had sedated them or actually worse was that the medications like Delazine made you have this endless restlessness. When you sat down your legs would jiggle like a marionette’s and when you’re standing up you’d pace the floor, you’d pace around and you couldn’t stand still for five seconds and your mind was restless too.

I had an experience where at one stage my neck was cramping and my tongue was cramping and I was contorted downwards and I thought I was dying.

Natasha Mitchell: Sandy Jeffs, speaking about the early days of the typical or conventional antipsychotic medications as they’re known. We know now that they were given in detrimentally high doses and, as it turns out, recent studies suggest they’re still effective, perhaps just as effective as the new medications and certainly cheaper.

But the arrival of the new atypical antipsychotics in the 1990s was hailed as the dawning of a new era. One of them was Zyprexa, also known as Olanzapine. Philip Dawdy is a Seattle based investigative journalist whose reporting on mental health has won him many awards. He also runs a blog called Furious Seasons which he describes as one man’s attempt to make sense of mental illness in America.

Philip Dawdy: They have variously over the years worked very aggressively to get this into the mental health marketplace, for lack of a better term, in literally every doctor setting you could think of. But yeah, they were greeted as silver bullets and wonder drugs and that’s why they started kind of getting used long term in bipolar disorder once the effects of acute mania were knocked down over a week, two weeks, three weeks. It was felt you could use these drugs and there would be no problem for patients except paying for them because they are very expensive.

Natasha Mitchell: Sure are… the picture is very different now. Zyprexa or Olanzapine has been at the centre of a great furore these past couple of months in the USA. You’ve been following it very closely — take us back to December Philip Dawdy when the New York Times story first hit. What was the story that broke?

Philip Dawdy: The first story that broke alleging that Eli Lilly had been instructing its sales force to downplay the known risks of this drug while selling the drug to doctors. That’s kind of in essence what the broad claim of that first article was. The reporting there, which was done by an investigative reporter at the paper named Alex Berenson, was based upon a bunch of documents, evidence in a court case that Eli Lilly had settled involving many thousands of patients. Somebody in the loop of people found a way to leak them out to somebody else who got them into the hands of the New York Times and off the New York Times went. In additions to accusations of downplaying risks there were also accusations of off label marketing of the drug as it’s called and in this country that means that they would have either been advertising or directly selling to doctors the drug for a purpose for which it was not licensed. That’s not allowed in this country.

Natasha Mitchell: What were the risks that the New York Times reporter was suggesting Eli Lilly had downplayed over the years? And we should let people know that these court documents were the basis of a pay-out by Eli Lilly in 2005 of 700 million US dollars to some 8,000 claimants who said that they’d got diabetes from Zyprexa.

Philip Dawdy: Or other injuries. There’s a kind of a constellation of complaints if I remember correctly around those cases. The broad subset of side effects that Berenson was going after in these articles was a risk created by this drug of inducing diabetes, of inducing hyperglycaemia — obviously the two are connected there, as well as introducing just explosive weight-gain in patients as well as some questions of cardiac problems that may have been caused by the drug as well.

Natasha Mitchell: I mean Eli Lilly have always been fairly up front it would seem about the weight-gain side effect, patients certainly know it really well.

Philip Dawdy: They really didn’t initially and when I say they didn’t initially, I mean patients, I don’t mean Eli Lilly, they have been aware of the weight issue and probably later on to the diabetes issues and the hyperglycaemic issues. But you know Eli Lilly’s principal obligation under the law in this country is to share that information with the food and drug administration. And the food and drug administration does an awful job of sharing that information both with doctors as well as patients, as well as the broader American public. They will often say, if you try to ask them about things like this, and I have run into this as a reporter with them, that they’ll say well that’s private information, that’s a trade secret for the company.

Natasha Mitchell: The New York Times journalist reported that Eli Lilly had underplayed an early finding and this is a quote from him that 16% of patients taking Olanzapine or Zyprexa for a year gained more than 66 pounds, that’s about 33 kilos.

Philip Dawdy: And certainly in the very famous landmark CATIE study that came out about a year and a half ago. There were patients taking Olanzapine in this study who gained upwards of 40 pounds in a fairly short period of time. That’s a problem. It’s hard to characterise it as anything except a problem because a very rapid weight gain like that, where you’re talking about people gaining 15%, 20% maybe even 30% in some cases of their body weight — that can really kick off some huge problems with the endocrine system.

Natasha Mitchell: Twenty million people have reportedly taken this medication since it was introduced ten years ago, that’s a lot of people for whom the medication is probably making a difference.

Philip Dawdy: Yes it quite possibly is. Out of this class of atypical antipsychotics there’s no question that Olanzapine and another drug known as Clozapine were considered the perfect molecules, for lack of a better term. These were the drugs that could really address both the positive and the negative symptoms of schizophrenia.

Natasha Mitchell: Philip Dawdy, you’ve been reporting as an award winning investigative journalist on mental health issues for many years now. How serious is this story? Because I can hear people listening going, well I don’t have schizophrenia, I don’t have psychosis.

Philip Dawdy: Well I suppose it would be one thing if this drug were just used for very acute cases of schizophrenia, because unfortunately the treatment options for schizophrenia are incredibly limited and it’s just ridiculously sad, it’s difficult to watch that — as well as some fairly advanced cases of bipolar disorder. But once you start getting into these milder mood cases with bipolar disorder and you start getting into the drug being used with some cases of depression, which it is, and it’s being used with autistic kids sometimes as well as with older folks with dementia, you get into a zone where you’re like wow, isn’t that like hitting those symptoms with a sledgehammer?

Natasha Mitchell: Journalist Philip Dawdy, who’s recently got hold of those sensational Eli Lilly documents via the internet himself and has published them on his website. It should be made clear that the antipsychotic medication we’re talking about, Zyprexa, is only approved for use in Australia for the treatment of symptoms of schizophrenia and bipolar disorder.

Sandy Jeffs certainly wasn’t aware of the prospects of weight gain when she started on the medication. The drug, she says, made a difference but the kilos became a burden.

Sandy Jeffs: It did settle my psychotic symptoms a bit but not totally, I still experienced delusional thinking, and my voices never went away entirely anyway. But what I noticed was I started putting on weight. I’d go out with friends to restaurants and stuff and I would invariably eat more than anyone else at the table, I just had this ravenous appetite I just couldn’t control. And then I asked my doctor if I could change because I was really concerned about running around the hockey field like an elephant, and she said fine, fine, no worries. I went on to Abilify and that was disastrous.

Natasha Mitchell: That’s more recently isn’t it?

Sandy Jeffs: That was two years ago and it actually sent me more psychotic than I already was, and I went into a mania, chronic insomnia. It was the most awful experience, I have to say, and since that time, two years ago, I’ve been very, very unwell for the entire two years, with lots of psychosis and depression and you name it, I’ve had it. It’s been a mind hell.

Natasha Mitchell: Triggered by medication.

Sandy Jeffs: Yes it was, yeah. I say to myself, do I blame myself for wanting to change the medication in the first place and upsetting the whole stability I sort of had? I sort of blame myself. But then what’s wrong with wanting to look at your body weight and your body image, now we are driven by body image in this society? Because I felt really bad, I felt cumbersome in my own body, I hated it. So I did change but it was disastrous, absolutely disastrous. And now I’m on Clozapine, which is a last-resort older drug which has been resurrected in terms of its use in modern psychiatry.

Natasha Mitchell: And how’s that going?

Sandy Jeffs: Well, I don’t know, I sort of describe it as the monster got out of its cage, the monster Madness got out of its cage, and I haven’t been able to put it back in and secure the lock to lock it away. It keeps creeping from its cage and … plus melancholia has emerged as well and she sort of trails behind me in her dowdy gown, you know, waiting to assail me with her darkness and her drear drear horrible nothingness. I keep wondering, when is it going to stop, when will I wake up one morning and feel OK about getting up? It’s really, really awful, I feel as though I’ve gone back 30 years.

Natasha Mitchell: Let’s consider Olanzapine and that drug because it’s certainly hit the headlines in recent weeks and the issue of weight gain is something that a lot of people experience isn’t it?

Sandy Jeffs: It is.

Natasha Mitchell: Were you warned about that?

Sandy Jeffs: I don’t recall being warned about weight gain or the possibility — if you have weight gain you’ve got a possibility of contracting diabetes. I know nothing was said along those lines. I have seen young women go from 60 kilograms to over 100 kilograms — the weight gain I have seen have been so significant and so obvious. Now body image for young women is really, really crucial in this horrible world we live in, we are so driven by it. And for someone like a young woman to go from 60 to 100 kilos I mean in terms of mental health it doesn’t help.

Natasha Mitchell: On ABC Radio National, I’m Natasha Mitchell, you’re with All in the Mind coming to you globally on Radio Australia and as podcast.

Well let’s hear then from Eli Lilly, maker of the antipsychotic med Zyprexa. Their US headquarters have allowed an Australian representative to speak to All in the Mind on the company’s behalf about the side effects of the medication – a rare interview on this issue. Unfortunately though, they’re not prepared to comment on the ongoing US legal cases with their latest payout of up to 500 million US dollars.

David Grainger is director of corporate affairs and health economics with Eli Lilly Australia. He’s been with the company for nearly 30 years.

David Grainger: One of the things about the antipsychotic medications is that they work as a class of medicines on a range of receptors in the brain. And inevitably with that you also get a range of side effects; some drowsiness, sometimes effects that are more related to stimulation of other receptors and sites in the brain. And in the case of Zyprexa also some weight gain.

Natasha Mitchell: In 2002 Eli Lilly Australia distributed a letter to Australian doctors informing them of the association between Zyprexa and hyperglycaemia — or elevated blood sugar levels, just to explain — and certainly other metabolic conditions related to diabetes. What was the basis, David, of sending that letter to the medical community in Australia?

David Grainger: Quite a complex little background to that, Natasha, you can appreciate people with serious mental illness, particularly schizophrenia, often have concurrent physical health problems. Things like disturbances to blood sugar levels are not uncommon but it also became apparent that they’re perhaps slightly more common in people taking antipsychotic medications.

Natasha Mitchell: You’d know from talking to people with schizophrenia who take Zyprexa or Olanzapine — and from studies — that weight gain is a significant and frustrating side effect for some patients on this medication. How does Eli Lilly view the side effect of weight gain?

David Grainger: Well there’s no doubt that for anybody with a serious mental illness life is very much about managing the symptoms of the illness, which as you’d appreciate can be very debilitating at times. Often that balance means weighing up the risk benefit balance, I guess, with any medication. Again with most of the antipsychotic medications weight gain can be seen in some people. And with Zyprexa it can be a significant amount of weight gain for some people. What we’re encouraging doctors and patients to do is to have that discussion and make decisions about what’s best for an individual patient on an individual basis.

Natasha Mitchell: Certainly Zyprexa has been associated from a number of studies with the highest degree of weight gain in a large scale, major, well respected trial conducted by the National Institute for Mental Health in the USA, it’s also fondly known as CATIE, the Clinical Antipsychotic Trials of Intervention Effectiveness. They reported in 2005 that 30% of people gained 7% or more of their baseline body weight for the length of time that they stayed on the medication. That must be surely a concern to Eli Lilly?

David Grainger: It was already well understood I think before the CATIE trial that this was something which is associated with Olanzapine and as I say with other antipsychotics. The other important aspect about the CATIE study was that it showed that people actually stayed on Olanzapine for a longer period of time than the other medications and you’ll appreciate that people stop a medicine for two reasons usually; one because it’s not working well enough or alternatively because they are having unpleasant side affects with it that might cause them to change or stop it.

Natasha Mitchell: Certainly 74% of patients in that study still discontinued Olanzapine after 18 months. More discontinuation was associated with weight gain or metabolic effects apparently. So it’s obviously a concern for patients.

[PLEASE NOTE – CORRECTION: “74% OF PATIENTS” as stated on-air in the question above should be “64% OF PATIENTS”. 74% of all patients in the CATIE study discontinued the study medication they were allocated before 18 months. 64% of those patients assigned spefically to Olanzapine discontinued the medication. See the full details in the publications produced by the CATIE study, linked to below].

David Grainger: It is and I think one of the other learnings from the CATIE study that the whole mental health community is taking on board is that this is an area that still needs a lot of improvement. So in other words it’s well recognised, it’s really important that people stay on medications as much as possible when they are in an active period of illness because to go off medication or to make sudden changes is often associated with a relapse of symptoms, and that can be you know extremely distressing or even tragic.

Natasha Mitchell: Can we do better than this though, I’m just wondering…Eli Lilly say that they take side effects and adverse drug reactions seriously. What then are you hoping to do about the weight gain issue that’s certainly plagued this particular medication for ten years?

David Grainger: Well I think there are two things Natasha. Firstly in the context of taking this seriously — the industry as a whole and Eli Lilly in particular has very well established processes for what we call pharmacovigilance, so the processes of collecting and reporting and documenting an adverse effect or side effect information now with drug medications.

Natasha Mitchell: It’s certainly still ten years since the launch of Zyprexa in Australia and the side effect of weight gain still remains a painful compromise for patients so I know people would be wanting to know what next, and what’s going on behind the scenes in terms of R and D to nail the weight gain concern?

David Grainger: It’s well recognised that this is an area where we need further innovation and development of medicines. In our case we have medicines in our research pipeline that are looking at other types of receptors and other actions in the brain in the hope that we are going to find a better balance, as you say, of our effectiveness with a better profile.

Natasha Mitchell: David Grainger from Eli Lilly. The company does fund a Mind Body Life Initiative in clinics around Australia to help people with mental illness deal with issues of wellbeing, weight and exercise. The website has plenty of pictures of smiling folk, cartwheeling in the sunshine, but does this once again put the onus solely on patients rather than on the side effects of the company’s drug?

Philip Dawdy: I mean I’m just sorry they haven’t a clue how the average schizophrenic or severely mentally ill person lives — you know they are covering their butts with this one. Unfortunately a schizophrenic who’s on 15. 20, 30 milligrams a day of Zyprexa is going to be zonked out for 12 to 15 hours a day and when they’re awake they are going to be so foggy that you know they are not going to be out in the front yard doing push-ups.

Sandy Jeffs: I think the problem is though that people with psychotic illnesses aren’t in the mind space where they can do that sort of stuff. But there is a tendency to blame people and not see that it’s the drugs fault. People’s lives don’t often have the space for good food, and good hygiene, and good stuff you know. I mean again it’s blame the victim, blame the victim.

Natasha Mitchell: Sandy Jeffs and before her investigative journalist, advocate, blogger, Philip Dawdy. He knows full well about the stultifying impact of antipsychotics and other psychotropic
medications. He was diagnosed as bipolar 18 years ago and is still working out the best mix of prescriptions for himself.

The Royal Australian and New Zealand College of Psychiatrists have acknowledged to All in the Mind that the profession is now well aware of the side effects of Zyprexa in their everyday practice and are cautious about starting people on it who are already overweight or at risk of diabetes.

There’s been considerable public debate in recent months as you’d know that whilst weight gain has been listed as a side effect of Zyprexa for many years, the concern is that Eli Lilly sought to downplay the extent of the weight gain and potentially associated diabetes. What’s Eli Lilly’s response to that concern, that you’ve been downplaying the risks?

David Grainger: I think there’s two things there, Natasha, firstly in terms of the weight gain, as I said it’s been documented in the information around the product..

Natasha Mitchell: But the full extent?

David Grainger: Well I think like a lot of these things there is a learning that goes on as the product is used more and more widely, and that’s why we have the monitoring of reports of side effects and an attempt to more fully characterise and understand that.

Natasha Mitchell: David Grainger, director of corporate affairs and health economics with Eli Lilly Australia.

David Grainger: The other point that you raise there is in relation to diabetes, and because this is known that there is an increased association of diabetes in people with serious mental illness regardless of any treatment, this has been the subject of a great deal of study as well. There is certainly no association or no direct causality been established between Zyprexa and diabetes.

Natasha Mitchell: That being the case though, and I realise that you can’t comment on the specific details of the litigation in the USA, but on what basis has Eli Lilly agreed to pay upwards of 1.2 billion US dollars to nearly 30,000 people in the last two years who claim that they’ve got diabetes and other problems from Zyprexa?

David Grainger: The position that Lilly’s taken on that litigation is firstly to continue to state and believe that Zyprexa is both a very effective medication for these conditions and a medication that has a good risk benefit profile. As you’d appreciate the whole medico-legal and litigation environment in the US is somewhat different to here in Australia. It got to the stage where health professionals were saying to the company that this is starting to cause people to go off their medication regardless of what it is, to make decisions about stopping or changing their medication, and in the case of serious mental illness that’s not a good thing to have happen. So the company decided that the best thing to do was to settle that litigation and move on, and enable people to take more measured decisions and have more measured discussions with their health care professional about their medication rather than having it being in their faces through the media around the litigation.

Natasha Mitchell: There are concerns though that elevated weight gain or rapid weight gain is linked to diabetes, so is there any effort on behalf of Eli Lilly to investigate that in relation to Zyprexa and the weight gain associated with Zyprexa?

David Grainger: Absolutely, this whole topic of what’s going on in terms of glucose metabolism and people with serious mental illness and what role does their often lack of physical exercise or less than ideal diet — what role do those things play and what role does medication play…

Natasha Mitchell: But more importantly what role does their medication play?

David Grainger: Exactly, that’s also been a subject of a great deal of research, and in spite of all that body of research there is no clear answer and there is no direct association between the antipsychotic medication and development of diabetes.

Natasha Mitchell: David Grainger from Eli Lilly. Two weeks ago a federal court judge in the US ruled that the confidential Eli Lilly documents you heard about earlier, leaked to the New York Times and now all across the web, must be returned.

But what sorts of questions does this reining in raise about the public’s right to access transparent information about the medications we take and the mental health messages we’re given? Philip Dawdy.

Philip Dawdy: That’s a great question and it’s also an incredibly complicated question. From where I come from I say patients — who are the ones paying the bills with their body, their brains, as well as with their pocket books — have an absolute right to know how drugs are designed, made, marketed, studied, side effects, the whole shooting match. Companies don’t like that. Frankly, because a lot of their studies — and I’m not saying this about Zyprexa — are incredibly biased towards positive results, and negative results that pop up in these studies are often buried, re- categorised as something else and really shielded from public view. In addition, I think what’s gone on here has been a very interesting indictment of the mental health advocacy system in this country.

You have groups like the National Alliance for Mental Illness, the Depression and Bipolar Support Alliance, and Mental Health America — all advocacy groups, and certainly with Mental Health America and the National Alliance for Mental Illness, both of them receive a lot of contributions, probably 50% of their annual budgets, directly from pharmaceutical companies. And all three of the groups I just named have been completely silent on the issues raised. The National Alliance On Mental Illness which is certainly the most powerful and influential of these groups, and has the highest profile, has been utterly silent.

Natasha Mitchell: Do they receive money from Eli Lilly directly?

Philip Dawdy: Oh yes. You know traditionally it’s been about a million dollars a year and in the late 90s and early noughts, they actually — their interim executive director was a Lilly executive who was on loan to them.

Natasha Mitchell: Well how do you view the payouts?

Philip Dawdy: When a company pays out that kind of money they are paying it out for a reason. And when you look historically at what’s gone on with settlements of law suits around mental health drugs over the last 15 or 20 years, in this country at least, there were a large number of law suits against Eli Lilly for Prozac, around suicidality and potentially violence induced by Prozac. Despite all those law suits they paid out — $50 million roughly was an estimate in 2000 by the Indianapolis Star — and it was the same legal team that’s representing them now.

Well here they are a few years later paying out $1.2 billion in claims. And these are not the kind of folks who fold their hand unless they have a gun pointed at their head, is my opinion of that.

Sandy Jeffs: I think that psychiatry hasn’t had a very good listening ear about weight gain with drugs, ‘cause all it wants to do is medicate a person and make them better. I do grasp my mental health as very important and the thing is I have to grasp it because if I didn’t have it I wouldn’t be doing anything. It’s just that I’ve got to navigate those waters between being big and being sane — it’s a horrible trade-off. I can’t see where the choice is.

Natasha Mitchell: Poet, performer and advocate Sandy Jeffs, with frank insights into her own medication roller coaster there. And before her journalist Philip Dawdy, you can read his meaty blog on the politics of mental health at FuriousSeasons.com

And you can catch the show again and download it from our website at abc.net.au/rn/allinthemind and a transcript there later in the week too. And pop us an email while you’re at it.

My thanks today to producer Anita Barraud and to sound engineer Tim Symonds. I’m Natasha Mitchell until next week, take care and look after that head of yours.

Further links and details below.

If you have any questions about medication for schizophrenia or bipolar disorder, consult your doctor or consider contacting the SANE Australia helpline via their website below or on 1800 18 SANE (7263).

Guests
Philip Dawdy
Seattle based investigative journalist
Blogger, Furious Seasons
http://www.furiousseasons.com

David Grainger
Director of Corporate Affairs and Health Economics
Eli Lilly Australia
http://www.lilly.com.au

Sandy Jeffs
Writer, performer and poet.
Advocate, and lives with schizophrenia.

Further Information
SANE Australia
The SANE Australia helpline is 1800 18 SANE (7263)

Mental Illness Fellowship of Australia

Mental Health Council of Australia

National Institute of Mental Health (USA) webpage on Schizophrenia

National Institute of Mental Health (USA) webpage on Bipolar disorder

Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)
National Institute of Mental Health (NIMH) Study To Guide Treatment Choices for Schizophrenia

Eli Lilly Said to Play Down Risk of Top Pill
New York Times, December 7, 2006 by reporter Alex Berenson

Lilly Settles With 18,000 Over Zyprexa
New York Times, January 5, 2007 by reporter Alex Berenson

Eli Lilly recovers confidential documents but loses secrets to the Web
by Staff writers, TechWeb, 16 February 2007

Eli Lilly’s official response to the New York Times articles

Eli Lilly (Australia)

Furious Seasons
Mental health and politics blog penned by journalist Philip Dawdy

Eli Lilly (USA)

Healthy Skepticism Library item: 8900

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