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A jury has awarded the first plaintiff’s verdict in all the years of negligence litigation against the manufacturers of the class of antidepressants including Paxil and Prozac. A Wyoming U.S. District Court panel awarded $8 million to the family of an oilfield worker who went on a homicidal rampage in 1998 after taking Paxil. The jury held Paxil manufacturer GlaxoSmithKline 80 percent responsible for Donald Schell’s killing of his wife, daughter, infant granddaughter � and then himself — immediately after he began drug therapy. As a result of the comparative negligence finding, the June 6 judgment against the manufacturer is $6.4 million. Schell, of Gillette, Wyo., shot his wife, Rita; their daughter, Deborah Tobin; their 9-month-old granddaughter, Alyssa; then himself. Tobin’s husband and Mr. Schell’s sister sued Smith-Kline Beecham, which merged with Glaxo Wellcome to become GlaxoSmithKline. Tobin v. GlaxoSmith-Kline, CV00-025. TRIGGERING ‘INNER TURMOIL’ In the two previous antidepressant trials, which involved claims that Prozac triggered violent episodes, manufacturer Eli Lilly won defense verdicts. Lead plaintiffs’ lawyer in the more recent case, Arnold Anderson “Andy” Vickery of Vickery & Waldner in Houston alleged that GlaxoSmithKline knew that Paxil put a small group of patients at risk of violence and suicide. “Don Schell was one of the small minority of people for whom [this class of antidepressant] drugs simply are a prescription for disaster,” he said. The drug can trigger inner turmoil and agitation called akathisia, he said, which can lead to violence. GlaxoSmithKline spokeswoman Mary Anne Rhyne said the company planned to appeal. She declined to say how many cases involving Paxil — marketed since 1991 — were pending or how many claims have settled. Defense lawyer Charles F. Preuss of Preuss Shanagher Zvoleff & Zimmer in San Francisco said in a written statement that the company was saddened about the Schell family’s tragedy, but “we do not believe that Paxil was responsible for what happened. No valid scientific evidence exists linking Paxil with the events of that day.” Plaintiffs’ lawyer Vickery said one possible reason for the victory is that the judge allowed him to inform the jury that GlaxoSmithKline includes a package warning when marketing Paxil in Germany. The warning states that in potentially suicidal patients or those with insomnia or restlessness, patients taking Paxil should also receive a sedative and be closely monitored, Vickery said, citing a German translation. The family doctor who prescribed Paxil to Mr. Schell was not warned, said Vickery. “If you were a primary care doctor with no special expertise in psychoactive drugs, then got a black box warning from SmithKline that says in 3-5 percent of the people, this drug could precipitate homicide or suicide, what would you do?” Vickery said. Germany also requires Prozac maker Eli Lilly to include a package warning that taking the drug has a “risk of suicide,” said Vickery. In one of the earlier trials against Eli Lilly — a Hawaii case in which Vickery represented the plaintiffs — the judge blocked the admission of that package-warning evidence. Vickery said he learned some “harsh lessons” from that trial, most notably that the jury shouldn’t be asked to decide whether the drug or the depression caused the violent outburst. “I wised up after that verdict,” he said, noting that he asked the jury in the Wyoming case “whether or not the depression was exacerbated or triggered by some biological agent that flipped it into something far worse than ordinary depression.” He said he also offered evidence that GlaxoSmith-Kline failed to conduct tests specifically to determine whether the drug triggers this problem. Vickery said the evidence undermined the defense argument that there was no scientific evidence establishing that the drug causes violence or suicide. Vickery said he would not be surprised if the defense alleges in the appeal that the trial judge erroneously allowed the plaintiffs’ scientific witnesses. The defense had fought to exclude those witnesses, but the trial judge found the testimony relevant.

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