Side Effects: Death, Confessions of a Pharma Insider

Side Effects: Death, Confessions of a Pharma Insider, John Virapen, Virtualbookworm Publishing, 2010

This book, written by a pharmaceutical industry insider, exposes many of the secrets that led to drugs with major side effects, like Prozac, to be approved and widely prescribed.

Born in Guyana (northeast South America) to Indian parents, Virapen found himself, in the 1960s, in Europe, hungry and homeless. He went to Sweden, to live with a woman he met in his travels. It was there that he got a job as a sales representative for Eli Lilly and Co. He visited local physicians, bringing them small gifts and other things and generally encouraging them to prescribe Eli Lilly drugs. He rose quickly through the ranks, eventually running the entire operation in Sweden. Virapen was very involved in getting drugs like Prozac approved, with a corresponding rise in the gifts given to doctors. They now ranged from expensive "scientific conferences" in exotic places to brothel visits, to outright bribery. This book is an attempt to atone for what he has done in the drug industry.

Virapen spends much of the book talking about Prozac. The drug industry has no problems with creating "diseases" like ADD (Attention Deficit Disorder), to get otherwise healthy people to think that they are sick, and need a pill (an expensive pill, of course). If a clinical trial is not going well; for instance, if Drug X works just as well as Prozac, a drug company can stop the trial, and switch Drug X with another drug against which Prozac works really well. There is no obligation to tell the Food and Drug Administration, or any of its foreign counterparts, about this. Clinical trials on psychotropic drugs, like Prozac, last a couple of months, at the most. There has been no attempt to study the effects of such drugs over years.

When it came time to get Prozac approved in Sweden, the information supplied by Eli Lilly was to be evaluated by an independent doctor, who would send his recommendation to the national authorities. Virapen's job was to figure out who that doctor would be and find out what it would take to get that doctor to give a favorable opinion. Unfortunately, that doctor was very willing to be bribed, even helping Eli Lilly to write the report the "right" way. Virapen mentions case after case of normal, well-adjusted people who, after taking Prozac for a very short time, kill other people or themselves.

On the positive side, this is a very interesting book that shows the lengths to which drug companies will go to create new markets for their drugs. On the negative side, if there are to be future printings of this book, it really needs a trip, or another trip, to a copyeditor or proofreader.