Michael Grinfeld summed up Lilly's legal situation well, and prophetically, writing in California Lawyer magazine in 1998: "Lilly may eventually face a court judgment in a Prozac case, but it has succeeded beyond all expectations in postponing that day." Indeed it has. On April 2, 1999, despite David Healy's testimony and the surfacing of the Lilly papers, the jury in the Forsyth trial found in favor of Eli Lilly. In the eyes of the jury, Prozac did not cause Bill Forsyth to kill his wife and then himself.

While Lilly has continued to survive all legal challenges to date, not all plaintiffs' cases involving the SSRIs have ended in defeat. In May 2001, Australian David Hawkins was freed from prison after a supreme court judge said it was "overwhelmingly probable" that Hawkins would not have killed his wife or attempted suicide had he not been using Zoloft. In another 2001 case, a Wyoming court found against GlaxoSmithKline, maker of the SSRI Paxil. The jury found that Paxil can cause some individuals to commit suicide and homicide, and had done exactly that in the case of 60-year-old Donald Schell. After complaining of anxiety, stress, and possible depression, Schell had been prescribed Paxil by his family doctor. Two days later, Schell shot to death his wife, his daughter, his infant granddaughter, and then himself. David Hawkins, too, had committed homicide after his first two days of SSRI treatment.

Stories like these litter the communities of North America and Europe, most of them concealed behind the confusion and secrecy that so often mark sudden family tragedies. By the spring of 1999, 2,000 suicides by Prozac users had been reported to the Food and Drug Administration, at least a quarter of which appeared to be linked to agitation and akathisia. According to the FDA's own estimate, only about one percent of serious side effects are ever reported on its "adverse event system." This means that, as David Healy has concluded, as many as 50,000 akathisia-related suicides had taken place by 1999. The total estimate for all SSRIs would of course be much larger.

In the face of such statistics, and with the loss of their exclusive patent on fluoxetine, Lilly announced in December 2001 that they planned to bring another antidepressant to market late in 2002. Not surprisingly, the new drug, duloxetine, does not selectively target serotonin. The SSRIs, once hailed as a revolution in the treatment of depression, are now in the process of being phased out. Oddly, this is making way for pharmaceuticals that act in essentially the same way as the drugs that the SSRIs originally replaced. Given this backward trend, one is left to wonder whether all the death and misery linked to the SSRIs might have been for naught. If so, a final conclusion seems unavoidable: that next to big tobacco and the marketing of cigarettes, the selling of the SSRIs is perhaps the deadliest marketing scandal of the 20th century.

Richard DeGrandpre is the author of Ritalin Nation (1999) and The Cult of Pharmacology (2007), For his full report on "The Lilly Suicides," click here. (PDF)