Furious Seasons again has a detailed analysis of more Zyprexa findings from his ongoing examination of the Zyprexa documents (it’s a long essay, but worth the read when you have a few minutes). This most recent analysis focuses on how Eli Lilly spent considerable effort marketing Zyprexa as an appropriate medication for “complex mood” disorders such as bipolar disorder and long-term use. This despite significant ongoing concerns from doctors around the country about Zyprexa and weight gain and hyperglycemia.

Eli Lilly wanted to position Zyprexa as a reasonable alternative to the long-standing, standard maintenance treatments for bipolar disorder, generic lithium (which is inexpensive, safe, and a well-known side effect profile) or Depakote (a newer mood stabilizer which is fairly inexpensive and often more effective than lithium for many people). The challenge is that Zyprexa’s chemical mechanisms are significantly different than either lithium or Depakote because it is an atypical antipsychotic medication. The other problem was apparently with people gaining significant amounts of weight and coming down with diabetes, two side effects which can be fairly debilitating to sales if widely known and disseminated.

It also appears Eli Lilly was pretty aggressive in its off-label marketing efforts. “Off-label” use of a medication is any use of a medication for which it was not specifically approved for by the FDA. This is a fairly common and standard practice amongst doctors, who find information in newly published research or through discussions with other doctors about off-label uses for a medication. But it is generally understood that pharmaceutical companies cannot market a medication for off-label uses to doctors. Off-label use is supposed to be a completely informal, clinically-driven process, not a marketing one.