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The Seroquel case explodes in the USA Seroquel is an antipsychotic drug used to treat PTSD and is alleged to have caused the deaths of many US war veterans since the start of the Iraq war in 2001

The war in Iraq has ended but some US soldiers still risk dying. In their own country. The terrible enemy is called  PTSD (post traumatic stress disorder editor's note) and it afflicts people returning from war . The illness itself is not fatal. The medicines prescribed by army doctors to combat it are. This is what emerges from the suspect deaths of a number of US soldiers returning from the Iraqi and Afghan war fronts. They were all treated with a cocktail of drugs which, subsequently, turned out to be lethal. In every cocktail there was the potent antipsychotic Seroquel, produced by the British pharmaceutical giant AstraZeneca.
Andrew White. The emblematic case in the struggle against Seroquel is that of Andrew White, a former marine, who died in his sleep at 23 years old in his bed at home in Cross Lane, West Virginia on 12 February 2008. After a nine-month tour of duty in Iraq Andrew was diagnosed with PTSD, brought on amongst other things by the death of his elder brother Robert, a sergeant in the army who was killed in a rocket attack on his Humvee. The daily treatment prescribed by doctors of the Veteran Affairs Department (VAD) was 20 mg of Paxil (antidepressant editor's note), 4 mg of Klonopin (benzodiazepine) and 50 mg of Seroquel (antipsychotic). After an initial success, the treatment started by White subsequently proved to be ineffective and medics, instead of suspending the treatment, increased the doses, with Seroquel alone being taken up to 1600 mg a day, double the maximum dose recommended for schizophrenia patients. A few weeks after the start of the treatment White manifested worrying side effects, some of which were listed in the Seroquel contraindications: weight gain (18 kilos), tremors, serious constipation, swelling of the mammary glands, slurred speech, disorientation, headaches and dry mouth. All these symptoms prompted the young veteran's doctor to refer him to an endocrinologist for further tests. Andrew White never made it to the appointment. His parents found him dead in his bed on the morning of 12 February two years ago. It was not suicide and it was not caused by taking medicines in a non-prescribed way. The autopsy report could not have been clearer: "accidental intoxication by Seroquel, Paxil, and pain medication". Thus, the question is: is there a risk of fatality in the standard treatment?
A struggle for the truth. After the death of their son, Stan and Shirley White launched a media battle to throw light on the drama that had erupted in their family. "It hurts even more to lose a son at home that came back safe and sound from the war" said Stan, a retired high school principal who now wants people to be made accountable for his son's death. "He was told if he had trouble sleeping he could take another Seroquel pill. Our objective – continued Stan – is to find out if the drugs are safe. If they are, it needs to be made public, if they are not, then it needs to be made public just the same". In the weeks following Andrew's death another six soldiers suffering from PTSD, three of them from West Virginia, died in their sleep of "intoxication by a cocktail of drugs". These too were being given "standard treatment". These too were taking Seroquel. "I believe there are many soldiers and marines who have died in their sleep like my son – said Stan – This is just the tip of the iceberg and we have got to find out who else lost their loved ones and is looking for answers". Other “sudden deaths”, like Andrew's, are those of Eric Layne and Chad Oligshlaeger, aged 21. The former had started the same treatment as Andrew and soon began to show symptoms which his widow Janette recalls as "incontinence, severe depression and continuous headaches [...] his breathing was laboured and he suffered from sleep apnea". Young Chad Oligshlaeger, who died in his bed at Camp Pendletron in California, was taking six types of medication to deal with anxiety and nightmares. The doctor that examined his body attributed his death to "multiple drug toxicity". His parents Eric and Julie Oligschlaeger now believe their son died of sudden cardiac arrest caused by Seroquel.
Seroquel. There is a great deal of shadiness surrounding this medication, endorsed by the Food and Drug Administration (FDA) in 1997. First of all, its use. This should be limited to the treatment of schizophrenia, but over the years, doctors, under pressure from the company's representatives, have started prescribing it "off-label" for other illnesses such as insomnia, depression and, of course, PTSD. The justification for this has been unanimous: "By accident, some people were giving them Seroquel for anxiety or depression, and the veterans said, 'This is the first time I have slept six or seven hours straight all night. Please give me more of that.'". This is what the Defense Department's deputy force director Michael Kilpatrick declared to the press. The by now habitual prescribing of Seroquel, as well as having caused the deaths of many former soldiers, according to a number of studies, has also pushed sales of the product to astronomical heights since the beginning of the war in Afghanistan in 2001. Despite the Veteran Affairs Department continually stating that Seroquel is only the third or fourth option for insomnia patients, the sales estimates could not be more clear. Seroquel is AstraZeneca's second most sold product, with profits from its sale in the United States reaching 4.2 billion dollars in 2009, placing it second amongst the VAD's most purchased drugs (after the anticoagulant Plavix), a total of 125.4 million dollars, as against 14.4 million in 2001. Sales, which have increased by 700 per cent since 2001, have also benefited from a marketing strategy bordering on illegality that has led to eight corruption scandals in 13 years, the most notable of these being the case of Richard Borison, former head of psychiatry at the Charlie Norwood Medical Center, who was debarred from medical practice, fined 4.26 million dollars and imprisoned for his involvement in a fraud case over the original research into Seroquel.
The tens of thousands of lawsuits have served little purpose, apart from forcing the London-based company to spend 520 thousand dollars on legal action against the United States government and change its tone on the subject of the dangers associated to the use of the drug. Nothing, on the the other hand, has been learnt by health authorities from the death of Rebecca Riley, a 4-year-old baby girl from Massachusetts who was being treated with the drug in question. As well as permitting Seroquel to be used for treating an ever broader range of illnesses, the FDA made no objection whatsoever to the actions of AstraZeneca which, last December, silently and unilaterally, approved its use for the treatment of children aged 10 to 17 suffering from bipolar disorder and for those aged 13 to 17 suffering from schizophrenia.

Antonio Marafioti

Antonio Marafioti