A staffer at the clinical test site where I've been a healthy subject guinea pig in drug studies once told me he gave up trying to take all the newer so-called anti-depressant drugs. The reason for his decision to stop taking the drugs was because they were all exceptionally difficult for his liver to eliminate. The newer generation of anti-depressant drugs, like Glaxo-Smith-Kline's (GSK) Paxil, are very hard on the liver and should not be taken by people who with either a low level or lack of the crucial P-450 enzyme in their livers. This is hardly news to informed people and people who have had difficulty withdrawing from these drugs, but you're not likely to know this when you leave the doctor's office with a prescription for one of these drugs.

Thanks in part to the efforts of the BBC's Panorama program, which produced a follow up to an October program about Paxil and addiction on May 11 (See: news.bbc.co.uk/1/hi/programmes/panorama/2982797.stm), British-based GSK has finally dropped its "no addiction" claim on its patient leaflet to the popular anti-depressant. However, in a move that will only increase the confusion about the company's line on Paxil withdrawal, GSK still insists the drug is "not addictive" even though they've changed the language of their patient leaflet.

GSK's head of European clinical psychiatry, Dr. Alastair Benbow, blamed patients in an interview with Panorama: "It was quite clear from talking to patients--and as a doctor that's very, very important to me--it's quite clear that the phrase 'Seroxat (The name for Paxil in the UK) is not addictive' was poorly understood by them." What Benbow is saying is that physiological problems commonly experienced by patients withdrawing from Paxil, like electric shocks in the brain and spine, should not be considered a sign of addiction. No, former Paxil patients like Paula Gardiner of Cardiff, Wales, who now runs her own Internet patient discussion board (See: paxilsupport.homestead.com/Index.html), weren't expecting to go through difficult withdrawals from the drug because of the patient leaflet. Seems to me the folks at GSK need a remedial lesson in drug addiction, because physiological problems that come about when patients quit a drug cold turkey, or significantly reduce their dose, are telltale signs of physical addiction. For patients like Gardiner, GSK's change in its patient leaflet came too little, too late for them.

Civil lawsuits have not been brought against GSK in the UK for the marketing of Paxil, as activists there have tried to pressure their regulatory agency, the Medicines Control Agency, to force GSK to change its labeling. Gardiner personally doesn't want to seek compensation from GSK through the courts. "I don't think the desire for compensation/money and the desire for real justice mix well," Gadiner told the author via e-mail. "If we go for compensation over here, and not an attempt to legally stop GSK, then we've lost a lot really. If I were in the litigation I'd be fighting to 'risk' losing compensation. I prefer to try to bring a judgment against GSK and that's difficult to achieve in court. Settling a compensation claim out of court, which is what happens most of the time, leaves GSK with no black mark, no admission of any wrong doing."

Meanwhile, here in the US, the class action status of the federal Paxil withdrawal lawsuit, filed in Los Angeles, has yet to be determined and we don't know whether or not GSK's labeling change in Britain will have any effect on the outcome of the suit. Trisha Spinelli of Colorado, who went through a very difficult withdrawal from Paxil starting over five years ago, is one of the plaintiffs in the suit. "As far as I know nothing new has developed," Spinelli wrote the author via e-mail. "There is another hearing in late June that will once again attempt to address this class action status before we file lawsuits state by state. Logically, this admission in the UK should sink their claims of denial here. The basis of the lawsuit is about the addictive nature and the withdrawals from this drug. If they are no longer going to defend their claims that it is NOT addictive, what leg are they going to stand on in court here? I hope it brings them to their knees in our case."