Prozac and the other SSRIs have been prescribed for all those problems and more, and have produced dramatic improvement in a majority of cases. “Prozac is a valuable drug,” Maris said. “For every horror story, there are thousands of persons who say their lives were saved by it.”

But he said, doctors need to be much more careful about prescribing it. They should investigate the patient’s history, particularly the psychological history, to see if there have been any indications of suicidal thought or other instability, and then should monitor each patient very carefully. He said that is not always done.

Because any physician can prescribe Prozac, and general practitioners, primary care doctors and specialists in other areas might not be as alert for danger signs as a psychiatrist might be, Maris said Lilly should have warned doctors about Prozac’s dangers.

The company did not do that. According to a Boston Globe story earlier this week, internal Lilly documents show that in 1990, corporate executives pressured Lilly scientists to alter records on physicians’ experiences with Prozac. They changed mentions of suicide attempts to “overdose” and of suicidal thoughts to “depression.”

Some of Lilly’s own studies were cited by the German equivalent of the Food and Drug Administration, delaying Prozac’s approval there. They showed that previously nonsuicidal patients who took the drug had five times the rate of suicide or suicide attempts as patients on older antidepressants. When the drug was approved for sale in Germany, a warning was required on the label. The label warned that the drug’s use carried a risk of suicide, and recommended that sedatives be given along with it.

The Globe said figures in Lilly internal documents showed that in early clinical trials, 1 in 100 previously nonsuicidal patients who took Prozac became anxious and agitated, and either attempted or committed suicide during the studies.

Some of the previously unknown information that Eli Lilly possessed about the drug has come to light during civil trials in which the company was sued for wrongful deaths following suicides, or during criminal trials in which defense lawyers argued that Prozac caused a defendant’s violent and homicidal behavior.

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