Maris has been an expert witness in a number of trials, including one in Hawaii last year in which Healy also testified. William D. Forsyth Sr., a retired businessman, stabbed his wife 17 times and then stabbed himself to death. He had been taking Prozac for 10 days. His family brought a wrongful death suit against Lilly, claiming that the company knew Prozac could make some people violent or suicidal, and failed to notify physicians about it.

The plaintiffs wanted $1 million in damages and the addition of a warning statement to the Prozac label. A jury found for the defendant, Lilly. So far, Lilly has won every Prozac-related civil suit against it, more than 100 and possibly 200. The number is difficult to verify because most did not go to trial. Some — Lilly says only a few — were settled out of court to avoid the expense of defending them.

In criminal cases up to now, prosecutors, frequently with the help of expert witnesses suggested by the company, have been able to obtain convictions despite defense claims that the drug had turned a previously stable and nonviolent person into a murderer.

The most often-prescribed antidepression drug in the world, Prozac has been Lilly’s major moneymaker ever since it was introduced in 1988. Its sales, however, have been falling, for which the company’s annual report blames “changes in wholesaler purchasing patterns and intense competition.” Four years ago, it accounted for more than one-third of Lilly’s total sales. Last year it represented just over one-quarter.

The company’s patents on Prozac will start to expire next year. A patent has been granted for its successor, R-fluoxetine, which Lilly will make and market. In the patent application, which the Boston Globe obtained, the company said the new drug will decrease such side effects such as headaches, anxiety and insomnia, and also “inner restlessness (akathisia), suicidal thoughts and self-mutilation.”

Akathisia, an overwhelming physical and mental restlessness, has been cited by physicians and researchers as a frequent side effect in the cases in which they believe Prozac is causing violent, impulsive and sometimes suicidal behavior. Teicher, who pioneered research on the question, observed it in a number of Prozac patients who attempted or committed suicide.

Teicher is one of the developers of the “new Prozac,” R-fluoxetine, and a co-owner of the patent.

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