Re: Re: Is Neurontin (Gabapentin) another problem d...

[Guest guest]

posted this transcript from the whistleblower who exposed the marketing techniques to get s many people as possible on this drug.

Whistleblower alleges illegal encouragement of off-label use - Dateline NBC

transcript

Greetings :-)

This transcript below is only one in a number of interviews and articles

about lin, PhD, and Warner-Lambert's blatant and aggressive

campaign to convince physicians to sell Neurontin for more than a dozen

off-label uses, few of which have any evidence to support the use of this

drug and none of which, at that time, had FDA approval for these uses.

I want to emphasize that what Warner-Lambert did is nothing more than

standard operating procedure in the pharmaceutical industry. The only

difference is that this company happened to hire a man who wasn't

comfortable with the deceit and manipulation so he blew the whistle on them.

I know this has served as somewhat of a wake-up call to others; however,

I'm not sure there is any penalty short of sanctioning a company's ability

to sell drugs that would serve as enough of a deterrent, considering how

much money there is to be made by doing this.

The field of psychiatry is particularly vulnerable to the

manipulations of drug companies because efficacy of drugs is more difficult

to quantify in the standard ways this would be done for other conditions.

There is always the opportunity to blame the "illness" or the "patient" when

questioning psychotropic drugs. It would not be exaggerating to say that

this is done on a regular basis.

I can tell you from years of experience in talking to physicians

in-depth, painstakingly laying out the lack of scientific evidence for most

psychotropic drugs as well as the long-term damage caused by them, the

pharmaceutical companies are masters at selling physicians on their products

while having little to nothing to support their claims of efficacy.

I'm assuming most of you are aware that Madison Ave. advertising firms are

hired for their expertise in marketing. In fact, two Madison Ave. firms are

owned by two parent companies of large pharmaceutical companies. I have

this info if anyone needs it.

Thanks for your patience during this intro. Now, on to the transcript.

Regards,

================================================

Drug giant accused of false claims

Whistleblower alleges illegal encouragement of off-label use

Scientist lin says he became part of a broad mission at

pharmaceutical company Warner-Lambert to deceive, even entice doctors to

prescribe drugs to patients whether it was scientifically justified or not.

NBC NEWS

July 11 - The questions began with the confession of an insider at one of

the nation's largest pharmaceutical firms. He says his former company

deliberately distorted information about one of its drugs, possibly putting

lives at risk, and costing patients and taxpayers millions of dollars.

"Dateline" went looking for some answers and has the results of a year-long

investigation into what may be one of the biggest medical deceptions in

history. NBC's Hockenberry reports.

DAVID FRANKLIN: "I was trained to deceive, to lie to doctors."

Hockenberry: "So these doctors were completely misled?"

lin: "Absolutely."

Who would train and then pay someone to mislead doctors? Scientist

lin says pharmaceutical company Warner-Lambert paid him to do

that back in 1996.

lin: "It was my responsibility to leverage the trust that

physicians had with pharmaceutical companies to corrupt the relationship

between the physician and the patient."

Hockenberry: "Your job was to find trust, and exploit it, to

produce more sales for Warner-Lambert."

lin: "Absolutely."

Since he was a little boy growing up in Rhode Island, lin says,

he wanted to be a scientist. But he wanted to use that science to help

people, doing medical research to cure disease. So lin got his Ph.D. in

biology at the University of Rhode Island and from there became a researcher

at the prestigious Dana Farber Cancer Institute. After more than three years

as a researcher, lin wanted to get out of the lab. He found a job at

Parke-, a division of Warner-Lambert. He would be a medical liaison,

using his scientific expertise to explain the scientific merits of drugs to

doctors.

lin: "The medical liaison was supposed to be fair and balanced,

where the physician could trust what the medical liaison was telling them."

Hockenberry: "So, doctors wouldn't necessarily see you as a company

guy, as much as they would see you as a scientist. As as a medical doctor,

like them in a way."

lin: "Exactly. A person whose primary responsibility is to care

of the patients, making sure that the doctor, to enable the doctor to

practice the best possible medicine that science would allow at this point

in time."

Hockenberry: "So, a doctor needs more drugs for their practice. They

call the salesman. But if they have questions about the medical use of that

drug, they call you."

lin: "Exactly."

But almost immediately, lin says, he became little more than a

salesman. The job he thought would be about caring for people turned out to

be little more than caring for the company's bottom line. With his Ph.D. and

the title of doctor, lin says he became part of a broad mission to

deceive, even entice doctors to prescribe drugs to patients whether it was

scientifically justified or not.

lin: "It was a matter of leveraging, corrupting, if you would,

perverting the science, to greatly increase sales and profitability."

This corporate whistleblower, telling his story to "Dateline" in his

first broadcast interview, has rocked the pharmaceutical industry to its

core. Pieced together with confidential documents and taped voicemails, you'

ll see a portrait of sales over science.

But mostly this is the story of how lin helped one little

drug become a star: Gabapentin, one of the drugs lin was responsible

for, which goes by the brand name Neurontin. Neurontin is a useful and

generally safe drug. The Food and Drug Administration approved it in 1993,

but for only one use - to help control epileptic seizures and only if taken

in conjunction with another drug.

But lin says he soon learned that Warner-Lambert had plans for

Neurontin, the little epilepsy drug, a plan to go directly to doctors and

get them to prescribe Neurontin for all kinds of uses the FDA hadn't

approved, called "off-label" uses.

Hockenberry: "Warner-Lambert basically told you, 'The FDA says,

scientifically, Neurontin treats epilepsy. But we can convince doctors. And

here's how you'll do it, to use Neurontin for a dozen other things."

lin: "Absolutely. This was holding their hands and pushing them

into to using Neurontin off-label."

And according to lin, the list of off-label uses was long,

everything from attention deficit disorder to alcohol and drug withdrawal.

Now, off-label uses are nothing new. Doctors have been observing

surprising new uses for drugs throughout history. Some of their discoveries

become medical breakthroughs. One of the best-known examples is aspirin,

once thought only good for pain, was found by doctors to increase blood

circulation and prevent heart attacks.

Hockenberry: "So it's legal for doctors to say, 'You know what? I

think this drug that is approved for your ear might be good for your throat.

'"

lin: "Not only is it legal, but it's good medical practice."

But what is not legal is for a drug company to promote such

unapproved, off-label uses or to exaggerate or report unproven breakthroughs

to doctors as a way to get them to prescribe their drugs. Assistant U.S.

Attorney Jim Sheehan, one of the country's leading prosecutors of health

care fraud, says such regulation exists because off-label use can be unsafe.

Sheehan: "Every prescription drug is an inherently dangerous product

with the potential to kill people as well as cure them. That's why we have

very strict regulation, that's why we have rules about what marketing and

promotion they can do. That's why we have rules about what they can produce

and how they produce it."

lin says the rules went out the window from the moment he

arrived on the job. For instance, he was told not simply to wait for doctors

to ask him for his scientific opinions, but to instead target doctors and

convince them to prescribe Neurontin, even though he knew that there was no

FDA approval for its off-label uses.

lin says he was actually "cold calling" doctors, showing up like

a salesman unannounced, and he found one thing about him opened a lot of

doors.

lin: "If I were to show up at a doctor's office and say, 'Dr.

lin is here to speak to Dr. ,' Dr. is much more likely to

respond, as opposed to his receptionist calling him in his office, and

saying, 'The Warner-Lambert sales rep is here to talk to you.'"

lin didn't say that he wasn't a medical doctor. Simply having

the title of doctor, the Ph.D. he was so proud of, was all that mattered,

lin says, and Dr. lin, it turns out, wore lots of hats, depending

on whom he was visiting.

Hockenberry: "So, you could have had a Ph.D. in economics or

metallurgy, and it would have been just as fine?"

lin: "As long as it granted me the title of Dr. lin."

Hockenberry: "What were you told to tell doctors about your

background?"

lin: "We actually trained the sales representatives to introduce

me as an expert in cardiovascular medicine."

Hockenberry: "Were you?"

lin: "Absolutely not. My Ph.D. was in microbiology. At 9 in the

morning I was an expert in cardiovascular medicine. At 10 when we walked

across the street to a neurologist office, I was an expert in neurology."

And once inside, lin would make his pitch to the doctor. As I played

the doctor's part - he showed me what he would say about Neurontin.

lin: "We're really being inundated with information from across

the country with physicians that are seeing a profound improvement in

patients with bipolar disease ... so we would suggest that you titrate the

patient up to 4,800 milligrams - you will see marked improvement in their

symptoms."

Hockenberry: "So your suggestion to me is triple the dose and I might

see some positive results."

lin: "Absolutely. It's not a matter of might. You will see an

improvement."

He's a scientist who couldn't sound more certain. But is there any

scientific validity to what he is saying about, for instance, bipolar

disorder?

lin: "None at all. And in fact, much of it is a fabrication. It

is simply untrue."

Hockenberry: "Was there any data that really supported the claims you

were making?"

lin: "Not at all."

At best the claims were based on promising anecdotal and untested

preliminary information that lin says was, promoted to doctors

vigorously, directly and illegally.

lin: "Not only is it illegal, it's downright immoral. It doesn't

just hurt the medical community, it has the potential of hurting patients."

But as you'll see, there was nothing potential about the money to be

made through these tactics. The billions to come were real ... as real as

the patients whose stories are just beginning to emerge. Was their health

compromised in a scientifically invalid campaign to raise sales of

Neurontin?

A PATIENT'S PERSPECTIVE

By the late spring of 1996, lin understood fully what he was

doing in supplying misleading information to doctors about the drug

Neurontin. What he didn't know, he says, was the effect on real patients. It

's a knot in his stomach that's still there today.

lin: "There hasn't been a day in six years that I haven't

thought about this and wrestled with my involvement in it."

Long after lin began to have his first reservations about

his job, 54-year-old Regina got her own education about off-label uses

of Neurontin.

: "My whole life was turned upside down, and I almost lost my

life because of it."

has bipolar disorder.

Hockenberry: "When were you first diagnosed with a condition that

might require ongoing use of pharmaceutical drugs?"

: "About 11 years ago."

Hockenberry: "And the symptoms you were exhibiting were?"

: "Mania, mostly mania. Because I had just lost touch with

reality."

Bipolar disorder occurs when the brain constantly cycles between

mania and depression. Those who suffer from it can experience uncontrollable

highs and lows.

Before she found a reliable treatment the disease played havoc with

' life. She divorced and was in and out of hospitals. Doctors finally

found a therapy that seemed to work, a drug called Depakote, FDA-approved

for bipolar disorder.

: "That worked really well, worked for my head. But the side

effect was weight gain."

Hockenberry: "Weight gain?"

: "I gained 100 pounds."

wanted the benefits of Depakote without all the weight, so she

asked her doctor for a different drug. The doctor recommended Neurontin At

first felt better and lost weight, but soon after things started to

come apart.

: "I became more and more out of control. My whole personally -

I'm very a sweet, nice person. And I got hostile."

Hockenberry: "Had you ever behaved like this before?"

: "No. No. My ex-boyfriend said he had never seen me, when I was

manic, act like this."

went back to her doctor for help.

: "She just kept increasing the Neurontin. I didn't want to go

any higher. I didn't want to get harmed from it."

Hockenberry: "And your doctor's response was, Increase the dosage.'"

: "Mm-hm."

Was there a risk? ' dosage was tripled. Neurontin is known to have

few if any side effects, one of its big selling points. But Neurontin was

now ' only treatment for bipolar disorder, which was very risky because

Neurontin, it turns out, does essentially nothing for bipolar disorder - and

that's a scientific fact.

Dr. Sachs: "Neurontin's a drug that has been studied under

double-blind conditions twice. And in neither case did it prove to have any

efficacy at all."

Hockenberry: "In neither case?"

Sachs: "In neither case."

Dr. Sachs runs the Bipolar Treatment Center at Massachusetts

General Hospital.

Hockenberry: "So, based on the science, someone with bipolar who's

only taking Neurontin is essentially untreated."

Sachs: "I think that's a fair assumption."

And for a bipolar patient like , being untreated can be

life-threatening. On Neurontin, ' manic behavior became uncontrollable.

She says she tried to kill herself. She ended up in the hospital.

Hockenberry: "If your doctor gives you something, your assumption is

that it works, and that somebody's shown that it works, right?"

: "Right."

Hockenberry: "In the case of Neurontin, was any of that true?"

: "Not for me."

We tried to talk to ' doctor at Meridian Behavioral Healthcare

in Gainesville, Fla. - and said she had no problem allowing us see her

medical records. But the company refused our request, issuing only a

statement from her doctor acknowledging that was treated with

Neurontin but that the drug was discontinued when she "experienced a manic

episode."

is back on her old medication and doing fine.

Hockenberry: "What do you have to say to the drug company that might

have been very interested in doctors' prescribing their medication?"

: "I think that they're greedy, and they just are after money.

And they don't really care about the person who takes the medicine,

obviously."

lin says he was surprised how easy it was for him to get

doctors to switch to Neurontin or to raise dosages.

Hockenberry: "And would they do it?"

lin: "It's remarkable the high percentage of physicians that

would do this."

Hockenberry: "How did you feel?"

lin: "I would leave a physician's office in pain. There was no

other way of describing it. This is - I was in - a combination of

embarrassed by what I had just done, felt responsibility to the patient, to

the doctor and the patient, that I had just misled this individual. And that

some third party that wasn't even in the room, some patient, may actually be

impacted by it."

Parke-' own internal documents obtained by "Dateline" show the

company couldn't have been more excited about: "new indications for

Neurontin," especially for people like with bipolar disorder: "Bipolar

disorders offer the greatest expected return on investment ... as much as

$55 million."

Even though the 1995 memo later states "there is no pre-clinical

evidence of efficacy in bipolar disorders." In other words, no real

scientific evidence that it would work. lin says the company's

enthusiasm about off-label prescriptions translated into real pressure on

the job - pressure, he says, to sell.

lin: "I was pressured to fill the gap that the sales team, the

actual sales representatives weren't filling. That the sales representatives

weren't as effective as medical liaisons. And that we had to, I think the

quote was, to take the ball and run with it."

And lin let "Dateline" experience this sales pressure just as he

did, through this recorded voicemail from his boss.

"You know there's a Neurontin push that's supposed to be on.... So

what we need to do is focus on Neurontin, when we get out there - we want to

kick some ass on Neurontin - we want to sell Neurontin on pain all right?

And monotherapy...I don't know if you guys are embarrassed, but I'm

embarrassed with where we are with Neurontin."

lin saved this voicemail because he could barely believe what

his boss was saying: sell Neurontin expressly for uses not approved by the

FDA. lin was frightened. What he was being asked to do, he believed,

was illegal. So he began to tape more conversations and messages from

company officials. Here's a quote from a senior Warner-Lambert executive on

a conference call:

"I want you out there every day selling Neurontin... holding their

hand, whispering in their ear - Neurontin for pain, Neurontin for

monotherapy, Neurontin for bipolar, Neurontin for everything.... I don't

want to see a single patient coming off Neurontin before they've been up to

at least 4,800 milligrams a day."

And then he said this:

"I don't want to hear that safety crap either.... It's a great drug"

We showed Assistant U.S. Attorney Jim Sheehan that colorful quote.

Sheehan: "It would seem to me that's a pretty clear advocacy for

off-label use by the company. And therefore a violation of the FDA's rules."

Hockenberry: "You know, I don't know if I'd use the word advocacy. I

might use, like, threat."

Sheehan: "When I look at this, Neurontin not for pain, not an

on-label use, Neurontin for bipolar, not approved, no application for that

either. Neurontin for everything, well, that's pretty obvious."

And company sales people got to make this pitch right in the inner

sanctum of doctors' offices. lin would tell doctors they could get paid

to let company sales reps go over patient medical records and to actually be

there in the examining room while patients were being treated.

lin: "If you are willing to allow a sales representative to

spend a day with you as you see patients, we'll compensate you for that. We'

ll pay you for it."

This is a voicemail lin recorded, in which a salesman boasts

about his success after a day spent with a doctor and his patients:

"The doctor would review the chart of each patient with me in a

one-on-one fashion. Then we would go meet the patient, the patient would be

examined. I saw the actual prescription generated in front of me... that was

certainly nice. I certainly felt that me being there, I had some influence

on that medical decision."

Medical decisions that were very good business. From its introduction

in 1993, Neurontin the little epilepsy drug, has rocketed to the top of the

sales charts. Today it's a more than $2 billion drug, outselling even

blockbuster Viagra, and more than three-quarters of Neurontin's sales, by

the parent company's own estimate, are from off-label uses.

But lin was having serious doubts about the safety of off-label

use, about his job and about what kind of legal trouble he might be in. He

would not make it through his first year at Parke-. In the summer of

1996, he decided he'd had enough.

GOING PUBLIC

By the early summer of 1996, after four months working as a medical

liaison for Warner-Lambert, lin began to realize it was time to

get out. He believed what he was doing was wrong and feared what would

happen if he stayed.

lin: "I knew that in the period of time that I had been there,

my own personal behavior was illegal, that I had done things that were

simply illegal."

His biggest worry was that he was aiding and abetting a medical

fraud. The scientist who reluctantly became a salesman now wondered if he

had what it took to blow the whistle on a drug company worth billions.

lin: ""Either I needed to own up to this now and put it behind

me, or at some point in the future, this could come back, and I'd find

myself on the wrong side of this investigation. I did believe, when I left,

that they were so aggressively ramping this up, that at some point, someone

would expose what was going on there. And therefore, I would find myself in

the equally, or even more difficult, position of trying to explain why I

ignored an obvious illegal and immoral activity within the company."

So on July 29, he drove to a co-worker's home, dropped off his office

keys and company car and turned his back on Parke- for good. Next stop?

Greene and Hoffman attorneys at law.

lin: "I showed up to their office saying, I've- I'm in trouble.

And I need some help out of this."

lin filed a lawsuit against Warner-Lambert and its Parke-

division charging the company with violations of the U.S. False Claims Act.

He says he was not motivated by the fact that he stands to be in line for a

percentage of the damages if the company loses or if it settles out of

court.

Tom Greene: "We had no idea the extent of the Neurontin

prescriptions, how successful this program had been."

Tom Greene is lin's attorney. He has spent the last seven

years amassing Warner-Lambert and Parke- documents going back to 1994.

He shared many of them with "Dateline" - they fill more than 160 boxes,

memos and reports that prove, Greene says, that lin was merely a

cog in a grand marketing strategy to deliberately and illegally encourage

off-label use.

Greene: "There are countless documents that support what he says and

go far beyond his story and bring the level of knowledge of this illegal

marketing program to the highest levels of the company."

For example, one memo shows that plans for marketing Neurontin for at

least one off-label use were sent to top executives, including Wild,

the president of Parke-' pharmaceutical division, and Lodewijk de Vink,

president of parent company Warner-Lambert. Neither responded to our request

for comment.

Other Parke- documents, like one from 1997, show that there were

teams inside the company not merely pushing the envelope on acceptable

marketing practices but deliberately advocating going around the expensive

FDA approval process, because the patent life of the drug was so short.

The "recommendation" is that Parke- "not file" an application

with the FDA but instead take the message straight to the doctors.

It was a full-court press. While sales reps and medical liaisons like

lin supplied company information in doctors' offices, documents

show company messages being planted aggressively in the scientific

literature.

Doctors simply trying to stay educated about new drugs would find themselves

inundated with research, paid for by the company and made to look like

independent scientific papers.

Greene: "They wanted to disseminate knowledge of these off-label uses

throughout the medical literature. They hired outside companies to write

articles about off-label uses so that the message about off-label use of

Neurontin could be planted in the medical literature around the country, and

indeed around the world."

Here's one example of how what Parke- called its "publication

strategy" worked: A company called Medical Education Systems of Philadelphia

(MES) was hired by Parke- to put together a series of articles on

off-label uses of Neurontin. MES would contact doctors hand-picked by

Parke- to author the articles. But in some cases, it appears that

articles were essentially ghostwritten by MES, and the doctor's name added

later. As one MES status report notes: "MES draft completed - we just need

an author."

And what did the doctors get for becoming authors of papers they

sometimes didn't write? Fees of up to one thousand dollars a pop.

Sheehan: "You are attempting to create a false impression, and you

are making false representations, and you're doing it for money. I just don'

t see how that approach can be supported or can be viewed as appropriate."

Hockenberry: "You know, it's always been my impression that the

finding of an author precedes the actual writing of the paper."

Sheehan: "One would hope that's what would happen."

Papers were just the beginning. lin says there was lots of money

to go around.

Hockenberry: "Did you pay doctors?"

lin: "I personally did not pay physicians. What my

responsibility was, was to let physicians know that there was money

available to them."

In fact the documents show there were all kinds of ingenious ways for

doctors to get paid for an education in the use of Neurontin. For instance,

"honoraria" are fees paid to doctors to hear information or a presentation

about Neurontin. Parke- records show that these scientific

presentations occurred in some unscientific places: "Bus to Yankee Stadium,"

"World Yacht Cruise" and "Braves Stadium."

Doctors were also recruited for teleconferences, seminars and trips

to places like Jupiter Beach, Fla., perhaps better known for golf than for

research.

Paying physicians like this, giving them drug company money to listen

to information about the products they prescribe, may be legal and common

practice in the industry, but to critics like Dr. Arnold Relman, professor

emeritus at Harvard and former editor of the New England Journal of

Medicine, it's a conflict of interest - especially in the case of Neurontin.

Relman: "What you have is an unproven drug being widely used for

difficult problems by doctors who are given a powerful economic incentive to

do it, spurred on by a company that's wildly aggressive in its marketing."

After seven years of legal motions and countermotions, lin's

lawsuit is now being scrutinized by the U.S. government and all 50 states to

see if government medical programs like Medicaid may have been defrauded

into spending millions on improper off-label prescriptions.

And in fact, in recently filed court papers, the Justice Department

said that lin's case "has presented evidence of an illegal off-label

marketing scheme that is rife with false statements and fraudulent conduct

all of which had one intended purpose and result - increasing sales ..."

Three years ago, Pfizer bought Warner-Lambert and Parke-, so now

the biggest drug company in the world is the defendant in one of the

highest-profile cases in the history of the industry. Pfizer officials would

not speak on camera but did provide this statement: "...the events to which

you referred are alleged to have occurred well before - in some cases years

before - Pfizer acquired Warner-Lambert. Pfizer completed the acquisition of

Warner-Lambert in June 2000. It is long-standing policy that Pfizer has not

and does not promote its products outside their FDA-approved labeling.... We

are unable to comment further because of the pending litigation..."

But it's litigation that will mean little to Regina , who says

she will always believe that her experience with bipolar disorder and the

drug Neurontin almost ruined her life.

: "Now that I look back, and that I know what I know now, I

wouldn't have ever taken the drug. I want everybody to know that's taking

this drug the truth about it."

Last year the FDA approved the use of Neurontin in the treatment of

post herpetic neuralgia, severe nerve pain, in addition to epilepsy. It is

still widely prescribed for pain and a variety of other unapproved uses,

some of which have been studied and endorsed by scientists and approved for

use in other countries.

And as for whistleblower lin, he may have escaped legal

liability for what he did during his four months with Parke-, but he

hasn't escaped his own conscience. He admits he should have known from the

start that he was heading down the wrong path.

lin: "Actually interviewing for this position, I was asked about

giving examples of where I had to bend the rules in the past and how I

handled that and how comfortable was I working in gray areas."

This case could end up clarifying some of those gray areas and end up

costing defendant Pfizer millions of dollars. And there's one more thing.

Because his lawsuit is filed under the federal False Claims Act, as a

whistleblower lin stands to get a piece of any monetary damages, up to

30 percent, which could add up to millions. So the four-month job in sales

that caused so much agony for this scientist, ironically, might in the end

have set him up for life.

Hockenberry: "But even after you get a settlement, if you do, or a

judgment if you do, or the case just completely goes away if it does, there

are patients out there who took drugs based on decisions doctors made

relying on your judgment."

lin: "Right."

Hockenberry: "They could be hurt because of that."

lin: "They may have been hurt. And that's something that I

wrestle with."

Hockenberry: "What's to wrestle with? If they're hurting, it's

because of you."

lin: "It's because of me. There hasn't been a day in six years

that I haven't thought about this and wrestled with my involvement in it and

the guilt I feel associated with it, and the sense that I need to correct

it."

Blind Reason

a novel of espionage and pharmaceutical intrigue

Think your antidepressant is safe? Think again.

[Guest guest]

Glitterari

Thanks for the mail. Been trying to get my head around this. It's hard to read let alone take in the information but I think I have the gist of it. My head is screwed up.

I was given neurontin for neuropathic pain.

Sorry about your name, looked at some of the posts I have saved but could not find your name to thank you.

Thanks again

Jobeth

[Guest guest]

Sorry about your name, looked at some of the posts I have saved but could not find your name to thank you.

Hey, Jobeth, don't worry about it! Ever since Dawn (a former member of the original group) dubbed me glitter, hardly anyone uses my real name, which is Trisha. I see responded to your post. He was on both FXR and Gabapentin and he managed to get free of both, so it can be done. Good luck to you.

Blind Reason

a novel of espionage and pharmaceutical intrigue

Think your antidepressant is safe? Think again.