He then asked Healy whether the female rats were exposed to Paxil for more than just the third trimester. "Yes, they were," Healy said. "They were actually exposed throughout the pregnancy and for a period of time before the pregnancy and after."
He also told the jury that there were three major malformations in the Paxil exposed group, and "there may well have been more."
"The figures from the studies do give grounds for concern that there were, in fact more," he said, "far more."
The fact that the more Paxil they got the more they died, "indicates that the drug has played a part ... in whatever the cause of death is," Healy told the jury.
"It's clearly the drug that has caused the death," he said. "What we aren't clear from here is just what actually happened. Why they died."
In 1980, Glaxo had a doctor by the name of John Baldwin review the Ferrosan rat and rabbit studies. In a March 20, 1980 memo to the company, Baldwin discussed the studies and further dispelled Varner's claim that the rats received 10 times the normal dose.
"At first the examination of individual litter data, et cetera, supports the possibility of embryo lethality then this observation at nonmaternally toxic dose levels which are only three to six times the proposed human dose could contraindicate the use of Paroxetine in pregnancy," Baldwin wrote.
"That means that this appears to be grounds for concern from the work that Dr. Baldwin has reviewed," Healy told the jury.
"That Paxil is a drug that if it comes on the market, may cause birth defects," he said. "So that it would be classified with the drug like Accutane where the drug would have to come on the market contraindicated."
Which "would mean in this case," Healy said, "do not use the drug in women of childbearing years unless, for instance, they're using some form of birth control."
Another portion of Baldwin's memo stated: "On the other hand, if the embryonic death is unrelated to treatment, we would have to repeat the study at higher dose levels to produce some maternal or embryonic/fetal effect. There remains the possibility of this compound could be teratogenic at higher dose levels."
"This means that Dr. Baldwin is saying there is a real risk here from the data that we have that this drug may cause birth defects," Healy told the jury. "We need to do more work to actually before it's out, does the drug come with this risk or not."
"He says we need to check and see if the company that has made this drug has conducted this extra research or are in the process of doing the extra research or not," Healy said. "The implication being that if they haven't done it, we should."
In reviewing the documents for the case, Healy found nothing to show that Glaxo ever did the studies that Baldwin was talking about. "I know they did further studies, but I don't think they did anything to address the issues that were raised by 295, 296, 297," he said. "Or if they did, they kept it well hidden it would seem."
Yet nine years after he wrote the memo, Baldwin published a 1989 paper on the reproductive toxicology of Paxil in a journal called, "Active Psychiatric Scandinavia," and stated: "There appeared to be no selective effect on the embryo or any signs of teratogenicity."
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While Healy was testifying, Tracey read part of a summary on the study that directly contradicted Varner's claims in stating: "Females were dosed for 14 days prior to pairing, throughout the pairing period, during gestation and for those females allowed to litter during lactation."
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