• The New York Times, Tuesday, March 25, 2008 11:30 AM

William Bigley says he knows President Bush, owns a private jet and has seen flying saucers. He suffers from paranoid schizophrenia, but he does not want to take Eli Lilly's antipsychotic, Zyprexa, or any other drug prescribed to help him battle his demons. He told a judge in an Alaska courtroom that they were "poison."

Documents being discussed in another trial in the same courthouse offered plenty of evidence that Bigley--whatever his delusions--has good reason to dislike the medicines. All anti-psychotics have side effects, and Zyprexa causes severe weight gain that can lead to diabetes, as well as sharply higher cholesterol and triglyceride levels in the blood. Those are all risk factors for heart disease.

Among themselves--in internal e-mail messages and memorandums--Lilly executive shared worries that Zyprexa's sales would fall if the drug was linked to weight gain or diabetes. But Bigley's case illustrates why psychiatrists and patients feel they have no choice but to use Zyprexa, whatever its side effects. He has been hospitalized more than 70 times since his first breakdown in 1980.

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