After a delay, the massive legal action over Risperdal side effects is moving forward.

Hundreds of lawsuits have been filed against the makers of Risperdal, alleging that the drug can cause a condition called gynecomastia, particularly in younger patients. Gynecomastia, also called “man boobs,” is a condition in which males experience female-like breast growth. Alleged Risperdal side effects like male breast growth can be an emotionally scarring experience for young men who are already dealing with mental illness.

The lawsuit over male breast growth and other Risperdal side effects have taken the form of a multidistrict litigation, or MDL. MDLs are kind of group lawsuit in which a group of plaintiffs allege they have suffered similar harm at the hands of the same defendant. In an MDL, the legal system groups similar individual cases together to coordinate them and avoid repeating very similar trials. Drug lawsuits, like lawsuits over alleged Risperdal side effects, are well-suited to MDLs, since plaintiffs’ cases often hinge on similar evidence and make similar allegations.

An order was issued on Sept. 24, rescheduling the next three individual cases in the Risperdal side effects MDL. These cases are now scheduled to start in November and run through February. These cases are bellwether trials, a special class of lawsuits within an MDL. Bellwether cases are intended to determine key issues in the MDL, setting legal precedents that will determine the outcome of the larger Risperdal side effects MDL.

Many of the lawsuits over Risperdal side effects allege that the drug’s makers illegally promoted the drug, leading to many of the cases. Under the law, a drug may only go to sale if its manufacturers test the drug according to FDA-approved protocols. Additionally, a drug’s manufacturer must test the drug for each use it intends to promote. However, physicians may prescribe a drug for other purposes, a rule intended to help physicians treat patients when the approval process lags behind medical research. This is called off-label usage. While off-label usage is legal, the law strictly forbids drug companies from promoting off-label usage. Many of the lawsuits over Risperdal side effects allege that the drug’s makers aggressively promoted off-label usage.

Risperdal is an atypical antipsychotic, a second-generation medication for schizophrenia. Later, the drug was approved to treat bipolar disorder and irritability/aggression associated with autism. The drug was designed to help treat the psychiatric illness without the serious side effects seen in older-generation schizophrenia drugs like Thorazine.

The Risperdal Side Effects MDL is In re: Risperdal Litigation, Case No. 100300296, in the Philadelphia Court of Common Pleas.