The battle over antipsychotics use for seniors and their marketing shows no signs of abating. The latest blow is a billion-dollar court decision against a pharmaceutical giant accused of too aggressively pushing the drug Risperdal, which is taken by many seniors with Alzheimer’s disease.

The Arkansas Medicaid program spent a total of $8.1 million on prescriptions for Risperdal. A lawsuit against Johnson & Johnson claimed that side-effects, including diabetes and schizophrenia, were either not noted or downplayed by Ortho-McNeil-Janssen Pharmaceuticals, a J&J sub-unit.

A jury ultimately ruled against Janssen. Pulaski County Circuit Judge Tim Fox handed down a $1.2 billion judgment Tuesday. That encompasses fines of $5,000 each for 238,874 fraudulent prescriptions that the state said Medicaid paid for.

It is one in a series of decisions against J & J in various states. The federal government rejected a settlement offer with the company last month.