Suicide warning over flu drug
Friday, 15 Jun 2007 08:02
Tamiflu is the most commonly prescribed anti-flu drug in the world
A senior UK doctor has urged GPs to be cautious when prescribing the antiviral drug oseltamivir (Tamiflu).
An article in the British Medical Journal (BMJ) notes advice from the Japanese health authorities issued three months ago that the prescription of the anti-flu drug could be connected to psychological problems in teenagers.
Two 14-year-olds committed suicide by jumping to their deaths while receiving Tamiflu, previously regarded as "well-tolerated and safe".
University of Edinburgh senior clinical pharmacology lecturer Simon Maxwell is advising British doctors to be cautious when prescribing the drug, despite guidance from the US food and drug administration (FDA) ruling that the two suicides in Japan "were not clearly drug related".
But the FDA did officially require doctors to be warned that Tamiflu patients be monitored for signs of abnormal behaviour; a position later also adopted by the European Medicine Evaluation Agency (EMEA).
Dr Maxwell notes that there have been more than 100 reports of neuro-psychiatric events among Japanese adolescents prescribed the antiviral drug.
In the UK oseltamivir is classified as a 'black triangle' drug, meaning it remains under intensive surveillance.
"There seems little doubt that oseltamivir reduces the number and seriousness of flu episodes when used as treatment and prophylaxis," Dr Maxwell writes.
"However, the impact of such events in otherwise healthy people is usually modest and of short duration, so they should be encouraged to use conservative strategies such as resting, increasing fluid intake, and taking simple analgesics.
"In people at higher risk of serious complications the potential benefit of treatment seems greater, although convincing evidence about reductions in hospital admission or mortality is still awaited.
"In these groups, vaccination still offers a cost-effective first line of defence," the doctor concludes.