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At the heart of general practice since 1960

40,000 told to see doctor in SSRI scare

GPs need not take every patient under 18 off selective serotonin reuptake inhibitors ­ despite the Government ruling that only fluoxetine is safe to use in children.

All 40,000 under-18s who are taking SSRIs have been urged by the Committee on Safety of Medicines to seek advice from their doctor after the committee ruled that paroxetine, venlafaxine, sertraline, citalopram, escitalopram and fluvoxamine should not be prescribed as new therapy for patients under 18 with depressive illness.

But CSM chair Professor Gordon Duff told GPs that if a patient was being successfully treated with any of the drugs, normal completion of the planned treatment course should be considered.

The safety warning was issued after an analysis of trial data concluded that in children, the risks of self-harm and other side-effects outweighed the benefits (see below).

Only fluoxetine (Prozac) was considered to have a favourable balance of risks and benefits for treating depression in under-18s. But the CSM said GPs should never prescribe it without seeking specialist advice.

Professor Duff reminded GPs not to stop SSRI use abruptly and said a gradual decrease in dose was especially important for paroxetine and venlafaxine.

Dr Ross Taylor, a GP member of the CSM expert group that made the ruling, said counselling and psychotherapy services were already overstretched. Dr Taylor, senior lecturer in general practice at the University of Aberdeen, said: 'The problem might be a lack of resources. There is already a shortage of non-drug services.'

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