GPs told to include young adults in Seroxat review
GPs have been urged by a Government drug safety adviser to review all young adults on Seroxat amid fears that
new research linking the drug with attempted suicide in the
under-18s could have implications for older patients.
Dr Jonathan Chick, a member of the Committee on Safety of Medicines' expert working group on SSRIs, suggested GPs take immediate precautionary action as the Government launched an urgent investigation into the safety of Seroxat in adults.
The Medicines and Healthcare Products Regulatory Agency (formerly Medicines Control Agency) last week ruled GPs should not initiate Seroxat (paroxetine) in under-18s with depression. Last year 8,000 such patients were prescribed the drug.
The agency also recommended GPs should withdraw the treatment gradually from under-18s not responding well.
It acted after new data received from manufacturer GlaxoSmithKline showed the drug was no more effective than placebo in treating depression in under-18s but raised the risk of emotional changes, including 'suicidal thoughts and attempts' by up to 3.2 times.
Dr Chick, consultant psychiatrist at the Royal Edinburgh Hospital, said: 'Children clearly develop at different rates and people treating those of 19 and 20 should be aware of this data.'
He added: 'If the risk is higher in adolescents aged 17 what is the implication for someone aged 19?'
He advised GPs should also question their use of SSRIs in adults in light of the review.
GPs should refer any child with depression for non-medical treatment such as cognitive behaviour therapy and if this was unsuccessful consider another SSRI or other antidepressant, he said.
LMCs have warned the
safety ruling could also deter GPs from prescribing Seroxat in adults.
West Pennine LMC chair Dr John Rhodes said: 'It seems Seroxat is catching all the fire for this particular group of drugs. Lots of GPs will think it's not worth giving this to adults as well.'
But the idea of being able to refer patients on to psychologists was 'pie in the sky' in some areas, he said.
GlaxoSmithKline said while its conclusions 'differed' from those of the agency it would work with it to implement the ruling 'as soon as possible'.
New guidance on Seroxat
· Do not prescribe as new therapy for depression in under-18s
· Review all under-18s on the drug
· If responding well, consider completing treatment course; if not, consider changing treatment, first to a non-pharmacological treatment if unsuccessful, switch to another SSRI
· When withdrawing Seroxat, reduce dose gradually using half tablets and then alternating days if necessary
· Advice on prescribing for adults unchanged
Source: Committee on Safety of Medicines