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GPs ignore drug suicide warning

Neither Britain nor the US approve the use of Aropax for anyone under 18, but increasing numbers of young New Zealanders are taking the drug.

Manufacturer GlaxoSmithKline wrote to New Zealand doctors last year advising them to consider gradually taking patients off Aropax.

The medicine was not licensed to those under 18 and studies had not shown any benefit for that group. The manufacturer wrote: "We cannot recommend its use."

Aropax and other drugs known as selective serotonin re-uptake inhibitors (SSRIs) - which include Prozac - came under further scrutiny last month when the US Food and Drug Administration recommended they carry a "black box" warning of the increased risk of suicide.

The warning is the strongest caution the FDA can issue.

But New Zealand medicines safety authority Medsafe has said although there were concerns about SSRIs, the evidence was inconclusive.

The number of New Zealanders under 18 using antidepressants such as Aropax and Prozac has increased by almost 60% since 1998 and around 24,500 prescriptions are written for young people each year. Aropax remains the most common.

An Otago Medical School study published last year linked antidepressants with 41 deaths in 2001.

New Zealand doctors say the medicine is a treatment vital for depression and the risks need to be balanced against the dangers of not prescribing the medicine.

Royal Australian and New Zealand College of Psychiatrists child psychiatrist Denise Guy said it had not been proved it was the medication rather than depression that caused suicidal thoughts.

Half the young people who developed depression attempted suicide.

Antidepressants such as Aropax were effective for young people, when used with caution. "We want to make sure we address the risk, but we want to be able to offer intervention that works."

Wellington Child and Adolescent psychiatrist John Lambe described SSRIs as life-saving and said concerns the drugs made young people's moods worse were overstated. Although he favoured Prozac, if a patient did not respond well he would offer Aropax, despite the warning. "I would (ignore the manufacturer's instruction) in that situation."

Marco Marinkovich, chairman of suicide lobby group Yellow Ribbon, said the warnings were not being taken seriously by doctors or the government.

The secrecy surrounding suicide meant not enough was known about the risks of the drug and more research was needed.

The public should be warned of the risks and parents should be told when their children were given antidepressants so they could monitor any change in moods, Marinkovich said.

Medsafe medical adviser Stewart Jessamine said many antidepressants had warnings advising against their use in children.

A Medsafe committee met last week to discuss the medication and its recommendations should be released later this month, a Health Ministry spokesman said.