Patients reassured over use of anti-depressant

Patients on anti-depressants have been urged not to stop taking them without first consulting their doctor, following an international study that linked the active ingredient paroxetine contained in some types of anti-depressant to an increase in suicide attempts.

The study was undertaken by researchers from the University of Oslo and recently made the headlines in several countries. The researchers recommended that restrictions on the use of paroxetine for children and adolescents should be extended to include usage by adults.

The vice-president of the Malta Association of Specialists in Psychiatry, Joseph Vella Baldacchino and Richmond Foundation chief executive officer Doris Gauci stressed that people must not stop taking the drugs without seeking a doctor's advice.

According to a local representative of pharmaceutical giant GlaxoSmithKlein, which produces a type of paroxetine, up to 10,000 people in Malta use the drug.

When contacted, the Medicines Authority said the class of drugs of which paroxetine forms part - selective serotonin reuptake inhibitors (SSRIs) - had benefits that outweighed the risks "if used at the right time, on the right patient and at the right dosage".

The authority said no adverse reactions to the drug or suicidal thoughts had been recorded on the local database maintained by the authority.

The authority, in collaboration with the European Medicines Agency, had issued a circular on the subject last April explaining the possible adverse drug reactions.

It had stated that SSRIs are not authorised in Europe for the treatment of depression and anxiety disorders in children or adolescents because clinical trials have shown an increased risk of suicide behaviour, but stressed that a decision based on clinical need was sometimes taken to treat such patients.

"In such cases, the patient should be carefully monitored for the appearance of suicidal behaviour, self-harm and hostility. This is particularly important at the beginning of treatment," it said.

When contacted yesterday, Dr Vella Baldacchino said risks existed with all drug preparations, adding that psychiatrists have a lot of clinical experience with SSRIs. He described these as a modern form of anti-depressant that were safe even if a person overdosed.

The psychiatrist stressed that suicidal thoughts were highly associated with depression. More than 80 per cent of people suffering from depression had suicidal leanings and when depressed patients were administered anti-depressants there was no guarantee they would still not harbour suicidal thoughts.

Ms Gauci said the foundation was not in a position to comment on the benefits or dangers of the paroxetine drugs.

She expressed concern, however, that people currently using these drugs may stop taking the medication without seeking medical advice after hearing about the Oslo research in the media.

Last year, the Food and Drug Administration issued a public health warning about the need to closely monitor both adults and children with depression, especially at the beginning of treatment or when the doses are changed.

GlaxoSmithKline has defended the use of its antidepressant Seroxat, a type of paroxetine, which was the most mentioned drug in media reports. In a statement, the company said the Oslo study only served to "cause confusion and unnecessary concern" for patients using a selective serotonin reuptake inhibitor for the treatment of depression.

Dr Vella Baldacchino said depression was quite a big problem in Malta, mainly because life had become more stressful and stress could increase depression. Additionally, people were more aware of the problem, he said.