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Pills and kids may not mix
Anxiety over SSRIs. Five Canadian deaths could be among 100 adverse reactions involving children
June 10, 2004
At least five teenagers in Canada have died, four of suicide, while being treated with the most widely prescribed antidepressants in Canada and at least 100 other children as young as 18 months old have experienced serious suspected adverse reactions to the pills, CanWest News Service has learned.
The most recent reported suicide involves a 14-year-old boy who killed himself after 25 days on Paxil, one of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs).
The antidepressants are at the centre of a growing storm over whether SSRIs, blockbuster drugs that have become among the most popular medicines in history, cause some children to become suicidal or trigger other severe emotional or behavioural changes within weeks of the commencement of treatment or a change in dose.
Health Canada was notified of the boy's suicide on July 22, 2003, nearly two weeks after the government and GlaxoSmithKline, the makers of Paxil, warned doctors not to prescribe the drug to children and teens because of a possible increased risk of suicidal thinking, suicide attempts or self-harm.
Health Canada learned in October 1996 of a 17-year-old boy who committed suicide while he was being treated with Zoloft. A suicide involving a male 18-year-old who had been taking Prozac was reported to the government in 1992.
In all three suicides, the antidepressants might have contributed to the deaths, according to adverse-drug-reaction reports contained in an edited, online Health Canada database.
It's estimated only one to 10 per cent of all adverse drug reactions are reported to Health Canada.
But there's no proof of a cause-and-effect link between the antidepressants and any of the suicides.
And it's not known from the reports why the teens were receiving treatment, or whether any had a history of suicide attempts.
"Health Canada did conduct an assessment to see whether the deaths were caused by SSRIs," department spokesperson Jirini Vlk said.
"There was no causal link established."
The fourth suicide involved an 18-year-old female who overdosed on Effexor; her death was reported to Health Canada in December 1998.
The fifth death involved a 16-year-old boy who died of cardiomyopathy, inflammation of the heart, after taking Celexa for 17 days.
It is not known from the report, received in May 2003, how long this teen had cardiomyopathy. The youth had also been taking another antidepressant, and possibly an anti-psychotic drug. According to the doctor who filed the report, Celexa "may be contributory" to the death.
The New York state attorney-general, Eliot Spitzer, launched a lawsuit last week against GlaxoSmithKline, alleging the drug giant "engaged in repeated and persistent fraud" by concealing critical scientific studies about the safety and efficacy of Paxil for depression in children and teens.
The company denied the charge.
Today, preschoolers make up the fastest-growing segment of the SSRI market, studies show. Even infants under one are being prescribed the drugs for anxiety or sleep problems.
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