Docs may ignore regulatory drug warnings
Last Updated: 2007-02-28 16:18:01 -0400 (Reuters Health)
NEW YORK (Reuters Health) - After five regulatory agencies issued advisories regarding possibly increased risk of suicides associated with some antidepressants, all but the first, which specified an increased risk in young patients, were virtually ignored by physicians who prescribe these agents, investigators in Canada report.
Dr. Paul A. Kurdyak, from the Centre for Addiction and Mental Health in Toronto, and colleagues performed a time-series analysis of new antidepressant prescriptions in Ontario between 1998 and 2005.
Their report was published online on February 28th by the American Journal of Public Health.
In June of 2003, the UK Committee on Safety of Medicines published a report advising doctors to not prescribe Paxil (also known as paroxetine) for depression in patients younger than age 18 because of increased suicides.
In October of that year, the US Food and Drug Administration (FDA) issued an advisory that emphasized use of all so-called selective serotonin reuptake inhibitors (SSRIs) in pediatric patients. A year later, the FDA issued two advisories further extending the warning to include use of any antidepressant in depressed patients of any age. A similar advisory was issued by Health Canada in June 2004.
To look for trends in antidepressant prescription coverage, Kurdyak's team examined computerized prescription records of the Ontario Drug Benefit program.
Only the first advisory was associated with a change: New prescriptions for paroxetine for patients younger than age 20 fell by a significant 54 percent. Otherwise, prescription patterns did not change for any other individual or class of antidepressants in any age group.
Kurdyak's team suggests that there was a response in prescribing practice after the first advisory because it was specific for one drug in a defined group of patients. Moreover, they add, the last four warnings about multiple antidepressants would have substantially restricted physicians' ability to treat patients for depression.
SOURCE: American Journal of Public Health, online February 28, 2007.
