Paxil and Suicide-Confirmed in trials

Specialties Psychiatric

Published

http://www.dailymail.co.uk/pages/live/articles/health/thehealthnews.html?in_article_id=306667&in_page_id=1797&in_a_source=

Shamed Glaxo's u-turn on 'suicide' drug

by BEEZY MARSH and TIM UTTON, Daily Mail

08:49am 15th June 2004

Britain's biggest drugs firm has caved in dramatically and revealed research which shows a leading anti-depressant can cause children to attempt suicide.

In an astonishing u-turn, Glaxo-SmithKline finally published full details of nine scientific studies and two clinical reviews which expose the dangers posed to under-18s who take Seroxat.

Children on Seroxat are twice as likely to have suicidal thoughts than those on a dummy pill, it emerged.

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Alarmingly, one study showed six youngsters on Seroxat wanted to kill themselves, compared to just one taking a placebo pill.

The drug was also linked to distressing side effects including hostility, insomnia, dizziness, tremors and emotional irritability.

Damning findings

Campaigners say the damning findings were suppressed for up to a decade while thousands of teenagers and children as young as six continued to be given the pills to ease depression.

At one point, doctors had even hailed Seroxat as a "wonderdrug" to help people overcome shyness.

The firm is facing a major lawsuit amid allegations that drug regulators were duped into thinking Seroxat - which is worth £2billion a year to Glaxo - was safe for children.

A number of youngsters are known to have committed suicide while taking the drug, but it was not until last year that doctors were banned from prescribing it to under-18s because of the suicide risk.

Some estimate that more than 50,000 under-18s in the UK were prescribed Seroxat between 1990, when it was licensed here, and last year when the ban was imposed by Government medical regulators.

Anguished parents

Anguished parents have complained that their children became suicidal while on Seroxat then showed horrendous withdrawal symptoms when they tried to come off it.

A civil lawsuit has been filed against Glaxo in the US by New York State attorney general Eliot Spitzer, who claims the firm suppressed at least four studies on the drug.

More than 3,000 UK families have also started legal action against Glaxo seeking compensation for their ordeal. They include a number of parents whose children committed suicide while on

Seroxat. Full details of the controversial studies were published on the Internet only after the medical establishment turned on Glaxo.

In an unprecedented attack, the respected Lancet medical journal last week accused the drugs giant of losing touch with its basic humanity over the Seroxat scandal.

'Suicidal thinking'

In an editorial, the journal said: "GSK appears to be floundering in the semantic depths.

"While it has been earnestly parsing the meaning of 'suicidal thinking' and 'publicly', it appears to have forgotten what lies behind those words - people. The time has come for these matters to be revealed in a bright and public light."

The Lancet said the safety and efficacy of Seroxat in children had been tested in "at least five studies sponsored by GSK, only one of which has been published".

It revealed that, although the results of this trial were mixed, they were heralded in a memo as showing "remarkable efficacy and safety in the treatment of adolescent depression".

The Lancet also poured scorn on Glaxo's argument that trials data was made public. This was done at scientific meetings attended only by specialists and published in the letters pages of medical journals.

Medical authorities here are investigating whether Glaxo complied with legal requirements to make all relevant clinical trial data on the drug available.

Too little too late

Last night. a leading consultant psychiatrist who was among the first to question the safety of Seroxat, said the publication of the Glaxo-funded Seroxat studies was too little, too late.

Dr David Healy, of the University of North Wales, said: "If the data had been out there from the start, we could have avoided some of the problems we have seen with Seroxat.

"If people had been aware of the evidence from the trials and seen the risks, they could have reduced the risks of adverse events happening. Parents could have been told to keep a closer eye on their children."

The nine studies were made available to the Government's regulators, the Medicines and Healthcare Products Regulatory Authority, only in May last year.

The details lay behind the decision to ban doctors from prescribing Seroxat to under-18s. A spokesman for GlaxoSmith Kline last night said it had already communicated the trials data to the medical community in the normal way through meetings, letters and papers over the last decade.

Medical regulators

Medical regulators were also given the data as soon as the risk of suicidal thoughts became clear.

But he added: "We thought in the interest of transparency and given the interest in this area that we would publish all the documents on the website.

"We have made no attempt to hide results or mislead regulators or the medical community. Studies individually show no consistent evidence of a problem in terms of the safety issue.

"It really was not until the nine studies had been completed and we had combined it with further review in 2003 that we saw there was a potential signal."

as i said, i am pro patient education. i have never, and i do mean never, condoned the fda's actions at suppressing information about paxil's clinical trials--especially if that information shows that the drug is contraindicated (or worse) in teenagers with depression. my heart goes out to those who suffered at the hands of pharmaceutical companies and physicians who were reckless and misinformed. the statistics that you provided indicate that there is surely some link between severe depression or mood disorders and suicide in conjunction with teenager paxil-users. furthermore nobody would dispute that ssri's have a terrible withdraw period. whether or not you want to let that overshadow the stellar accomplishments of this drug in other arenas is completely up to you. per those 6 tragic suicides, there were 154 lives that significantly benefited from this drug. while that in no way minimizes the loss of such young lives, it does speak of the effectiveness of paxil to treat depression. thank you for your "concern" lysorke, but i've not been "cured" of my anxiety; rather, i am now able to control my symptoms in a way that lets me go about my daily life without having an anxiety attack. (and yes, this ssri in particular was not only approved for panic disorder but proved effective in treating generalized anxiety in "most" adults. per the ams, "the u.s. food and drug administration has approved paxil cr for the treatment of major depressive disorder and panic disorder. in national studies paxil cr has proven useful in the treatment of generalized anxiety." if you don't mind, lysorke, i would like to know where you got your information! if my physician prescribed me the wrong medication...i would like to know. you do make a good point, though. i bet a good percent of the people who wean off paxil are those who are experiencing adverse reactions. congratulations to your son for conquering the terrible withdrawal process. as for me, while i have not made a decision to "stay on this medication for life", i do not anticipate tapering anytime soon. i am still in amazement at how much i am able to accomplish thanks to this medication....

Specializes in Med-Surg, Wound Care.

http://www.oag.state.ny.us/press/2004/jun/jun2b_04.html

http://www.antidepressantsfacts.com/casualties.htm

http://www.ssricitizen.org/SSRIdangers.html

http://www.gsk.com/media/paroxetine.htm

http://www.dailymail.co.uk/pages/live/articles/health/thehealthnews.html?in_article_id=306667&in_page_id=1797&in_a_source=

http://www.nj.com/search/index.ssf?/base/news-0/1087747940194050.xml?starledger?prs

http://www.drugawareness.org/home.html

http://www.paxilprogress.org/

http://www.cbc.ca/stories/2004/06/03/antidepressant040603

http://bmj.bmjjournals.com/cgi/content/full/328/7444/879?

I have more, but this should get you started.While I agree with you that not all people have bad reactions to Paxil, the inability to determine who MIGHT makes these drugs very scary. My son was wonderful on Paxil for the first 3 months and then very slowly we saw anger,aggression etc. that the psychiatrist determined was because he wasn't on a high enough dose. His final dose was Paxil CR 50mg(twice the recommended dose for an adult)When I questioned the psychiatrist about this elevated dose I was told "I've never had any problems with using this dose". After he refused to continue to see my son after the suicide attempts I realized he never saw any problems because he CHOSE not to and just dropped the patient.

thank you for the information. i shall read on, as all of my research thus far has confirmed that paxil cr is proven effective against panic disorder, which is quite different then generalized anxiety disorder. indeed, most people do not have adverse reactions to paxil cr (other then the expected withdraw). the inability to determine who might have a bad reaction to this drug should be the responsibility of a proficient psychiatrist, which clearly you and your son were lacking. my heart goes out two the both of you, who, from the sounds of it, were victims of an inattentive quack. i hope this idiot looses his license! :angryfire thanks again, lysorke, and i am glad your son is feeling better!

Specializes in Med-Surg, Wound Care.

"The inability to determine who might have a bad reaction to this drug SHOULD be the responsibility of a proficient psychiatrist"

There in lies the problem!! There are no predisposing factors.My son was never suicidal, never self harming. Neither was Stephanie Fritz(15) who hung herself after 4 months on Zoloft, or Julie Woodward(17) who hung herself after 4 days on Zoloft.Not to let the psychiatrist off the hook(which I won't!) but there have been no consistent predisposing factors that would warn of a bad reaction.

Thank you for your good wishes with my son. When you decide to come off Paxil, PLEASE be very careful and make sure those around you know the behaviors to look for.

:) Thanks again Isyorke.

I'm not taking any chances. I have to take care of my 82 year old mom and 2 senior cats. Besides this paxil is too expensive anyway. I am withdrawing slowly and so far so good. Yippie I'm looking forward to being paxil-free soon!

Specializes in Med-Surg, Wound Care.

Good Luck! If you have any questions paxilprogress.org has a great group of people who are withdrawing or have gone through withdrawal who can help.

The fact that your only on Paxil for 2 months hopefully you won't have much problem.

That said, statistics still indicate that for every person Paxil has caused harm, it has liberated many others. After all, every drug is not for every person. In fact, I can’t take painkillers because I have a sensitive stomach. The nausea it causes me is much worse then the original pain; it’s all a matter of personal choice. I am all for patient education, but legislation that demonizes a drug that has been a blessing for so many?

The FDA pulls drugs off the market all the time that have helped many people but have too high a profile of serious side effects or have been linked to a significant number of user deaths. We're not talking about "nausea" here -- we talking about patient deaths. If it were really about "personal choice," Thalidomide, Rezulin, Baycor, "Fen-Fen,", etc., would still be available in the US ...

Specializes in Med-Surg, Wound Care.

New drug insert for Paxil and Paxil CR is up on the FDA Website listing a suicide warning.

http://www.fda.gov/medwatch/SAFETY/2004/safety04.htm#wellbutrin

Scroll down for Paxil and view with Adobe Acrobat. I agree Elkpark! Just because it works for some doesn't discount the horrible side effects that a good percentage of people have.This is evidence in the new labeling. Its a shame that patients never see the drug inserts. At least now I can legally instruct my patients of the risk since its in the drug insert.

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