Coroner to probe drug-death link — (The Nelson Mail)

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The Nelson Mail

Tuesday, 13 February 2007

The Nelson coroner is investigating the relationship between a certain type of anti-depressant drug and suicide.

Coroner Ian Smith said he planned to release a report into Nelson suicides where the victims had been prescribed selective serotonin reuptake inhibitor drugs (SSRIs), which are used to treat depression.

The drugs have already been linked to increased suicidal thoughts and behaviour in young people, and drug safety authority Medsafe says it is continually monitoring new information.

Mr Smith said the cases he was investigating involved adults and young people who had been prescribed SSRIs and had committed suicide. He was unable to indicate Tuesday how many cases were involved.

Mr Smith raised the issue in the Nelson Coroner’s Court on Monday while considering the self-inflicted death of Stoke man Shaun Penney, 21, on July 5 last year. Mr Penney had been prescribed Fluoxetine and Aropax for depression.

Mr Smith reserved his findings, saying the case would be covered in his investigation. He planned to release the findings in a couple of months.

Speaking outside court, Mr Smith said he did not want to scare people off taking medication but felt that more consideration should be given to how SSRIs were used.

`It needs far more than to pop a pill.”

He planned to recommend that health services provide more one-on-one counselling for depressed people, and he hoped his report would lead to a better understanding of SSRIs.

Figures from government drug-buying agency Pharmac show that in the year to June 2005, 137,813 prescriptions were written for SSRIs, including 2727 for people aged under 18.

Mr Penney’s GP John Ayers told Monday’s inquest that Aropax had been linked to an increased suicide risk but he was unsure how much evidence there was for this.

Medsafe principal technical adviser Stewart Jessamine said the safety of SSRIs was continually monitored.

Current prescribing advice was that all patients with “major depression” should be regularly monitored for suicide risk regardless of whether they were taking anti-depressants, he said.

It was especially important to seek specialist advice when treating children or adolescents with anti-depressants.

Dr Jessamine said the Health Ministry had advised that when treating children and adolescents with depression, the risk of suicidal thoughts and behaviour with SSRIs generally outweighed the possible benefits from the medication.

Although there was some evidence that there was a possible increased risk of suicidal thoughts and behaviours in some adults taking SSRIs, the overall proven benefits outweighed the possible risks, he said.

Nelson Marlborough District Health Board Mental Health Service clinical director Siri Wettasinghe said it used current best practice guidelines in prescribing, and took into consideration the fact that medications had side effects.

“We must not be too hasty in making judgments over negative effects of prescribed medications that work extremely well for the majority of patients and save lives.”

At Monday’s hearing, Mr Smith also ruled that the deaths of Caleb Stevenson, 19, on July 25 last year and Adam Clayton, 89, on August 8 were self-inflicted.