The Medicines and Healthcare Products Regulatory Agency (MHRA)has
advised that the antidepressant paroxetine (marketed asSeroxat)
should not be prescribed for children or adolescents.It did so on
the recommendation of an independent expert workinggroup,
commissioned by the Committee on Safety of Medicines(CSM).
Paroxetine, which is made by GlaxoSmithKline, has never been
licensed for children, but about 8000 patients under 18 weretaking
paroxetine in the United Kingdom last year because itis legal to
prescribe it if the doctor responsible deems itappropriate.
The new advice is based on studies showing that there are higher
rates of suicidal thoughts and behaviour in the patients whotook
paroxetine (25 out of 738; 3.4%), compared with thosewho took
placebo (8 out of 647; 1.2%). There was no case ofan actual suicide
in all the patients in these studies.
The MHRA emphasised that it was important that patients didnot
stop taking paroxetine abruptly. Instead, patients shouldseek their
doctor's advice on how to taper off the drug. Forsome young patients
who were already taking the drug "it mightbe favourable to continue
with the drug, if they do not sufferfrom suicidal thoughts or
behaviour," said Dr Jonathan Chick,a psychiatrist on the CSM's
expert working group on the issue.
A spokesman for the agency said that it was known that nine
studies into the drug had been conducted, but the results ofonly one
was "in the public domain."
Professor Alasdair Breckenridge, the agency's chairman, said:"The
Committee on Safety of Medicines will immediately investigatethe
relevance of these findings for the usage of paroxetinein adults."
He stated that "at the moment patients on paroxetinewho do not show
suicidal behaviour should continue taking it."
Dr Alastair Benbow, head of European psychiatry for GlaxoSmithKline,issued the following statement: "While we believe that today's
move will inevitably limit the choices available to doctorstreating
children and teenagers under 18 years with major depressivedisorder,
and the conclusions we draw from the data differ,we recognise the
MHRA's decision for UK paediatric patientsand we will work with them
to implement the changes as soonas possible."
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