By Jennifer Hough (Irish Examiner)
Saturday, December 24, 2011
THE Irish Human Rights Commission (IHRC) has written to the Medical Council, requesting thatpatients are informed that certain anti-depressants can cause suicidal thoughts as a potential side effect.
The IHRC is also urging ongoing supervision when the drugs are prescribed. The anti-depressants are known are SSRIs, and popular brands include Prozac, Zoloft, Lexapro Paxil and Celexa.
The move came after a request to the IHRC for an inquiry into the prescribing of such drugs from the mother of 22-year-old Shane Clancy, who took his own life after fatally stabbing another man a month after he began taking anti-depressants.
Leonie Fennell believes her son had a serious adverse reaction to citalopram, as it was found he had high levels of the tablets in his system.
An expert witness at his inquest, Dr David Healy, the professor of psychiatry at Cardiff University in Wales, told the court that behaviour such as suicidal or violent thoughts or actions, seen in some patients prescribed SSRIs, arose from the drugs and not from the patient’s condition.
Such extreme side effects are rare, but there is evidence that in a minority of cases, SSRIs can cause a person’s behaviour to change dramatically.
This week, the IHRC wrote to the Medical Council asking that patients be informed and closely monitored.
It also suggested that the consistency of care of someone presenting with symptoms of depression would be served by ensuring the following matters are expressly required to be explored and addressed by the medical practitioner with their patient:
* Discussion of alternate therapies.
* Referrals for counselling/ psychiatric review.
* Within medical practices, seek to ensure the same doctor deals with the person at all stages if at all possible.
* Oral explanation of risks/ side effects of SSRIs in advance of prescription, together with relevant written information.
* Guidelines regarding prescribing SSRIs from initial stage through ongoing treatment.
* Level of monitoring and ongoing supervision required when SSRIs are initially prescribed.
* Maintenance of adequate consultation notes.
* The necessity to obtain a full patient history before prescribing SSRIs.
Ms Fennell said she was happy the IHRC seemed to be taking the issue seriously.
“Finally somebody is taking us seriously and asking for changes to be implemented in the way SSRIs are being prescribed by medical professionals in Ireland,” she said.
In 2004, the US Food and Drug Administration issued a public warning about an increased risk of suicidal thoughts or behaviour in children and adolescents treated with SSRIs.
In 2006, the warning was extended to include adults up to the age 25.