Anti-depressants doubles a child’s risk of suicidal behaviour.

Suicidal thoughts, attempts and self-harm increase in young people prescribed antidepressants, concludes study

Anti-depressants should be a doctor’s last resort when trying to treat children and adolescents with depression, according to the results of a new two year-long study.

The meta-analysis involved researchers conducting a systematic review of all available and relevant test data. Researchers examined 70 trials comparing antidepressants with placebos in order to find out how the use of antidepressants related to increases in suicide, suicidal behaviour and aggressive behaviour in young people.

In 11 of those trials, researchers found out that antidepressants doubled the risk of aggressive behaviour and suicidal behaviour in young people. Suicidal behaviour includes suicide thoughts and attempts, actual suicides and self-harming behaviour such as deliberately cutting oneself.

“There are still psychiatrists who deny that antidepressants can cause suicide in children, which is absolutely incredible,” Peter Gøtszche, the head of the Nordic Cochrane Centre at Rigshospitalet who is the co-author of the new study, told Videnskab.

“I think it is irresponsible to use antidepressants in treating children and adolescents.”

Results no surprise
Anne Katrine Pagsberg – a clinical associate professor, senior researcher and medicine chief physician at the Child and Adolescent Centre, Capital Region Psychiatry at the University of Copenhagen Hospital – was not surprised by the results.

“We are very aware of this risk,” she said. “Especially for children and young people there has long been an awareness that there may be an increase in suicidal behaviour. All our patients are closely monitored and their families informed about the risks.”

Pagsberg said that the national guidelines for the treatment of children and adolescents suffering from depression recommend that antidepressants should never be ‘front-line therapy’ and should never be used as a stand-alone treatment.

“They must always be coupled with psychosocial interventions, and patients should always be closely monitored for side-effects.”

Self-harm may not equate to suicide
Pagsberg said that self destructive behaviour may not always be a sign of suicidal intent.

“Self-harm is a serious symptom, but a young person who cuts their arm is not necessarily suicidal,” she said.

No children or young people in the 70 trials actually committed suicide, but 3 percent of the children and young people taking anti-depressants exhibited suicidal behaviour, compared to 1 percent in the placebo group.

“The front-line treatment for children and adolescents with depression will always be psychotherapy,” said Pagsberg. “In cases of severe depression, we may need to try treatments using anti-depressants, but even then the psychotropics should never stand alone.”

http://cphpost.dk/news/anti-depressants-doubles-a-childs-risk-of-suicidal-behaviour-say-danish-researchers.html

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British Medical Association

“Prescribing of psychoactive drugs is a major clinical activity and a key therapeutic tool for influencing the health of patients. But often their use can lead to a patient becoming dependent or suffering withdrawal symptoms.

In the absence of robust data, we do not know the true scale and extent of the problem across the UK. However the evidence and insight presented to us by many charity and support groups shows that it is substantial. It shows us that the ‘lived experience’ of patients using these medications is too often associated with devastating health and social harms.

This represents a significant public health issue, one that is central to doctors’ clinical role, and one that the medical profession has a clear responsibility to help address.

That is why we have undertaken a project working collaboratively with key stakeholders to start to identify what positive action can be taken for the future benefit of patients. This has had a particular focus on the prescribed use of benzodiazepines, z-drugs, opioids and antidepressants.”

Working collaboratively with key stakeholders

In March 2014, the BMA board of science sent out a call for evidence to gather the views of stakeholders on ways to improve the prevention and management of prescribed drug dependence.

We received a wide range of responses from professional organisations and charity and patient groups. This evidence was set out in an analysis report published in October 2015, bringing together the views of all the organisations who made representations.

Following this we’ve hosted a series of roundtable meetings with stakeholders to discuss what collaborative actions can be taken in light of the issues identified in the analysis report.

These actions focused on key policy recommendations:

  1. the creation of a national helpline for prescribed drug dependence;
  2. an increase in provision of specialist support services;
  3. revised guidance for doctors on safe prescribing, management and withdrawal of prescription drugs;

We launched these policy calls in October 2016, accompanied by appearances on BBC Breakfast, BBC5 Live Investigates and national newspaper coverage. You can find links to the various media items at the bottom of this page in the Media coverage tab.

While there is a wide range of actions needed to address this issue comprehensively, the following recommendations set out key policy calls identified through our ongoing programme of work.

Since October 2016 we continue to work with stakeholders to lobby on our key policy calls.

Full text

Suicide- 87% on antidepressants

The stats also reveal that more than 87% of people were taking antidepressants at the time of death, while 44.6% were on drugs used in psychoses and related disorders.

New figures have revealed that almost three quarters of all suicides in Dundee were among men.

The latest statistics released by the NHS show that there were a total of 147 suicides in Dundee between 2009 and 2015, of which 109 were men.

The figures also show that the majority of men who committed suicide in the city were employed in senior positions, such as managers, while 43% of men who committed suicide were unemployed, disabled or living off their own means.

One Dundee dad who knows only too well the devastation and heartbreak caused by suicide is Phil Welsh.

Lee Welsh, 27, of the city’s West End, took his own life in August, leaving his friends and family devastated. Phil called for a crisis centre — similar to one in Edinburgh, which is open 24/7 and provides community based, emotional and practical support at times of crisis — to be set up in Dundee.

Phil told the Evening Telegraph: “Not until Lee died did I appreciate just how many men took their own lives.

“Lee’s death left our family heartbroken and we’re doing everything we can to stop this happening to other families.

“We would like to see a crisis centre set up in Dundee similar to the one in Edinburgh where people who feel suicidal can turn.”

The Tele previously told that Lee had battled mental health issues for almost a decade prior to his death.

Lee’s suicide prompted his parents to campaign for more action to help people with similar issues and following his death, the website Not in Vain for Lee was established.

He said: “If through this focus we can prevent one family from enduring the heartache we as a family are currently suffering, then Lee’s death will not have been in vain.”

Rob Burns, development manager of Dundee’s mental health service the Hearing Voices Network, said that the figures relating to men did not surprise him.

Mr Burns said men who have taken their own lives may not have spoken to anyone about the issues they are experiencing.

He added: “It is really quite frightening the number of people who take their own lives.

“We are very aware that up until now men have not been as willing to come forward to talk about their mental issues or other things that are concerning them as women have been.”

“I would think the men in Dundee who have taken their own lives have not previously spoken to anyone about their concerns.

“We are currently doing a lot of work to get men to open up, including taking on more male volunteer supporters.”

The majority of men — 64% — who took their own lives were also single, compared to just over 18% who were married or in a civil relationship.

The figures also revealed that 36 suicides took place within five years of discharge from a mental health service.

More on this story

https://www.eveningtelegraph.co.uk/fp/call-new-crisis-centre-dundee-help-folk-thinking-suicide/amp/?__twitter_impression=true

Britain loses medicines contracts as EU body anticipates Brexit

Britain’s leading role in evaluating new medicines for sale to patients across the EU has collapsed with no more work coming from Europe because of Brexit, it has emerged.

The decision by the European Medicines Agency to cut Britain out of its contracts seven months ahead of Brexit is a devastating blow to British pharmaceutical companies already reeling from the loss of the EMA’s HQ in London and with it 900 jobs.

All drugs sold in Europe have to go through a lengthy EMA authorisation process before use by health services, and the Medicines & Healthcare products Regulatory Agency (MHRA) in Britain has built up a leading role in this work, with 20-30% of all assessments in the EU.

The MHRA won just two contracts this year and the EMA said that that work was now off limits. “We couldn’t even allocate the work now for new drugs because the expert has to be available throughout the evaluation period and sometimes that can take a year,” said a spokeswoman.

In a devastating second blow, existing contracts with the MHRA are also being reallocated to bloc members.

Martin McKee, the professor of European health at the London School of Hygiene and Tropical Medicine, who has given evidence to select committees about Brexit, said it was a disaster for the MHRA, which had about £14m a year from the EMA.

The head of the Association of British Pharmaceutical Industry said it was akin to watching a “British success story” being broken up.

Mike Thompson, the chief executive of the association, said: “Clearly we’ve all been incredibly proud of the MHRA’s role over the last few years. They’d established themselves as one of the most respected regulators across all of Europe and industry. It’s been a British success story.”

The EMA said that because of the long lead-time involved in assessing medicines it could no longer award the lead contracts to British people since there was no guarantee they would be part of the EU after March 2019.

It is understood the MHRA bid for 36 EMA contracts this year but were only awarded two, and these were for drugs for which evaluation had already begun.

The situation is a stark contrast to 2016 when the UK was the lead assessor, known as the rapporteur, on 22 applications, and was joint lead or co-rapporteur on 19 multinational applications.

This made it the number one in Europe, with Germany’s regulator behind with 22 lead contracts but only 12 co-contracts.

…..

An MHRA statement said:

“We want to retain a close working partnership with the EU to ensure patients continue to have timely access to safe medicines and medical devices. This involves us making sure our regulators continue to work together, as they do with regulators internationally, and we would like to explore with the EU the terms on which the UK could continue to participate in the EMA.”

 

more on this story here

 

 

Tramadol: The most dangerous drug in the world

Over the years, as often happens, a difference between clinical trials and the real world started to emerge.

Imagine a prescription medication that relieves pain just as well as narcotics like Oxycontin, but isn’t addictive. Too good to be true?

Turns out, yes.

For years, that was the case with Tramadol, a synthetic opioid drug that was released in 1995 under the brand name Ultram to great expectations. This new drug seemed to offer all the benefits of more powerful, more addictive drugs, but with fewer of the downsides of dependency — at least in clinical trials. This was apparently in part because trials examined tramadol use by injection, but it is manufactured — and far more potent — in pill form.

And if the drug was unlikely to make people dependent, it was not likely to be abused, unlike other opioid alternatives like Vicodin (also known as Norco), Percocet — let alone be as dangerous as high potency opioid medications like morphine, Dilaudid, or Fentanyl.

So for many years, Tramadol was widely prescribed by doctors as a “safer” alternative to narcotics for pain. The difference between narcotics and opioids is subtle, but opioids are natural or synthetically made drugs that function metabolically in the body like opium derivatives derived from poppy plant, while narcotics is more often used as a legal term, classifying drugs that blur the senses and produce euphoria, including cocaine and other non-opiates.

Indeed, unlike other opioid drugs, the Drug Enforcement Agency didn’t classify Tramadol as a controlled substance, because the FDA believed it had a low potential for abuse.

Though there were concerns about tramadol abuse in the years after release, the FDA repeatedly determined that the drug was not being widely abused, and so left it as an unscheduled drug.
This made Tramadol a particularly dangerous drug — because it was, in fact, highly addictive and prone to abuse. But because it was easier to obtain and had less concerns from physicians, it was more widely prescribed. Over the years, as often happens, a difference between clinical trials and the real world started to emerge. Emergency rooms began to report a growing number of overdoses related to Tramadol ……..

full article here