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21 Jun 2004 : Column 1265W—continued
Anti-depressants
Paul Flynn: To ask the Secretary of State for Health if he will encourage manufacturers of selective serotonin reuptake inhibitors and related drugs now under review to introduce dosage forms of tablets no stronger than one-quarter of the present recommended dose. [178294]
Ms Rosie Winterton:
A number of selective serotonin reuptake inhibitors (SSRIs) are available in liquid formulations to enable flexible titration of the dose. Any advice to manufacturers about the need for new dosage strengths or forms for the SSRIs will be decided on the outcome of the review of the Committee on Safety of Medicines' expert working group.
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Paul Flynn: To ask the Secretary of State for Health (1) whether the current review of selective serotonin reuptake inhibitors and related anti-depressants will examine the risks of drug-induced suicidal behaviour for elderly users; [178296]
(2) what conclusion the current review of selective serotonin reuptake inhibitors and related anti-depressants has reached on whether, irrespective of presumed benefits, the risks of drug-induced suicidal behaviour are different for young adults than for children; [178297]
(3) whether the current review of selective serotonin reuptake inhibitors and related anti-depressants will examine the risks of drug-induced suicidal behaviour in all representative age groups; [178298]
(4) what assessment he has made of whether the risk of suicidal behaviour induced by selective serotonin reuptake inhibitors and related drugs is an age-related adverse effect. [178299]
Ms Rosie Winterton: The Committee on Safety of Medicines' (CSM) expert working group on selective serotonin reuptake inhibitors (SSRIs) advised in December 2003 that paroxetine, venlafaxine, sertraline, citalopram and escitalopram should not be used in children and young people under 18 years because of a lack of benefit in this patient population and an increased risk of adverse events including suicidal behaviour.
The recently completed Europe-wide review of the safety of paroxetine, led by the United Kingdom and the Netherlands, has delivered advice on the need for careful monitoring during paroxetine treatment of patients at risk of suicidal behaviour, including those with a history of suicidal behaviour and young adults.
The expert working group has yet to complete its review of all the evidence relating to a possible increased risk of suicidal behaviour associated with SSRIs. It includes among its membership clinical expertise in the treatment of depression in all age groups including the elderly.
Paul Flynn: To ask the Secretary of State for Health if he will investigate the relationship between obesity and anti-depressant drug consumption. [178302]
Ms Rosie Winterton: As with all medicines, the Medicines and Healthcare products Regulatory Agency (MHRA) and Committee on Safety of Medicines (CSM) continually monitor the safety of antidepressants. Both weight loss and weight gain have been reported in association with most selective serotonin reuptake inhibitors (SSRIs) and this is reflected in the product information for prescribers and patients. The MHRA and CSM are not aware of evidence linking SSRIs or other antidepressants specifically with obesity.
Tim Loughton:
To ask the Secretary of State for Health (1) whether the review of selective serotonin reuptake inhibitor and related anti-depressants will examine the risks of drug-induced suicidal behaviour (a) for elderly users and (b) in all age groups; and what assessment it has made of the level of risk of drug-induced suicidal behaviour for young adults; [178333]
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(2) what research he has conducted on whether the risk of suicidal behaviour induced by selective serotonin reuptake inhibitor and related drugs is an age-related adverse effect. [178334]
Ms Rosie Winterton: The Committee on Safety of Medicines' (CSM) expert working group on selective serotonin reuptake inhibitors (SSRIs) advised in December 2003 that paroxetine, venlafaxine, sertraline, citalopram and escitalopram should not be used in children and young people under 18 years because of a lack of benefit in this patient population and an increased risk of adverse events including suicidal behaviour.
The recently completed Europe-wide review of the safety of paroxetine, led by the United Kingdom and the Netherlands, has delivered advice on the need for careful monitoring during paroxetine treatment of patients at risk of suicidal behaviour, including those with a history of suicidal behaviour and young adults.
The expert working group has yet to complete its review of all the evidence relating to a possible increased risk of suicidal behaviour associated with SSRIs. It includes among its membership clinical expertise in the treatment of depression in all age groups including the elderly.
Mr. Burstow: To ask the Secretary of State for Health if he will assess possible links between anti-depressant drug consumption and obesity. [178440]
Ms Rosie Winterton: I refer the hon. Member to the reply I gave to my hon. Friend, the Member for Newport West (Mr Paul Flynn), above.
Mr. Burstow: To ask the Secretary of State for Health if he will make it his policy to encourage manufacturers of selective serotonin reuptake inhibitors and related drugs now under review to introduce dosage forms of tablets no stronger than one-quarter of the present recommended dose. [178521]
Ms Rosie Winterton: I refer the hon. Member to the answer I gave to my hon. Friend the Member for Newport, West (Paul Flynn), above.
Mr. Burstow: To ask the Secretary of State for Health (1) whether research indicates that the risk of suicidal behaviour induced by selective serotonin reuptake inhibitors and related drugs is an age-related adverse effect; [178564]
(2) whether the current review of selective serotonin reuptake inhibitors and related anti-depressants will examine the risks of drug-induced suicidal behaviour for elderly users; [178569]
(3) what conclusion the current review of selective serotonin reuptake inhibitors and related anti-depressants has reached on whether, irrespective of presumed benefits, the risks of drug-induced suicidal behaviour are different for young adults than for children; [178570]
(4) whether the current review of selective serotonin reuptake inhibitors and related anti-depressants will examine the risks of drug-induced suicidal behaviour in all representative age groups. [178571]
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Ms Rosie Winterton: The Committee on Safety of Medicines' (CSM) expert working group on selective serotonin reuptake inhibitors (SSRIs) advised in December 2003 that paroxetine, venlafaxine, sertraline, citalopram and escitalopram should not be used in children and young people under 18 years because of a lack of benefit in this patient population and an increased risk of adverse events including suicidal behaviour.
The recently completed Europe-wide review of the safety of paroxetine, led by the United Kingdom and the Netherlands, has delivered advice on the need for careful monitoring during paroxetine treatment of patients at risk of suicidal behaviour, including those with a history of suicidal behaviour and young adults.
The expert working group has yet to complete its review of all the evidence relating to a possible increased risk of suicidal behaviour associated with SSRIs. It includes among its membership clinical expertise in the treatment of depression in all age groups including the elderly.
Tim Loughton: To ask the Secretary of State for Health if he will encourage manufacturers of selective serotonin reuptake inhibitor and related drugs now under review to introduce dosage forms of tablets no stronger than one-quarter of the present recommended dose. [178341]
Ms Rosie Winterton: I refer the hon. Member to the reply I gave to my hon. Friend, the Member for Newport, West (Paul Flynn), above.
Tim Loughton: To ask the Secretary of State for Health if he will investigate a possible relationship between obesity and anti-depressant drug consumption. [178342]
Ms Rosie Winterton: I refer the hon. Member to the reply I gave to my hon. Friend, the Member for Newport, West (Paul Flynn), above.
Tim Loughton: To ask the Secretary of State for Health for what reasons the manufacturers of Seroxat were permitted to market that product in a 30mg tablet size. [178343]
Ms Rosie Winterton: Paroxetine is licensed in the dose range 10–60 milligrams (mg.), depending on the indication. The recommended starting dose for all indications is 20 mg. and this was the subject of a reminder to prescribers in March 2004. Clinical experience is that some patients not responding to the recommended dose may benefit from having their dose increased. Changes in dosage should be made progressively according to individual response both at the beginning of treatment and at the end of treatment. The 30mg. tablet allows for flexibility in titration within the licensed dose range.
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