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Care urged on drug linked to child suicide

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Doctors and parents have been warned to closely monitor the health of children taking the hyperactivity drug atomoxetine, which has been linked to the suicide of a boy and suicidal thoughts in dozens of other youngsters.

The medicines watchdog said it had received reports of 74 psychiatric disorders associated with the use of atomoxetine, including 42 instances of suicidal thoughts – more than half of them in children – resulting in two suicide attempts and one death by suicide.

“The risks of suicidal ideation and behaviour with atomoxetine are well known,” the Therapeutic Goods Administration said. “Health professionals should carefully weigh the risks against the benefits of atomoxetine therapy, and patients should be carefully monitored for [suicidal thinking and behaviour], especially in the first few months of treatment and whenever there is a change in dose.”

A TGA spokesman said the risk of suicidal thoughts and behaviour among those taking atomoxetine – prescribed to treat attention deficit hyperactivity disorder (ADHD) – was low, and could be minimised by appropriate clinical treatment.

“The TGA’s assessment is that the benefits of the medication continue to outweigh the risks,” the spokesman said.

The decision by the watchdog to issue the safety reminder has reignited concerns about the extent to which children displaying hyperactive behaviours are being medicated, with claims of a rapid increase in doctors resorting to drugs to alter the behaviour of children.

The Sydney Morning Herald has published data from the Department of Health and Ageing purporting to show that the number of children taking ADHD medication has almost doubled in the past eight years, from 35,000 in 2005 to 69,000 last year.

But the TGA warned caution should be exercised in interpreting the figures, explaining that they were likely to include instances of double-counting of patients if they took more than one medicine in a year.

The TGA spokesman said an analysis of medication rates for ADHD undertaken by a sub-committee of the Pharmaceutical Benefits Advisory Board had found there had been “a small but steady increase” in the prescription of drugs to treat ADHD through the Pharmaceutical Benefits Scheme in recent years.

The TGA said a copy of the report would be released by the end of the year.

Adrian Rollins