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Paul A. Kurdyak, MD, David N. Juurlink, MD, PhD and Muhammad M. Mamdani, MPH, PharmD

Paul A. Kurdyak is with the Centre for Addiction and Mental Health, Toronto, Ontario, and the Insitute for Clinical Evaluative Sciences, Sunnybrook Health Science Centre, Toronto. David N. Juurlink and Muhammad M. Mamdani are with the Institute for Clinical Evaluative Sciences, Sunnybrook Health Science Centre, Toronto.

Correspondence: Requests for reprints should be made to Dr. Paul A. Kurdyak, Centre for Addiction and Mental Health, 33 Russell Street T311, Toronto, Ontario, Canada, M5S 2S1 (e-mail: paul_kurdyak{at}camh.net).

Objectives. We studied whether 5 regulatory agency advisories concerning the possible increased risk of suicidal behavior during antidepressant therapy had an effect on antidepressant prescription trends in Ontario.

Methods. We conducted a population-based, time-series analysis of new monthly antidepressant prescriptions dispensed by the Ontario Drug Benefits program in 3 age groups (younger than 20 years, 20–65 years old, and older than 65 years) over a 7-year period (April 1998 to March 2005). The impact of five advisories about the possible risk of suicide during antidepressant therapy was also analyzed.

Results. The number of new prescriptions for selective serotonin reuptake inhibitors as a group did not change after any antidepressant warning in any age group. However, the rate of new paroxetine prescriptions in patients younger than 20 years declined by 54% immediately after the first warning for paroxetine was issued in the United Kingdom in June 2003. That same warning had no effect on new paroxetine prescriptions in the other age categories.

Conclusion. The warning about paroxetine use in depressed patients younger than 18 years that was issued in the United Kingdom led to a significant decrease in new paroxetine prescriptions for young patients in this country. By contrast, warnings in North America did not influence new antidepressant prescription rates in any patient group.

This article has been cited by other articles:

				L. Y. Katz MD, A. L. Kozyrskyj PhD, H. J. Prior MSc, M. W. Enns MD, B. J. Cox PhD, and J. Sareen MD Effect of regulatory warnings on antidepressant prescription rates, use of health services and outcomes among children, adolescents and young adults Can. Med. Assoc. J., April 8, 2008; 178(8): 1005 - 1011. [Abstract] [Full Text] [PDF]

				M. M. Mamdani PharmD MPH Health advisories: when good intentions go bad Can. Med. Assoc. J., April 8, 2008; 178(8): 1025 - 1026. [Full Text] [PDF]

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