Plea for suicide alert on anti-depressants
The call has been made by Nelson coroner Ian Smith.
He is concerned the casual prescription of the drugs, coupled with ineffective mental-health treatment, was related to the suicides of at least four men in Nelson last year.
Pharmac figures show more than 600,000 prescriptions for new generation SSRI (selective serotonin reuptake inhibitors) anti-depressants were issued to New Zealanders last year at a cost of more than $27 million.
This was up from around 50,000 prescriptions in 1993.
Commonly prescribed SSRI medications include Prozac (Fluoxetine), Aropax (Paroxetine), Cipramil (Citalopram), Zoloft (Sertraline) and Luvox (Fluroxamine).
Pharmac medical director Peter Moodie said the increased use of SSRIs was because they had fewer side-effects.
There was also greater awareness of depression, and thus greater use of anti-depressants, he said.
Pharmac had no reason to be concerned at the use of SSRI medication, but the coroner's comments should be taken seriously and all clinicians needed to review how they handled patients with depression, he said.
Dr Stewart Jessamine, of Medsafe, said the Medicines Adverse Reactions Committee recommended new warnings go on antidepressant data sheets in 2004 to indicate possible increased suicide risks and the need to closely monitor patients.
Although there was some increased risk for some adults taking SSRIs the overall benefits outweighed the risks, he said.
The coroner's recommendations came in his finding into the self-inflicted death of David Stringer, 37, who died last January.
He said he was concerned that the theory behind SSRI treatment - that the drugs restore normal mood by allowing neurotransmitters to accumulate in the spaces between brain cells - was too simplistic.
He said he was worried the drugs were too casually prescribed and too widely used.