Study debunks fears of increased teen suicide risk from popular flu drug

March 13, 2018, University of Illinois at Chicago

A new study published by researchers from the University of Illinois at Chicago suggests that the drug oseltamivir—commonly known as Tamiflu—does not cause an increased risk of suicide in pediatric patients.

The U.S. Food and Drug Administration originally approved the drug in 1999, but subsequent case reports of abnormal behavior in adolescents who used the medication led the agency in 2006 to require that all packaging of the drug include a warning label about potential neuropsychiatric side effects, such as hallucinations, delirium, self-harm and even .

However, clinical studies examining the association between the use of Tamiflu and neuropsychiatric side effects in children, including suicide, have so far been inconclusive and limited by methodology and potential confounding factors.

"When the FDA puts a warning out about a drug, doctors and the public take notice," said corresponding author Dr. James Antoon, assistant professor of clinical pediatrics in the UIC College of Medicine. "While the warnings are necessary, they are often not based on conclusive clinical data, which can make it difficult for physicians to truly know the potential side effects of a drug as they evaluate its possible benefits for individual patients."

To fill this gap, Antoon and his colleagues in the UIC College of Pharmacy retrospectively studied the association between the use of Tamiflu—the only commercially available medication approved by the FDA to treat the flu—and the most consequential of those reported side effects: suicide.

"The potential link between a drug and suicide is a particularly difficult topic to study," Antoon said. "Many events, which can happen simultaneously or over time, can influence a person to attempt suicide, as can an illness itself—so it can be difficult to study scientifically.

"That's why we used a novel method called a case-crossover design," Antoon said. "This analysis is different because it allowed us to use each individual subject as his or her own comparison—we retrospectively studied how patients behaved when on Tamiflu and compared it to their behavior when they were not taking the drug."

The researchers identified 21,047 children between the ages of 1 and 18 who attempted suicide during five recent flu seasons (2009-2013) from a national administrative claims database. Of this group, 251 of those children were exposed to Tamiflu, which was determined based on outpatient pharmacy dispensing data. The mean age of this group was 15 years, 61 percent were female, and 65 percent had an underlying diagnosis.

"For each of the 251 patients, we assigned the 10-day period immediately before the suicide attempt as the case period and we identified up to four earlier control periods of the same length, in the same flu season," Antoon said. "This helped us to account for within-person confounders, like depression, mental health, trauma and abuse, and other factors, like race or ethnicity."

The researchers repeated the analysis with flu diagnosis alone, without the use of Tamiflu, to see if the infection itself could have been a confounding factor associated with suicide risk.

"We did not find any association between exposure to Tamiflu and suicide in ," Antoon said.

While Antoon believes the findings, which are published in the Annals of Family Medicine, will help to alleviate some fears health care providers may have about prescribing the medication in healthy children, he says doctors will likely continue to prescribe Tamiflu with caution.

"I think physicians will welcome a large, rigorous study on this topic and factor this information into their decision-making process," he said. "While this study addresses suicide, there are still many other questions about other possible neuropsychiatric side effects of the drug, which we plan to study in the future. There are also other reasons to use caution when prescribing the , including resistance and efficacy in children."

Explore further: FDA approves first generic version of tamiflu

More information: Rachel Harrington et al, The Relationship Between Oseltamivir and Suicide in Pediatric Patients, The Annals of Family Medicine (2018). DOI: 10.1370/afm.2183

Related Stories

FDA approves first generic version of tamiflu

August 8, 2016
(HealthDay)—The first generic version of the flu medication Tamiflu has been approved by the U.S. Food and Drug Administration.

Suicide attempts on the rise in US, finds study

September 13, 2017
New data confirm that suicide attempts among U.S. adults are on the rise, with a disproportional effect on younger, socioeconomically disadvantaged adults with a history of mental disorders. The study, by researchers at Columbia ...

Broader firearm restrictions needed to prevent suicide deaths

July 4, 2017
Limiting firearm access only for persons with a mental health condition or those who previously attempted suicide likely is not enough to reduce suicide deaths. The brief research report is published in Annals of Internal ...

Risk of suicide attempts in army units with history of suicide attempts

July 26, 2017
Does a previous suicide attempt in a soldier's U.S. Army unit increase the risk of other suicide attempts?

Asthma drug tied to nightmares, depression

September 20, 2017
(HealthDay)—The asthma medication Singulair (montelukast) appears linked to neuropsychiatric side effects, such as depression, aggression, nightmares and headaches, according to a new review by Dutch researchers.

AAP: doctors should screen teens for suicide risk factors

June 29, 2016
(HealthDay)—Suicide is the second leading cause of death among U.S. teens, and health care providers should screen teen patients for suicide risks, according to a report published online June 27 in Pediatrics.

Recommended for you

A bad mood may help your brain with everyday tasks

July 18, 2018
New research found that being in a bad mood can help some people's executive functioning, such as their ability to focus attention, manage time and prioritize tasks. The same study found that a good mood has a negative effect ...

Depression-induced inflammation during pregnancy may impact newborns

July 18, 2018
The physiological impacts of depression on pregnant mothers may affect babies while in the womb and lead to changes in the behaviour and biology of newborns, finds new King's College London research.

Depression during pregnancy rises in a generation

July 18, 2018
Anxiety and depressive symptoms during pregnancy have risen by 51 per cent within a generation according to findings from a major study by the University of Bristol published last week [Friday 13 July].

Forty percent of people have a fictional first memory, says study

July 17, 2018
Researchers have conducted one of the largest surveys of people's first memories, finding that nearly 40 per cent of people had a first memory which is fictional.

Researchers explore how information enters our brains

July 17, 2018
Think you're totally in control of your thoughts? Maybe not as much as you think, according to a new San Francisco State University study that examines how thoughts that lead to actions enter our consciousness.

Celebrating positives improves classroom behavior and mental health

July 17, 2018
Training teachers to focus their attention on positive conduct and to avoid jumping to correct minor disruption improves child behaviour, concentration and mental health.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

grandpa
1 / 5 (1) Mar 13, 2018
My guess is that the loss of incandescent lights and outdoor light contributes significantly to social problems.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.