BMJ  2007;334:1232-1233 (16 June), doi:10.1136/bmj.39240.497025.80

Editorials

Tamiflu and neuropsychiatric disturbance in adolescents

The case is not proved but caution is advisable

The first 150 words of the full text of this article appear below.

In March 2007 the Japanese authorities advised against prescribing oseltamivir (Tamiflu, Roche) to adolescents aged 10-19 years.¹ This unusually severe measure resulted from the separate suicides of two 14 year olds who jumped to their deaths while taking oseltamivir; 52 other deaths (14 in children or adolescents) have been associated with the same drug. So far, similar action has not followed in Europe. When a regulatory authority warns doctors not to prescribe a drug but decides not to retract its marketing authorisation prescribers and patients are entitled to be concerned and a little confused.

Oseltamivir is a sialic acid analogue that inhibits influenza type A and type B neuraminidase, the viral enzyme that allows the release of virus from infected cells. Its main licensed indications are the treatment of flu, short term postexposure prophylaxis after contact with a diagnosed case of flu, and more prolonged (up to six weeks) "seasonal" . . . [Full text of this article]

Clinical Pharmacology Unit, University of Edinburgh, Queen's Medical Research Institute, Edinburgh EH16 4TJ

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• Izumi, Y, Tokuda, K, O'Dell, K., Zorumski, C., Narahashi, T (2008). Synaptic and behavioral interactions of oseltamivir (Tamiflu) with neurostimulants. Hum Exp Toxicol 27: 911-917 [Abstract]  
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Fifty sudden deaths are more serious reactions probably related to CNS suppressive action of Tamiflu (oseltamivir phosphate)

Rokuro Hama
bmj.com, 21 Jun 2007 [Full text]

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