Editorials

Tamiflu and neuropsychiatric disturbance in adolescents

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39240.497025.80 (Published 14 June 2007) Cite this as: BMJ 2007;334:1232
  1. Simon R J Maxwell, senior lecturer
  1. Clinical Pharmacology Unit, University of Edinburgh, Queen's Medical Research Institute, Edinburgh EH16 4TJ
  1. s.maxwell{at}ed.ac.uk

    The case is not proved but caution is advisable

    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” prophylaxis when flu is circulating in the community. The licence was extended in 2005 to include …

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