Intended for healthcare professionals

Rapid response to:

News Roundup [abridged Versions Appear In The Paper Journal]

Regulator restricts use of SSRIs in children

BMJ 2005; 330 doi: (Published 28 April 2005) Cite this as: BMJ 2005;330:984

Rapid Response:


We welcome the BMJ’s recognition that reporting ongoing safety
concerns regarding medications in children, especially the use of
unlicensed medications in this group, is a priority, however we feel it
important to address some inaccuracies in the article, as this may have a
detrimental effect on clinician decision-making and patient compliance.

Atomoxetine does not increase the risk of suicide related behaviours.
The article suggests that atomoxetine is included in a group of medicines
that demonstrate a higher incidence of suicidality. This statement is
incorrect with regard to atomoxetine as recognised in question 4 of the
European Medicines Agency's (EMEA) review of antidepressants in children
and adolescents, reported in their press release of 25th April 2005
( It is correct
that atomoxetine has a potentially increased risk of hostility and
emotional lability.

The article suggests that atomoxetine is an antidepressant; this is
incorrect. Atomoxetine demonstrates no antidepressant activity as is
recognised by the EMEA Q&A document. It has undergone a comprehensive
clinical trial progam in children and adolescents that has established its
efficacy and safety in a paediatric population. Atomoxetine is licensed as
a treatment for attention deficit hyperactivity disorder (ADHD)in children
and adolescents.

The article classifies atomoxetine as an SSRI or SNRI; this is
incorrect. Atomoxetine has activity only at the pre-synaptic
norepinephrine (noradrenaline) transporter and is in keeping with the
description of the pharmacological action of atomoxetine as described in
its Summary of Product Characteristics

It is important to clarify these points, specifically noting that
atomoxetine is licensed only for the treatment of ADHD, and shows no
increase in the rate of suicide related behaviours: these are important
amendments to make as the BMJ website is accessed by many patients and
carers, and inaccurate information may lead to inappropriate and premature
withdrawal of the medication with potentially detrimental effects on
patient care.

Competing interests:
Dr Suyash Prasad is a full time employee of Eli Lilly and Co

Competing interests: No competing interests

05 May 2005
Suyash Prasad
Paediatrician and Clinical Research Physician
Eli Lilly and Co Ltd, Lilly House, Priestley Rd, Basingstoke, Hampshire, RG24 9NL