1 Selective serotonin reuptake inhibitors (SSRI) – sales, withdrawal ...

It was not possible to use a systematic search strategy, which is in accordance with the document
analysis approach, as a qualitative research method. We have, apart from a general search strategy
described in the paper as figure 1, used a snowball method, by which references between documents
are used to identify further documents to include into the analysis.
In the analysis of the documents the focus was on the institutional context, the genre of the
document and the content. All the documents are given validity through their publication from a
public authority. With the publication of a document the authority is defining the reality and if the
definition should be challenged this would also challenge the authority.
This study is based on a not systematic document search in the drug authorities´ positioning with
regard to benzodiazepine dependence and SSRI withdrawal syndrome. It was not a possibility to
perform a systematic search and this is a limitation of this study. There might exist documents that
it was not possible to search or that the search strategy did not catch up.
Results
We identified 6 documents for the benzodiazepines and 23 documents for the SSRIs (table 1). All
documents are official and convey drug regulators’ positions, express one-way communication and
are authoritative. Public focus on SSRI withdrawal syndrome initiated a review process, during
which working groups were established in drug agencies, referring to each other in the documents.
Table 1
Description of the documents included in the study:
Benzodiazepines
Year Reference Citation Genre
1964 BMJ 1964, 31. October
List of substances especial liable to cause drugdependence:
Article in BMJ.
Drugs of addiction
Librium, chlordiaze-poxide
1980 Committee on the Review of Medicines (1980).
Systematic review of benzodiazepines. BMJ;280,
910-2.
However, following an extensive review of all
available data the committee concluded that, on the
present available evidence, the true addiction
potential of benzodiazepines was low. The number
dependent on benzodiazepines in the UK from
Systematic review
1980 Cirkulære om lægers ordination af
afhængighedsskabende lægemidler [Circular
1960 to 1977 has been estimated to be 28 persons.
[All mentioned groups of drugs can cause
addiction. The risk is greatest for morphine and
Circular – a law text
37