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

http://www.mhra.gov.uk/home/groups/l-csel/documents/committeedocument/con003341.pdf
2000 European Medicines Agency (1999/2000).
EMEA/CPMP/2775/99.
2000 Medicines Control Agency, Committee
on Safety of Medicines (2000). Current
problems in pharmacovigilance,
association with
benzodiazepines but that these
features were not evident in
patients taking SSRIs.
The material provided by the
pharmaceutical companies
with regard to dependence and
withdrawal of SSRIs is of
variable quality and quantity.
For the majority of the
compounds the studies were
not designed to study
withdrawal phenomena and
lack sufficient observations in
the critical period after
stopping administration.
In 1993 we alerted prescribers
to the possibility of
withdrawal reactions
occurring with paroxetine.
Whilst the withdrawal
symptoms reported were
generally not serious, there
have been isolated reports of
more serious symptoms on
withdrawal such as severe
electric shock sensations,
vertigo and manic reactions.
2000 EMEA CPMP 2278/00 Some of the SSRIs have been
shown to reduce intake of
addictive substances like
cocaine and ethanol. The
interpretation of this aspect is
difficult.
2002 Tonks A. (2002). Withdrawal
from paroxetine can be severe,
warns FDA.
British Medical Journal, 324, 260.
2002 MHRA response to Panorama
programme on Seroxat
2002 Ad Hoc Expert Meeting 21 November
on the safety of SSRIs
2003 DKMA Danish Medicines Agency
(19 June 2003). Summary of Product
Characteristics for Serorex
(paroxetine)
http://www.produktresume.dk/docushare/dsweb/Get/Document-
14813/Serorex%2C+filmovertrukne+tabletter+20+mg.doc
FDA Warning against
paroxetine because of the risk
of withdrawal symptoms.
All SSRIs may be associated
with withdrawal reactions on
stopping but they are not
drugs of dependence.
The Group did not consider
that withdrawal reactions and
dependence were
synonymous. The Group did
not consider that SSRIs
caused dependence.
[Though abstinence reactions
can occur at discontinuation,
all preclinical and clinical data
do not indicate that SSRIs
cause dependence]
Position paper
Article in the
bulletin sent out
from the MCA to
doctors,
pharmacists,
dentists and
coroners
News in BMJ
Safety message
Minutes
SPC
2003 DKMA Lægemiddelstyrelsen (2003).
Antidepressive midler under vurdering
(Antidepressants under assessment).
2003 Meeting of the CSM Expert group on
the safety of SSRIs held on
Tuesday 22nd July.
[It is important to emphasize
that it is about discontinuation
symptoms and not actual
dependence to the drugs.]
The group commented that it
was a challenge to
disseminate the information
[about withdrawal reaction] in
Article to the
public because of
media referring to
problems with the
antidepressants.
Minutes
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