Suicide girls on antidepressants banned in Britain

Rory Callinan
August 25, 2011
The Australian

TWO 16-year-old girls who hanged themselves while under the watch of Queensland's child safety officials had been prescribed antidepressants that have been linked to juvenile suicide and banned from use by young people in Britain.

Traces of the antidepressants were found during post-mortems conducted on the girls, yet the deaths were not reported to the drugs' manufacturer, Pfizer.

When told of the deaths by The Australian yesterday the company said it recommended that neither Venlafaxine nor Zoloft should be prescribed to juveniles who had depression, and it would immediately move to alert the Therapeutic Goods Administration about the deaths.

Friends Zoe Gough and Felicia Goodson hanged themselves within weeks of each other in Maryborough, on Queensland's central coast, despite concerns being raised by their mothers about Child Safety Services' failure to protect the girls.

The deaths of Zoe in April 2009 and Felicia a month later, revealed last Saturday by The Weekend Australian, have been cloaked in secrecy. The local coroner compiled a short report into the deaths but did not hold a public inquest and the Bligh government refused to comment on the cases.

Child psychiatrists yesterday expressed concern that the teenagers had been prescribed the drugs, as the Bligh government came under attack in parliament for not providing detailed information about the deaths.

Coroner's reports obtained by The Australian confirmed Felicia had traces of the "prescribed anti-depressant" Venlafaxine in her system when she died, and Zoe had been taking the anti-depressant Zoloft for a number of months prior to her death.

Zoloft and Venlafaxine have been banned for use by under-18s by the Medicines and Healthcare Products Regulatory Agency in Britain because of concerns they could increase the risk of suicide.

They can be prescribed to juveniles in Australia under the "off-label prescription" rules, but in 2004 Australia's Adverse Drug Reaction Advisory Committee warned that Venlafaxine and Sertraline (Zoloft) had been linked to an increased risk of suicide and self-harm among children and adolescents.

AADRAC also warned that any use should occur only with comprehensive management of the patient and include careful monitoring.

Zoe was taking Zoloft despite her history of self-harm, overdosing on painkillers and illicit drug use – even after she had been assisted by Child Safety Services officials to live in a residence with two very young children without a responsible adult present. Two months before her death, Zoe had been subject to a Child Safety Services care order effectively putting her under the supervision of government officials.

Felicia's death occurred after she had been denied foster care by Child Safety Services officials and had resorted to living on the streets in order to escape abuse.

Adelaide psychiatry professor Jon Jureidini said there were many reasons to be concerned about the prescription of such drugs to the girls.

"We should be very cautious about prescribing anti-depressants to young people in any circumstances and we should be doubly cautious when the medicine is not being properly supervised or we don't know what else these kids might be taking in the way of other drugs or whatever," Professor Jureidini said.

"Venlafaxine is not a drug that should be used in young people because it does seem to be a more risky drug than ordinary SSRIs (selective Seratonin re-uptake inhibitors)."

Venlafaxine has featured in suicide cases such as that of Perth newsreader Charmaine Dragun, who had been prescribed the drug among others prior to her death in 2007.

As recently as 2008 in Victoria, a mother sued a local doctor after her daughter tried to kill herself six times after being prescribed Zoloft. The mother received a confidential settlement.

This week Zoe's mother, Tracey-Lee McSweeney, told The Australian that on the day Zoe died the girl told her about forgetting to take her medication but having then made up for it by taking some more. She said she had not had control over her daughter as the department had taken over her daughter's care.

Queensland's Communities Department, which includes Child Safety Services, yesterday declined to comment, saying the girls' use of prescription drugs was "a medical matter and appropriately handled by doctors".

A spokesman refused to say how many of the 8025 children in Queensland who were in state care might be on such drugs or what, if any, policy was in place to ensure their medication was appropriately supervised.

A spokeswoman for Pfizer said: "We are now taking immediate steps to report these two adverse events, including notifying the TGA within 15 days in accordance with local regulations. We will also update our own global safety database within one business day."

This article appears on The Australian website at http://www.theaustralian.com.au/news/health-science/prescribed-anti-depressants-carried-risks-for-juveniles/story-e6frg8y6-1226121563444