Oseltamivir does not increase suicide risk in children, adolescents

Issue: April 2018

Patients aged younger than 18 years who took oseltamivir were not at higher risk for suicide despite a warning in the package insert, according to findings recently published in Annals of Family Medicine.

“Prior U.S. observational studies of a link between oseltamivir and suicide have examined older data (through the early 2000s) or a single influenza season, and have included suicide only as a secondary outcome,” Rachel Harrington, a PhD candidate at the University of Illinois at Chicago College of Pharmacy, and colleagues wrote. “Moreover, these studies’ designs were unable to account for important clinical and sociodemographic variables, suggesting that findings may have been influenced by unmeasured confounding.”

The researchers looked at Truven MarketScan Commercial Claims and Encounters data from children aged 1 to 18 years during the 2009-2013 influenza seasons. Exposure to oseltamivir was determined by looking at patients’ pharmacy records.

Harrington and colleagues found that of 21,407 suicide-related events, 251 were in patients who had been exposed to oseltamivir. Case-crossover analysis showed no significant link between suicide and receiving an influenza diagnosis alone (OR = 0.63; 95% CI, 0.34-1.08) or receiving oseltamivir (OR = 0.64; 95% CI, 0.39-1).

The findings of the study did not change in sensitivity analyses, the researchers said.

“This result is consistent with those from previous studies that used different study designs, and contrasts with the warning in the package insert. The association for influenza-only exposure was of similar direction and magnitude as that for oseltamivir exposure, suggesting no confounding by indication of underlying influenza,” Harrington and colleagues wrote. – by Janel Miller

Reference:
Harrington R, et al. Ann Fam Med. 2018;doi:10.1370/afm.2183.

Disclosures: The authors report no relevant financial disclosures.