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Tamiflu does not increase suicide risk in children, adolescents

Patients aged younger than 18 years who took oseltamivir were not at higher risk for suicide despite packaging indicating so, 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, BA, PhD candidate, 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.”

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

Harrington and colleagues found that of the 21,407 suicide-related events studied, 251 were in patients who had been exposed to oseltamivir. Case-crossover analysis showed no significant link with suicide either for 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).

“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.

“The findings of our study did not change in the sensitivity analyses. Although we found a statistically significant reduction in risk with some alternative case and control time periods, results should be interpreted with caution,” researchers continued. “For instance, the 15-day window analysis of oseltamivir, although biologically plausible, extends the drug’s effect duration to its extreme. This extension may lead to an exaggeration of the effect due to misclassification of the case period as ‘exposed.’” – by Janel Miller

Disclosure: The authors report no relevant financial disclosures.

Patients aged younger than 18 years who took oseltamivir were not at higher risk for suicide despite packaging indicating so, according to findings recently published in Annals of Family Medicine. Source: Shutterstock.