Oseltamivir Does Not Increase Suicide Risk in Pediatric Population

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The authors intend to study other possible psychiatric side effects of oseltamivir in the future.
The authors intend to study other possible psychiatric side effects of oseltamivir in the future.

The use of oseltamivir, a treatment for influenza, does not appear to increase the risk of suicide in pediatric patients, according to a new study published in the Annals of Family Medicine.

In 2006, the Food and Drug Administration (FDA) made it a requirement for oseltamivir labeling to carry a warning about neuropsychiatric side effects based on case reports of abnormal behavior in adolescents. However, findings from studies examining the association between oseltamivir and neuropsychiatric events in children have been mixed and limited by sample size and potential confounding.

To investigate the relationship between oseltamivir and suicide in pediatric patients, researchers from the University of Illinois at Chicago College of Pharmacy analyzed 21,407 suicide-related events among 1 to 18 year old individuals using a national administrative claims database. Exposure to oseltamivir was ascertained through pharmacy dispensing. A case-crossover design was used (each individual was used as their own comparison) which the researchers hoped would minimize confounding.  

A total of 251 individuals (mean age of 15 years) who were involved in suicide-related events, were exposed to oseltamivir. For these subjects, the researchers set a case period of 10 days immediately before the suicide attempt and up to 4 earlier control periods of the same length, in the same flu season, to account for confounders. No association was found between oseltamivir exposure and suicide (odds ratio = 0.64; 95% CI, 0.39–1.00; =.05). 

Additionally, a separate analysis of flu diagnosis alone – without the use of oseltamivir – found that influenza itself was not associated with suicide (odds ratio = 0.63; 95% CI, 0.34–1.08; =.10).

The authors acknowledged that their study focused solely on suicide and they intend to study other possible psychiatric side effects of oseltamivir in the future. "I think physicians will welcome a large, rigorous study on this topic and factor this information into their decision-making process," said James Antoon MD, PhD, assistant professor of clinical pediatrics in the UIC College of Medicine and coauthor of the analysis.

Related

Harrington R, Adimadhyam S, Lee TA, et al. The relationship between oseltamivir and suicide in pediatric patients. Ann Fam Med. 2018 Mar;16(2):145-148.

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