Kedgley Sue: Questions for Oral Answer — Questions to Ministers 
Kedgley Sue: Questions for Oral Answer — Questions to Ministers 
[Volume:616;Page:11916] 
8.  
SUE KEDGLEY (Green) 
 to the  
Associate Minister of Health 
: When was he first advised that some antidepressant drugs can trigger dangerous side effects such as suicidal thoughts in adolescents? 
Rodney Hide 
: That was 2 years ago! 
Mr SPEAKER 
: That is Mr Hide’s final warning. The member had started the question. 
Hon JIM ANDERTON (Associate Minister of Health) 
: 
 Neither I as Associate Minister nor the Minister of Health has been briefed although there is nothing unusual in that. But I am advised that Medsafe’s expert advisory committee on medicine safety—the Medicines Adverse Reactions Committee—has been reviewing data on the safety of antidepressants in particular the selective serotonin reuptake inhibitor known as SSRI antidepressants since June 2003. 
Sue Kedgley 
: Will the Government be following the example of the British Government now that it has this information in stopping general practitioners from prescribing most of these SSRI antidepressants for adolescents and children because these drugs have been shown to have few if any beneficial effects and considerable risks; if not why not? 
Hon JIM ANDERTON 
: I can advise the member and the House that the UK has not banned these drugs. Rather it has contra-indicated or in normal language strongly warned against the use of them in children under 18 with major depressive disorders. The products are still on the market and doctors can still use them at their own discretion. Contra-indication is a warning not a ban. Doctors here are being warned against the use of SSRIs without specialist advice. Similarly the United States and Australia have also issued statements and a warning to doctors but no attempt has been made to ban continued prescribing. 
Steve Chadwick 
: What action has been taken in relation to advising prescribers of these drugs? 
Hon JIM ANDERTON 
: As information on particular SSRIs showed in 2003 that they should not be used in the treatment of children with major depressive disorder—that is those under 18—letters were sent to doctors at that time. When the UK Committee on Safety of Medicines strongly warned against the use of all but one SSRI in children under 18 in December 2003 the Medicines Adverse Reactions Committee in New Zealand reviewed the UK reports. Based on that review Medsafe issued advice this month to doctors that the risk was in its view still unclear and further data was being sought but that doctors should only consider using the products for adolescents on the advice of psychiatric specialists. 
Dr Lynda Scott 
: As these drugs have become more widely available in the last 4 years why do we not have updated data on suicide rates—the last data being available for 1999-2000—to compare whether New Zealand still has the second-highest rate of suicide for males and the fourth-highest rate for females in the OECD? 
Hon JIM ANDERTON 
: There are two separate issues really—one is the reporting of suicides. This is a complex issue because our suicide statistics are among the most accurate in the world and depend on reports from coroners’ inquiries inquests and so on. The latest reports will be released next month which will take us up to 2001. That is far too long and this Government has taken steps to improve the coroner’s position in New Zealand and to professionalise it further and to improve through a variety of electronic means data records and the way in which we report. 
 The second issue really is about the impact of these drugs on suicide and as the member almost certainly knows suicide is a very complex issue and cannot be pinned on one or other cause. If it could be most of us would be very happy to see that solution followed. 
Barbara Stewart 
: Does he believe that rather than focusing solely on the drugs themselves those who have the authority to prescribe these drugs also need to be scrutinised with a move towards limiting this authority to mental health experts rather than local general practitioners who are currently freely able to prescribe such drugs? 
Hon JIM ANDERTON 
: I think we have to be careful not to jump to conclusions. One of the reasons that drug use in this area has increased is that there has been an improved diagnosis of depression in adolescents. Most of us of a vintage age can recall when this was probably not recognised by anybody. Now that it is recognised there are modern drugs available—and these drugs that we are talking about are modern drugs. They are better than the drugs of say 10 years ago. Counselling and one-on-one discussion is still the front-line treatment for this kind of illness in adolescents but drug therapy is there and on advice—in the case of these particular drugs it is suggested to general practitioners that it be on advice of specialists—it is a back-up treatment that is obviously being more used by general practitioners now because of the nature of the new drugs that are available. 
Judy Turner 
: When was he first advised of dangerous side effects such as harm to the central nervous system neurotoxicity cognitive decline psychosis exacerbation of schizophrenia in vulnerable individuals and damage to the respiratory immune and cardiovascular systems from cannabis use by adolescents and is he surprised that the Greens do not support the banning of this drug? 
Hon JIM ANDERTON 
: I do not unless I request specific advice get that kind of advice from committees quasi-Government committees that are set up with professionals to examine these kinds of issues. That is why Ministers do not normally get briefings or advice—because these committees act on the information and professional advice that comes through the literature and through the experience of doctors and they act independently of the Government. It would be only on request or if a change of policy were indicated that Ministers would be informed or involved. 
Sue Kedgley 
: Does it concern the Minister that recent evidence shows that Glaxo Smith Kline the manufacturer of the antidepressant Aropax knew as long ago as 1998 that Aropax had no beneficial effect on children with depression but held back its data in order to “minimise any negative commercial impact” and would the Government have acted earlier if it had had access to that data? 
Hon JIM ANDERTON 
: The Government sets up these specialist committees so that the best information and the best advice can be followed in the use of these drugs and in the advice to doctors and clinicians and so on. I can say that I regret reading the press release of the Green Party on this matter where there is some suggestion that the Government or its advisers is following this course of action only because it wants to protect drug companies. That is outrageously wrong and I suggest that the facts should actually be checked out a lot more clearly by the Greens before they issue such releases. 
Sue Kedgley 
: Does the Associate Minister agree that consumers as well as doctors have a right to know the side effects of these drugs and will the Government therefore be warning the thousands of unsuspecting New Zealand parents whose children are taking these drugs unaware of the potentially serious side effects of them? 
Hon JIM ANDERTON 
: Yes of course I do agree that patients ordinary New Zealanders and others need to know and have a right to know the side effects. They are usually quite complex—and there are side effects from everything. I suggest to the member that this applies both to chemical drugs and natural remedies as well. 
Sue Kedgley 
: Does the Minister consider that an acceptable way to treat depressed children in New Zealand is for Glaxo Smith Kline to suppress the information about the lack of beneficial effects of Aropax on children while general practitioners were prescribing Aropax to children presumably in complete ignorance of the true data? 
Hon JIM ANDERTON 
: Politicians are well advised to rely on specialist advice in those areas; they are complex. If anyone wants to stand up in this House or anywhere else in New Zealand to propose themselves as experts on depression and suicide they should take a 7-year course in it before they even begin. 
Sue Kedgley 
: I seek leave to table an internal document from Glaxo Smith Kline that shows that the company was not intending to table negative data. 
Document by leave laid on the Table of the House.