All those Japanese teenagers displaying abnormal behavior - such as trying to jump off balconies - after taking Tamiflu has one UK doc worried. And so Simon Maxwell, a University of Edinburgh senior clinical pharmacology lecturer, advises caution when prescribing the drug, despite guidance from the FDA that two suicides in Japan “were not clearly drug related”.

In an article in the British Medical Journal, he points out that Japanese health authorities belatedly issued guidance three months ago that Tamiflu could be connected to psychological problems in teenagers. Two 14-year-olds committed suicide by jumping to their deaths while receiving Tamiflu, which was previously regarded as “well-tolerated and safe,” and there have been more than 100 reports of neuro-psychiatric events among Japanese adolescents.

“There seems little doubt that (Tamiflu) reduces the number and seriousness of flu episodes when used as treatment and prophylaxis,” Maxwell writes. “However, the impact of such events in otherwise healthy people is usually modest and of short duration, so they should be encouraged to use conservative strategies such as resting, increasing fluid intake, and taking simple analgesics.”

He notes, however, that the FDA did officially require docs to be warned that patients should be monitored for signs of abnormal behaviour, a position later also adopted by the European Medicine Evaluation Agency. In the UK, the Roche drug is classified as a ‘black triangle’ drug, meaning it remains under intensive surveillance.

“In people at higher risk of serious complications the potential benefit of treatment seems greater, although convincing evidence about reductions in hospital admission or mortality is still awaited,” Maxwell concludes. “In these groups, vaccination still offers a cost-effective first line of defence.”

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