ANTIDEPRESSANTS 'ARE AS ADDICTIVE AS TRANQUILLISERS'

Valium is out, Prozac is in, but the risk of dependency could be as great.

Ian Murray reports

ANTIDEPRESSANT drugs such as Prozac could prove as addictive as
tranquillisers such as Valium, according to a study published today by the
medical consumer group Social Audit.

The study claims that there is now overwhelming unpublished evidence of the
risk of dependence on the drugs, with many people having marked withdrawal
symptoms when they try to stop taking them. Eli Lilly, makers of Prozac,
said that evidence did not support the idea that the drug was habit forming.

"As doctors have been led to believe that withdrawal symptoms are very
rare, they may yet again be mistaking the psychic distress caused by drug
withdrawal for relapse," the report says.

The author, Charles Medawar, is a member of the World Health Organisation's
advisory panel on drug policies and management. He has long been a thorn in
the flesh of the pharmaceutical industry and recently wrote a book claiming
that almost every drug prescribed for psychological distress is addictive.

"There is now compelling evidence that much of what was called anxiety in
the days of Valium has in effect been repositioned or relabelled as
depression," the report says. "The decline in tranquilliser prescribing in
the late 1980s has been matched by huge increases in antidepressant use.
Then we were anxious: now we are depressed. Valium out: Prozac in."

There was a 60 per cent increase in antidepressant drug prescribing
between 1992 and 1996. "This cannot be explained by superiority of the
newer antidepressants over the older ones. For all the hype, the
similarities between older and newer antidepressants are far greater than
any differences between them, another reason to be concerned about
dependence risk."

The report, published in The International Journal of Risk & Safety in
Medicine, claims that the drugs have not yet been used long enough for
anyone to be confident of knowing if there are any longterm effects.

Mr Medawar says the Government's Medicines Control Agency (MCA) and the
independent Committee on Safety of Medicines were mistaken in believing
that there were no addiction problems. He cites their own published figures
on the number of cases of reported adverse effects of the drugs. These show
802 cases of withdrawal reactions to paroxetine, sold as Seroxat by
SmithKline Beecham, and 58 cases involving fluoxetine, which Eli Lilly
markets as Prozac.

The MCA said in a statement last night that withdrawal reactions had been
noted with the drugs, but there had been no other characteristics of
addiction. Prescribers were informed of withdrawal reactions through a drug
safety bulletin and appropriate warnings appear in authorised product
information.

Eli Lilly said that since it was approved for marketing in 1986, 30 million
people had taken Prozac. There had been 6,000 scientific publications
addressing its safety and it was shown to be an effective antidepressant
well tolerated by most. The evidence did not support the idea that the drug
was habit forming.