Health Canada warns ADHD drugs may boost risk of suicide
Health Canada may have unduly “terrified” families Monday with a surprise warning that an array of widely used ADHD drugs could boost the risk of suicidal thoughts or actions in patients, says a prominent psychiatrist.
With more than four million prescriptions for the medications dispensed yearly in Canada, the regulator said new and stronger warnings will soon be included in the products’ labelling to reflect the possible suicide-related risk.
It also advised patients and their families to keep an eye out for the side effect, while stressing that the drugs’ benefits continue to outweigh their potential risks.
Still, one specialist complained that Health Canada gave doctors no chance to prepare parents for the announcement, and has yet to reveal the source of the information behind it.
“(It) comes out of the blue, and now you’ve got all these families across the country potentially terrified that they’re giving their kids these drugs and they’ll make them suicidal,” said Declan Quinn, head of adolescent and child psychiatry at the University of Saskatchewan.
“That’s not fair. ... This is like West Jet or Air Canada saying ‘Your flight’s been delayed,’ but there’s no more information. You don’t know if you’re leaving tonight or next week or if you’re stranded.”
Quinn said he and colleagues first heard two months ago that Health Canada was talking to drug manufacturers about placing a new warning on the medications’ “product monographs.”
No child psychiatrists were consulted, however, and when he asked the regulator on behalf of the Canadian ADHD Resource Alliance for a look at the information that led to the alert, there was no response, Quinn said.
About 4.5 million prescriptions for the various ADHD drugs, costing $408 million, were sold last year, according to the market research firm IMS Brogan.
The prescribing information for one of the drugs, Strattera, has included a warning since 2005 that it could make suicidal “ideation” or behaviour more likely.
But new information has emerged that the risk might also apply to eight other medicines, from Adderall to Concerta and Ritalin, said the Health Canada alert.
“The reports involved thoughts of suicide, suicide attempts and, in a very small number of cases, completed suicide,” said the notice. “These events have been reported at various times during treatment, particularly at the start or during dose changes, and also after stopping the drug treatment.”
The department then adds a number of caveats, including that there is little evidence of a causal relationship, and that ADHD and other psychiatric conditions suffered by the same patients can themselves make suicide more likely.
Heidi Bernhard, head of the Centre for ADHD Awareness Canada and mother of three sons with the condition, said she thought the Health Canada notice was reasonable, but stressed that the drugs remain an essential tool.
“For a child who cannot focus and pay attention in school for more than a few minutes at a time, but who is very bright — (the medication) is literally life changing.”