Health Check: 'The public response to Seroxat should give us pause'

The edition of Panorama on the antidepressant Seroxat, which was broadcast last autumn, triggered the biggest response from the public in the BBC programme's history. Yesterday, there was a follow-up programme prompted by the 67,000 calls and 1,400 e-mails that flooded in after the first programme from patients and relatives worried about the safety of the drugs.

The edition of Panorama on the antidepressant Seroxat, which was broadcast last autumn, triggered the biggest response from the public in the BBC programme's history. Yesterday, there was a follow-up programme prompted by the 67,000 calls and 1,400 e-mails that flooded in after the first programme from patients and relatives worried about the safety of the drugs.

The scale of the response echoes that which occurred in the early 1980s to an item about the difficulty some patients had in coming off tranquillisers, such as Valium, on That's Life.

Tens of thousands of viewers wrote in with similar experiences alerting doctors to the addictive properties of the drugs, which they had previously dismissed. New warnings about the long-term use of tranquillisers followed, and prescribing of the drugs plummeted. It was the first time a TV programme, rather than a randomised controlled trial, could claim to have changed medical opinion.

So the lesson of history is that a public response to a programme on this scale should give us pause. Seroxat is the most widely prescribed anti-depressant in Britain, more popular even than Prozac. Is it safe?

The Medicines Control Agency responded to the first Panorama programme by setting up an independent expert group to examine the safety of Seroxat, Prozac and similar drugs. But the group was disbanded in March after it emerged that two of its members had links with drug manufacturers...

Now that we know the extent of public concern about Seroxat, the need for the safety review is more urgent than ever. Among the e-mails that the programme received there were 16 cases of suicide, 47 of attempted suicide and 92 where people had thoughts of harming themselves or others – all linked with taking the drug.

But before leaping to conclusions there is an important caveat. The head of one mental health charity told me he found the scale of the Panorama response unsurprising. "It is what you would expect," he said. People being treated for depression are a highly vulnerable group, anxious about their health and state of mind and prone, therefore, to seek causes for any fluctuation in mood.

Studies also show that where anti-depressant prescribing has risen, suicide rates have fallen. The drugs, despite their tainted image, do save lives.

We need an urgent and thorough investigation of the safety of antidepressants– but in our eagerness to expose their risks we should not forget that the suffering they were devised to treat is intense, under-recognised and too often fatal.