Paroxetine, Panorama and user reporting of ADRs: Consumer intelligence matters in clinical practice and post‐marketing drug surveillance

Article type: Research Article

Authors: Medawar, Charles^; | Herxheimer, Andrew | Bell, Andrew | Jofre, Shelley

Affiliations: Social Audit Ltd., London, UK | DIPEx Project, Department of Primary Health Care, University of Oxford, Oxford, UK | British Broadcasting Corporation (BBC), London, UK

Note: [] Address for correspondence: Charles Medawar, Social Audit Ltd., P.O. Box 111, London NW1 8XG, UK. Tel./Fax: +44 (0)20 7586 7771; E‐mail: charles@socialaudit.org.uk.

Abstract: We systematically analysed two complementary samples of emails relating to patients' problems with the popular SSRI antidepressant, paroxetine. These mainly concerned serious mood disorders and drug withdrawal symptoms. 1,374 emails were immediate responses to a major BBC‐TV documentary programme. These were contrasted with 862 messages on similar themes sent to a website discussion forum over a period of nearly three years. Despite the limitations of most individual email reports, we judged their collective weight to be profound. We also suggest that the value of “immersion” in a large body of such data may be greater than continuing exposure to a variable trickle of reports. We discuss the significance of these data in relation to the patient–prescriber relationship and pharmacovigilance. We suggest that the Internet offers unparalleled opportunities for soliciting and monitoring patients' reports of adverse drug reactions, and propose practical initiatives to capture peoples' experiences and thereby promote safer and more effective drug use.

Journal: International Journal of Risk and Safety in Medicine, vol. 15, no. 3-4, pp. 161-169, 2002