Inquest hears of teenager’s SSRI use

CBC News

A coroner’s inquest in Fredericton was told Tuesday that a 16-year-old foster child may have stopped taking an anti-depressant medication just weeks before she killed herself in November 2003. The year after Heather White’s death, Health Canada issued a warning about the class of drug Heather’s family doctor had been prescribed to deal with her depression. She was taking a medication called Celexa, a selective serotonin re-uptake inhibitor (SSRI).

INDEPTH: Depression medications

The warnings advised doctors to carefully monitor patients of all ages for suicidal thoughts, especially in the early stages of taking SSRIs. Health Canada also warned patients to tell their doctors before changing the dosage or stopping the medication entirely.

The legal counsel for the inquest said Heather had 18 Celexa tablets in a pill bottle when she died, which meant she hadn’t been taking them regularly or had stopped taking them about two weeks before her death.

Heather’s family physician, Dr. Gareth Morgan, said he prescribed Celexa after hearing that Heather had attempted suicide in June 2003. He thought it was a good choice because of all the SSRIs, Celexa was considered to have the fewest side-effects.

She filled her first prescription in August of that year.

When Morgan saw the girl again on Sept. 8, 2003, the medication hadn’t improved her mood. He told the inquest that he didn’t consider that to be unusual because SSRIs can take several weeks to take effect.

He decided to keep Heather on Celexa and asked her to return about two weeks later. She missed the appointment and he never saw her again.

In November of that year, she shot herself in the head with a rifle she’d taken from a gun cabinet in her foster family’s home in the Nackawic area, about 40 kilometres from Fredericton.

FROM JULY 12, 2005: Communication flawed, suicide inquest told

Cathy Peterson of Health Canada told the inquest that all SSRIs have similar characteristics and can be effective in combatting depression. In rare cases, though, they can have the opposite affect. Peterson said two SSRIs — Paxil and Effexor — were specifically linked to a possible increase in suicidal thoughts and behaviour in young people. Those tendencies can also emerge if a person suddenly stops taking them without proper medical supervision.

Peterson said she didn’t advocate a complete ban on prescribing SSRIs to teenagers because they were better than some of the alternative medications for depresssion.

But seven months after Heather’s suicide, Health Canada was sufficiently concerned about SSRIs that it ordered warnings be placed on all of them, including Celexa.

The inquest continues until Friday.

With files from Canadian Press.