Attention public interest lawyers. Do I have a claim for you…you can now sue the big evil drug company for oodles of money because a commonly used medicine that prevents people from dying of the flu can make a tiny number of those people hallucinate and kill themselves.

Actually, the lawyers are already on it…and the bad news is if they succeed, they might force the withdrawal of the only medicine that might keep you from dying of Bird Flu.
Tamiflu is one of several medicines that they use for type A influenza.
There are several types of influenza, usually classed into type A and type B. Type A perculates around all the time, and you can use anti viral drugs. Type B changes all the time and you need the subtype for your vaccine.
But if you have a type A or other strain of influenza in your area, and people start it right away, they can significantly shorten the sickness of influenza, and presumably lower the death rate. And you can give it to people exposed to the flu. (I once had a flu epidemic in our nursing home…three people came down with it and almost died; we stopped visitors and gave the rest an anti viral, breaking the epidemic and the budget at the same time).
However, we usually don’t give the medicine to young healthy people, since they rarely die of influenza.
There are several medicines we use to treat influenza.
One is a medicine used for Parkinson’s disease: Symmetrel (amantidine). It works for type A influenza, and someone noticed that parkinson’s symptoms improved, so now we use it for that disease.
But why Tamiflu? And is it the medicine, or the influenza virus that causes the psychiatric problems?

One clue is something called the “blood brain barrier”. The brain has a barrier that keeps certain drugs from entering the brain. In babies, it is thin, and there had been one study showing that Tamiflu is able to enter the brains of rats easily. This might be a clue why mainly teenagers have been affected. You see, children acting strangely will be watched by mom, adults might not get that side effect as strongly, but teens are in between. For example, this teenager jumped over a rail in front of a truck; which makes it sound more like hallucinations rather than suicide. But mom would have been able to stop a younger kid, and an older person might have recognized he was hallucinating, and that it might be the medicine (I have had people hallucinate and call me and ask me if it was the medicine. These things are not common, thank God, but do occur).
But to put it into perspective, six million people have taken the drug in Japan alone, and 33 million around the world. Even if all 28 deaths in Japan are attributed to the medicine, one has to compare that to the number of people who would die from influenza or influenza related bacterial infections.

This has to be compared to the 20 000 to 30 000 excess deaths in the United States in recent flu epidemics. However, since most of the deaths and hospitalizations were in the elderly, withholding Tamiflu from teenagers is good advice. However, in case of a high mortality influenza like Birdflu, which has killed younger people and teenagers, the risk benefit ratio would change and if Tamiflu is effective, the small risk of psychiatric problems and even suicide would be outweighed by the risk of dying of Birdflu.—————–

Nancy Reyes is a retired physician living in the rural Philippines with her husband, six dogs, three cats, a rooster, and a large extended family. Her webpage is Finest Kind Clinic and Fishmarket and she posts medical essays on Hey Doc Xanga Blog

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