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Release of the Report of the Psychiatric Drug Safety Expert Advisory Panel
The Australian community has an expectation that all therapeutic goods available in Australia are safe, effective and of high quality. The work of the TGA is based on applying scientific and clinical expertise to decision-making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines and other therapeutic goods by:
- identifying, analysing and evaluating the risks and benefits presented by a product before it can be approved for supply in Australia;
- identifying, analysing and evaluating any risks that may arise following approval of the product to ensure that the benefit risk balance remains positive (post market surveillance).
The TGA adopts a number of different post-market risk assessment approaches to ensure the continued safe supply of medicines and other therapeutic goods. A core component in monitoring drug safety in Australia is the spontaneous voluntary reporting system, which has been in operation for more than 4 decades and has generated more than 200,000 adverse drug reaction (ADR) reports. Unfortunately, all medicines can cause adverse reactions in a proportion of patients who take them and the TGA relies on the public, healthcare professionals and industry to report these reactions. All serious ADRs reported to the TGA are reviewed by medical officers within the TGA, and followed up for further assessment where necessary. Potential safety issues are referred to the Adverse Drug Reactions Advisory Committee (ADRAC), and any subsequent regulatory action is informed by the committee's assessment.
In addition, from time to time the TGA may draw upon additional scientific and clinical expertise to undertake a review of the specific issue and to inform its ongoing assessment of the risk-benefit balance of the product or products in question.
In August 2008 the TGA established an independent panel of psychiatrists and epidemiologists to undertake a specific review of selective serotonin reuptake inhibitors (SSRIs) and atypical antipsychotic medicines. The panel, known as the Psychiatric Drug Safety Expert Advisory Panel (PDSEAP) was tasked with undertaking a detailed review of the safety of these particular psychiatric medications. The PDSEAP has now completed its work and its report is being made public.
The PDSEAP has concluded that the risk-benefit balance for each of these medicines remains positive and that they are an effective part of treatment regimens for patients with certain psychiatric conditions.
The PDSEAP has made recommendations in three main areas:
- Changes to Australian Product Information documents;
- Educational activities for prescribers; and
- Enhancements to post-marketing surveillance.
The TGA's Office of Prescription Medicines will be working with sponsors to progress changes to the Product Information documents in line with these recommendations. Regular review of these documents was also recommended and this is consistent with process reforms being implemented by the TGA's Office of Medicines Safety Monitoring as part of a larger series of regulatory reforms currently underway within the TGA. In addition, in early 2010 a new Advisory Committee on the Safety of Medicines (ACSOM) will be convened and the views of the new Committee will inform the TGA's consideration of how best to take the remaining recommendations forward.
The members of the PDSEAP were:
- Professor Wayne Hall, a pharmacoepidemiologist who is an NHMRC Australia Fellow, Professor of Public Health Policy at the University of Queensland and Chair of the Drug Utilisation Subcommittee of the Pharmaceutical Benefits Advisory Committee (PBAC);
- Professor Steve Kisely, a psychiatrist, epidemiologist and public health physician at the University of Queensland, and Director of the Queensland Centre for Health Data Services; and
- Dr Frances Wilson, a consultant psychiatrist at Westmead Hospital, Sydney.
The Panel members have declared to the TGA that they have no known, real or perceived, conflict of interest in relation to their authorship and to the provision of advice to the Commonwealth on this subject.
Report of the Psychiatric Drug Safety Expert Advisory Panel
The full report of the Psychiatric Drug Safety Expert Advisory Panel is available below.
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