herald

Thursday 24 August 2017

Coroner to take advice on link between Prozac and suicidal ideation after teen shot himself

The Dublin coroner is to take independent expert advice on the link between Prozac and suicidal ideation at the inquest into the death of a 14-year-old boy who shot himself.

Jake McGill-Lynch died at Tallaght Hospital on March 20, 2013, as a result of a self-inflicted gunshot wound at his home at Woodford Terrace in Clondalkin, Dublin 22.

The inquest into his death being held at Dublin Coroner’s Court was previously adjourned after his mother Stephanie McGill-Lynch raised concerns that he had been prescribed Prozac. She told the court she would never have agreed to him taking the drug had she known the side effects.

At a mention of the inquest, coroner Dr Brian Farrell said he has asked Dr Brian Houlihan, consultant child psychiatrist and clinical director at Temple Street Children’s Hospital, to review world medical literature in relation to the link between Prozac and suicidal ideation. Dr Houlihan will act as the coroner’s expert at the inquest.

“I want him to review the medical literature in an objective way and set out the current status of the medical literature in relation to the question which is at large here and that is the relationship of fluoxetine [Prozac] to suicidal ideation,” he said.

He said that Dr Houlihan will present not only the consensus view following the review of the literature but also “a view setting out the pros and cons in relation to the question”.

Solicitor for the family Michael Finucane sought further information on Dr Houlihan’s relationship with the HSE citing this as an issue of concern. Dr Farrell said he would “ensure that there is no conflict of interest”.  

Dr Houlihan is expected to have a report ready for the inquest before the end of April.

The inquest had heard that Jake was diagnosed with Asperger's Syndrome in early 2012 and he suffered from anxiety issues. He was seeing a psychologist at Clondalkin Linn Dara Child and Adolescent Mental Health Services (CAMHS) and had been prescribed Prozac to help with his anxiety.

Giving evidence on the first day Mrs McGill-Lynch said she and her husband were not informed that possible side effects of Prozac include an increase in suicidal ideation. They were given no patient information leaflet when the prescription was collected from a pharmacy, she said. She told the coroner that in the US Prozac carries a “black label” warning that it should be given to under-18s who have anxiety problems only when all other avenues have been exhausted.

Consultant child psychiatrist Dr Maria Migone, who prescribed the Prozac for Jake’s anxiety, told the inquest the US black label was based on a meta-analysis carried out in 2003 but subsequent studies have found no increase in suicidal ideation in young people with anxiety taking Prozac. The Irish Medicines Board contacted doctors in 2003 to say that having studied the class of medications affected, they recommended Prozac as being the safest in children under-18, she told the court.

The inquest was adjourned, pending Dr Houlihan’s report, for further mention on April 28.

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