Dr. James W. Antoon, Assistant Professor of Pediatrics at the Vanderbilt University Medical Center, talks about how Tamiflu affects children’s mental health.
Interview conducted by Ivanhoe Broadcast News in 2023.
After reading about your study, how do these studies determine whether it’s the flu or Tamiflu that’s causing problems in the children?
Antoon: That wasn’t the focus of this study. The flu is a common and sometimes life-threatening illness in children and flu is known to have many complications and can make your underlying conditions worse. We studied whether flu was associated with serious neuropsychiatric events. Serious meaning, they needed to be treated in the hospital. These neuropsychiatric events included things like brain inflammation, seizures, and acute behavior changes like suicide attempts. To do that we looked at over 150,000 children in Tennessee who were diagnosed with the flu and found that less than one percent of them had a neuropsychiatric event associated with their flu diagnosis. The rate of neuropsychiatric events was about 10 times higher and those with underlying psychiatric conditions and 100 times higher than those with underlying neurologic conditions. Importantly we did see these events in otherwise healthy kids who had no underlying conditions at all. The reason that this is important is that every year parents discuss with their pediatricians the risks and benefits of vaccinating for the flu, and the risk of these neuropsychiatric events should be part of that conversation. For example, the risk of serious adverse reactions from the flu vaccine is about one to two per million and we found in our study that the risk of these serious neuropsychiatric events with the flu was about 500 per million. Our findings are also important as you mentioned the anti-viral Tamiflu or oseltamivir has a black box warning for neuropsychiatric events, and every year in the news and on TV you hear about Tamiflu-induced neuropsychiatric events. It’s important for parents to be aware that these events can happen even without Tamiflu being on board. We found in our study the same rate and same incidence of neuropsychiatric events in children who got Tamiflu and children who didn’t get treated and this should be part of the discussion as well and families should know that these events can occur with just the flu itself and at about the same rate as with Tamiflu.
What are the complications of taking Tamiflu that you are already aware of?
Antoon: The most common side effect of Tamiflu is vomiting. Vomiting is very common with the flu as well, but it occurs about 10 to 15 percent more with Tamiflu. Tamiflu also has that black box warning for neuropsychiatric events. Although we really don’t know if it’s Tamiflu or the underlying flu itself that’s causing those events.
How did you first find out the effects of it, what led to the study?
Antoon: When Tamiflu first came out there were several case reports and coverage in the media about acute neuropsychiatric events mainly out of Japan. Due to this, the FDA put a black box warning on these neuropsychiatric events for Tamiflu. Since then, studies have been mixed on whether Tamiflu truly causes these events or not, and we’ve learned more, and more about the flu and more and more about the neurologic and psychiatric side effects of the flu. But nobody has looked at how often these occur in children what those events look like and who is most likely to get them and that’s what we did in this study.
What’s in Tamiflu?
Antoon: It’s an antiviral, it’s technically a neuraminidase inhibitor. The trade name is Oseltamivir.
What are you hoping to discover or find out as the studies keep progressing?
Antoon: I think first it’s important for families to know the risk of these events with flu itself and knowing, having that information when they decide whether to get vaccinated or whether to treat with an antiviral medication. The next step is to determine whether is it Tamiflu that’s causing some of these events or if is it an underlying flu that’s causing the events. It’s very difficult sometimes to tell whether it’s the treatment or the thing that you’re treating that’s causing a side effect. That ongoing work is part of our group is now to evaluate whether Tamiflu is truly causing some of these events or if is it all just underlying flu.
Why would the flu itself cause the neuropsychological event?
Antoon: There are several potential ways that can happen. It’s very well known that flu can cause inflammation in the brain, can cause something called encephalitis and encephalopathy that causes acute behavior changes and can be a very serious condition. Flu is also known to cause seizures in some children because they get high fevers and it induces seizures we also know that flu can make your underlying conditions worse so If you’re predisposed to having one of these events, having a flu infection could trigger that for you.
Should patients keep taking Tamiflu?
Antoon: Tamiflu has been shown to decrease how long you have symptoms of the flu and prevent certain complications of the flu. It’s been shown to prevent ear infections from the flu and pneumonia from the flu. I think it’s too early to tell, I shouldn’t say that parents should discuss with their doctors the risk of neuropsychiatric events from Tamiflu compared to neuropsychiatric events from flu itself that we found in our study.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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