I am writing further to the reply sent by Mrs Anderson on 6 January to your letter of 2 December 1997 with enclosures in which you raised a number of matters regarding anti-depressant treatment and the procedures for licensing and monitoring human medicines.

With respect to your contention that SSRIs can cause physical dependence, I am advised that evidence to date does not appear to establish such an effect. Nonetheless, the MCA are reviewing the position in detail and obtaining a wide range of expert advice on this matter. I have asked the MCA to keep you informed of developments.

On your views about the MCA, Ministers agreed last year a revised Framework Document, setting out the management and accountability framework within which the MCA operates. This was published in July 1997 and a copy is enclosed. This will be reviewed by April 1999. There are no plans to conduct a further formal review. However, as I believe you know, the MCA is examining current policies on access to information prior to the legislation on freedom of information set out in the White Paper Your Right to Know. This will include consideration by the CSM of what further action they can take to make information available, taking account of the recent government consultation on Opening up Quangos. You may be aware that, as from 1 January, lay representatives have been appointed to serve on the Medicines Commission. All members, in accordance with the procedures laid down by the Code of Practice published in the annual report of the Commission's and associated Committees' work, are required to declare any personal and non-personal interests in the pharmaceutical industry and are excluded from decisions when appropriate. This procedure has worked well. 

KR0503.07

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