Panorama is the BBC's flagship current affairs programme: nearly 50-years later, it is the longest-running public affairs TV programme in the world.

In October 2002, Panorama broadcast a 50-minute documentary about serious mood disorders and drug withdrawal symptoms linked to one of the leading SSRI antidepressants, paroxetine (Paxil, Seroxat, Aropax etc).

An estimated 4.4m people watched "Secrets of Seroxat" and the programme attracted a record response: some 65,000 telephone calls, 124,000 website hits, and 1,374 emails. An analysis of these emails has just been published in the International Journal of Risk & Safety in Medicine. To read this paper, click here:  IJRSM-161-169.pdf (but you need ‘Adobe Acrobat’ to do so).

The Panorama broadcast also led to a flurry of Parliamentary Questions. The Department of Health responded by announcing an "intensive review" of the problem by the Medicines Control Agency/Committee on Safety of Medicines. That was in December 2002. Three months later - on day three of the Gulf War – the MCA quietly revealed that that the review team had been disbanded.

The MCA disclosed this in an email to the Seroxat Users Group – representing some 4,000 people wanting to take legal action against the manufacturers of paroxetine, GlaxoSmithKline. The number of claimants had hugely increased after the Panorama broadcast: many learned, for the first time, that the drug might be to blame.

The "intensive review" (it was never intended as such) was abandoned because of perceived conflicts of interest: two key members of the "intensive review" team declared interests in GlaxoSmithKline, but one invited expert forgot to do so. He had much to disclose. This led to complaints of cronyism and a referral to the Ombudsman on behalf of Social Audit, by Frank Dobson MP.

Panorama’s follow up programme – "Seroxat: E-mails from the edge" - will be broadcast on Sunday, 11 May 2003 at 22:15 BST on BBC-1 TV. The programme is based on the testimony of some of the very many patients with awful stories to tell.

If the dark side of the SSRIs has a silver lining, it is this. From this point on, no honourable and competent regulatory agency will dare to fail to put patient experience, alongside professional observation, at the heart drug safety monitoring.

Another wider lesson from this story has yet to unfold. The secrecy that is pervasive in drug regulation is truly deadly. If the available evidence in this case had been made public at the time, many thousands of tragedies would never have happened.

Thanks to the very best of the press and media – rather than the ‘competent authorities’ – the secret is on its way out. To get up to speed, try doing a search on "Sarah Boseley" on The Guardian and then watch Panorama on Sunday.

This story is not only about paroxetine and like drugs; the underlying issues have everything to do with the integrity of public health.


Charles Medawar
May 2003


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