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MHRA Advertising Unit, 14-112 Market Towers
Medicines and Healthcare products Regulatory Agency
Market Towers, 1 Nine Elms Lane
London SW8 5NQ

17 April 2005


Dear Sirs, 

This is a complaint about the full-page advertisement for Efexor (venlafaxine) published on the back cover of the British Medical Journal dated 16 April 2005, and presumably elsewhere. A photocopy is attached.

It seems entirely inappropriate that any advertisement for this product, published in a journal circulated mainly to primary care physicians should all but conceal in small print, and under the heading ‘Dosage’, the key warning that "Initiation of treatment with venlafaxine should be restricted to specialist care and treatment should be managed under specialist supervision or shared care arrangements". Only the most assiduous reader would be likely to take this in, when the prominence, placement and presentation of the advertisement otherwise give no hint of it.

This advertisement appears to make nonsense of the legal requirement to promote the rational use of this product, more especially when safety issues are concerned and when the restriction on prescribing has been only recently introduced, following ten years of unrestricted use. As the MHRA says: "Where safety issues are being discussed, it is particularly important that a balanced view of the evidence is presented to enable readers to make informed decisions."

Yours sincerely,
Charles Medawar