[Pharmacovigilance and 2nd generation antidepressive agents]

Genuine side effects of antidepressants are difficult to specify. Except for rare cases, imputability of a severe effect is questionable. However, several recent drug surveillance studies allow to better assess the tolerability of these compounds. The first is British: it compared the blood toxicity of mianserin and amitryptiline (Inman). The second (Henry) is based on the calculation of a lethal toxicity index (deaths per millions of prescriptions), varying with the different compounds. The third (Cooper) pools the data of all the comparative trials of fluoxetine as well as all the relevant effects noticed with this drug (more than 7,500 prescriptions in 1988). Antidepressants generally have to be used on a long term basis. The study of the safety of their long term use is absolutely necessary.