More Tamiflu deaths

I posted a few days ago about 2 deaths of Japanese teenagers on olsetamivir (Tamiflu) and was skeptical of the connection.

There are now additional cases with 12 total suspected deaths in addition to instances of non-fatal behavioral changes (the first two deaths were trauma suspected to be secondary to unusual behavior brought on by use of the medicine):

An update by FDA staff also includes reports of 32 “neuropsychiatric events” associated with Tamiflu, all but one experienced by Japanese patients. Those cases included delirium, hallucinations, convulsions and encephalitis.

High fever from influenza can cause delirium, convulsions and viral infections cause many cases of encephalitis, so most or all of these events may well be unrelated to Tamiflu.

In addition, the drug is most widely used in Japan, so it's not surprising possible side effects are emerging there:

Of 32 million people treated with Tamiflu since its approval in 1999, 24 million were in Japan.

The additional cases, both deaths and non-fatal cases of unusual neurologic events and strange behavior certainly raise my concern. However, overall safety data remain reassuring:

Roche said that several studies in the United States and Canada had shown that the death incidence rate of influenza patients who took Tamiflu was far below those who did not.

So far, these reports wouldn't change my view that olsetamivir is safe and effective, especially in the case of a pandemic.