Flu drug once blamed for seizures in kids gets a surprising reversal
A long-running debate over Tamiflu’s safety in children may finally be settled. Researchers found that influenza, not the antiviral medication, was linked to serious neuropsychiatric events like seizures and hallucinations. Even more striking, kids treated with Tamiflu had about half the risk of these events compared to untreated children with the flu. The results suggest the drug may be protective rather than harmful.
For many years, doctors questioned whether a commonly prescribed antiviral drug for children with the flu was responsible for serious neuropsychiatric symptoms, or whether those effects were actually caused by the infection itself. Reports of seizures, confusion, and hallucinations fueled uncertainty among medical professionals and families alike.
New research from Monroe Carell Jr. Children's Hospital at Vanderbilt now challenges that long-held concern about oseltamivir, widely known as Tamiflu.
Study Finds Lower Risk With Oseltamivir Use
The study, published in JAMA Neurology, found that children who received oseltamivir during a flu illness were less likely to experience serious neuropsychiatric events. These included conditions such as seizures, altered mental status, and hallucination.
"Our findings demonstrated what many pediatricians have long suspected, that the flu, not the flu treatment, is associated with neuropsychiatric events," said principal investigator James Antoon, MD, PhD, MPH, assistant professor of Pediatrics in the Division of Pediatric Hospital Medicine at Monroe Carell. "In fact, oseltamivir treatment seems to prevent neuropsychiatric events rather than cause them."
What the Researchers Discovered
The study identified three key findings that together point to influenza as the main driver of these complications.
Influenza infection itself was linked to a higher rate of neuropsychiatric events when compared with children who did not have the flu, regardless of whether oseltamivir was used. Among children who did have influenza, those treated with oseltamivir experienced roughly a 50% reduction in neuropsychiatric events. Children without influenza who received oseltamivir as a preventive measure showed the same rate of events as children with no flu exposure.
"Taken together, these three findings do not support the theory that oseltamivir increases the risk of neuropsychiatric events," said Antoon. "It's the influenza."
Large-Scale Analysis of Pediatric Health Data
Researchers examined de-identified health records from children and adolescents ages 5-17 who were enrolled in Tennessee Medicaid between July 1, 2016, and June 30, 2020.
The study followed 692,295 children over four years, with a median age of 11. During that time, 1,230 serious neuropsychiatric events were recorded, including 898 neurologic events and 332 psychiatric events.
The clinical outcomes included neurologic conditions such as seizures, encephalitis, altered mental status, ataxia/movement disorders, vision changes, dizziness, headache, and sleeping disorders. Psychiatric outcomes included suicidal or self-harm behaviors, mood disorders, and psychosis/hallucination.
Why the Findings Matter for Families