SOMBA K'E/YELLOWKNIFE - The doctor who prescribed a man three months worth of an antidepressant which ultimately caused the man to die was following hospital procedures when it was administered, according to the Health department's medical director.

At a press conference Thursday morning, Dr. David King said medical professionals in the NWT have been aware of the risks associated with Effexor, a commonly prescribed antidepressant, since the first warning issued by Health Canada in 2004. King reviewed the department's policy on prescribing medication to ensure patient safety, and said he found no problems with the way the situation was handled.

"The recommendations record a suggestion toward having a mechanism in place for patient safety and warnings, and that was in place prior to this event occurring," King said of recommendations made in a coroner's report released earlier this month into the death of a 20-year-old man who overdosed on the drug, which raised questions on how the drug is administered and monitored.

The Inuvialuit man, who was living in Yellowknife before his death, had a history of alcohol abuse and previous suicide attempts. He had gone to Stanton Territorial Hospital on the day he died in February 2009 with an empty bottle of Effexor prescribed less than a month prior to his death. He was rushed onto a medevac flight for Calgary but suffered a cardiac arrest in the plane and died.

A toxicology report revealed the man had a fatal dose - 59 times the therapeutic level - of Effexor, also known as venlafaxine, in his blood stream.

Sandy Lee, minister of Health and Social Services, said the department takes coroner recommendations seriously and assured the public proper procedures are being followed by medical professionals.

"Doctors do practise with respect to this medication the way the coroner said we should," she said.

"I want to ensure all residents of the NWT that all medical professionals are on top of all medical warnings from Health Canada and practise due diligence when prescribing medication."

Dr. Jim Corkal, medical director for Stanton Territorial Health Authority, said the hospital conducted an internal review following the man's death, and implemented some recommendations similar to those made by the NWT Coroner's Service, including to provide better information on the drug for patients and doctors.

The coroner's report also recommended that prescriptions be only partially filled for high-risk patients. The man who died had completely filled a three-month prescription for Effexor.

When asked if it was normal for a patient to be given a three-month prescription for an antidepressant, King said it wasn't the department's mandate to review how the drug is administered and how much is prescribed, citing it is between the patient and the physician to determine how the situation is handled.

He added later that the NWT Pharmacy Act allows for pharmacists to contact doctors if concerns arise about a prescription, but said it wasn't his place to judge whether or not doctors and pharmacists take advantage of this.

"I don't regulate pharmacists and pharmacists don't regulate physicians," he said.

"I think collaboration is the way to go and there is a means to do that, whether or not an individual physician or pharmacist avails themselves to that opportunity, it's not for me to judge."

Lee said she couldn't discuss the specifics of the case even though the coroner's report is on public record, and reports the man was given a three-month prescription.

"We cannot necessarily accept that that is the fact of the situation," she said. "The procedures we are following are correct and safe."

Corkal said there is no "cookbook approach" to how drugs are prescribed, that they're done on a case-by-case basis.

"It's going to depend on your family support, your support in the community and how the physician assesses your risk at that particular time," he said. "There is an extremely broad spectrum of approach to any individual patient when they come in with this particular problem."

Hospital CEO Kay Lewis told Yellowknifer shortly after the coroner's report was released that she had no plans to review the report unless required to act on the recommendations by the Department of Health and Social Services. She didn't say anything about the hospital having already taken action. Lewis was unavailable for comment prior to press time.

Deputy chief coroner Cathy Menard said Thursday her office had no idea the hospital had already made changes to its drug policies following the 20-year-old's death. Corkal had said during yesterday's press conference that the coroner's office had access to the hospital's review.

Eggenberger has also recommended the territorial government open a fully staffed detox centre.