Charmaine Dragun's unusual behaviour a few days prior her death was observed in symptoms seen in people altering the doses of anti-depressant medications and could trigger suicide, an inquest into her death has been told.

In the days before her death, friends of Ms Dragun had noticed that she was anxious, agitated and nervous. She had been switching medications but had informed a close friend, Sarah Bamford she was not feeling better as quickly she had hoped.

The inquest into the death of the 29-year-old at Glebe Coroner's Court today, was centered on the potential side effects of anti-depressant drugs, the extent of warnings and if they are discussed with the patients.

The potential of under-reporting of side-effects could be due to the reliance on patients to inform their doctor, who would then relay the information to regulatory authorities.

The regulatory affairs director at Wyeth Australia, Karen James, also the manufacture of the anti-depressant Efexor, informed the court that much of the information provided to medical professionals, who, it was assumed, would have consulted with their patients.

Ms James accepted the potential side effects of Efexor, which includes anxiety and nervousness, as conveyed by David Hirsch, counsel assisting the NSW Coroner Malcolm MacPherson. Ms James says that some of the symptoms exhibited might be precursors to suicidal thoughts.

In Australia, Efexor has been available since 1998 and by 2009, a total of 280,000 people have been prescribed with the drug. Ms Dragun was rapidly reducing the dosage of Efexor, which she had been taking for three years, under the advice of her doctors. She had then started taking Lexepro.

The maker of the drug Lexapro, Dr Deborah Pelser from Lundbeck Australia, said the company recommended one to two drug-free days, for the patient who was switching to the drug from another anti-depressant, Efexor.

Ms James said patients whose Efexor medication was being changed, must be kept under close supervision in order to check for suicide ideation symptoms. She said the consumer information about Efexor was not contained on the packets of the drug, but the chemist and the prescribing doctor must share the information with the patients.

Based on the production information, patients should be monitored appropriately and observed closely for worsening depression and suicidal thoughts when there is an increase or reduction of their dosage. The inquest continues on Monday.

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