Magazine article The Futurist

Youth Depression and Suicide: Medical Advisory Warnings May Have Some Nasty Side Effects

Magazine article The Futurist

Youth Depression and Suicide: Medical Advisory Warnings May Have Some Nasty Side Effects

Article excerpt

Warning labels meant to protect young people might be doing them more harm than good, according to a Nationwide Children's Hospital study on antidepressants and youth suicide rates.

The study finds that suicides of Americans under 20 years old rose 18% between 2003 and 2004 --the largest single-year increase in more than 15 years. The rate went back down by a slight 5% from 2004 to 2005.

The spike coincides with U.S. Food and Drug Administration's 2003 and 2004 public warnings that antidepressants might trigger "suicidality"--suicidal thoughts and behaviors, short of actual suicide --in young people age 20 and under who use them, though suicidality usually abated after the first few months of treatment. The FDA first alerted consumers to a possible antidepressant-suicidality link in June 2003 when tests suggested increased risk in young consumers of the antidepressant parotexine.

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Over the following 14 months, the FDA sponsored studies of all major antidepressants and held public hearings that discussed findings. It concluded that all brands of antidepressants needed to carry a note of caution; a young patient taking them would be 4% more likely to exhibit suicidality.

In October 2004, the agency ordered drug companies to place "black-box" warnings on the inserts of all their antidepressants. Every warning was to state the increased risks and urge doctors prescribing antidepressants to watch patients closely for any changes in behavior: "Anyone considering the use of [drug name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior."

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The first warnings appeared in 2005. FDA spokeswoman Sandy Walsh told THE FUTURIST that the warnings were meant to make doctors and patients more cautious.

"The FDA's intent is to fully inform doctors about the risks and benefits of antidepressants, and not to discourage appropriate prescribing," says Walsh.

But critics say that doctors and patients became too cautious. Jeff Bridge, Nationwide Children's Hospital study author, suggests that the warnings might have scared some physicians into not prescribing antidepressants and some young children into not taking them. …

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