New Doubts about Medicating Kids ; Pressure Is Mounting to Ban or Curtail the Use of Antidepressants on Children. an FDA Panel Heard Evidence This Week
Gregory M. Lamb writer of The Christian Science Monitor, The Christian Science Monitor
Personal tragedies and scientific evidence are combining to call into question the use of powerful antidepressant drugs on children and teens.
Pressure has been building for months to ban or curtail their use. Recent scientific studies have found a link between the use of these drugs and suicidal tendencies among children. In December, Britain banned the use of some antidepressants on patients under 18. The fallout from a hearing called by the Food and Drug Administration (FDA) this week is ratcheting up the pressure for some kind of action on this side of the Atlantic.
"Until I went to the conference, I felt I would be out of step with my colleagues not to" prescribe these drugs, said Lawrence Diller, a pediatrician from Walnut Creek, Calif., in a telephone interview after the hearing. Parents and even children themselves expect to be given a pill today, he says. But "I think pediatricians are going to be much more careful after hearing about this," by either writing fewer prescriptions or monitoring the children more closely.
Dr. Diller - author of the book "Should I Medicate My Child?" - was one of several physicians and researchers who testified at the hearing outside Washington Monday. The advisory panel also heard from numerous grieving parents and relatives whose children had either killed or injured themselves or others while taking prescription antidepressant medications. Meanwhile, one presentation from researchers showed the drugs to have little or no more effectiveness than placebos - sugar pills.
The FDA had been planning to issue a report on the drugs next summer. But the advisory panel urged the FDA to act now to warn doctors and parents. While the warning wouldn't place a ban on prescribing such drugs, it would caution both physicians and parents to watch for signs that the drugs might be having a harmful effect.
"Our sense is that we would like, in the interim, the FDA to go ahead and issue stronger warning indications to clinicians regarding possible risks of these medicines," said Dr. Matthew Rudorfer, a scientist at the National Institute of Mental Health and the chairman of the FDA advisory committee. "We think such warnings are required to elevate the level of concern and attention that practitioners use in prescribing them.... We want to put a speed bump in the road."
About 40 relatives of children who had taken antidepressant drugs testified at the hearing that they believed the prescribed drugs had had tragic consequences.
Parent Sara Bostock, said that after two weeks of taking Paxil her daughter fatally stabbed herself with a kitchen knife. "To die in this violent and unusual fashion ... led me to believe Paxil must have put her over the edge," Ms. Bostock said.
Another parent, Mark Miller of Kansas City, Mo., said his 13- year-old son, Matt, hanged himself after taking seven Zoloft pills. "You have an obligation today ... [to prevent] this tragic story from being repeated over and over again," he said.
Two parents testified that they thought the drugs had helped their children and urged the FDA not to ban them.
Diller and others are also concerned that scientific studies about the drugs have either been suppressed or misinterpreted.
Diller says he spoke in his testimony about his "loss of faith in my academic colleagues to generate accurate information and opinions that I feel I can trust because of the extremely intimate link between researchers and the drug industry. …