Confusion for parents and doctors regarding FDA antidepressant warning

Main Category: Mental Health
Article Date: 19 Sep 2004 - 17:00 PDT

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Last Tuesday, an advisory panel of the FDA (USA) accepted publicly that antidepressants can bring on suicidal thoughts in a number of teenagers who are being treated for depression. According to the panel, there should be stronger 'black box' warnings on the drugs. The problem here is that the warning should not deter people who need antidepressants from taking them.

The leading cause of teenage deaths in the USA is accidents, followed by homicides, followed by suicide. In many cases, intensive counselling alone does not help teenagers with depression. The health professional, and the parent(s) have a challenge in treating the depression. In most cases the antidepressants help the patients.

Antidepressants that work well with adults also work well for the majority of teenagers and young people.

Health experts are asking that the warnings on the drugs should emphasize close observation of the teenager during the initial stages of treatment with the antidepressant (the first few weeks).

It seems that the use of antidepressants is more effective than counselling alone (recent National Institute of Mental Health study). The National Institute of Mental Health, USA, found that the most effective treatment for teenagers was a combination of drug treatment with counselling.

According to health experts, 50% of teenagers with depression will attempt to commit suicide, 7% of them will succeed (kill themselves).

11 million young Americans took antidepressants in 2002.

According to other studies, 3% of teenagers on antidepressants will have suicidal thoughts in comparison to 1.5% of those on a placebo. In a study of 4,600 teenagers, the percentages of suicidal thoughts among antidepressant takers and placebo takers were the same (3% on the drugs and 1.5% on placebos), none of them actually killed themselves.

These messages are worrying and confusing for parents, health professionals and teenagers. On the one hand they are being told to be careful, while on the other hand they are told that counselling alone is less effective than counselling with drugs.

Does the USA (and for that matter, any country) have enough counsellors and mental health professionals to keep a close eye on all the teenagers during the first few weeks of treatment on antidepressants? The answer is probably, no.

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