A new study funded by the federal government and Pfizer shows that heavy warnings in 2003 about the possibility of antidepressants (SSRIs: Zoloft, Paxil, Prozac, etc…) increasing suicidal behavior among teens coincides with an increase in suicides among adolescents between 2003-2004. The 2003 warnings may have had a ripple effect on adult drug treatment for depression as well, which have declined significantly according to a new report. This report, however, does not mention that there has been an increase in the use of antipsychotic drugs among the U.S. pediatric population.
According to the Archives of General Psychiatry:
“There has been a sharp national increase in antipsychotic treatment among children and adolescents in office-based medical practice. Second-generation antipsychotics are being widely prescribed, and emerging empirical evidence provides a base of support that is limited to short-term safety and efficacy.”
According to a report by Shankar Vedantam of the Washington Post:
“The data suggest that for every 20 percent decline in antidepressant use among patients of all ages in the United States, an additional 3,040 suicides per year would occur, said Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois at Chicago, who did the study…. David Healy, a British psychiatrist who has been critical of the drugs, disagrees. He said that the increase in suicides was more likely caused by the growing use of antipsychotic drugs among children rather than a decline in antidepressant use. “I would be absolutely certain that the increase is not because kids are not being treated,” he said. “They may not be getting SSRIs, but they are getting psychotropics.”
Neither report discusses alternative treatments for depression.
UPDATE: In new study released in the October 2007 issue of The American Journal of Psychiatry, Gonzalo Laje, M.D. and his team of researchers at the National Institute of Mental Health (NIMH) in Bethesda, Maryland, may have unlocked the reason for the suicidal tendencies in certain populations taking SSRIs for depression.
Two specific genes, GRIA3 and GRIK2, corresponded significantly to increased risks of developing suicidal thoughts while using citalopram.
“Markers within GRIK2 and GRIA3 were associated with treatment-emergent suicidal ideation during citalopram therapy. If replicated, these findings may shed light on the biological basis of this potentially dangerous adverse event and help identify patients at increased risk” [Laje, et al.].
For more information on SSRI use and suicidal tendencies read:
- Youth Suicides Increased As Antidepressant Use Fell (washingtonpost.com)
- Teen antidepressant warning had ripple effect (healthcentral.com)
- Increased prescribing trends of paediatric psychotropic medications (adc.bmj.com)
- National Trends in the Outpatient Treatment of Children and Adolescents With Antipsychotic Drugs (archpsyc.ama-assn.org)
- Rational prescribing for children (www.bmj.com)
- The Story Behind the Increase in Teen Suicide Rates (psychcentral.com)