Antidepressants: More Good Than Harm?
6 CommentsBy Ed Silverman // April 17th, 2007 // 7:33 pm
This is likely to continue the debate, not end it. A study in this week’s JAMA finds that the benefits of antidepressants for children and teens far outweigh the risk of suicide, and the FDA should revise strong warnings that may have scared off some doctors and patients.
A review of 27 major clinical trials assessing antidepressant use in 4,400 children and adolescents with major depressive disorder, obsessive-compulsive disorder and anxiety disorders showed the risk of suicidal behavior was smaller than previously thought.
“The benefits seem to be much stronger than the risks,” says David Brent, a researcher at the University of Pittsburgh School of Medicine, who questioned the use of Black Box warnings on the SSRIs that caution a higher rate of suicidal behavior among children and teen-agers.
The FDA says there’s no reason to change the labeling and that docs are still free to prescribe the drugs to young patients. The warnings were issued in October 2004 after studies suggested the pills may increase the risk of suicide in youngsters.
“Clearly, their intent was to protect people, but you have to then re-evaluate whether your warning may be doing more harm than good,” Brent told Reuters. According to Medco, the number of children 19 and under taking antidepressants fell by 13 percent from 2004 to 2005. Brent noted suicide rates in adolescents have, at the same time, begun to rise. “That is after 10 consecutive years of a decline in the rate,” he said.
He pointed to a February study in the journal Pediatrics that found deaths from suicide in 10 to 19-year-olds rose 18.2 percent in 2004 from 2003. No other causes of child death increased during that period. “It is possible that people who would benefit from this medication are being frightened away,” he said.
The analysis, funded by the National Institute of Mental Health, included data from an additional 700 patients not available when the FDA issued its warning. The study showed an increased risk for suicidal thoughts and attempts, but the size of the effect was smaller than in the FDA report. There were no completed suicides.
One thing to keep in mind: the Pediatrics study Brant cites didn’t measure the suicide rates after the black box warnings were issued. Some psychiatrists aruge the media attention in 2004 prompted some docs to write fewer scrips. Maybe. But the warnings didn’t show up on the labeling for several months after the October 2004 decision.
Further reading….
Reuters;
JAMA study (subscription may be required).[tags]Antidepressants, JAMA[/tags]
Lisa Van Syckel
Has Mr Brent reviewed the raw clinical trial Data.Did Mr.Brent attend or review the Congressional &FDA hearings when testimony was given under oath.Has Mr Brent even seen the patiient medication guides for the use of antidepressants in children under 18.Has Mr. Brent seen the glaxo emails were they discuss ways to manipulate the press.Mr. Silverman you should know better than to give this idiot a platform!!SHAME ON YOU!!! I challenge Mr. Brent to an open public debate.If Mr. Brent declines my invitation to a debate,it will demonstrate to the American people that he is a mere coward.Come on Mr.Brent show me what your made of!! Put your pharma money were you mouth is.YOU ARE COWARD, AND LIAR!!!!!!!!!
Laurie
My anger aside…what parent given the statistic of 60% feel better with drugs vs. 50% feel better with a placebo(with NO therapy), would accept any risk of increased suicidality? I know if I had been given this information i wouldn’t have taken that risk! But I wasn’t given that information and it almost cost my son his life. Even the smallest risk is HUGE, when it’s your child. I know I’ve been there!
I’m so tired of distorted facts, misrepresented statistics, and kids dying horrible violent deaths….yet mainstream media continues to report these “studies”, lulling unsuspecting parents into putting their child at risk.
Now, how about withdrawal….they has been covered up nicely with gag orders.
Our socieity is paying the price of brain altering chemicals…
ed
Lisa and Laurie,
You both made good points. And I understand your anger, some of which is directed at me: Why was this study posted?
This site is part news site, part blog. It’s not just about me being smarmy or provocative every now and then. Stories of all sorts get posted. Some things seemingly contradict other stories. Sometimes I add a zinger or a question or a flip remark. Many are just straight summaries. I’m not taking sides simply by posting something. It’s my job to throw all sorts of things on the screen.
That said, it’s not as if I don’t have an opinion. And I sometimes offer it. I don’t always do so, depending upon time or the length of the piece or if I can find something to say at that moment. Sometimes, I try to find a way to come back to a topic later because I feel I have something of my own to add.
On that note, I agree that this flies in the face of so much else that I’ve seen over the past few years on this subject, although its not the first time. I’m sure one can always find an individual who can benefit from a particular drug, even if most others don’t. But there’s nothing prudent about downplaying risk or making sweeping generalizations about an entire group of drugs that have caused so much controversy and difficulty.
The debate over these drugs has been going on a long time and its not about to end tonight or tomorrow. And I intend to stick with it. That means, over time, there will be posts about various aspects of the issue. Some may be annoying, some may be pleasing. Some may be straight news. Some my reflect my thoughts. But there’ll be more.
ed
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Lisa Van Syckel
When it comes to the safety of the medicines we give our children,give us the facts and not Pharmas junk science.Im sure theyve opened the bubbly thinking you have put NJ parents in their place.I noticed that there isnt any financial disclosure here,why not!My offer for an open public debate still stands.We will see if the good Dr. is man enough to take me up on my offer!!
Laurie
Ed, I understand where you are coming from. It just gets very frustrating to have these “studies” come out about how “safe” these drugs are, and then talk to parents and adults begging for help to get free of these drugs by the thousands.