Kids’ Suicide Risk Is Same For All Antidepressants
6 CommentsBy Ed Silverman // April 13th, 2010 // 7:15 am
There appears to be no difference among antidepressants in raising a youngster’s risk of suicidal thoughts, according to a new long-term study in Pediatrics. The research supports the FDA decision in 2004 to mandate a “black box” on all antidepressants for increased suicidality risk in children and adolescents who take the meds and answers the question about which med carries the most risk, HealthDay writes.
“Across the most frequently prescribed antidepressant agents, there was no difference in risk of suicide attempts and completed suicides,” lead researcher Sebastian Schneeweiss, an associate professor of epidemiology at the Harvard School of Public Health, tells HealthDay.
The FDA showed a doubling in the risk of suicidal ideation among kids taking antidepressants, compared with placebo, he notes, but adds the FDA analysis didn’t specify which meds were used, so there was no way to tell whether there were differences in risk. “Physicians need to know if there is an agent where the risk is reduced or particularly elevated,” he tells HealthDay. The report is published in the April 12 online edition of Pediatrics (subscription required).
Data was collected on 20,906 youngster aged 10 to 18 who were diagnosed with depression in British Columbia. They were followed for nine years and were on several commonly prescribed antidepressants, including Celexa, Prozac, Luvox, Paxil and Zoloft. In the first year after starting treatment, there were 266 suicide attempts and three completed suicides. However, no significant difference in attempted or completed suicides was noted based on which antidepressant was taken.
elmore
I’m convinced children’s depression needs to be treated differently than adults, with a lot more focus on whether there are specific causes, such as bullying at school. Children often have no power to alter situations that are contributing to depression such as where they live, go to school, etc. When adults are aware of the problems and refuse to act, there is not only a sense of powerlessness but a sense that no one cares.
pharmavet
I don’t fault these kinds of studies. However, they generate a false sense of security if they generate data that may “seem to suggest” that one agent in a particular class of drugs is safer than another.
I hate to keep harkening back to when I started in pharma durring the Jurassic Period, but what we called “class labeling” was an accepted fact of life. When we got an NDA approved for a drug in a class that also had a drug with a black box safety warning, we knew that we were getting the same treatment, and accepted it. Nowadays, some misguided Regulatory folks think that if they can do the “right” study, they might be able to escape from class labeling.
A similar running theme has been going on in the statin world as to which stating in combination with a particular fibrate may be “safer”. Even if a such study could make the case, the combo would not lose the warning in the PI concerning rhabdomyolysis.
david egilman md mph
generic old style drugs were not tested
jg pharmd
The abstract indicates ” Tricyclic agents showed risks similar to those of selective serotonin reuptake inhibitors (RR: 0.92 [95% CI: 0.43–2.00]” so yes data was collected on “generic old style drugs.”
Lisa Van Syckel
Bottom line is that, all antidepressants are dangerous for the pediatric population. These drugs are still being prescribed haphazardly, and children are dying!!
Dr. Thomas Johnson
I am glad to see this research published and to see you reference it in Pharmalot. There has been a lot of confusion and uncertainty about the meaning of the USDA black box warnings. Some health care providers and parents strongly believe in the value of antidepressants whereas other critics,including such well know psychiatrists as William Glasser, MD and James Gordon, MD , have consistently raised concerns about the dark sides of SSRIs and encourage more psychologically and holistically oriented assessments and interventions. It is not widely known that the UK’s MHRA ( equivalent to the USA’s FDA) essentially banned the prescription of SSRI’s except for Prozac which:” at best,helps only one in 10 children.” Shortly after this was reported Eli Lilly sent out a fact sheet to all UK physician’s indicating that Prozac was “not indicated for children” for any condition. A copy of this letter can be viewed at the http://www.ahrp.org web site under the title “ELI LILLY PROZAC UK FACT SHEET:Not Recommended-PMDD Withdrawn in UK, December 19, 2003. In spite of this, Prozac and the other SSRI’s continue to be widely prescribed in this country for children. Perhaps this latest research will cause more parents and health care providers to pause and consider less risky alternatives to help children struggling with depression.