It's premature to blame FDA for suicide rise

The front page headline in the Washington Post was alarming: "Youth suicides increased as antidepressant use fell." A new study argued that a record increase in youth suicides in 2004 may have been the unintended consequence of federal warnings that antidepressants such as Prozac can trigger suicidal thoughts in children. Media outlets across the country reported the painful irony that the Food and Drug Administration's attempt to prevent suicides seemed to have increased them by discouraging doctors from properly treating depressed young people.

"We may have inadvertently created a problem," lamented Thomas Insel, director of the National Institute of Mental Health, to the Post earlier this month.

But a closer look at the numbers suggests that the suicide fears are at least premature, if not baseless, say people who specialize in health statistics.

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Suicides up after warning, study shows

A 22% drop in prescriptions for antidepressants for teens and children following government warnings about hazards of the drugs led to a sharp increase in suicides the following year, according to Chicago researchers.

The change in labeling in 2003 warned that use of the drugs could increase suicidal thoughts and behavior among youths, but the labeling seems to have backfired, according to a report in the September issue of the American Journal of Psychiatry.

In the year after the change in labeling, the suicide rate rose 14% among those younger than 19, the largest increase since the government started collecting suicide statistics in 1979, said biostatistician Robert D. Gibbons and his colleagues at the University of Illinois at Chicago.

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Diagnosis, Treatment of Youth for Depression Fell After FDA Alert

Researchers are troubled by data indicating that large numbers of young people with depression are being left untreated after the FDA issued its first advisory about the antidepressants in 2003.

Rates of the diagnosis and pharmacological treatment of depression among children and adolescents dropped sharply after October 2003, when the U.S. Food and Drug Administration (FDA) issued its first public health advisory informing health care professionals of an increased risk of suicidality among youngsters taking antidepressants.

These findings, which appeared in the June American Journal of Psychiatry, have heightened the concerns of researchers and clinicians alike that suicide rates among untreated children and adolescents will rise unchecked. In fact, a study published in the February Pediatrics revealed an 18.2 percent increase in suicide from 2003 to 2004 among youngsters under the age of 20 (Psychiatric News, March 2).

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