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Antidepressant Warnings & Teen Suicide Attempts

Overreaction to FDA warning may have led to undertreatment of depression, experts say

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The FDA now recommends that doctors consider both the risk of prescribing an antidepressant and the risk of not prescribing the drug. Doctors should also monitor patients for suicidal thoughts.

Undertreating depression is worse than the slight increase in suicidal thoughts antidepressants may cause, Lu said. "It's also a reminder for doctors to weigh the risk of a drug with the risk of not treating or undertreating the condition," she said.

For the study, Lu and colleagues used the Mental Health Research Network to collect medical claims data from 11 U.S. health plans from 2000 to 2010. This database includes records for 1.1 million teens, 1.4 million young adults and 5 million adults.

To measure suicide attempts, the researchers used records of overdose with mind-altering drugs, such as marijuana, amphetamines, tranquilizers and Ecstasy.

They found that suicide attempts rose 21.7 percent among teens and 33.7 percent among young adults.

The report was published June 18 in BMJ online.

Tony Tang, an adjunct professor in the department of psychology at Northwestern University in Evanston, Ill., said, "The article addresses a possible blind spot in the thinking of the general public."

Although some antidepressants might increase suicidal thoughts, they also prevent some suicides just by alleviating depression, he said.

"It is fashionable to believe the worst about everything not natural or organic. In this atmosphere, perhaps the general public has overlooked the suicide prevention benefits of antidepressants," Tang said.

Cognitive behavioral therapy has been proven effective in treating depression and superior in preventing depression relapses, he said. If people are so concerned by the FDA warnings, they should seek out other proven treatments, such as therapy, he suggested.

Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said, "FDA advisories and boxed warnings should be represented accurately by the media, taken seriously by the public and health professionals, and then used as the starting point for an open, interactive and ongoing discussion between the clinician and patient about the relative risks and benefits of all available effective treatments along with more active monitoring of all patients at risk, regardless of which intervention is selected."

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