Teen Suicide Rates Increase as Prescriptions Decrease

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Antidepressant Medication and Teenagers

A lot of teenagers, and even children, are prescribed antidepressants, somewhere from 1% to 1.5% of the population. At one point studies estimated that as many as 1.66% of children or adolescents were prescribed antidepressant medication, but after the FDA required a "black box" warning label for the medications in 2005, the prescription rate has dropped. The warning label states that the use of antidepressants among children and teenagers is associate with an increased risk of suicial thoughts, and suicial behaviors. So physicians have backed off of prescribing the medications.

However, the estimated suicide rate among American adolescents is about 16%.

Research indicates that as a result of fewer depressed teenagers receiving antidepressant treatment, the suicide rate among teenagers has gone up. See Hamilton B, et.al., Annual Summary of Vital Statistics: 2005. Pediatrics. Also see Greenhouse, J., et.al., Generalizing from Clinical Trial Data: A Case Study. The Risk of Suicidality Among Pediatric Antidepressant Users. Carnegie Mellon University.

Follow along with me here:

1. Antidepressants can increase suicidal thoughts and behaviors in children and adolescents who were not having any, or many, suicidal thoughts or behaviors, according to a study of 4,600 children and teens (and, by the way, no one in this group of 4,600 committed suicide). This was the basis of the FDA's black box warning label.

2. But in children and teens who ARE having suicidal thoughts or behaviors prior to treatment with medications, antidpressants LOWER the risk of suicide. Simon and his group studied 65,000 medical records and found that the highest risk of suicide among the depressed was the month PRIOR to beginning treatment, and that the risks greatly diminished after beginning treatment with antidepressants (Simon GE, et.al., Suicide risk during antidepressant treatment. Am J Psychiatry. January, 2006)

3. Other studies have found that the more often antidepressants are prescribed to children and adolescents who could benefit from them, the lower the suicide rates (Gibbons RD, et.al., The relationship between antidepressant medication use and rate of suicide. Archives of General Psychiatry. 2005)

So the bottom line is, black box warning label or not, if your child or teenager is not depressed and is not having suicial thoughts or behaviors, they are probably better off not taking an antidepressant medication.

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