Wednesday, February 17, 2010

In Defense of antidepressants:culprit or falsely accused?

In 2004 the FDA added a "black box" warning on all antidepressants, advising parents that antidepressants prescribed to children and adolescents may increase suicidal thoughts and or behavior, mind you, the operative words here are "may" and "increase"

Now, here is some interesting news: According to a September 2007 CDC report, from 1990 to 2003 the combined suicide rate for people age 10 to 24 declined from 9.48 to 6.78 per 100,000 persons. But from 2003 to 2004 the rate increased from 6.78 to 7.32 per 100,00 people for the same age group.

Do you see where I am driving at here? Let me elucidate: Another study surveyed non-specialist prescribing physicians(meaning physicians that are not psychiatrist) and found that 91% misunderstood the warning to mean that there was a risk of death associated with antidepressants. This means that physicians stopped prescribing medication to youngsters who would have benefited from it. Parents are less inclined to take their children to psychiatrists and even less inclined to give medication that their doctor is telling them will cause their child to kill himself. According to the above mentioned CDC report suicide rates that had decreased since the advent of antidepressants have risen since the warning was added.

I believe that in this case we have thrown out the baby with the proverbial bath water. What research has unequivocally shown is that a combination of therapy and medication, in cases where medicaiton is necessary, is the most effective approach. Instead of outright rejecting medication for moderately to severely depressed kids and adolescents parents should work closely with their physicians and their psychologists so that they can integrate medication with other treatments that are effective, like psychotherapy. Well documented research and my own professional experience has shown that therapy is as effective as medication and has more permanent results, but there are cases where medication is necessary and life saving at least until therapy has been given time to produce results. So, before we write the final epitaph for antidepressants lets give them another serious and educated look.