Treatment Online

Latest Report on SSRI Prescriptions Tempers Concern with Caution
> 1/9/2008 2:15:15 PM

The latest report on the effects of the FDA's antidepressant warnings, published in this month's edition of the Archives of General Psychiatry, concluded that the warnings did result in a leveling-off of SSRI prescriptions, but that this shift occurred mainly among the targeted population. To arrive at this conclusion, researchers from Columbia University's Department of Psychiatry examined prescription data from three distinct periods: data occurring before any warnings were announced, during an initial warning period, and after the black box warnings were issued. The pre-warning period was characterized by increasing prescriptions of all types of antidepressants, while those prescriptions began to level out after news of possible warning labels began to make the rounds.

The researchers make no speculation about the results of declining prescription rates, but we had harsh words regarding the effects of the FDA's warnings on antidepressants. This new evidence simply confirms what we already knew: prescription rates decreased. The decreases occurred in what these researchers called the targeted area, which was that of adolescents and young adults. Unfortunately, we can only fully understand the implications of these actions as they play out over time.

The most important observation drawn from this study may be that the change in prescription rates preceded the actual warnings, which shows that physicians and psychiatrists are keenly aware of the debate that rages about the safety of SSRI medications. This could mean that just as prescribers appeared to take more caution before the warnings, they may become more comfortable and judicious with their scrips now that time has passed and the initial shock of the warnings has abated. This could lead to more effective use of SSRIs, especially in combination with therapy, which would improve overall treatment, and ideally, counteract any initial negative responses to the warnings.

The wild card in this situation is research into the genetic basis for poor SSRI response. With a greater understanding and appreciation for how and why different medications affect different individuals in unique ways, we should be able to greatly improve current outcomes for psychopharmacological approaches to depression. Any news out of this research sector could greatly alter the landscape of the SSRI warnings debate. We'll continue to keep an eye out.

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