Treatment Online

Is the FDA Warning About Antidepressants Wrong?
> 1/7/2006 10:24:17 AM

In 2004, in an ill conceived and some what hysterical 2004 advisory, the Food and Drug Administration (FDA) warnedthat suicidal behavior may emerge after antidepressant treatmentis begun. This warning was carried in the media broadly and the traditionally psychiatry hating press reported on the dangers of SSRI�s particularly in teenagers. Now in a study that is likely to not receive such media coverage a 10-year population-based study by Simon et al. indicates just the opposite about antidepressant treatment especially SSRI�s and particularly in teenagers. Among 65,103 patients in alarge health plan who filled prescriptions for antidepressantsduring 1992�2003, the number of suicide attempts felldramatically after antidepressant treatment began and then declinedmore slowly. Completed suicides were few and did not vary overthe first 6 months of treatment. Adolescents had more suicidalbehavior than adults, but attempts decreased by over 60% inthe first month of treatment. The FDA advisorynames 10 newer antidepressants, but in this study the decreasein suicide attempts after treatment began was actually greaterwith newer agents than with older antidepressants.

    The damage that ensues from rash judgements about psychiatric treatment only emboldens the Tom Cruise contingencies of our society and discredits the hard work that mental health professionals log on a daily basis. I still see patients that believe Prozac makes you want to kill people and will not consider it's prescription because of all the negative implications about the drug. Unfortunately, the public will remember that antidepressants make you want to kill yourself and forget that the above article based on ten years of data indicates the complete opposite.

    The FDA owes Psychiatry an apology (like this will ever happen) and should redraft the warning on suicidal ideation to reflect that antidepressant prescriptions should be taken seriously and only dispensed by trained psychiatrists with close follow-up in therapy by mental health professionals who monitor response and continue to explore the underlying psychology of the suicidal ideas and their ultimate motives.

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