Antidepressants and Teen Suicide

Teen suicide rates have tripled since 1970, and statistics indicate that for every suicide, there are 50 to 100 attempted suicides. The impact of this increase is felt in our own community. Just last week, I attended the funeral for one of those teens. What needs to be done to control the increase in teenage suicide? Is prescribing antidepressants the answer?

Astralian researchers have found that antidepressants such as Prozac, Zoloft, and Paxil offer only a modest benefit over placebos in depressed patient under age 18. But they also carry significant risks. And a researcher, appointed by the FDA, concluded that children given antidepressants were nearly twice as likely to become suicidal as those given a placebo.

At a recent hearing held by the FDA, parents related stories of teenagers committing suicide with no warning signs and with in days or weeks of beginning treatment with antidepressants. These stories prompted the FDA to issue a warning about a possible link between antidepressants and suicidal behabior in teens. But despite the warning, many doctors are still prescribing Paxil to teens. Although Paxil has never been approved by the FDA for use in children under 18, there are over 11 million children in the United States on antidepressants.

With the uncertainty of how these drugs affect the risk of suicide, is prescribing these drugs, as stated by one Washington, D. C. doctor, preferable to doing nothing? http://abcnews.go.com/wire/Living/ap20040914_66.html


John West said...

This is a very tough issue that affects everyone in some fashion or another. The evidence supporting a link between teen suicide rates and antidepressant prescriptions is fascinating, but the underlying issue is why are kid's depressed/committing suicide in the first place. Rates have steadily risen since the 70's, but so have the overall expectations placed on teens.

Another issue plaguing the nation that may be intertwined with this problem, is the amount of single parent homes in the country. Teens aren't always given the best environment in which to grow up in and it can be hard to overcome such obstacles. Much more research needs to be done in order to combat this issue.

Dr. Tufte said...

My economic take on this is anti-depressent caused teen suicide is probably an overrated issue.

With our current system, there is a big potential downside to this sort of finding, and a lot of incentive for ambulance chasers to blow it out of proportion.

There isn't much of a constituency for the benefits of these drugs. People just don't line up to contribute money "to the system" if an anti-depressant helps them out, but the do line up to cash out of "the system" if they suspect they can prove a problem.

This is almost a perfect application of public choice theory: a small group on whom costs are focused, and a larger group with more diffuse benefits. The former usually wins out. This in no way should be construed as being insensitive to these peoples claims, I'm just pointing out that the other side is unlikely to be well heard out.

(BTW: the author of The Dynamist Blog has a testimonial that these medications helped her).