Kids and Antidepressants: A Growing Problem (cont.)
"[Prozac] alone produced almost as good results as the combination of [Prozac] and cognitive behavioral therapy. CBT alone was 10% better than placebo, and you got another 8% response when you added it to the medication. There wasn't an interaction -- the medication didn't work better because they were also getting CBT," he says. "The part that worries us is that there are not a lot of people that can do CBT, and now you're going to be telling people that the standard of care is something that most people can't get."
Not All Evidence Points to Antidepressant, Suicide Link
Other researchers have questioned whether antidepressants are even really at fault.
As reported by WebMD on Dec. 15, researchers at the University of Colorado Health Science Center analyzed insurance claims on more than 24,000 teens with depression and found that when the data were broken down by severity of depression and other risk factors for suicidality, the use of antidepressants did not account for the increase.
The researchers, led by Robert J. Valuck, PhD, RPh, director of pharmaceutical outcomes research at the UCHSC, found that teens who were on antidepressants for six months were less likely to attempt suicide than their nonmedicated counterparts. They reported their findings in the December 2004 issue of the journal CNS Drugs.
"People see that crude relationship between antidepressants and suicide attempts and say antidepressants are bad," Valuck told WebMD. "But what if we adjust for all these factors that may contribute to the person's likelihood of attempting suicide? When we do that, the relationship goes away. There are a lot of things going on in teens who attempt suicide. It is not just the antidepressant drugs."
Brent, writing in the Oct. 14 New England Journal of Medicine, argues that banning or severely curtailing the use of antidepressants in children "would turn the clock back 25 years to a time when the only thing we could offer the families of suicide victims was the hope that someday we would have effective treatments. Ideally, the FDA, families, and clinicians will find the right balance between the risk of suicidality and another, greater risk: the risk that lies in doing nothing."
Back to the Top Stories of 2004
Published Dec. 22, 2004.
SOURCES: Thomas Newman MD, MPH, professor, departments of pediatrics and epidemiology and biostatistics, University of California, San Francisco. Miriam Kaufman, MD, associate professor, department of pediatrics, University of Toronto. David A Brent, MD, professor of psychiatry, pediatrics, and epidemiology, University of Pittsburgh School of Medicine. Marshall Korenblum, MD, associate professor, department of psychiatry, University of Toronto. FDA. Medicines and Healthcare Products Regulatory Agency, United Kingdom. Child and Adolescent Bipolar Foundation. The New England Journal of Medicine; vol 351: pp 1595-1601. Whittington, C. The Lancet; vol 363: pp 1335-1341. Rushton, J. Pediatrics, June 2000; vol 105: p e82. March, J. The Journal of the American Medical Association, Aug. 18, 2004; vol 292: pp 807-20. WebMD Medical News.
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