Antidepressants Reduce Suicide in Children Despite FDA Warning

By Lucy Williams, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Children taking antidepressants may be at risk for suicidal thoughts, according to the FDA's "black-box" warning. However, new research reveals antidepressant use could prevent completed suicides in children.

Researchers at the University of Illinois at Chicago examined childhood suicide rates in each county in the United States from 1996 to 1998. Counties with the highest antidepressant prescription rates had the lowest suicide rates in children ages 5 to 14.

"The apparent contradiction between our findings and findings of the FDA could be very puzzling to people," lead author Robert Gibbons, Ph.D, of the University of Illinois at Chicago, told Ivanhoe. "But the two studies are looking at different endpoints. One, suicidal thinking on the part of the FDA, and two, suicidal completion on the part of our study."

The FDA's black-box advisory warns antidepressant use could lead to suicidal thinking. But this new research suggests antidepressant use prevents actual incidence of suicide. Researchers estimate antidepressant medications prevent about 253 suicides each year in children in the United States.

When the black-box warning was initiated, some members of the scientific advisory board had concerns the warning would lead to a decrease in the prescription of antidepressant medications. The black-box warning was intended to encourage doctors to pay closer attention to patients, particularly children, taking antidepressant medications. Instead, the warning apparently led to a decrease in antidepressant treatment. The rate of childhood antidepressant treatment dropped by about 30 percent after the black-box warning was issued.

Researchers are concerned children may not get the depression treatment they need. Dr. Gibbons said, "There's concern there is a lot of untreated depression in children and the potential for increases in the rates of suicide."

The black-box warning should not prevent patients from receiving treatment for depression, according to Dr. Gibbons. Rather, it should encourage doctors to more closely monitor children taking those medications.

In a recent related study, researchers at the University of Texas in Austin found antidepressant treatments caused more aggressive behavior in juvenile hamsters. This reaction could be due to fluctuations in the brain during puberty. They concluded antidepressant treatments could be riskier and less effective for children because their brains are still maturing.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

SOURCE: Ivanhoe interview with Robert Gibbons, Ph.D., University of Illinois at Chicago; American Journal of Psychiatry, Nov. 2006;163:1898-1904