Too Far

You find the funniest things when you're out and about.

Today I was waiting (forever it seemed) in the doctors office. To kill time, I picked up Newsweek and was surprised to see a story on anti-depressants .....

I've written on an earlier blog about the ridiculous "warnings" given to parents about using the family of SSRI's (Prozac et. al.) on teens. The anecdotal evidence of Prozac causing suicides was ridiculous on the face, and not supported by the evidence. But the lawyers and grieving parents, in my estimation, wrongly put enormous pressure on the FDA and it worked. Recommendations against the drug's use and labeling changes went forward.

Well, now it looks like the truth is starting to emerge:

According to a new study in The Journal of American Psychiatry, the number of SSRI prescriptions for pediatric depression (ages 5 to 18) tumbled more than 50 percent between 2003 and 2005. In a troubling parallel development, the number of teen suicides jumped a record 18 percent between 2003 and 2004, the most recent year for which data exist.

Are the two trends connected? Many experts say yes. "All the data point in one direction: antidepressants save lives and untreated depression kills people," says Dr. Kelly Posner, a Columbia University child psychiatrist. She and others cite an unwitting instigator: the Food and Drug Administration—which may have scared parents and doctors away from SSRIs in 2003 when it issued a health-advisory warning of a potential link between the popular drugs and teen suicide. The agency, assisted at the time by Posner, followed up in 2004 with a "black box" warning of an "increased risk of suicidal thinking and behavior among children and adolescents." Now, amid fears that it's done more harm than good, there are calls for the FDA to modify and even repeal its black box. "I think the FDA has made a very serious mistake. It should lift its black-box warning because all it's doing is killing kids," says Dr. Robert Gibbons, of the University of Illinois's Center for Health Statistics. (Gibbons was a dissenting member of the FDA advisory committee that voted for the black box.) Others agree, including Dr. John Mann, a suicide expert at Columbia University, who fought the warning on the ground that it would have a chilling effect on treatment. "Short of rescinding, the FDA should shift its balance to reflect new wisdom about the beneficial effects of antidepressants," he says. Drugmakers continue to support the FDA but also suspect its actions have had a dangerous impact.

So it took a few dead kids to change the law, and it's now taking a whole lot more dead kids to have rationality return to drug policy.

Do you remember any headline stories about the evidence showing SSRI's are probably better than not? It was in the July 16th issue of Newsweek and I don't remember a thing about it in any other publications .... anywhere. Compare that with the hysterical headlines when the momentum started to go against Prozac. It's like a headline proclaiming that you molested your kid and a next day a retraction appears on page C15.

Good job FDA. Good job media. Shame on parents and practioners for falling for the hype. And RIP to the kids who likely could have been saved.