That’s the conclusion of yet another study in the American Journal of Psychiatry, which finds that teenage suicides rose 14 percent from 2003 to 2004, a year in which the debate that antidepressants actually cause suicide gained widespread publicity. (Here is the abstract).
The data suggest that for every 20 percent decline in antidepressant use among patients of all ages in the United States, an additional 3,040 suicides per year would occur, Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois at Chicago, who did the study, tells The Washington Post.
Meanwhile, the CDC today released new data showing the suicide rate for 10- to-24-year-olds increased by 8 percent in 2004, the largest single-year rise in 15 years. The decline took place from 1990 to 2003 (from 9.48 to 6.78 per 100,000 people), and the increase took place from 2003 to 2004, (from 6.78 to 7.32), the report said. Rates rose for 10- to-14-year-old females, 15 -to-19-year-old females and 15- to-19-year-old males.
The FDA held widely publicized meetings on antidepressants and suicide in the fall of 2003, and Black Box warnings were placed in product labeling in early 2004. Gibbons says those warnings led to a broad decline in antidepressant scrips for all patients younger than 60, but prescription rates continued to rise among those older than 60, and his study found this was the only group in which suicides dropped between 2003 and 2004.
“We may have inadvertently created a problem by putting a ‘black box’ warning on medications that were useful,” says Tom Insel, director of the National Institute of Mental Health. “If the drugs were doing more harm than good, then the reduction in prescription rates should mean the risk of suicide should go way down, and it hasn’t gone down at all - it has gone up.”
In June, the same medical journal pubished a study that offered the same conclusion, prompting Tom Laughren, the FDA official who oversees psychiatric drugs, to say that if CDC data for 2005 shows a similar trend, the Black Box warnings may be repealed. This week, he hints at the same possibility: “We will continue to monitor antidepressant use and suicide rates,” he tells the Post, “and will take appropriate regulatory actions as new data become available.”
The journal, by the way, is published by the American Psychiatric Association, which has regularly criticized the Black Box warnings, saying some docs and patients are being scared away from meds that could be helpful.
What should the FDA do about the warnings?
- Leave the Black Box warnings alone (95%, 142 Votes)
- Repeal the warnings (5%, 8 Votes)
Total Voters: 150