Others question whether the antidepressants might have more of a "rebound effect" in children.The kids feel better when the drugs are in their system, but may feel even worse as the drugs wear off.
We know kids metabolize drugs faster," Okiishi explains."One possibility is that we may not be giving them enough."
Doctors agree it is important to watch a person starting antidepressants very carefully.Jay Reeve, senior psychologist at Bradley Hospital in Providence, R.I., explains, "We often admit [severely depressed kids] to the hospital.We watch them very closely for at least three to four days.After that, we make sure we have a lot of parental education about possible side effects."
But with increased suicidal thinking as a possible side effect, some feel you can't be too careful. Dr. Thomas J. Moore of George Washington University told World News Tonight, "I believe there is not enough evidence that these drugs are safe."
The ACNP report notes safety evidence in adults is much better."More than 20,000 adults have been studied in clinical trials of SSRIs and other antidepressants … Analysis of the database found no relationship between SSRIs and suicidal attempts or actual suicides in adults."
Experts hope the FDA hearing will provide more answers to the question of effectiveness and safety of antidepressants in children."We need large scale multi-site studies," Fassler says."A hearing to evaluate what we know and what we don't know is a good thing."
Verdict Not Likely to Come Soon
For the millions of people taking SSRIs for depression, a definitive answer is not immediately in sight.Dr. Russell Katz of the FDA explains: "We don't believe we have the information at the moment to be able to make that decision, and we think it is very, very important to get this correct, because a mistake in either direction can have very significant health consequences."
Meanwhile, some question whether the FDA panel may be overly biased in favor of the drug companies.
The Center for Science in the Public Interest, for instance, has urged the FDA to remove three of 11 scientists on one of its advisory boards evaluating the link between antidepressants and suicide in youths because they have been paid consultants for the companies that make the drugs under investigation.
The FDA says they are just beginning the review process and may not have an answer until next summer.In the meantime, they have urged doctors to be especially careful when prescribing antidepressants to children.
All doctors emphasize parents should not stop their children's antidepressant medications without first talking to a physician.
"Drugs are not the whole answer," acknowledges Fassler."But there is a high risk of not treating kids."
Okiishi explains, "I have 15-20 patients with a parent overseas in the Gulf.The parents heard the British report on the BBC [about SSRIs and suicide] and wrote home to have their kids taken off the medications without consulting me. I ended up with some pretty sick kids."
Okiishi says his young patients are back on their medications and doing fine.