Some Experts Blame FDA Labeling for Child Suicide Increase

Whether SSRIs actually increase the likelihood that a child or teen will commit suicide is still unclear. Studies at the time did show that young patients taking the drugs did have increased thoughts of suicide.

But whether increased thoughts lead to increased action when it comes to suicide is still a matter of debate.

"There could be a small relationship, but we don't have the evidence to support that there is a causal link at this point in time," said Bernadette Melnyk, dean and professor of nursing at the Arizona State University College of Nursing and Healthcare.

"What we know about the link between antidepressants and suicide is they can cause an increase in suicidal thinking, but no study has shown an increase in suicides as a result of antidepressants," said Lori Evans, project coordinator of Treatment of Adolescent Suicide Attempters.

"We do not have the data to know if there has been a significant decrease in the amount of prescriptions given to teens since the warning. Therefore we certainly cannot say there is a causal link."

But Fassler said the new figures suggest that the black box warnings may be doing more harm than good.

"The FDA decision to place a black box warning on these medications remains controversial," Fassler said. "To this day, there are no data demonstrating that SSRI antidepressants increase the actual risk of suicide.

"Conversely, the current data suggest that the decreased use of these medications is, in fact, associated with an increase in actual deaths attributable to suicide."

More Evidence Needed

Despite the suggestions of a connection between the drop in SSRI prescriptions and the spike in child and teen suicides, more research will be needed before a conclusive link can be drawn.

And some say the government has not yet sought an adequate answer to the question of whether this link truly exists.

"I don't think that we know for sure, and that is the fundamental problem here," said Dr. Bennett Leventhal, director of the Center for Child Mental Health and Developmental Neuroscience at the University of Illinois.

"The NIH, CDC and other agencies have failed their responsibility of funding proper studies with enough power to answer the important questions about medical treatment of suicide in children, as well as the side effects of these medications."

Another possibility is that a shortage in child therapists could lead to a decreased ability of children and teens to seek psychological help when it is needed.

"We lack approximately 30,000 child psychiatrists in the U.S., so the gaps in mental health services for those children and youth who need them are huge," said Bernadette Melnyk, dean and professor of nursing at the Arizona State University College of Nursing and Healthcare.

"With one out of four children and teens affected by a mental health problem, less than 25 to 30 percent receive any treatment."

Leventhal said the lack of trained professionals means young patients must sometimes wait a long time for treatment.

"Depression is horrible, but waiting without treatment is worse," he said. "Imagine if we tolerated that for cancer or heart disease."

But the fact that the jump in youth suicide corresponded with the changes in SSRI labeling has many suggesting that the government re-examine its policy toward antidepressant warnings.

"I hope the FDA studies this report carefully," Fassler said. "I think they have an obligation to monitor the impact of their regulatory decisions and to make such modifications as may be appropriate based on subsequent research findings."

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