Experts to FDA: Don't Change Antidepressant Labels


"Several of those studies show that increasing rates of antidepressant use have been accompanied by stable or declining suicide rates," he said.

"The epidemiologic research is dramatic and consistent," Vuckovic said. "Suicide rates among adolescents and children have dropped dramatically in conjunction with more aggressive use of [antidepressants] in that population."

Physicians Split on Impact on Practice

Some practitioners said additional package warnings could cause their patients to second-guess medications, even if those drugs are recommended by a physician.

"A black-box warning would increase the questions and concerns patients have on the medication," said Dr. Davin Quinn, a clinical fellow in psychiatry at Massachusetts General Hospital. "Black-box warnings may make some patients more concerned about being treated by an antidepressant. Black-box warnings may even cause some patients to decline to be treated by those medications."

However, not all practitioners believe the additional warning will affect their practices.

"There have been black-box warnings on anti-psychotics, and they're still prescribed by clinicians," said Dr. Jennifer Narvaez, another clinical fellow in psychiatry at Massachusetts General Hospital. "I don't think people are going to stop taking antidepressants or anti-psychotics entirely because they are helpful. Having black-box warnings do raise consciousness among physicians and patients."

"In general, I feel that it's good to error on the side of prudence," said Dr. David Mischoulon, assistant professor of psychiatry at Massachusetts General Hospital. "Even when there's a hint of adverse effect, especially serious, it's good to put out the warning, so that doctors and patients have that information.

"The black-box warnings probably will not change my practice."

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