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Officials call for research of antidepressant use by children

THE STATE OF OUR CHILDREN: Officials call for research of antidepressant use by children

BY MARC CHASE
Times Staff Writer

Preschool children -- ages 5 and younger -- are the fastest-growing population of youths taking antidepressants, yet doctors know little or nothing about the effects the pills have on our kids, region and national health officials warn.

With the number of overall pediatric patients taking pills for depression growing by nearly 10 percent every year, the medical community should hustle to determine the effects of antidepressants on them, those mental health experts agree.

Given that doctors are prescribing antidepressants, including Paxil, Prozac and Zoloft, to children at record rates, some parents might assume doctors know the medication is effective in treating children with depression, a researcher for a St. Louis-based pharmaceutical company said.

The research is spotty and at best shows that antidepressants are only moderately effective in treating depression in kids, said Dr. Thomas Delate, a pharmacy sciences specialist with Express Scripts Inc., a prescriptions-by-mail company.

Some medical experts even believe such drugs can cause the very symptoms the substances are meant to fight against. The Food and Drug Administration now recommends that such medication carry warning labels cautioning of a higher risk for suicide among those that take such pills.

Meanwhile, a recently published study conducted by Delate and three other doctors shows the number of commercially insured children receiving antidepressants grew from 1.6 percent in 1998 to 2.4 percent in 2002.

The fastest-growing group of children taking antidepressants are those 5 and younger, with the use among girls in that age group doubling and the use among boys growing by 64 percent during the time period of the Express Scripts study, Delate said.

Bob Krumwied, executive director of Tri-City Comprehensive Community Mental Health Center in East Chicago, said there is some cause for concern in that rate of growth, especially given that so few studies have been conducted to determine the effectiveness or impacts of antidepressants on children.

"More than 40 percent over that period of time is a pretty significant increase," Krumwied said. "There is a burgeoning use of these types of medications among children, and we best be looking into the safety and efficacy of prescribing antidepressants to children."

Krumwied's facility treats about 1,000 region children suffering from depression per year. Those kids, mostly residents of North Township, make up about 20 percent to 25 percent of the center's total patients.

"There is quite a bit of research out there as it relates to adults taking antidepressants," Krumwied said. "There is very little for kids. There is a group of kids for whom antidepressants are life saving. Then there are those for whom we are just not sure."

Delate said doctors should get sure -- and quickly.

Much of the increase in pediatric antidepressant use can be explained by an overall increase in depression among children, Delate said. The increases also appear to be parallel with a practice by insurance companies in the late 1990s to pick up the bill for pills rather than counseling and other therapy.

Regardless of the degree of effectiveness in children, antidepressants should almost always be coupled with intensive therapy, said Dr. Peter Nierman, deputy director for the Illinois Department of Human Services Division of Mental Health.

Patients must realize that medications alone will not solve the problem and that children taking the pills must be monitored closely by their parents and their doctors, Nierman said.

Marc Chase can be contacted at (219) 933-3243 or mchase@nwitimes.com.

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[EXTRAS]

By the numbers
1.6 -- Percent of commercially insured children receiving antidepressants in 1998
2.4 -- Percent of commercially insured children receiving antidepressants in 2002
113 -- Percent increase of girls taking paroxetine, also known as Paxil.
91 -- Percent increase of boys taking paroxetine.

Source: Express Scripts Inc. study of antidepressant use by commercially insured youth.

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