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| Risks of antidepressants |
NYT
Friday, September 17,
2004 |
| The latest medical
verdict on the use of antidepressant pills to treat teenagers and
children is every bit as depressing as the original warnings raised
months ago. There is remarkably little evidence that most of the
pills are effective in treating depression in such young patients
and increasing evidence that they can lead to suicidal thoughts and
behavior. An advisory panel to the U.S. Food and Drug Administration
was quite right this week when it urged the strongest possible
warnings for doctors and patients about the potential
dangers.
The panel shied away from urging a complete ban on
antidepressants in children and teenagers, and for good reason.
Doctors need weapons to combat major depression, even if those
weapons carry some risk.
Unfortunately, nothing in their
arsenal is notably effective. One large trial showed that talk
therapy was no better than a placebo at alleviating depression in
these young patients, and a vast majority of antidepressant pills
have also failed when tested for this age group.
Only Prozac
has shown consistent effectiveness, although there is new evidence
that it, too, can cause suicidal tendencies. The other
antidepressants are prescribed by doctors in the belief, perhaps
mistaken, that they are effective for young people.
The FDA's
expert panel thought the pills too important to ban. A third of the
panelists opposed even an extra-strong warning on information sheets
for doctors lest it discourage treatment that could be lifesaving
for some young patients. The FDA typically gives great weight to the
views of its advisory committees, but it is not obliged to adopt
them.
What patients, parents and doctors most need is not
just a warning, but the clearest possible guidance as to which of
these drugs are safer and more effective than the others.
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