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Risks of antidepressants
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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