The New York Times The New York Times Business See the newest makes and models

NYTimes: Home - Site Index - Archive - Help

Welcome, charlygroen - Member Center - Log Out
Site Search:  

Email This Article E-Mail This Article
Printer Friendly Format Printer-Friendly Format
Most E-mailed Articles Most E-Mailed Articles
Reprints & Permissions Reprints & Permissions


Prescribing Caution
Graphic: Prescribing Caution



. Second Thoughts on Restricting Drugs to Treat Depression in Adolescents (September 21, 2004)



Children and Youth

Medicine and Health

Food and Drug Administration

Suicides and Suicide Attempts

NYT Store
A Nation Challenged: Young Reader's Edition
A Nation Challenged: Young Reader's Edition
Price: $18.95. Learn More.

Now‚ what’s cooler than bein’ cool?   Outkast’s Andre 3000 surely knows the answer.

Take a look at Andre’s sense of style.
See what else is hot in Men’s Fashion.

Study Finds Less Youth Antidepressant Use


Published: September 21, 2004

The number of teenagers and children being prescribed antidepressants in the United States dropped 18 percent over the last year after studies found that the medicines appeared to lead some to become suicidal, according to one provider of drug benefits.

In a study done at the behest of The New York Times, Medco Health Solutions found that 43,859 of the roughly 3.5 million children and teenagers for whom the company provided drug benefits in July, or 1.26 percent, were prescribed antidepressants that month. That is down from 60,902 children and teenagers, or 1.69 percent of the total, who were prescribed the drugs a year earlier. It was the first decline in prescriptions for antidepressants among teenagers and children in years, the company found.


Some experts greeted the news with guarded optimism, saying that it meant that physicians may be using more care when prescribing the drugs to youngsters.

"You would hope that the inappropriate use of these medicines has dried up a bit," said Dr. Richard Malone, a pediatrician in Baltimore and a member of the Food and Drug Administration's advisory committee that concluded last week that the agency should place a strong warning on the drugs about the risk of suicidal thoughts or behavior in pediatric patients.

The finding by Medco Health Solutions is at odds with information provided last week by the F.D.A. to its advisory committee. An F.D.A. official told the committee that prescriptions of antidepressants for children and teenagers continued to rise by 7 percent this year despite a growing controversy about the safety of the drugs. "We did not see any decline," Michael Evans, a drug use specialist with the F.D.A.'s office of drug safety, told the committee.

Mr. Evans told the committee that his information came from IMS Health, a health information and consulting company. Lance Longwell, a spokesman for IMS Health, said that the company provided data to the agency, but that the agency did its own analysis.

IMS Health obtained most of its information about drug use by surveying pharmacies, but it did not collect patient information. Mr. Longwell said that he did not know how the agency distinguished between prescriptions given to adults and those given to teenagers and children. A spokesman for the F.D.A. said the agency would not comment.

Medco provides prescription drug benefits for about 60 million Americans over the course of a year, or about a fourth of those who have health insurance in the United States. The company's finding on antidepressants resulted from a direct analysis of its patients' prescription drug histories, said Ann Smith, a Medco spokeswoman.

The Medco data suggest that the controversy about the safety of antidepressants has made an impression on physicians, young patients and their parents. Last summer, GlaxoSmithKline, the manufacturer of Paxil, and Wyeth, the maker of Effexor, both warned that studies of their drugs in youngsters indicated that some had become suicidal. For GlaxoSmithKline, the warning came from an analysis requested by the F.D.A. that looked at studies that the company had kept largely secret. None of the children in the trials committed suicide, but some thought about or attempted suicide, researchers found.

After these findings, the F.D.A. asked manufacturers of seven other antidepressants to study the effects of their drugs on children and teenagers. Taken together, the studies found that children and teenagers given antidepressants are twice as likely to become suicidal as those given placebos. In February, the F.D.A.'s advisory committee suggested that the agency provide a general warning about the risks of suicide among antidepressants users, which the agency did in March.

Last week, the advisory committee voted that the drugs' warnings should be strengthened. The agency is still studying the committee's recommendation and promised to act within months.

Dr. Lauren Marangell, an associate professor of psychiatry at Baylor College of Medicine in Houston and another member of the advisory committee, said at last week's hearing that despite the growing evidence of the risks of the drugs she was not hoping for a decline in antidepressant use among the young.

"I don't want to see prescriptions drop because these people need to be treated," Dr. Marangell said at the hearing. "They need to be warned about the risks."

In an interview yesterday, Dr. Marangell said it was impossible to tell whether the decline found by Medco was real and, if so, whether it was beneficial.

"It's bad news if kids that need treatment don't get it, and it's good news if people who don't need the drugs aren't getting them," Dr. Marangell said. Others said that the Medco data were consistent with their experience.

Dr. Malone, the Baltimore pediatrician, said he received two telephone calls from parents of patients he had put on antidepressants asking if it was time to end the therapy.

"I have 3,500 children in my practice, and to get two calls on the same issue on the same day is pretty unusual," he said.

Both parents said that they were concerned about the newfound risks of the drugs, Dr. Malone said.

James McGough, a professor of clinical psychiatry at the University of California, Los Angeles, and another member of the advisory committee, said that antidepressants were often given to the wrong young patients for the wrong reasons. On the other hand, he said he saw a depressed young girl yesterday who needed antidepressant therapy. "But her parent is so afraid of the medicines that it's getting in the way of what this girl truly needs."

Free Trial of The New York Times Electronic Edition.

. F.D.A. Panel Urges Stronger Warning on Antidepressants (September 15, 2004) 
. Childhood: Shortness Is No Stigma (September 14, 2004) 
. U.N. Cites Gains for Women Worldwide, but Health Issues Linger  (September 1, 2004)  $
Find more results for Children and Youth and Medicine and Health

. Orders for Durable Goods Fell 0.5 Percent
. Bankruptcy Judge Rules Against United Airlines
. S.E.C. Is Investigating Morningstar Over Data
. Troubled Unit of Halliburton May Go on Block
Go to Business

PeopleSoft Demand-Driven Manufacturing See a white paper

FREE Stock Market Outlook!
>>Download here

AT&T CallVantage Cable/DSL home calling

The Vanguard Group