Published: September 16, 2004

Topics:
Children and Youth
Suicides and Suicide Attempts

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 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 for
children and teenagers, and for good reason. Left untreated,
depression can create a far greater suicide risk than the pills.
Doctors desperately 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, and only Prozac has
been specifically approved for use in young patients, 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 in 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.