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    More Concern on Antidepressants in Children

    As FDA Considers Their Place, Antidepressant Use Skyrockets Among Italian Youths

    Worldwide Use continued...

    Although most SSRIs are not specifically approved as a childhood depression treatment, worldwide, they are considered the first line of defense against depression in all age groups. Prozac is the only SSRI specifically approved by the FDA for use in those under 18.

    Two FDA advisory panels met last month to hear from experts and parents, some detailing their children's suicides after starting SSRI treatment and others claiming that the controversial drugs had saved their kids' lives.

    Medication Better Than Taking No Action

    At least 1 million children and teens in the U.S. are currently taking SSRIs for depression, says child and adolescent psychiatrist David Fassler, MD, who testified before the FDA panels as an expert for the American Psychiatric Association. In the U.S., childhood depression affects about one in 20 kids -- and about one-third of them will attempt suicide at some point during the course of their illness, regardless of their medication.

    "Probably the worst thing parents can do if they suspect their child has depression is nothing at all; the biggest risk is to be left untreated," he tells WebMD. "The FDA is doing the right thing, because this is a very serious issue and we don't want to make a mistake in either direction. But with all this media attention, sometimes I am concerned that parents may become reluctant to get any help for their kids."

    His advice: "If you see signs that your child might be depressed or you are concerned, get a good evaluation from a trained mental health professional," says Fassler, of the University of Vermont. "There are treatments other than medication. Certain forms of psychotherapy, on their own, are very effective."

    Even with medication, he says counseling should be part of a multi-pronged approach to effective treatment; often, it's not. "But in my own review of data, I'm not convinced there is an increased risk of suicide from SSRI use."

    And he's not alone. The American Academy of Child and Adolescent Psychiatry says SSRIs can be effective in treating childhood depression. And in January, an American College of Neurophsychopharmacology Task Force found no evidence of an SSRI-suicide link after reviewing clinical trials, epidemiological studies, and toxicology results from autopsies of teenaged suicide victims. Its review of 49 adolescent suicides indicated that 24% of those kids had been prescribed antidepressants, but none had any trace of SSRIs in their system at the time of their death.

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