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Antidepressant Suicide Checkup Lacking

Despite Suicide Risk, Doctors Fail to Check on Patients Starting Depression Drugs
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 10, 2006 -- Despite the risk of suicide in patients starting antidepressant treatment, 80% of new patients don't get recommended mental healthmental health care.

The finding comes from data on 84,514 adults and children who started antidepressant treatment between 2001 and 2003. Medco Health Solutions Inc., a pharmacy benefits company, collected and analyzed the data.

It's long been thought that people with depressiondepression are at increased risk of suicide soon after they start treatment. This has recently become a concern for patients -- particularly children -- starting antidepressant therapy.

Beginning in 2004, the FDA has required "close monitoring" of patients given prescriptions for antidepressant drugs. But even before then, treatment guidelines strongly advised doctors to check up on patients soon after they start depression treatment.

That hasn't been happening, find Medco senior vice president Glen D. Stettin, MD, and colleagues.

"This study brings to light potentially serious inadequacies in the follow-up care of patients on antidepressants," Stettin said, in a news release. "The level of follow-up care seen during this period of time would be considered substandard even according to older guidelines."

Substandard Depression Care

Current guidelines call for anyone -- children and adults -- to have at least weekly face-to-face meetings with a health care provider during the first month of antidepressant treatment.

That doesn't happen, the Medco study shows. Only about half of all patients see any kind of health care provider during the first month of antidepressant treatment. And fewer than 18% of all patients get a mental health checkup during this crucial time.

In fact, half of children -- and three out of four adults -- get no mental health checkup within three months of starting antidepressant treatment.

"When adults and children begin a new course of antidepressant therapy for any indication, they tend to receive far less follow-up care than is recommended by the current product labeling," Stettin and colleagues conclude.

The study appears in the August issue of The American Journal of Managed Care.

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