Study: Child Antidepressant Use Down
But Decline Corresponds With Suicide Increase
April 2, 2007 -- Prescriptions for antidepressants dropped dramatically among children and teens following public warnings about deadly side effects, but now suicides are up, researchers say.
The findings highlight the critical role of mass media in driving medical care, and they are especially troubling in light of reports showing an increase in actual suicides in children and teens at the same time antidepressant use was declining because of fear the drugs may cause an increase in suicidal behaviors, a study co-author tells WebMD.
In 2004, for the first time in a decade, suicide rates among children and adolescents rose instead of declining. That was also the year the FDA held highly publicized hearings that led to stronger warnings about suicide risk on selective serotonin reuptake inhibitor (SSRI) antidepressants like Prozac, Paxil, Zoloft, and Celexa.
The move followed an FDA warning of an increased risk of suicidal attempts, thoughts, and behaviors among children and teens who took SSRIs. That warning was issued in the fall of 2003, and it was also widely publicized.
“Mainstream media had a very large impact on prescription practices,” says Amir Kalali, MD, of the private research group Quintiles Transnational. “There hasn’t been much thought given to quantifying the impact of mass media [on health care practices], but we hope this paper gets the dialogue going.”
16% Decline in 6 Months
Kalali, Charles Nemeroff, MD, PhD, of Emory University in Atlanta, and colleagues analyzed prescription data and physician surveys detailing prescription practices to identify trends in antidepressant use among children and adolescents.
The data they analyzed included more than half -- 55% -- of all U.S. retail pharmacy prescriptions, including private payers, Medicaid, and cash transactions.
The physician survey involved about 3,400 office-based physicians across 29 specialties.
The examination of antidepressant prescription practices from 2000 to 2005 showed a sharp decline in prescriptions to children and teenagers beginning in February 2004.
Between April 2002 and February 2004, antidepressant prescriptions among kids and teens increased by an average of 0.79% a month. Between February 2004 and July 2004 prescriptions declined by an average of 4% a month.