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Suicide Warning Cut Antidepressant Use

Study: 'Black Box' Warnings Reached Their Target Group of Children, Teens
WebMD Health News
Reviewed by Louise Chang, MD

Jan. 7, 2008 -- Warnings about suicide risk in youths taking antidepressants have affected the use of those drugs.

New research shows that antidepressant use by kids and teens fell nearly 10% annually after the drugs got a "black box" warning -- the FDA's sternest warning -- about youth suicide risk.

That news is based on data from Medco, one of the largest pharmacy benefit managers in the U.S. The data included more than 2 million people.

The researchers analyzed antidepressant use by children aged 6-17 and adults before, during, and after FDA warnings on antidepressants and youth suicide risk came out in 2003 and 2004.

From May 1, 2002 to June 19, 2003 -- before any warnings were put in place -- antidepressant use by youths rose by 36%.

On June 19, 2003, the FDA recommended that the antidepressant Paxil not be used to treat depressed children and teens. From then until October 2004 youth Paxil use dropped by 44% and youth use of all antidepressants dipped by about 1% per year.

In October 2004, the FDA established its black box warning about suicide risk in youths taking any antidepressant. That warning also noted that children and adults taking antidepressants should be watched closely for increased suicidal thinking and behavior, note the researchers.

From October 2004 until the end of 2005, youth antidepressant use dropped by about 10% per year.

The trends throughout the study were stronger in kids and teens than in adults.

"It is reassuring that the pattern of changes in treatment, which were modest in size and greatest for treatment of youth, were broadly consistent with the FDA warnings and the scientific literature," write the researchers.

They included Mark Olfson, MD, MPH, of the New York State Psychiatric Institute and Columbia University.

The study, published in the Archives of General Psychiatry, doesn't cover antidepressant use following the FDA's May 2007 recommendation to update the drugs' black box labels to include young adults aged 18-24.

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