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Group Finds No Suicide-Antidepressant Link
Jan. 21, 2004 -- The SSRI class of antidepressants don't increase suicide in children and teens, a medical group says.
SSRIs -- selective serotonin reuptake inhibitors -- include the popular antidepressant drugs Prozac, Paxil, Zoloft, and Celexa.
Reports of suicide in young people treated with these drugs last October led to an FDA warning about the drugs. The FDA's warning followed a stronger action by the U.K. Medicines and Healthcare Products Regulatory Agency. The British agency advised doctors not to use the drugs in children and teens.
Both the U.S. and U.K. are currently studying the issue. An FDA advisory panel will consider the issue at a Feb. 2 meeting.
But the American College of Neuropsychopharmacology -- an expert group of psychiatrists and pharmacologists -- convened its own task force on the issue. That task force today released its own findings. Its co-chair, J. John Mann, MD, is professor of psychiatry and radiology at Columbia University and chief of the neuroscience department at New York State Psychiatric Institute.
"Our conclusion is that when you look at the SSRIs as a group, there is evidence they are effective for treating depression in children and adolescents," Mann tells WebMD. "Instead of being a risk for suicidal behavior, they are potentially therapeutic. Doctors must go on treating depression, and SSRIs appear to be a reasonable choice."
"No SSRI/Suicide Report" Still Preliminary
The ACNP task force looked at all available published information. But the panel stresses that it did not have access to "a substantial amount" of unpublished data -- including detailed findings held by drug companies -- that will be made available to the FDA panel.
Mann will be a member of the FDA panel. He says he's keeping an open mind.
"The FDA is examining the data we looked at plus it is examining in more detail the data provided from pharmaceutical companies in terms of the type of suicidal behaviors that have occurred," Mann says. "That is new evidence. Based on how that is assessed, the FDA is attempting to look in a uniform way across seven or eight kinds of antidepressants. That will offer a unique opportunity to look at the data individually and collectively."
Still, Mann says, there's a critical need for more research. People enrolled in clinical trials tend to be less suicidal -- and given much better, much more detailed care -- than those treated in real-world settings.
"What are needed are new studies of the efficacy of SSRIs in depressed kids who are suicidal," Mann says. "Most studies actually excluded kids with suicidal behavior. So we must study the effect of SSRI treatment on those suicidal thoughts and behaviors in a way that's up front in the design of the clinical trials."
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