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Wednesday, September 13th, 2006

Emily Halevy | CWK Producer

The controversy surrounding anti-depressant use with teens continues to confuse and concern parents. Experts say there’s still much to be known about these drugs, but one fact they do know for sure is that untreated depression is one of the main factors for suicide.

“Have you taken your medicine this morning?” asks Elora’s mother.

14-year old Elora is just one of the millions of teens being treated for anxiety and depression with anti-depressants.

“It [has] helped me a lot,” she says. “It helped me not be afraid. I’m not as nervous anymore and you know, just happier altogether.”

But then her mom heard there was a link between anti-depressant use and an increased risk of suicide.

“I was horrified,” she says. “And the first thing I wanted to do was stop giving Elora the medication.”

But experts say while there is cause for concern, parents should also look at the numbers.

“You know, we need to remind ourselves that in all the FDA studies that were looked at, that lead to the ‘black box’ warnings, there was not a single child who completed suicide - who actually killed themselves,” says Dr. Shannon Croft, assistant professor of psychiatry at Emory University and medical director of child psychiatry at Grady Hospital.

In fact, experts say, the suicide rate started to decline right after the first anti-depressant, Prozac, was introduced.

“Since 1988, there has been a tremendous decline in the rate of suicide,” explains Dr. Sharon Jones, a psychiatrist. “And that is as anti-depressant sales has risen, so there’s a parallel.”

But Croft says it’s not that simple, “That seems to suggest that treatment of depression with anti-depressants might be responsible for the drop,” he says. “Unfortunately, it doesn’t prove that - it just shows there’s a link.”

He says there may be a slight risk that anti-depressants can increase the risk of suicide, “but it is significantly overweighed by the possible benefit of improving depression. The much greater risk would be not treating a child with everything that would be helpful for them, and that we kind of know.”

Experts say if your child has a problem with depression and anxiety talk to your doctor -and talk to your child.

That was advice Elora’s mom took. “I speak with Elora a lot and I know what her mental framework is,” she says, “and I don’t see that as being a problem for her or for us.”

Tips for Parents

• Families are tremendously important when discussing depression in teenagers, as well as proper treatment options. Children and teens are at an advantage when it comes to treatment plans. Their support networks are usually larger than adults’ – and can watch changes in their behavior and attitude. (Dr. Shannon Croft, psychiatrist)
• Any anti-depressant can slightly increase the risk of suicide in people who are severely depressed. Many times, the severely depressed are so immobilized by their condition that even if they are thinking of killing themselves, they don’t have the energy to actually go through with the act. Anti-depressants can give them energy immediately, but can take several weeks to improve their mood. (Dr. Dirk Huttenback, psychiatrist)
• After starting anti-depressants, patients should see their doctor once a week for the first month. (U.S. Food and Drug Administration)
• Within the first month of treatment, contact a medical professional immediately if any of the following symptoms occur: new or more thoughts of suicide, suicide attempts, a deepened depression, agitation, worsened irritability, impulsive behavior and extreme hyperactivity. (U.S. Food and Drug Administration)
• The link between suicide and anti-depressant use is still unclear. What is clear, however, is that depression left untreated can lead to suicide. (Dr. Shannon Croft, psychiatrist)

References

• National Institute of Mental Health
• Grady Health System
• American Academy of Child & Adolescent Psychiatry

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