There’s a very interesting debate/poll going on at Pharmalot regarding the FDA proposal to consider repealing the black box warning on antidepressants.
The potential flip-flop comes amid growing noise by some psychiatrists that the agency’s Black Box warnings in 2004 that antidepressants are somehow linked to suicide in youngsters may be scaring some docs, parents and teenagers.
As evidence, some psychiatrists cite a recent study in The Journal of American Psychiatry, which found the number of scrips for pediatric depression, ages 5 to 18, fell more than 50 percent between 2003 and 2005. At the same time, the number of teen suicides jumped a record 18 percent between 2003 and 2004, the most recent year for which data exist.
Perhaps the psychiatrists should consider this comment on Pharmalot (from ‘Ernest’):
The Black Box warnings on antidepressants need to stay. In fact they need to be expanded to state that not only can antidepressants cause suicidal ideation and suicide, they can also cause homicidal ideation and homicidal acts such as Virginia Tech, Red Lake, Columbine and the hundreds of school and workplace shootings that have been carried out by people on antidepressants. How can any “medical professional” compare the side-effects of antidepressants to other medications. True, some other drugs have a risk of causing harm but what other drug causes the user to kill innocent bystanders? One of the most important reasons to keep that Black Box labeling in place is to protect and give notice to all the innocent people who are NOT on antidepressants but who have to be around people who are so we can decide if we want our kids to be around them or we want them in our homes or so we can avoid getting into a confrontation with them that might result in violence, ie: road rage.
As to the Black Box label causing increased suicides in 2004 consider this: On 15 October 2004 the FDA issued a “Public Health Advisory to warn the public about the increased risk of suicidal thoughts and behavior (”suicidality”) in children and adolescents being treated with antidepressant medications.” It went on to say, “The agency is directing manufacturers to add a “black box” warning to the health professional labeling of all antidepressant medications…”
Now consider this. The drug companies got official notice on 15 October 2004 to put the black box on antidepressant labeling. How long do you think it took to have new packaging made? Do you think they put that labeling in place any faster than they had to? How long do you think it took to sell all the old medications sitting in pharmacies, hospitals, distributors and at the factory? It would take months and months. I think anyone with half a brain (psychiatrists excluded) can say that the public received no significant warning during any part of 2004 that antidepressants can cause suicide. So who are these “mental health professionals” running around claiming the increased rates of teen suicides in 2004 as reported by the CDC were caused by Black Box warnings on antidepressants. I’ll tell you who many of them are. Many of them come right out of the psychiatry department of Columbia University–a department that continually fronts for pharmaceutical companies and a place that should be thoroughly investigated to see who there has received compensation or consideration from drug companies. This is the same place that has spawned the much-opposed and despised TeenScreen program that is attempting to assembly-line the diagnosis of hundreds of thousands of school kids as having mental disorders needing psychiatric treatment–and of course putting them on psychiatric medication follows that. When I think of lowly places inhabited by those willing to sell out the future of the human race–our children– I think of the psychiatry department at Columbia.
Quite likely, 2004 or 2003 marked the point of the highest number of antidepressants prescibed to teens. The increased teen suicides in 2004 may well have resulted from the record number of kids put on antidepressants in the years leading up to that point. In truth, every suicide needs to have a full toxicology screening done that checks for the presence of antidepressants and other psychiatric drugs–especially the antipsychotics like Zyprexa, Geodon, Risperdal and Seroquel. That is the only way we can avoid burying the evidence and the only way we can go back and nail a lawsuit on every drug company executive and mental health practitioner who actively worked to put people on antidepressants after October 15th, 2004.