Doctors to Restrict Antidepressant Use September 23, 2004
News Summary
Following a U.S. advisory panel's warning, some psychiatrists, pediatricians, and family practice doctors said they would curb their use of antidepressants for young patients, the New York Times reported Sept. 16.The Food and Drug Administration (FDA) panel determined from a review of clinical trials on nine antidepressants that certain children and teenagers treated with the drugs were at risk for suicidal thoughts and behaviors. The panel recommended that prominent warnings about the risk of suicide be placed on the label of the drugs.
"Some parents are very uncomfortable with their kids being on medication to begin with, and this will be enough so that some parents will not allow their kids to be on medicines," said Alexander Lerman, M.D., a child and adolescent psychiatrist in New York City, who plans to stop prescribing the antidepressants to certain children. For others, Lerman said, he would hold detailed discussions with parents about the risks of the drugs.
By restricting usage of the antidepressants, doctors are faced with how best to treat depressed children and teens, since few alternative options are available.
"I can tell you that my writing for antidepressants for kids has dropped off dramatically," said Dr. Phillip Kennedy, a family practice physician in Augusta, Ga. "It used to be that when I saw a kid who was 14, 15, or 16 and who was really down, I felt very comfortable writing them an SSRI (antidepressant) prescription. I don't now."
Albert Melaragno, M.D., a pediatrician in Valencia Calif., plans to be cautious in prescribing antidepressants, opting instead to refer patients to psychiatrists. But he voiced concern that many patients who need the medications would refuse therapy.
"It's raised such a specter with patients that more of the teens who have the need for treatment will be frightened off of using it and suffer more because of that," said Melaragno.
The FDA also plans to evaluate whether the antidepressants can cause suicidal tendencies in adults.
"I think there might be more to be learned, based on what we learned from the pediatric studies," said Dr. Janet Woodcock, the agency's deputy commissioner of operations.
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