June 24, 2014

FDA warnings on antidepressants may have backfired


Changes in antidepressant use may have led to more teen suicide attempts

The Food and Drug Administration (FDA) placed safety warnings on antidepressants in 2003 and 2004, saying that the medications could raise the risk for suicidal thoughts, attempts, and completed suicides in children and adolescents—extending the warnings to include young adults in 2007. But those “black-box warnings,” which were widely reported in the media, seem to have had unintended consequences.

Young people most affected

A new national study in The BMJ linked less use of antidepressants to more suicide attempts. It found that depressed teens (age 10–17) and young adults (age 18–29) are receiving much less medical treatment since the warnings—and are more likely to try to kill themselves. This didn’t happen in adults age 30–64. The study’s co-authors include Group Health Psychiatrist and Group Health Research Institute (GHRI) Senior Investigator Greg Simon, MD, MPH, and Associate Investigator Rob Penfold, PhD. Media coverage included Bloomberg, NBC, NPR, and the Washington Post.

The study is based on information on 1.1 million teens, 1.4 million young adults, and 5 million adults from the Mental Health Research Network (MHRN), which Dr. Simon leads and includes Group Health patients. Part of the HMO Research Network, the MHRN is a consortium of research centers affiliated with 11 large health systems across the United States, with funding through a cooperative agreement with the National Institute of Mental Health (NIMH).

Drs. Simon and Penfold’s coauthors are at Harvard Medical School, Harvard Pilgrim, HealthPartners, Henry Ford Health System, Kaiser Permanente, Scott & White Healthcare, and Veterans Affairs. Dr. Simon has a joint appointment at the University of Washington (UW) School of Medicine; and Dr. Penfold is also at the UW School of Public Health.

Dr. Simon published a related study in 2007, finding that in in more than 100,000 patients treated for depression, suicide attempts declined during the first month of treatment—whether that treatment consisted of medication, psychotherapy, or both.

This article originally appeared on GroupHealthResearch.org.