Antidepressants still have a viable role in treatment

Steve Stoner, PharmD, BCPP, chair and clinical professor of the Division of Pharmacy Practice University of Missouri-Kansas City School of Pharmacy, presented data on suicidality. The data came from various studies done throughout the United States. He used the data to help give some perspective as to where the country is in comparison to other countries and to identify common risk factors associated with the use of antidepressants and increased suicidal behavior and ideation.

"Antidepressants have been criticized a lot lately," Dr. Stoner says. His remarks were designed to help attendees better understand the benefits of antidepressant drugs and realize that, if used correctly, can help treat the serious problem of acute or major depression.

Dr. Stoner notes the U.S Food and Drug Administration's involvement on the topic in May 2004, when it released warnings pertaining to antidepressants, specifically, the agency's proposal that makers of all antidepressant medications update the existing black box warning on their products' labeling to include warnings about increased risks of suicidal thinking and behavior in young adults ages 18 to 24 during initial treatment (generally the first one to two months).

Tracking statistics showed that after that warning by FDA, antidepressant prescribing decreased significantly in the United States. However, the number of adolescents and teenagers who committed suicide increased, also significantly. Dr, Stoner points out there was no evidence in the correlation between the two, other than the statistics.

Between 2004 and 2005, the number of suicides in the same group decreased. So it's unclear just what is driving the numbers.

"The FDA's overall goal was to strengthen the safeguards," he says. But he adds that a question remains concerning the warning that children and adults taking antidepressants can become suicidal in the first weeks of therapy. Physicians should watch patients closely when first giving the drugs or changing dosages. However, he also queries whether the warning and other similar warnings by the FDA didn't actually deter people from getting the medications they needed.