Experts urge caution in using SSRIs for depressed kids

The FDA orders a review of conflicting data on the role these antidepressants play in suicidal thinking by children and teens.

By Susan J. Landers, AMNews staff. March 1, 2004.

Washington -- The Food and Drug Administration is expected to decide by summer whether antidepressants should be prescribed for children. In the meantime, physicians and parents are cautioned that the medications, while helpful, could lead some children to consider suicide.

The federal agency asked researchers at Columbia University to review the available data on the use of selective serotonin reuptake inhibitors in children and teens. The FDA hopes this review will produce a more definitive answer about whether these medications are more likely to help or hurt.

Two FDA advisory panels reviewed existing data in early February and heard often emotional testimony from parents. The data and the testimony provided a conflicting picture -- some studies claiming the SSRIs led to an increase in suicidal thoughts while others found no evidence of harm. Meanwhile, some parents presented heart-rending stories of their children's suicides while others said the drugs saved their children's lives.

The conflicting data and testimony indicate there is no simple answer to the question, said David Fassler, MD, who testified before the panels for the American Psychiatric Assn. Dr. Fassler is a clinical associate professor of psychiatry at the University of Vermont.

"In some of the studies it seems that there could be a slight increase in the risk of suicidal thinking, but other studies seemed to show the exact opposite," said Dr. Fassler. "It also was apparent that the studies used different definitions of suicidal thinking and behavior."