Antidepressants Often Not
Effective, Healthy, Safe or Good for Children
The following article includes
research conducted by MIchael Conner, PsyD, Director for Mentor
Research Institute (MRI). The article reports that antidepressants
are not nearly as affective as they are marketed and the benefits
come with significant health, safety and psychological side effects.
UPI Senior Science Writer
Author, “Suffer the Child: How the Healthcare System Is Failing Our
Future,” (Capital Books, 2007)
Reproduced under the Fair Use
USC § 107 for noncommercial, nonprofit, and educational use
SAN FRANCISCO, June
17, 2006 (UPI) -- With the older tricyclic anti-depressants
generally deemed unsuitable for the young and depressed, treatment
of this age group most often relies on the so-called
serotonin reuptake inhibitors.
Of this class,
Prozac is the only drug approved for such use.
specifically target the brain levels of the feel-good neurochemical
serotonin, SSRIs present fewer side effects than their predecessors
-- though not few enough to satisfy their critics.
Widely touted as
safer than the tricyclics that came before them, SSRIs are less
likely to prove lethal even in large quantities, doctors say.
The downside is that,
with decreased worry of a fatal overdose, the risk of overuse rises
while attention to monitoring declines, critics say.
A Food and Drug
Administration warning, in fact, calls for minimizing the dosage to
lessen the risk of an overdose and maximizing followup of young
patients to lower the odds of unwanted consequences.
overprescribed because they were believed to be safe and the drug
companies do such an incredibly effective marketing job,” said Peter
Wayne, Pa., pediatric and family psychologist.
“I see a lot of really
young children who someone else would encourage prescribing drugs
for; when you take the sweet young children off the medication, it’s
clear it’s not doing anything,” he said.
“I also see adolescents
who, without medication, would be in deep trouble,” he added. “For a
17-year-old, who is close to being an adult and who really has
bipolar disorder and not the diagnosis de jour, it can be
But only if the
medicine is properly applied and the patient, adequately supervised,
“With SSRIs, it’s
easy to write a prescription and say, ‘Come back in three months,’”
said Donna Palumbo,
associate professor of neurology and
pediatrics at the University of Rochester School of Medicine and
Dentistry in Rochester,
temptation is all the greater for time-pressed primary-care
providers who now see the majority of depressed patients, she said.
know that’s not how to treat depression,” she said. “Patients change
moment to moment, whether they’re on medication or not.”
sets the stage for a raised risk of suicide, cautioned Dr. Julio
Licinio of the University of California, Los Angles, whose study
tracked an overall decline in suicide rates since the SSRIs came on
the market scene.
"When people start antidepressant therapy, the first symptom to be
alleviated is low energy, but the feeling that life isn't worth
living is the last to go," he said.
"Prior to taking SSRIs, depressed people may not have committed
suicide due to their extreme lethargy,” he said, explaining one
commonly held theory. “As they begin drug therapy, they experience
more energy, but still feel that life isn't worth living. That's
when a depressed person is most in danger of committing suicide."
increased possibility of suicidal tendencies has attracted the most
public attention, it applies to only a small minority of
may be prone to suffering other ill effects from the drugs, which,
despite their reputation of superior safety, do not come risk-free,
A two-year review
of the medical records of 82 children and adolescents treated with
an SSRI at Massachusetts General Hospital for depressive or
obsessive compulsive disorders found 22 percent experienced
psychiatric adverse effects, "most commonly related to disturbances
in mood,” within three months of treatment.
The rate went up
to 44 percent for those who restarted taking the drugs.
percent of the young patients had an adverse reaction to an SSRI
over the course of their therapy, the authors reported.
indicates some 60 percent of minors can benefit from antidepressants
without suffering serious complications, although there is debate
over how much of the gain might be attributable to the “placebo
effect” that could just as easily be obtained with a sugar pill or
simply to time’s healing touch.
get better anyway for other reasons,” said
Michael Conner, a
Bend, Ore., clinical psychologist, researcher,
director of the nonprofit
Mentor Research Institute and author of "Crisis Intervention with
Adolescents; A Guide for Parents and Professionals," (AuthorHouse,
2006). “The results are often
‘lumped together,’ which makes the benefits of antidepressants look
better than they actually are.”
Whatever the true
source of relief, a finding that some 60 percent of children taking
antidepressants improve with few or no side effects presumably
suggests the other 40 or so percent gain no advantage from the drugs
or do so at a cost.
mild side effects may include
insomnia, rashes, headaches, joint and muscle
pain, stomach upset, nausea or diarrhea, doctors say.
A more serious
potential complication presents itself when reduced blood clotting
capacity opens the way for stomach or uterine bleeding -- a risk
that doubles when SSRIs are mixed with certain painkillers, such as
aspirin, ibuprofen, naproxen or COX-2 inhibitors, research
have mild side effects managed by modifying the dosage, some may get
sleepy or nauseous, some children may get agitated, but in general
the medications are well tolerated,” said child and adolescent
psychiatrist Dr. David Fassler, a trustee of the American
predisposed children, the drugs may raise the risk of mania or its
less severe version, hypomania, according to one study.
A 14-month Yale University investigation found 8 percent of patients
admitted to the
Massachusetts General Hospital psychiatric unit in 2001 may have
been suffering from mania or psychosis brought on by their
nationally, that would translate to some 150,000 possibly
SSRI-induced hospital admissions a year, researchers said.
bloggers and defense lawyers have made much of the possibility SSRIs
may at times trigger deranged mental states conducive to murder or
other acts of violence.
A review in the
Journal of the
Academy of Psychiatry Law
pointed out it is difficult to dismiss the anecdotal reports out of
hand, but convincing scientific evidence supporting -- or negating
-- such a connection is scanty.
Use of the
“involuntary intoxication defense” will likely continue to grow
alongside development and marketing of novel psychotropic
medications and advancement in understanding of their actions and
effects, the authors predicted.
Most SSRI users
do not experience severe side effects, Licinio stressed.
“My concern is
if you list every possible side effect, people will say, ‘I’ll have
all of these? Then, I shouldn’t take it,” he said.
(Editors’ Note: This series on depression is based on a review of
hundreds of reports and a survey of more than 200 specialists.)
Mentor Research Institute is an
Oregon 501c3 non-profit research and educational organization with a
focus on mental health for youth and families including
homelessness, effective intervention, public and professional
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