Antidepressants: benefits exceed risks

A recent review of all studies on antidepressant use in children and teens concluded that benefits of the medication far outweigh the risks.

This wide-reaching review showed the risk of suicidal behaviour is smaller than previously thought and should be viewed in light of the relief these drugs can offer to depressed young people.

This comes after black box warnings were placed on medication labels cautioning about possible risk of suicidal behaviour in children and teens when using antidepressants such as Prozac, Effexor, Zoloft and others. Today researchers say the benefits of treatment seem much greater than the risks.

Research had previously found a one percent increase in suicidal behaviour among children and teens taking antidepressants. It is important to emphasize that when talking about suicidal behaviour in this context, they are not talking about actual suicide. There were no suicides in this group of research subjects. They are referring primarily to suicidal thoughts which are very common in depressed people of all ages.

There has even been some debate about whether this reported increase in suicidal thoughts is even necessarily a bad thing. It occurs also in psychotherapy studies and may represent patients becoming more comfortable and trusting so that they are actually admitting what they have previously been keeping to themselves.

In spite of the new findings, regulators in the US are not planning to remove warnings on antidepressant labels and this is unfortunate. Although the black box warnings are intended to protect people, they could be deterring some genuinely ill people from getting appropriate medical help for their conditions.

It is well documented that depression among young people is under diagnosed and often goes untreated. Untreated mental illness is the leading cause of suicide and we should be doing all we can to ensure that people of all ages feel comfortable speaking with their doctors about their symptoms and seeking effective treatment.

Between 2004 and 2005, antidepressant use in children aged 19 and younger fell by 13 percent – likely due to fears surrounding medication use. Suicide rates among this age group increased by about 18 percent during this time after 10 years of steady decline.

Here we are talking about actual suicides not suicidal thoughts. So ask yourself, is it reasonable to worry so much about a one percent elevation in suicidal thoughts that we take an action (black box warnings) that causes an 18 percent increase in actual suicides?

As with any medical treatment, the use of antidepressant medication should be considered carefully before being started and it should also be monitored closely throughout treatment. Individuals who are not benefiting from this treatment should not continue on the medication.

All treatments for any disorder do have risks and that is why professional advice is important. In most cases, the risks of not treating a given illness are greater than those incurred by the treatment itself.

If you think your child is suffering from depression, I urge you to talk with your doctor about all available options. Effective treatments including cognitive behaviour therapy and medication are available. If you are referred to a psychiatrist, he or she will be able to address all of your concerns or fears about treatment and help you decide on the best course of action.

Unfortunately, depression will not simply go away if you leave it. This is usually a chronic, life-long condition and it benefits greatly from being treated as early as possible.


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