The ongoing controversy over the links between antidepressant use and suicide among teenagers remains one of the great debates in health care these days.
Ever since the FDA acknowledged the problem by holding highly publicized hearings in 2004, which were then followed by Black Box warnings in 2005, a fresh debate erupted among doctors and others who feared the moves would cause the proverbial pendulum to swing too far - fewer scrips would be written and, consequently, more suicides would result.
For instance, two years after Health Canada warned about prescribing antidepressants to children, a study reported the number of kids who died by suicide increased 25 per cent after years of steady decline. And here's background on a similar study last year in the American Journal of Psychiatry. However, recent data from the Agency for Healthcare Research and Quality found antidepressant scrips in the US actually rose in 2005.
Now, a new report in the Journal of the American Medical Association finds that the overall observed rate of suicide among youth aged 10 to 19 years fell by 5.3 percent between 2004 and 2005 - from 4.74 to 4.49 per 100,000 kids. But the rates for both 2004 and 2005 were still significantly greater than the expected rates based on the 1996-2003 trend.
"The significant excess mortality due to youth suicide in 2004 and 2005 suggests that the marked increase in suicide rates from 2003 to 2004 was not a single-year anomaly," the authors conclude. "Attention must now be directed toward understanding whether this increase in the youth suicide rate after a decade-long decline reflects an emerging public health crisis."
Unfortunately, the authors - two of whom have past ties to drugmakers that sell antidepressants - leave us with little into the reasons for their findings. That's because there is no information at all in the study, which was supported by the National Institutes of Health, about whether anyone was treated with antidepressants And so, the conundrum remains, at least for the time being.