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Depression Treatment Wanes Following FDA Warnings
Date:6/1/2009

Advisories led to 'unintended consequences,' researchers say

MONDAY, June 1 (HealthDay News) -- Newly diagnosed cases of depression in America have dropped sharply since the government's warning of an increased risk of suicidal behavior among children and teens taking antidepressants, a new analysis finds.

Researchers at the University of Colorado say the U.S. Food and Drug Administration's advisories about the use of selective serotonin reuptake inhibitors (SSRIs) appear to be associated with "unintended" and "persistent" changes in the diagnosis and treatment of depression, especially in children and teens. They also observed a "spillover effect" on adult depression care.

"We don't know why; we just do know after the warnings these things did change, so it had an effect on treatment patterns for depression," said study co-author Robert J. Valuck, a professor of clinical pharmacy at the University of Colorado Denver's School of Pharmacy.

The report appears in the June issue of the Archives of General Psychiatry.

From the time the FDA issued its warning in 2003 through June 2007, primary-care physicians wrote 44 percent fewer SSRI prescriptions for pediatric patients than historical trends predicted, and 37 percent fewer for young adults. Yet there was no change in alternative medications or psychotherapy to compensate for the decline in SSRI prescriptions for these patients.

"It does look concerning, that the patients are not getting treated," said John F. Curry, director of clinical psychology training at Duke University Medical Center in Durham, N.C.

In October 2003, the FDA warned about the increased risk to children and teens of taking SSRIs, citing an increased risk of attempted suicide and suicidal behavior. A little over a year later, the agency directed pharmaceutical manufacturers to add a "black box" warning to medication labels, urging close monitoring of pati
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