Antidepressants dangerous for teens

Young people taking a popular class of antidepressants may be at increased risk of suicidal and violent thoughts, according to British health officials and an advisory panel to the Food and Drug Administration.

While the FDA continues to study antidepressant use in children and teenagers, the faculty members of Penn's Psychiatry Department have made some changes in treatment, including no longer starting new underage patients on the disputed drugs.

Debate concerns a type of drug called "selective serotonin reuptake inhibitors," which work by replacing depleted chemicals in the brains of depressed individuals. Fluoxetine, commonly known as Prozac, is the only SSRI approved by the FDA for use in children.

Penn Medicine's policy is to start new patients under the age of 18 on Prozac but to allow existing patients to continue on other treatments. Most patients seen by Counseling and Psychological Services -- a resource for Penn students -- are 18 or older, so a greater number of SSRIs are approved for their use.

Although technically adults, college students are viewed by some as a potential risk population for SSRIs because they have adolescent hormones and the added stress of adapting to college life.

Younger patients are typically seen at the Children's Hospital of Philadelphia, which is staffed by Penn faculty. CHOP attending psychiatrist Elizabeth Weller said that young patients and their families are alerted to the potential risks of SSRIs.

Vice Chairman of Psychiatry Charles O'Brien also stressed the importance of notifying patients of risks.

"The worst thing to do is not talk about suicide" when exposing any depressed person to psychopharmaceutical drugs, he said.

The current debate over the safety of SSRIs began with an advisory published in December by the Medicines and Healthcare Products Regulatory Agency -- the British equivalent of the FDA.

The MHPRA and other groups point to a greater number of suicidal thoughts in children taking SSRIs versus placebos.

Despite their practical response to the unknown risks of SSRIs, Penn faculty members urge caution in interpreting the study results.

"I think there is no need for getting hyped up and scared," Weller said. "Depression itself gives suicidal ideation."

O'Brien added, "Suicide is the second-leading cause of death in young people." He said that the rate of antidepressant medication is going up, while the suicide rate is in decline.

Faculty members cite a number of possible reasons for a correlation between antidepressant use and self-destructive thoughts in children.

Weller suggested that often, early onset depression is actually misdiagnosed as bipolar disorder. Antidepressants may cause bipolar children to feel worse, provoking suicidal thoughts.Both psychiatrists expressed the desire to wait for more information.

The FDA, which is conducting a study of data provided voluntarily by drug companies, is expected to publish conclusions over the summer.

Please note All comments are eligible for publication in The Daily Pennsylvanian.