SSRI use declines, youth suicides rise

Following public health warnings a few years ago about the possibility that antidepressant drugs could make young people suicidal, the number of antidepressant prescriptions for children and teenagers declined in the United States and the Netherlands. During the same period, youth-suicide rates increased in both countries, raising concerns that the much-publicized regulatory efforts backfired, a new study finds.

A team led by biostatistician Robert D. Gibbons of the University of Illinois at Chicago examined U.S. and Dutch data from 2003 to 2005 on prescription rates of selective serotonin reuptake inhibitors (SSRIs) to youngsters up to age 19. SSRIs include fluoxetine (Prozac) and other medications commonly used to treat depression. The researchers also tracked youth-suicide rates from 1998 through 2004 in the United States and through 2005 in the Netherlands.

As of 2005, SSRI prescriptions for kids and teens had decreased by about 22 percent in both countries after regulators issued warnings, Gibbons and his coworkers report in the September American Journal of Psychiatry. In the Netherlands, the youth-suicide rate increased by 49 percent between 2003 and 2005. The U.S. youth-suicide rate rose 14 percent between 2003 and 2004, the largest 1-year change in suicides for this population since federal researchers began collecting such data in 1979.

In a related study, national data collected by managed care plans from 1998 to 2005 show marked declines in rates of diagnosis and treatment of youth depression following the 2003 regulatory warning. Physicians didn’t prescribe other psychoactive medications in place of antidepressants for depressed youth, note Robert J. Valuck of the University of Colorado, Denver and his colleagues. Their report appeared in the June American Journal of Psychiatry.