The Future is Now My crystal ball let me down. A few years ago, in the e-Alert "Safety for Sale" (4/12/04), I gazed into the future and predicted that the news about increased suicide risk among teens and adolescents who take antidepressant drugs would have no effect on sales of those drugs. I thought that was a pretty good bet. After all, doctors were advised only to monitor their young patients for signs of suicidal tendencies. But according to a new study, antidepressant drug prescriptions for U.S. youths dropped by more than 20 percent in the year following the highly publicized warning. So I was wrong about the sales of Prozac, Paxil, Zoloft, and other selective serotonin reuptake inhibitors (SSRIs). But in that same e-Alert I suggested several alternatives to drugs in the treatment of depression, and as we'll see, lives might have been saved if these alternatives had been put to use. The new study - which appears in the September 2007 issue of The American Journal of Psychiatry - also reports a very sad statistic. As teen and adolescent use of selective serotonin reuptake inhibitors (SSRIs) dropped, suicide rates went up. Of course, the mainstream reaction to this news could only run in one direction: In the absence of SSRI therapy, many depressed kids took their own lives, which would supposedly prove that these drugs should be used more freely in young patients. Thomas Insel, M.D., who is the director of the National Institute of Mental Health, told the Washington Post that these medications are useful, and noted that the FDA-required black box warning about suicide risk "may have inadvertently created a problem." Dr. Robert Gibbons (the lead author of the study) went a step further and called the decision to require a warning "misguided," and added that better education of doctors would have been more appropriate than issuing a warning. Hello! Earth to Dr. G! The warning IS the education. And the idea of withholding a warning about a proven deadly danger in order to somehow "protect" consumers is absurd. It's easy to imagine how a parent of a depressed teen might react to the suicide warning by asking the family doctor if there's a way to treat children without resorting to powerful SSRIs. At that point, there are two paths a doctor might follow… Path Number One: antipsychotic drugs In the Washington Post article, British psychiatrist Dr. David Healy offers a theory that antipsychotic drugs (designed to treat mental illness) were likely prescribed as an alternative to SSRIs when the suicide warnings began circulating. Dr. Healy says he's "absolutely certain" that the spike in suicides is not the result of the absence of treatment, but rather from treatment with antipsychotic drugs. Path Number Tw Stop drugging our children! In the e-Alert "Life is Good" (7/31/07), I noted these lifestyle changes and treatments that any depressed adolescent, teen, or adult might find helpful before beginning a drug regimen: - Daily exercise
- Complete abstinence from junk food and highly processed foods
- Improved sleep habits
- Folate supplements
- B complex supplements
- Magnesium supplements
- Increased intake of omega-3 fatty acids
- Increased intake of vitamin D (through daily sun exposure or supplements)
- St. John's wort
These steps won't alleviate every case of depression, but you can be certain none of them will ever be linked to suicide risk. Sources:
"Early Evidence on the Effects of Regulators' Suicidality Warnings on SSRI Prescriptions and Suicide in Children and Adolescents" American Journal of Psychiatry, Vol. 164, No. 9, September 2007, ajp.psychiatryonline.org
"Youth Suicides Increased as Antidepressant Use Fell" Shankar Vedantam, The Washington Post, 9/6/07, washingtonpost.com | 
