A move by US health officials to warn the public of an increased risk of suicidal thoughts among young people taking antidepressants was actually associated with an increase in suicide attempts, suggests a new study.
It could be that doctors avoided prescribing those medications after media reports of the warnings and children and teens with depression went untreated, researchers suggest in the medical journal BMJ.
“In this case, we think we’re seeing the decreased use of the medication in kids who had appropriate use of the medications,” said Stephen Soumerai, the study’s senior author from the Harvard Pilgrim Health Care Institute in Boston.
Between 2003 and 2004 the US Food and Drug Administration (FDA) issued warnings that antidepressants were tied to an increased risk of suicidal thoughts and behaviors in about one percent of children and teens. The agency required the warning to be printed on antidepressant drug labels in October 2004.
The warnings were expanded to include young adults in 2007.
About seven percent of Americans have depression, according to the Centers for Disease Control and Prevention.
Previous studies had found that antidepressant use fell after the warnings were issued but that use of other treatments for depression, such as therapy, did not increase. There was also a decline in the number of people being diagnosed with depression.
To look at how suicidal behavior might have been affected, Soumerai and his colleagues analyzed data from 11 healthcare organizations that provide care to about 10 million people in 12 states.
They found that antidepressant use decreased by 31 percent among adolescents, about 24 percent among young adults and about 15 percent among adults after the warnings were issued.
At the same time, there were increases in the number of adolescents and young adults receiving medical attention for overdosing on psychiatric medicines, which the authors say is an accurate way to measure suicide attempts.
Those poisoning increased by about 22 percent among adolescents and about 34 percent among young adults after the warnings. That translates to two additional poisoning per 100,000 adolescents and four more poisoning per 100,000 young adults, the researchers write.
There was no change in poisoning among adults, they found.
There was also no change in completed suicides. Soumerai said the study may not have been large enough to detect an increase because completed suicides are relatively rare.
Dr. Mark Olfson, a professor of psychiatry at Columbia University Medical Center in New York, cautioned that poisoning from psychiatric drugs may not