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http://abcnews.go.com/sections/GMA/D...ts_040203.html


More than 1 million Americans under 18 take antidepressents such as
Prozac, Paxil and Zoloft.
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Looking for Answers
Are Antidepressants Too Risky for Kids?
ABCNEWS.com
Feb. 3— The stakes are high for families and for pharmaceutical
companies in the wake of a warning that children and teenagers taking
antidepressants may be at greater risk of suicide.


serotonin reuptake inhibitors, or SSRIs, is the fastest-growing
segment of the pharmaceutical industry, raking in $12 billion a year.
The Food and Drug Administration has begun a series of public hearings
to determine if antidepressants are safe for the more than 1 million
Americans under 18 who take them. The hearings come after British
health authorities last year announced long-suppressed research
suggests certain antidepressants might increase the risk of suicidal
behavior in youngsters.

The FDA's full analysis of the data on children and antidepressants,
which includes 20 studies in all, is not likely to be completed until
summer, said Dr. Tim Johnson, ABCNEWS' medical editor. Among the
evidence the FDA will consider is a report from the American College
of Neuropsychopharmacology, which examined a total of 15 clinical
trials of SSRIs — totaling more than 2,000 kids and teens — including
those reviewed in Britain last year. That report concluded there is no
reliable evidence linking antidepressants to increased suicide in
teenagers.

In the meantime, parents of children on antidepressants should consult
their doctors if they are planning to take their children off the
drugs, Johnson said.

"We know one thing for certain: That people of all ages should not
stop taking the drug suddenly," he said. "That is very dangerous and
can cause a rebound effect of anxiety and depression. It can be so
powerful that it can lead to suicide or self-harm. So if a parent is
to stop their child's treatment with antidepressants they must only do
it under the guidance of a physician."

Prozac Not Part of Ban

Britain has banned the use of all antidepressants except Prozac for
use by children. There have been several rigorous studies conducted
with children treated with Prozac, and all the evidence points to it
doing more good than harm, Johnson said.

"The evidence is there to prove that Prozac is effective in treating
depression in children," Johnson said. "But it may not be safe."

Since depressed children are already at a seriously increased risk of
suicide, it is hard to know if the drug or the disease is causing
suicidal behavior. Also, when people who are depressed start taking
antidepressants and begin to feel better they often gather enough
mental and physical strength to commit suicide, Johnson said.

"It seems counterintuitive, but often the severally depressed don't
have the strength and ability to even consider suicide, let alone
carry it out," Johnson said. "So this is another factor that
complicates getting to the bottom of this."

Metabolization Issue

There is some evidence that adolescents — the main group of people
under 18 who are prescribed the drugs — may metabolize these
antidepressants at a faster rate than adults.

"That means the drugs could disappear from their bloodstream at a
faster rate, leaving them with less of the drug in their system,"
Johnson said. "So it's possible the teens are not getting enough of
the drugs and that they may need higher doses."

Although many studies have been conducted on Prozac on children, with
positive results, there have been fewer studies on other
antidepressants, such as Paxil.

"There haven't been as many trials, and the results have been mixed,"
Johnson said. "That's why the FDA is going to gather all the clinical
data available, and look at it as a whole, and then make a
recommendation."