Studies indicating a slightly increased risk of suicidal thoughts, or attempts, in children taking antidepressants sparked a firestorm of public debate and criticism. As a result, FDA mandated all antidepressants being sold in the U.S. have a black box warning on the label similar to the warnings found on cigarette packages.
This contributed to a growing distrust of the drugs – at least when it comes to using them to treat children.
Antidepressants are powerful medications that save lives.
However, as with any medical treatment, they must be used cautiously after a careful diagnosis, and they require close monitoring by a physician and family members.
Before any medication is prescribed to your child, it is very important that the prescribing doctor take time to discuss all risks and benefits of the proposed treatment. Also, the doctor should explain the real risks your child will face if depression is left untreated.
Virtually all medical treatment involves some risk to the patient, but this does not mean that the treatment should never be used. Antidepressants are safe and effective medications providing they are used conscientiously and with careful diagnosis and supervision.
Mental illness is a significant health problem among children and adolescents. In fact, 10 per cent of this population suffer from a mental illness that is severe enough to warrant some form of treatment.
Diagnosing mental illness in children is often more difficult than in adults. In some cases, it is nearly impossible to determine between depression and the depressed stage of bipolar disorder in children.
If a patient with bipolar disorder is given antidepressant medication it can cause symptoms to worsen and can also trigger a dramatic shift in mood from one extreme to another. This is another argument for the use of caution in diagnosing and treating children.
Although there is a risk in taking medication, the risk of suicide is much higher among depressed children who are not receiving treatment.
For the most part, the proper use and monitoring of these medications in combination with appropriate counseling is quite safe and an effective way to help people of all ages in the treatment of depression.
Continued clinical research is needed to determine the safety and effectiveness of medication use in all age groups. This is more difficult in children as there are more ethical concerns to take into consideration.
Full public disclosure of clinical trial results by the pharmaceutical industry is also very important so that all health care consumers can make informed decisions about their own care or the care of their children.
Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.
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