March 7, 2006

Study Details Link of Drugs and Thoughts of Suicide

By BENEDICT CAREY
http://www.nytimes.com/2006/03/07/health/07depress.html?_r=1&oref=login

Antidepressant drugs raise the small risk of suicidal thoughts and behavior in depressed children and adolescents, scientists at the Food and Drug Administration are reporting today in a detailed published account of findings they reached in 2004.

The study, an analysis of 4,582 patients in 24 drug trials, is the first widely published evaluation of data that the agency reviewed that year. The analysis found that about four children and adolescents of every 100 who took the drugs reported suicidal thoughts or behavior, twice the number among those who took dummy pills.

The publication of the study is not likely to alter the debate about the relative risks and benefits of antidepressant treatment, experts said. No one in the trials committed suicide, and the suicide rate among adolescents has dropped significantly since doctors began prescribing the drugs to minors in the early 1990's.

But some experts said publication of the report, in today's issue of The Archives of General Psychiatry, may make it harder to deny that antidepressants like Prozac, Zoloft and Effexor cause a worsening in a small number of children and adolescents with depression, stirring in them thoughts of suicide they would not otherwise have had. The findings so impressed F.D.A. officials in 2004 that they voted then to require a suicide warning on the drug's labels, "and we felt and still feel that was the right thing to do," said Dr. Thomas Laughren, director of the agency's Division of Psychiatry Products, who was a co-author of the study.

Still, a spokesman for the American Psychiatric Association, Dr. David G. Fassler, a child and adolescent psychiatrist in Burlington, Vt., said the study had yet to clarify the relationship between suicidal thinking and behavior.

"It shows that kids taking the medications are twice as likely to tell the clinician about suicidal thinking," Dr. Fassler said, not whether there is a significant difference in the incidence of suicide attempts.