Study: Anti-Depressants Lower Teen Suicide Rates

An analysis of teen suicide rates in different countries shows that in 2003 and 2004, when fewer teens used anti-depressants, suicide rates rose sharply. The new study provides the most direct evidence so far that, on balance, anti-depressants lower suicide rates among teens.

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MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

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And I'm Melissa Block.

Two new studies show an alarming increase in the rate of suicides among young people. The increase began about the same time the Food and Drug Administration issued warnings about the safety of a popular type of antidepressant. The studies suggest - but don't prove - that those drugs were protecting young people.

In a moment, we'll talk with a psychiatrist about what doctors and parents should do with this information. First, details on the new studies from NPR's Joanne Silberner.

JOANNE SILBERNER: Ileana Arias heads the injury division of the Centers for Disease Control and Prevention, which did one of the two studies. It looked at suicide rates in the past two decades.

Dr. ILEANA ARIAS (Head, Centers for Disease Control and Prevention, Injury Division): We found that combined suicide rates for persons 10 to 24 years declined 28.5 percent from 1990 to 2003. But from 2003 to 2004, the rate increased by 8 percent, the largest single rise in 15 years.

SILBERNER: That's about 340 more suicides in 2004. Arias says the numbers are undeniable.

Dr. ARIAS: In surveillance speak, this is a dramatic and huge increase.

SILBERNER: A second study published in the American Journal of Psychiatry cited a similar rise in the U.S. and an even more dramatic increase in the Netherlands, 49 percent between 2003 and 2005. The increase in youth suicide came just as the U.S. Food and Drug Administration and overseas regulatory agencies were issuing warnings about a popular class of antidepressants, SSRIs. Several studies showed no effect on actual suicides, but an increase in suicidal thoughts and attempts.

Doctors and parents took note. Prescriptions for SSRIs for young people dropped about 22 percent in both the U.S. and the Netherlands. Tom Laughren, head of the FDA Psychiatry Division said the agency didn't want to keep the drugs from kids with depression who could benefit, but his agency had to put out the warnings.

Dr. TOM LAUGHREN (Head, FDA Psychiatry Division): You know, we do, as a regulatory agency, have an obligation to alert prescribers and patients of risks that we find with drugs that are being used. And so it's a dilemma for us, but clearly, it's a concern.

SILBERNER: Laughren says the FDA will consider the increase in suicides.

Dr. LAUGHREN: We are obviously concerned about this. We will continue to monitor both suicide rates and antidepressant use and other new data as they come out and take whatever regulatory actions we think are appropriate.

SILBERNER: The FDA is likely to remain in the position it's been in for years -pressured by psychiatrists and parents who want young people to have access to the drugs and pressured by others who are concerned about safety issues. Vera Sharav heads the Alliance for Human Research Protection. She has testified against SSRIs at most of the FDA hearings. The new data haven't changed her mind.

Ms. VERA SHARAV (Founder, Alliance for Human Research Protection): You cannot determine a causal effect because you're not looking at other circumstances.

SILBERNER: She says anything could be increasing the youth suicide rate - the use of other antipsychotic drugs or maybe something like greater caffeine intake. But child psychiatrist, David Fassler, who has also testified at several of the FDA hearings, says that there are multiple studies that suggest that antidepressant medications limit the incidents of suicides.

Dr. DAVID FASSLER (Child and Adolescent psychologist): We even have one study that looks specifically at the change in the suicide rate by zip code. And we can show that in areas of the country where more medication was used, that there'd be a greater reduction in the suicide rate at a particular point in time.

SILBERNER: There will be more information on whether the trend is real or temporary soon. Preliminary suicide numbers for 2005 will be available in a couple of weeks.

Joanne Silberner, NPR News.

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