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And I'm Linda Wertheimer. New research has reignited a debate about how best to treat depressed teenagers. A major Harvard study concludes government warnings that antidepressants might be risky for teens are backfiring. It finds the warnings could actually be causing more young people to try to kill themselves. But as NPR's Rob Stein reports, that remains the center of intense controversy.
ROB STEIN, BYLINE: This is the story of good intentions possibly gone bad. In 2003, the FDA started issuing warnings about antidepressants like Prozac, Zoloft, Paxil, saying that they might actually increase the risk kids might think about or even try to commit suicide.
STEPHEN SOUMERAI: This was a huge, worldwide event in terms of the mass media.
STEIN: Stephen Soumerai at Harvard Medical School's been studying what happened as a result.
SOUMERAI: Many of the media reports actually emphasized an exaggeration of the warnings.
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UNIDENTIFIED ANNOUNCER 1: What if your child suddenly became suicidal or violent?
UNIDENTIFIED ANNOUNCER 2: All antidepressants carry black box warnings that they increase the risk of...
UNIDENTIFIED ANNOUNCER 3: ...Suicidal thoughts and behavior among children.
UNIDENTIFIED ANNOUNCER 4: ...Medicine would increase the likelihood of homicide or suicide.
STEIN: In fact, no one knew for sure if the drugs were really dangerous. The idea was to get doctors and parents to keep a closer eye on kids taking them, just in case it was true.
SOUMERAI: The warnings were well-intentioned, but people were concerned that the ferocity of the messages might affect clinicians, parents and young people in a way that would reduce needed medications.
STEIN: And in new research being published in the British medical journal BMJ, Soumerai and his colleagues conclude that's exactly what happened.
SOUMERAI: This incredible attention caused an overreaction by everybody involved.
STEIN: Soumerai and his colleagues studied medical records from more than 7 million people and concluded that antidepressant use among teenagers, and even young adults, plummeted after the warnings came out. And, they say, lots more kids and even young adults tried to kill themselves.
SOUMERAI: Among adolescents, suicide attempts increased by almost 22 percent. Young adults, suicide attempts increased by about 33 percent.
STEIN: Big numbers. But others say Soumerai's team hasn't made its case. Michael Schoenbaum is with the National Institute of Mental Health.
MICHAEL SCHOENBAUM: I don't think one can interpret the findings the way the authors interpret the findings.
STEIN: For one thing, there could be different explanations for why antidepressant use fell. For another, there's big questions about whether suicide attempts really went up. Soumerai's team based its conclusion on the fact that drug overdoses rose.
SCHOENBAUM: I think it's questionable whether the data they are using to measure suicide attempts are actually reflecting suicide attempts at all.
STEIN: They may actually be accidental overdoses, not attempted suicides, he says. But Soumerai and his colleagues dispute those criticisms. And other researchers, like Robert Gibbons at the University of Chicago, say the new study is consistent with what earlier research has suggested.
ROBERT GIBBONS: I think that there were a lot of mistakes made in terms of how this risk was communicated to the public, which led a lot of parents to be terrified to have their children on these medications. And they took them off, and there was a lot of untreated, serious depression.
STEIN: Soumerai and his colleagues say their findings show the FDA needs to do a better job explaining warnings about drugs.
SOUMERAI: We feel that there is a need for communications by the FDA to be coordinated better to avoid exaggerated messages to the public.
STEIN: The FDA sent NPR a statement defending its warnings, saying the agency never intended to discourage giving kids antidepressants and made it clear that depression is a serious illness that needs to be treated. Rob Stein, NPR News.
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