By Ed Silverman
Originally published February 11th, 2013
Several years ago, the Black Box warnings that were added to antidepressants over suicidal thoughts and behaviors for youngsters caused a backlash, as some suggested the language had pushed physicians and parents to avoid usage when the medications could have done some good. The debate may have slipped from view, but never really ended. A pair of papers published last year, in fact, renewed the controversy, and Glen Spielmans, an associate professor of psychology at Metropolitan State University, recounts why the issue remains fraught with challenges and a recent spat that erupted when an effort was made to critique the papers.
Antidepressants can cause suicidality – suicidal thoughts and behaviors – in children and adolescents. This message has been widely disseminated since October 2004, when the FDA placed a Black Box warning on such medications. The warning was based on findings from placebo-controlled trials, in which kids taking antidepressants had an elevated rate of suicidal thoughts and behaviors (see this). But research led by Dr. Robert Gibbons, professor of biostatistics at the University of Chicago, suggests that this warning is counterproductive, scaring parents and kids away from getting safe and effective antidepressant treatment.
Gibbons was the main author on two papers published in 2012 in psychiatry’s premier journal, Archives of General Psychiatry (which was changed to JAMA Psychiatry last month). One paper examined the potential association between antidepressants and suicidality and the other focused on the efficacy of antidepressants.
The entire op-ed is here.