Antidepressant Safety Warnings Have Unexpected Consequences

Suicide has been the 3rd leading cause of death among persons 15 to 24 years of age in the U.S over the past several years. But there is much controversy over antidepressant treatment and conflicting evidence about the effects of antidepressants on suicide risk in youth. Between 2003 and 2004, the FDA issued several health warnings about antidepressant therapy in this population.

DPM Instructor and researcher, Christine Lu, PhD, and colleagues undertook a study to investigate if the warnings and related media coverage were associated with changes in antidepressant use and suicidal behavior.

The researchers analyzed claims data for the years 2000 to 2010 from 11 health plans in the Mental Health Research Network; the study sample consisted of 1.1 million adolescents, 1.4 million young adults and 5 million adults. Main outcome measures were rates of antidepressant dispensings, psychotropic drug poisonings (a validated proxy for suicide attempts), and completed suicides.

Results demonstrated that in the two years following the FDA warning, antidepressant prescriptions fell by 31% and 24.3% in adolescents and young adults, respectively.

Simultaneously, there was a 21.7% increase in psychotropic drug poisonings among adolescents and a 33.7% increase among young adults.  There were no increases in psychotropic drug poisonings among adults, who had smaller reductions in antidepressant use.  There were no changes in completed suicides for any age group.

The authors conclude that widely publicized FDA warnings and information communicated by the media can have unexpected negative effects and it’s critical to monitor and reduce potential unintended consequences. We need to improve risk communications to the public and to health professionals – in this case, better understanding of and communication about the risks of taking – and not taking – medications.

To read the full article in the British Medical Journal, click here.