July 2, 2007
In a study of more than 100,000 patients treated for depression, suicide attempts declined during the first month of treatment–whether that treatment consisted of medication, psychotherapy, or both. The findings, published by Group Health researchers in the July American Journal of Psychiatry, show a similar pattern for populations of adolescents and young adults (up to age 24) as for older adults.
Suicide attempts, overall, are not raised by medication, either for adults or adolescents/young adults. Nonetheless, some people do become suicidal despite never having been so before. The prof suggests that this is due to subgroups (duh, some of the 30-40% of bipolar patients who get hypo/manic/mixed, but I wonder if there’s anyone else – maybe we’ll find out eventually).
I do wonder, though, if some of the improvement isn’t regression to the mean – people frequently don’t start treatment until they’re quite bad off, and mood episodes tend to pass with time.
June 19, 2007
From Psychiatric News: Diagnosis, Treatment of Youth for Depression Fell After FDA Alert
It’s not just that children and adolescents are less likely to be prescribed SSRIs following the alert – it’s that they’re now less likely to be diagnosed and less likely to be treated at all (there has been no corresponding increase in psychotherapy, atypical antipsychotics, or anxiolytics).
You can view the original journal article here.
In the article they suggest it’s possible that in the wake of the recommendation families may not be fully disclosing symptoms, or filling prescriptions written for them.
They also note that the rates of diagnosis are lower than the published incidence rates (i.e. how many people get diagnosed if you go and look and see, instead of only diagnosing people who come to you). So it’s unlikely that we used to be overdiagnosing and overprescribing, and likely that we are now even further underdiagnosing and undertreating.