University Times

The FDA now requires drug manufactures to label antidepressants with a warning that they increase the suicide risk in children and adolescents.

But warning the parents of emotionally disturbed teen-agers about the possible effects of antidepressants has been a part of the program for David Brent, who holds the country’s first endowed chair in suicide studies and is director of Pitt’s Services for Teens At Risk. But the new FDA order issued this month may give pause to non-psychiatrists who have been prescribing anti-depressants more casually, he said.

Brent is in the middle of a study, “Treatment of Resistant Depression in Adolescents,” which he describes as the only head-to-head comparison of antidepressant treatments in adolescents. The study parses the effectiveness of four treatments offering different combinations of antidepressants and psychotherapy. “We’re trying to figure out the next step after the first method of treatment doesn’t work,” he said.

“Right now a lot of antidepressants are being prescribed by non-psychiatrists and I don’t think it’s necessarily a bad thing,” Brent said, “although, it’s important that the person who prescribes the drug give the time and attention to the patient that is necessary to monitor their response.” Anyone working with adolescents and antidepressants needs to provide a certain level of scrutiny, he said, including weekly checkups during the first month of treatment, and then biweekly visits. “And I want to underscore that any drug can do anything to anybody.”

While antidepressants provoke suicidal tendencies in 1 out of every 50 young people who take them, Brent says, they significantly help alleviate depression for 1 in 5 who take them. “Is that a favorable ratio or not? I think it is,” Brent said. “The bottom line is that it’s up to the parent and the kid to decide. As a doctor, you give your opinion and then if somebody feels they don’t want to take the chance or they’ve had or know of a bad experience, then you try to do something else.”

To identify suicidal tendencies in a teen, parents and practitioners need to ask teens verbally or by using a questionnaire, Brent said, “You could tell for example, if they’re agitated or uncomfortable. With a therapist, such a question should always be a part of the interaction.”

For more information on the “Treatment of Resistant Depression in Adolescents” study, contact STAR at 866/666-2538.

-Mary Ann Thomas