Posted by SLS on May 15, 2013, at 20:32:55
In reply to Lou's Little Shoppe, posted by Lou Pilder on May 15, 2013, at 11:31:41
> antidepressants cause suicide rather than preventing them
It is unfortunate that some people should feel compelled to confine themselves to polar "either-or" thinking regarding this issue.
Antidepressants, even in young people, prevent more suicides than they provoke. The suicide rates in young people have been increasing since 2003, the year that the black-box warning first appeared on antidepressant labeling. This was demonstrated by the CDC as early as 2007. I don't think cause-and-effect has yet been established, though. One can find conflicting interpretations of this data. Nevertheless, they exist.
http://abcnews.go.com/Health/Healthday/story?id=4508580&page=1#.UZQ0zcoQtJI
Antidepressants can make some people feel more depressed. This is a negative reaction, to be sure. Sometimes, whereas one antidepressant fails to produce an improvement, another might succeed. Paradoxically, some people actually experience an increase in suicidal ideation early in treatment precisely because the antidepressant begins to work. As anergic vegetative symptoms begin to recede without a commensurate improvement in outlook, one has more mental energy to act on their negative impulses.
Each pediatric case must be evaluated individually. I am not a doctor, but I should think it preferable that psychotherapeutic modalities be explored first before pharmacotherapy in this population.
A more balanced perspective, perhaps?
I haven't come to any firm conclusions regarding the use of antidepressants in young people. If the illness is severe enough, I'm not sure there is any better choice but to use one. I don't doubt that antidepressants affect the immature and developing brain of young people in ways that differ from those of adults. The rate of iatrogenic suicidal ideation in younger people is probably higher. One statistic I saw was 0.2% for placebo versus 0.4% for active drug.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1043694
URL: http://www.dr-bob.org/babble/admin/20130109/msgs/1043715.html