Although not the intent, the initial regulatory
actions resulted in reduction of antidepressant
prescriptions to those less than age 18 years.
Given the seriousness of suicidal, and the
pronounced media attention that this issue
garnered, this outcome was not necessarily
surprising. Diagnoses of pediatric depression also
declined during this period (a significant change
from the historical trend)
and, for the first time in
decades, the incidence of adolescent suicide
reversed trend and began to rise.
While it is
impossible to know whether the recent increase in
adolescent suicide was related to reduced antidepressant
use, the temporal relationship suggests
the regulatory warnings, while well-intentioned,
may have been partially responsible. One notion
that most experts seem to agree on is that
untreated depression carries a significant risk for
suicide. Depression diagnoses and antidepressant
use in adults also reportedly declined after the
initial pediatric warnings were issued. Whether
the expansion of the “boxed” warning to encompass
young adults will further reduce antidepressant
use in adults, particularly in young adults,
remains to be seen
Although not the intent, the initial regulatoryactions resulted in reduction of antidepressantprescriptions to those less than age 18 years.Given the seriousness of suicidal, and thepronounced media attention that this issuegarnered, this outcome was not necessarilysurprising. Diagnoses of pediatric depression alsodeclined during this period (a significant changefrom the historical trend) and, for the first time indecades, the incidence of adolescent suicidereversed trend and began to rise. While it isimpossible to know whether the recent increase inadolescent suicide was related to reduced antidepressantuse, the temporal relationship suggeststhe regulatory warnings, while well-intentioned,may have been partially responsible. One notionthat most experts seem to agree on is thatuntreated depression carries a significant risk forsuicide. Depression diagnoses and antidepressantuse in adults also reportedly declined after theinitial pediatric warnings were issued. Whetherthe expansion of the “boxed” warning to encompassyoung adults will further reduce antidepressantuse in adults, particularly in young adults,remains to be seen
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