Antidepressants and Adolescent Suicide
The number of U.S. children taking antidepressants has more than doubled since the early 1990’s. In the past year, new evidence has emerged suggesting a possible connection between starting antidepressant treatment and an increase in suicide risk. The FDA says to watch for signs of increased suicidal thinking in children and adults who start taking antidepressants or when the dose changes. Until more is known, experts advise parents of a depressed child to follow these guidelines:
o Treat depression promptly and aggressively because the condition itself is a major risk factor for suicide.
o Try intensive talk therapy first. Use antidepressant medication only as a last resort if there’s no improvement.
o When medication is necessary, children starting a drug should be watched closely for signs of thoughts of self-harm. Symptoms include talking or writing about death, self-mutilation, abrupt withdrawal from family and friends, and giving away prized possessions. Other symptoms that warrant concern include increased anxiety, agitation or restlessness, insomnia, irritability, and hostility.
o Children who have been on antidepressants for more than a few months can safely continue if the medication is helping and they are not having suicidal thoughts or unacceptable side effects.
o Never discontinue an antidepressant without consulting your doctor. Abrupt stopping can bring on discontinuation symptoms such as increased agitation or restlessness. Your doctor can provide a schedule for gradually tapering off the dose.
More information on antidepressants and adolescent suicide is available free at www.ConsumerReports.org.
Understanding Talk Therapy Options
Consumer Reports’ reader survey found that a combination of talk therapy and drugs was the overall winner for treating depression and anxiety. “Mostly talk” therapy was almost as effective if it lasted 13 or more visits. But striking the right balance between medication and “enough” therapy sessions can be tricky. Asking hard questions of the professional recommending treatment can help you understand the options. These questions should include:
o What’s your understanding of this problem?
o What kind of treatments would you recommend and why?
o How long will it take to experience some relief of symptoms?
o How long will I need to stay on medication and/or continue talk therapy to get the maximum benefit?
Action Steps for Best Results
Consumer Reports’ research has found that it requires some consumer savvy to get the best results from treatments for depression and anxiety. In Consumer Reports’ survey of about 3,000 readers, respondents who were most satisfied with their mental-healthcare and had the best outcomes were more likely to:
o Research their problem in advance of seeking help.
o Interview more than one professional.
o Ask therapists whether they had experience treating that problem.
o Bring a family member or a friend to an office visit.
o Keep a written record of their treatment and emotional state.
o Apply what they were learning in treatment to their daily lives. This involves working hard at therapy and putting suggestions into action–the best predictor of a good outcome in the Consumer Reports survey.
News media can reprint this information using the following citation: Reprinted with permission from Consumer Reports, October 2004, www.ConsumerReports.org.