Katie Beach Should Adolescents Be Prescribed Antidepressants?

Mental health professionals have noticed a spike in the use of antidepressants in the adolescent populations over the past two decades. While the main intent is to assist in the recovery of adolescent depression, studies have found a statistically significant number of adolescents who either have suicidal ideation or who commit suicide. Because of this the FDA has even gone so far as to create a warning label that warns mental health professionals and parents of this risk. Controversy has ensued over this warning as many professionals take a stance on whether or not the warnings are truly justified. In 2004, a black box label was placed on all antidepressants that warned mental health professionals about the risk of suicide in adolescents. The actual wording on the label states that the patient may only have suicidal thoughts and the warning does not specifically say that there is a risk of death by suicide. It is also a fact that, ³suicide rates appeared to decline in most portions of the American population as antidepressant use became prominent´ (Sammons, 2009) and ³declines for adolescents between 15-24 were also prominent´ (Sammons, 2009). A pediatric trial of antidepressants showed that of 4,400 children and adolescent patients, there were no suicides. Secondly, suicidal ideation in the pediatric population was very low as only 146 of the 4,400 had thoughts of suicide (or 4% of the population). Most of the thoughts occurred very early in the treatment, and it does take up to a month for the effects of some antidepressants to begin to work. Even with the statistically significant data, it was a small population that drove the FDA into placing the special warning label. (Rudd, Liliana, & Bryan, 2009) ³The association between suicide rates and antidepressant use in adolescents or other

anxiety. Yet. medical professionals should find other treatments for these illnesses to avoid the side effects and the risk of suicide. This is inherently unethical.´ (Sammons. there is still the chance of the suicidal thoughts and it should be observed more in order to understand it before more adolescents are prescribed antidepressants. and premenstrual symptoms. can be relatively inexpensive. . psychotherapy is expensive and often not covered by insurances so they must be paid for by the patient or the patient¶s family. One treatment that has been brought forth is psychotherapy. 2009) Even with the numbers being low. (Brown 2009) A percentage of adolescents are prescribed antidepressants for the treatment of problems other than depression. To be on the safe side. With this fear. there was a drop of SSRI usage among adolescents. while antidepressants can start to show effects within two weeks. Even though depressed adolescents are more prone to suicide. While antidepressants are a form of treatment for depression. Because of the label. and is likely more correlational than causal. Antidepressants can also be prescribed for issues such as chronic pain. researchers are unsure on the relationship between adolescents getting treatment by antidepressants for these other symptoms. In 2007. parents and mental health professionals are wary to use antidepressants as a form of treatment for adolescents. insomnia. which in turn caused more adolescents to commit suicide. Even in the Netherlands.groups is unclear. other treatments do exist. Antidepressants are often covered by insurance and especially for generics. there was a 49% increase of suicides alone following the placement of the warning label. just to avoid potential risks of treatment. professionals many not diagnose adolescents that truly have depression with depression. Psychotherapy also takes longer to show results. It is been proven effective and does not have the side effects that antidepressants do.

One argument against prescribing antidepressants to adolescents is that not many of the drugs are researched for use on adolescents. 2009) If a therapy that has been proven to work as effectively as antidepressants is available that does not have the potential for serious negative side effects. then therapy should be used for the treatment for depression. the follow up visits to the professionals are few and lacking. ³The literature suggests generally equivalent efficacy for the use of psychosocial treatment and antidepressant therapy may be indicated for the management of depression in children and adolescents.´ (Simon. but a general practitioner or pediatrician. some mental health professionals have been referring their patients to psychotherapists. If these professionals are not treating their patients this way. These health professionals usually have . ³fluoxetine (Prozac) is the only drug whose antidepressant effect has been clearly established in a pediatric population and is the only drug approved in the United States for the treatment of depression in children and adolescents. After the placement of the warning label many mental health and health professionals have stopped prescribing antidepressants to their adolescent patients. 2006) If other drugs are currently not evaluated how can mental health professionals know how the drug works on adolescents or even the risks? Not to mention that when the medications are prescribed. If evidence on how other antidepressants besides fluoxetine work is lacking and professionals are not observing how they work. Currently.´ (Brown. the risks in adolescents cannot be properly evaluated. Sometimes it is not mental health professionals who make the diagnosis of depression for adolescents. Instead of prescribing antidepressants to adolescent patients. that shows that they are unwilling to take the risk.On the other side of the issue are those that argue that antidepressant use in adolescents does cause suicide and should not be prescribed to adolescents.

is limited compared to what we know about treating depression in adults. the side is strong because there have been cases where there has been suicide and suicidal ideation as a result of antidepressants. the weakness of this argument is the lack of research supporting it. There has also only been research on one antidepressant testing its effects on adolescents. Even the National Mental Health Institute (NIMH) has stated ³«our knowledge of antidepressant treatments in youth. ³What different antidepressants are they adolescents being prescribed that could cause the suicidal ideations or the suicide itself?´ To thoroughly examine the causes of suicide while an adolescent is on antidepressants. The close monitoring of the adolescents would make sure that . The future direction for this controversy is to continue to study the usage of antidepressants and adolescents. longitudinally. People who support prescribing antidepressants to adolescents argue that the benefits of antidepressants outweigh the risks. though growing substantially.little expertise in mental health. Even if the diagnosis of depression is accurate. The adolescents would be asked keep a journal of their thoughts and whether or not they are having suicidal ideations. this side also has the weakness of lack of through and comprehensive research. For the argument against antidepressants. then there may be an inverse reaction that could cause the suicidal ideations or suicide itself. The study should follow.´ (National Institute of Mental Health. 2009) One question that could be asked is. If depression is wrongly diagnosed and antidepressants are prescribed. Thus. The main research examines a limited population which can only show correlational evidence. Yet. the adolescent from time of prescription of antidepressant to the time that the symptoms are relieved or treatment has stopped. a study could be created. health professionals should be educated in other means of controlling depression rather than the prescription of the antidepressant medications.

. It is important that the relationship between antidepressants and suicide in adolescents be understood because antidepressants should not cause even suicidal ideations. then a question that could be asked is. then antidepressants should be questioned on whether or not they do the job they were designed for. The study would note what antidepressant medication the adolescent was taking. Most mental health professionals would agree that adolescents are chemicals balanced differently than adults and their body changes are a factor to consider. This is a good reason why other forms of therapy should be sought rather than being prescribed antidepressants initially. Another line of research that may be beneficial would be to try designing an antidepressant that works in adolescents specifically. but rather should make the adolescents¶ mood even out. The function of antidepressants is to remove depression from the life of adolescents so there are fewer depressed thoughts and actions. If antidepressants do lead adolescents to suicide. ³Why does the FDA insist that it does?´ The FDA should be an agency that reports clear and honest information to the public.they would not commit suicide. Antidepressants were designed for use in adults and studies in adolescents have been lacking. The studies done in the past also had a relatively large number of participants (4000 in one study) and having a more research done would help find reasons for the suicidal ideations in adolescents. If it is found that antidepressant usage in adolescents does not cause suicidal ideations or lead teens to commit suicide. A drug that is designed specifically for the chemical composition of adolescents would perhaps eliminate even the suicidal ideations. not to spread fear and prevent adolescents from obtaining effective treatment for their depression.

As both side cite evidence that does support their argument. the disagreement still remains strong. the controversy over prescribing antidepressants to adolescents is strong as suicide and suicidal ideations are very important. there is the hope that more research will be done to figure out if the antidepressants can be safely and effectively be prescribed to adolescents. . In the future.Currently.

Professional Psychology: Research and Practice . Cordero. 327329. Psychiatric Services . (2006). Recipt of Psychotherapy by Adolescents Taking Antidepressants. C. Professional Psychology: Research and Practice . and Bryan. Simon. 330-332. 355 (26). (2009). & Bryan.nimh. 40 (4). M. Antidepressants and Suicide: A Commentary on a Significant Contribution to This Debate. November 9). 40 (4). L. 40 (4). 963. from NIMH: http://www. Goldney. E. New England Journal of Medicine .nih. R.Works Cited Brown. A Time To Consider Health Care Reform: A Reply to Rudd. 97-98. Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. T. Crisis . . National Institute of Mental Health. Retrieved November 10.. (2008). (2009). C. Liliana. D. 2009. 321-326. t. (2009.shtml Rudd. (2009). M. 26 (2). G. D. Sammons. Professional Psychology: Research and Practice . Mark. 2272-2273.gov/health/topics/child-and-adolescentmental-health/antidepressant-medications-for-children-and-adolescents-information-forparents-and-caregivers.. R. J. Writing a Wrong: Factors Influencing the Overprescription of Antidepressants in Youth.Considering Suicide Risk When Treating Adolescent Depression. 59 (9). (2005). What Every Psychologist Should Know About the Food and Drug Administration's Black Box Label for Antidepressants. T. The Antidepressant Quandry .

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