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Kids and antidepressants: The mix raises questions
A Food and Drug Administration advisory panel has recommended putting a "black
box" warning on antidepressants to indicate they might raise the risk of suicidal
behavior in children and teens. It raises questions for parents of the more than 1
million kids on the medications. USA TODAY's Marilyn Elias gets answers from
David Fassler of the American Psychiatric Association and FDA officials.
Q: Does this mean the "black box" will go on antidepressants and, if so, what will it say?
A: The FDA typically follows the advice of its scientific panels, but not always. A decision is expected this fall. A
black box is the strongest warning label that can be put on a medication. If approved, the box will warn that the drugs have been found to increase the risk of suicidal behavior in children and teens. It also may say whether the drug has been found to work in studies. Only Prozac has been approved for use in depressed children because the drug has worked in two studies. Other popular antidepressants are approved for adults, but they have been legally prescribed to children "off-label." Q: How serious is the risk of suicide?
A: For every 100 kids taking antidepressants, about two to three will think about or attempt suicide because
they're on the drug, according to 24 studies of more than 4,600 children on the drugs. There was not a single suicide in the studies. Some parents believe their children's suicides were triggered by antidepressants; these kids were not in studies that carefully check for participants' worsening mood. Q: Are depressed children better off not taking the drugs?
A: Not necessarily. If an antidepressant is working well, with no bad side effects, a child may be better off on it.
More than half of children with major depression try to kill themselves; about 7% do commit suicide. So the benefits of the pills may outweigh the risks for some young patients. Q: Can children be taken off the drugs immediately if a parent desires?
A: Any parent with concerns should talk to the child's doctor. Abruptly stopping antidepressants never should
be done because it can trigger bad side effects. Patients are taken off drugs gradually. Q: What is the best way to get treatment for a child who seems depressed?
A: Physical causes first should be ruled out by a doctor. Then a thorough evaluation should be done by a
children's mental health specialist. A child's school behavior and any family history of mental illness should be considered before starting treatment. Parents should get as much information as possible on any drug prescribed, and children taking antidepressants almost always need to be in therapy, too. 9/16/2004 - Kids and antidepressants: The mix raises questions Q: What study results did the FDA panel consider before deciding to recommend the label changes?
A: There were pediatric studies using Celexa, Luvox, Paxil, Prozac, Zoloft, Effexor XR, Remeron, Serzone and

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