Doctors' group says antidepressants safe for teens

[David Baxter PhD]

Doctors' group says antidepressants safe for teens
Mon Jun 20, 2005
By M. Mary Conroy

CHICAGO (Reuters Health) - A new report from the American Medical Association's Council on Scientific Affairs (CSA) suggests that antidepressants -- including so-called SSRIs such as Prozac -- are appropriate therapies for the treatment of depression in adolescents.

The CSA report, which was discussed at an AMA reference committee hearing Sunday, was immediately endorsed by delegates representing the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics.

"We believe this is a fair and balanced report," said Dr. Melvyn Sterling, clinical professor of medicine at the University of California, Irvine, and chairman of the council.

Sterling said the council report recommends that SSRIs remain available for use in both children and adolescents and states that current clinical evidence "indicates that (Prozac) is an effective SSRI in children and adolescents with major depressive disorder."

Antidepressants, especially SSRIs, have come under increased scrutiny by the Food and Drug Administration and Congress amid reports of increased suicides among teenager treated with the drugs.

The AMA will begin voting on this issue and many others later this week.

 

[David Baxter PhD]

Doctors' group says antidepressants safe for teens
Mon Jun 20, 2005
By M. Mary Conroy

CHICAGO (Reuters Health) - A new report from the American Medical Association's Council on Scientific Affairs (CSA) suggests that antidepressants -- including so-called SSRIs such as Prozac -- are appropriate therapies for the treatment of depression in adolescents.

The CSA report, which was discussed at an AMA reference committee hearing Sunday, was immediately endorsed by delegates representing the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics.

"We believe this is a fair and balanced report," said Dr. Melvyn Sterling, clinical professor of medicine at the University of California, Irvine, and chairman of the council.

Sterling said the council report recommends that SSRIs remain available for use in both children and adolescents and states that current clinical evidence "indicates that (Prozac) is an effective SSRI in children and adolescents with major depressive disorder."

Antidepressants, especially SSRIs, have come under increased scrutiny by the Food and Drug Administration and Congress amid reports of increased suicides among teenager treated with the drugs.

The AMA will begin voting on this issue and many others later this week.

 

[healthbound]

"...current clinical evidence "indicates that (Prozac) is an effective SSRI in children and adolescents with major depressive disorder."

"Antidepressants, especially SSRIs, have come under increased scrutiny by the Food and Drug Administration and Congress amid reports of increased suicides among teenager treated with the drugs."

"The AMA will begin voting on this issue and many others later this week."


----What is your opinion on this issue? Are they safe for children and adolescents?

 

[healthbound]

"...current clinical evidence "indicates that (Prozac) is an effective SSRI in children and adolescents with major depressive disorder."

"Antidepressants, especially SSRIs, have come under increased scrutiny by the Food and Drug Administration and Congress amid reports of increased suicides among teenager treated with the drugs."

"The AMA will begin voting on this issue and many others later this week."


----What is your opinion on this issue? Are they safe for children and adolescents?

 

[David Baxter PhD]

In my opinion, there was never an undue risk, providing that patients just starting an SSRI are monitored for the first 2-3 weeks, which should always be the case anyway. I have read the literature on this debate and I've never seen any credible evidence that it increases suicide risk. Depressed individuals do come with a certain risk for suicidal thinking or attempts -- that's part of the disorder -- and teenagers because of their emotional state are more prone to feelings of helplessness and hopelessness and more impulsive by nature. That's what causes suicide attempts, not medication, in my opinion.

I'd also point out that these medications are also used to treat anxiety disorders, OCD, eating disorders, etc., etc., and there has never been a shred of evidence, not even bad evidence, to suggest that individuals taking SSRIs for these other disorders are at risk. Unfortunately, the warnings issued by government health agencies failed to specify that so the "ban" became a ban on the medications instead of a caution regarding the use in youn depressed patients. All in all, I was very disappointed in the response of government agencies -- although I do of course understand the concern, I think it could have been better handled.

 

[David Baxter PhD]

In my opinion, there was never an undue risk, providing that patients just starting an SSRI are monitored for the first 2-3 weeks, which should always be the case anyway. I have read the literature on this debate and I've never seen any credible evidence that it increases suicide risk. Depressed individuals do come with a certain risk for suicidal thinking or attempts -- that's part of the disorder -- and teenagers because of their emotional state are more prone to feelings of helplessness and hopelessness and more impulsive by nature. That's what causes suicide attempts, not medication, in my opinion.

I'd also point out that these medications are also used to treat anxiety disorders, OCD, eating disorders, etc., etc., and there has never been a shred of evidence, not even bad evidence, to suggest that individuals taking SSRIs for these other disorders are at risk. Unfortunately, the warnings issued by government health agencies failed to specify that so the "ban" became a ban on the medications instead of a caution regarding the use in youn depressed patients. All in all, I was very disappointed in the response of government agencies -- although I do of course understand the concern, I think it could have been better handled.

 

[Peanut]

Do you think that an anti-psychotic medication like Risperdyl is an appropriate treatment for teenagers to treat anxiety (when SSRIs are not effective enough)?

 

[Peanut]

Do you think that an anti-psychotic medication like Risperdyl is an appropriate treatment for teenagers to treat anxiety (when SSRIs are not effective enough)?

 

[healthbound]

Or Seroquel?

 

[healthbound]

Or Seroquel?

 

[David Baxter PhD]

Are you asking if Seroquel is safe for children and teens? Truthfully, I haven't really investigated that but I can't say that I've heard of any major concerns.

 

[David Baxter PhD]

Are you asking if Seroquel is safe for children and teens? Truthfully, I haven't really investigated that but I can't say that I've heard of any major concerns.

 

[healthbound]

Yes. I'm asking about Seroquel for teens.

My son was diagnosed with GAD a couple of years ago. He seems to phase in and out of anxious times particularly when he needs to perform or write tests etc.

Since a very small amount of Seroquel has been successful for helping reduce anxiety for me, I have wondered if a small amount would do the same for him.

Once I was able to help tone down my anxiety, I could focus on the task at hand. So maybe during exams a small amount might do the same for him? He's 14 years old, by the way.

Last year we tried 2 different approaches to both of his exam times. The first set of exams I helped him manage regular study times leading up to his exams. He was very anxious for the 2 week "exam period" and says he froze during everyone. When I asked him what he meant by freezing, he explained that he goes blank and can not recall anything. This also happened to him when he had to do an oral exam in French. He studied and new his whole speech by heart right up until he had to speak it for his teacher. He simply had no idea of any part of his speech.

The second (and last) set of exams we tried not studying at all unless he felt like it. We looked at his GPA and knew that even if he didn't write the exams at all, he would still maintain B's. No pressure.

The second way seemed to work the best and we'll continue to do that again this year, providing he maintains grades that will allow for him to possibly freeze during exams.

Anyway, that's one example of his experience with anxiety.

When I was a teenager I did not have a clue about what I was experiencing. I learned that drinking a lot and pre-occupying myself with risk helped take my focus off of my own anxieties about what was going on with me and at home. My son is NOTHING like I was. At his age I was smoking, doing drugs, stealing, drinking and running away from home. He is militantly against drugs of any kind and absolutely hates smoking. He also sometimes complains that he thinks some of the girls at his school dress too scantily. Like - is this kid even MINE?! lol.

OK Enough rambling. The point - during times when he is experiencing more anxiety I would love to help him not be so pre occupied with his fears but to be more focused on living his life. I can't learn or think clearly when I'm anxious and I perceive it to be similar with him.

 

[healthbound]

Yes. I'm asking about Seroquel for teens.

My son was diagnosed with GAD a couple of years ago. He seems to phase in and out of anxious times particularly when he needs to perform or write tests etc.

Since a very small amount of Seroquel has been successful for helping reduce anxiety for me, I have wondered if a small amount would do the same for him.

Once I was able to help tone down my anxiety, I could focus on the task at hand. So maybe during exams a small amount might do the same for him? He's 14 years old, by the way.

Last year we tried 2 different approaches to both of his exam times. The first set of exams I helped him manage regular study times leading up to his exams. He was very anxious for the 2 week "exam period" and says he froze during everyone. When I asked him what he meant by freezing, he explained that he goes blank and can not recall anything. This also happened to him when he had to do an oral exam in French. He studied and new his whole speech by heart right up until he had to speak it for his teacher. He simply had no idea of any part of his speech.

The second (and last) set of exams we tried not studying at all unless he felt like it. We looked at his GPA and knew that even if he didn't write the exams at all, he would still maintain B's. No pressure.

The second way seemed to work the best and we'll continue to do that again this year, providing he maintains grades that will allow for him to possibly freeze during exams.

Anyway, that's one example of his experience with anxiety.

When I was a teenager I did not have a clue about what I was experiencing. I learned that drinking a lot and pre-occupying myself with risk helped take my focus off of my own anxieties about what was going on with me and at home. My son is NOTHING like I was. At his age I was smoking, doing drugs, stealing, drinking and running away from home. He is militantly against drugs of any kind and absolutely hates smoking. He also sometimes complains that he thinks some of the girls at his school dress too scantily. Like - is this kid even MINE?! lol.

OK Enough rambling. The point - during times when he is experiencing more anxiety I would love to help him not be so pre occupied with his fears but to be more focused on living his life. I can't learn or think clearly when I'm anxious and I perceive it to be similar with him.

 

[David Baxter PhD]

I haven't been able to find any information as to the use of Seroquel in younger patients, although I did see references to its use in children and adolescents. I'd strongly suggest you ask your doctor about this.

 

[David Baxter PhD]

I haven't been able to find any information as to the use of Seroquel in younger patients, although I did see references to its use in children and adolescents. I'd strongly suggest you ask your doctor about this.

 

[healthbound]

At what point does medication become an option?

I lived with my anxiety for many years before I began medication. What is your opinion about the best time to introduce medication into the mix?

Thanks.

 

[healthbound]

At what point does medication become an option?

I lived with my anxiety for many years before I began medication. What is your opinion about the best time to introduce medication into the mix?

Thanks.

 

[David Baxter PhD]

As soon as you are ready to accept it and old enough to take it, in my opinion. I don't believe in unnecessary suffering. Medication may not be the whole answer but it helps someone suffering from an anxiety disorder to bring down the anxiety enough to learn other coping strategies.

 

[David Baxter PhD]

As soon as you are ready to accept it and old enough to take it, in my opinion. I don't believe in unnecessary suffering. Medication may not be the whole answer but it helps someone suffering from an anxiety disorder to bring down the anxiety enough to learn other coping strategies.