Judy Foreman

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How can I decide whether to take antidepressants?

April 16, 2007 by

Untreated depression is a terrible disease, and antidepressants help millions of people. But they should be taken under tight medical supervision, said Dr. Alexander Bodkin, chief of clinical psychopharmacology research at McLean Hospital.

During the first few days of taking an SSRI-type antidepressant, many people feel intense agitation, even panic. This is actually “a sign that the SSRIs are on the way to making you better,” said Bodkin. But precisely because these feelings can be so scary, it is important for doctors to stay in close touch with patients and for patients to report any distress immediately.

Despite anecdotal reports of adverse reactions to antidepressants in children and adolescents, particularly SSRIs like Prozac and Zoloft, there are actually no cases of suicide related to taking antidepressants in all the pediatric clinical trial data that the US Food and Drug Administration re-evaluated in recent years, said Dr. John Mann, professor of psychiatry and radiology at Columbia University and director of research for the New York State Psychiatric Institute.

In a 2004 report, the FDA noted that spontaneous reports of suicidal thinking and nonfatal suicide attempts occurred at the rate of about 4 percent in young people taking antidepressants, and only 2 percent in those taking placebos. For this reason, the FDA made manufacturers put a “black box” warning on antidepressants for people up to age 18. But even during this time, noted Mann, who has done extensive research on the subject, “nearly all the suicides in children and adolescents were in people NOT taking antidepressants.”

New figures from the Centers for Disease Control and Prevention show that in the months after negative stories about antidepressants first came to light, the number of youth suicides actually went up — from 1,601 in 2003 to 1,828 in 2004 — after many years of declining numbers. This rise in youth suicides parallels a 20 percent drop in antidepressant prescriptions, Mann said.

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