FDA Labeling Change And Child Suicide Increase-Is There A Link?

The mandate of a black box warning by the U.S. Food and Drug Administration concerning many antidepressant medications over the last few years has sparked a debate among many scholars as to whether the mandate has caused an increase in teenage suicide. The warning, which informed doctors of a potential risk of increased suicidal thoughts among its users, was ordered by the FDA in 2004 on selective serotonin reuptake inhibitors (SSRIs), such as Paxil, Zoloft, and Prozac. According to various studies and statistics, the suicide rate among teens and children rose in 2004 for the first time in decades. Many scholars think the black box warning is partly to blame for this rise:

“The sudden increase in the adolescent suicide rate,” Fassler continued, “corresponds to the significant and precipitous decrease in the use of SSRI antidepressants in this age group.”

“As a result of the agency’s activities, dramatic decreases in the use of SSRIs in the adolescent population were noted,” said David Shern, president of Mental Health America in a statement issued Monday. “Other research has indicated a general relationship between the use of SSRIs and decreasing suicide rates in the general population.
“We must therefore wonder if the FDA’s actions and the subsequent decrease in access to these antidepressants have caused an increase in youth suicide.”

Other scholars and professionals are not convinced of the link:

“There could be a small relationship, but we don’t have the evidence to support that there is a causal link at this point in time,” said Bernadette Melnyk, dean and professor of nursing at the Arizona State University College of Nursing and Healthcare.

“What we know about the link between antidepressants and suicide is they can cause an increase in suicidal thinking, but no study has shown an increase in suicides as a result of antidepressants,” said Lori Evans, project coordinator of Treatment of Adolescent Suicide Attempters.

“We do not have the data to know if there has been a significant decrease in the amount of prescriptions given to teens since the warning. Therefore we certainly cannot say there is a causal link.”