How the FDA’s Antidepressant Warning Impacted Youth Suicide Rates.
Suicide rates rates among US youth were trending downward in the late 1990’s and early 2000’s. Then in 2005, the FDA slapped a black box warning on antidepressants. The FDA claimed that antidepressants were likely associated with suicidal thoughts and behaviors in youth. The warning led to confusion and fear among patients and providers, compounding the pre-existing stigma surrounding mental health medications.
According to last month’s article in Health Affairs, the black-box warning caused more harm than good. It led to a reversal in the declining suicide rates among children and adolescents for one.
Here are other ways that the warning hurt thousands of American youth in the years following the warning.
Higher suicide-related events:
- A 22% increase psychatric medication overdoses among adolescents and a 34% rise among young adults after the warning.
- An estimated 2,500 additional youth completed suicide in the three years after the warning.
- Suicide rates were declining in the late 1990’s and early 2000’s until the warning. Rates started to increase immediately after.
There was a decrease in depression care:
- Depression-related visits decreased nearly 50% among Medicaid patients aged 5-17 within three years after the warning.
- The biggest drops occurred among primary care providers, the largest group of antidepressant prescribers.
There was a reversal in antidepressant use:
- Antidepressant prescriptions to patients under 18 decreased by nearly 50%.
- Again, primary care providers (eg. pediatricians, family practice docs) were among the most likely to curb antidepressant prescribing to youth.
Patients and families still ask me about the black-box warning, wondering if taking antidepressants will lead to suicide. Psychiatric medications aren’t the answer to all mental health problems. But, for the sake of those who can benefit from the meds, let’s not add to the stigma.
Photo Credit: Jack Bell Photography
