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Black box warnings meant to lower suicide risks of antidepressants may have the opposite effect, study finds

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Antidepressant Warnings May Have Unintended Consequences for Youth Mental Health #

A new systematic review has found that boxed warnings on antidepressants may have had unintended negative consequences for pediatric health care and suicidality. The study, published in a peer-reviewed journal, suggests that these warnings may have led to reductions in mental health care and increases in psychotropic drug poisonings and suicide deaths among youth.

The review analyzed 11 reports that measured changes in outcome trends following the implementation of warnings about antidepressant use in young people. Key findings include:

  • Doctors monitored fewer than 5% of pediatric patients in accordance with recommendations for scheduled contact after the warnings were implemented.
  • Significant declines in doctor visits for depression symptoms or diagnoses were observed.
  • Abrupt and sustained declines in antidepressant use, ranging from 20% to 50%, occurred after the warnings.
  • Increases in psychotropic drug poisonings and suicide deaths among children were reported.
  • Effects of the warnings also impacted young adults ages 18 to 24.

The researchers suggest that the consistency in observed harms and absence of observed benefits after the warnings indicate that these outcomes are not coincidental. They recommend that the warnings be reconsidered or potentially removed.

It’s important to note that the study doesn’t show that antidepressants or boxed warnings directly cause suicidality. Other factors, such as the ongoing mental health crisis and the COVID-19 pandemic, may also contribute to increased suicide rates.

The findings highlight the complexity of treating depression in young people. Healthcare providers and families should carefully consider the potential benefits and risks of antidepressant therapy, and ensure close monitoring of patients regardless of whether medication is prescribed.

For those concerned about depression in children or young adults, it’s crucial to be aware of warning signs such as drastic changes in behavior, mood, sleep patterns, social life, school performance, or interest in activities. Seeking professional help and discussing all available treatment options is recommended for addressing these concerns.