Several years ago, the Black Box warnings that were added to antidepressants over suicidal thoughts and behaviors for youngsters caused a backlash, as some suggested the language had pushed physicians and parents to avoid usage when the medications could have done some good. The debate may have slipped from view, but never really ended. A pair of papers published last year, in fact, renewed the controversy, and Glen Spielmans, an associate professor of psychology at Metropolitan State University, recounts why the issue remains fraught with challenges and a recent spat that erupted when an effort was made to critique the papers.
Antidepressants can cause suicidality – suicidal thoughts and behaviors – in children and adolescents. This message has been widely disseminated since October 2004, when the FDA placed a Black Box warning on such medications. The warning was based on findings from placebo-controlled trials, in which kids taking antidepressants had an elevated rate of suicidal thoughts and behaviors [see this]. But research led by Dr. Robert Gibbons, professor of biostatistics at the University of Chicago, suggests that this warning is counterproductive, scaring parents and kids away from getting safe and effective antidepressant treatment…
The reason to read this in full is not just about the Gibbons papers that have occupied so much space here over the last year. It’s because Glen tells the story of the difficulty in submitting dissenting opinions. In my opinion, these Gibbons articles shouldn’t have been published, or once published, retracted. But he and plenty of others had a hell of a time even getting our criticisms published in the journal. So Glen Spielmans is telling a meta-story, the kind Ed Silverman of Pharmalot often calls the "back story" – an all too common back story of how dodgy science can stay on the front page and be widely reprinted because there’s no chance to respond in a timely manner before it can do its damage…
On Fox News, Peter Breggin, calling psychiatry the Handmaiden of the psychopharmaceutical industry! Pointing out the role of Paxil. Prozac, Zoloft etc in mass shootings at Columbine, Aurora, Sandy Hook and dozens of other documented tragedies, saying that what people need is a strong personal relationship, someone to talk to, support helping them to overcome their troubles… On Fox News, link on http://www.madinamerica.com CHEERS!
I saw an ad for Pristique the other day, and most of the ad was listing possible side-effects and dangers. Without those, the ad would have been about five seconds long.
God bless Ed Silverman.
Thank you so much for the incredible website and insight into the world of psychiatry. I find your articles to be very insightful and inline with my own thinking. However, I would like to know if you could (or have already done so) write a post about what actually works for people who have suffer from depressed mood.
The critical view you provide is excellent – but I am still left wondering whether there is anything that actually works (whether therapy or medication). I would very much like to hear your thoughts on this.
Alex
Thanks for posting this, Mickey. Your blog was inspirational to me as I investigated the Gibbons papers.