Antidepressant Seen as Effective in Treatment of Adolescents

...take a hard honest look at what kind of parents you are.

Yes, of course you're correct. But I'm assuming a problem with depression is severe enough to warrant immediate outside intervention. Kids can do stupid things really quickly.

If more kids went to church, there would be less need for any of these discussions.

And parents can't spend too much time with children. If they're with you, they're not getting into trouble.

Fluoxetine is no longer under patent protection and there are generics available.

I don't get the contradiction in suicide numbers, either, unless the difference is that the data only comes from the first 12 weeks.

12 weeks is enough to measure efficacy of the drug to reduce the symptoms of depression. However, the studies have shown that the SSRI's work best - sort of "resetting" the depression - if used for one ful year. There is a center in the brain that fires impulses more often in those that are depressed, and this center quiets down in those who are successfully treated with antidepressants - that is, those that actually report improvement in symptoms on the drug.

SSRI's don't actually add serotonins. They work to decrease the uptake and destruction of the chemical as it functions between synapses in the brain (and, incidentally, in the gut).

I agree that we over medicate our children and teens. I do not believe that every single person should react in the same way that every other person does. Nor do I believe that depression should be diagnosed after 2 weeks of symptoms, except when the symptoms are very severe.

I do believe there is a place for antidepressant treatment in teens and adolescents and that some children are miserable, do not like themselves, and are unable to function in even limited society groups. These children should be closely monitored and possibly treated.

However, some of the children that I see for evaluation of depression or hyperactivity (or both) are simply causing someone to spend a little more energy on them and are not actually outside the norm for activity or depression. Others have very poor environments or their parents or teachers are the ones with the problems.

Careful, slow, and deliberate consideration and evaluation are the keys to all healthcare, but especially in young minds in growing bodies.

"This study should put to rest doubts about whether these drugs work in teenagers with severe depression," said Dr. Graham Emslie, a professor of psychiatry at the University of Texas Southwestern Medical Center and an author of the study, which was presented here on Tuesday at a meeting of psychiatric drug researchers.

Of course Emslie would say that. He's made a fortune pushing drug company-funded antidepressant studies of extremely dubious scientific value.

But when confronted by this same reporter last year (Debate resumes on the Safety of Depression's Wonder Drugs) on why negative results of Paxil's safety when taken by children were routinely withheld from the public, Emslie had this to say:

Dr. Graham Emslie, a professor of psychiatry at the University of Texas Southwestern Medical Center who was a researcher in four of GlaxoSmithKline's studies of Paxil, said he suspected that the other studies went unpublished at least in part because the results were unfavorable.

"Some of these studies were finished a couple of years ago," Dr. Emslie said. "But negative trials tend not to get published."

Dr. Perera, the GlaxoSmithKline official, said that publishing studies "takes time." He declined to say if the company would seek to publish the eight Paxil studies that have not appeared in journals.

According to Dr. Emslie, other companies have withheld negative studies of S.S.R.I.'s. "I know of at least a half-dozen other studies of antidepressant treatments in children and adolescents that have been completed but as yet have not been published," he said. "More than enough time has passed for these to be published at least in abstract form." He refused to identify the companies or the drugs involved because he, like other researchers involved in similar research, has signed contracts promising secrecy.

Since Dr. Emslie is such a staunch supporter of full disclosure and since only the first 12 weeks of the 36-week study were reported, I'm looking forward to the full and honest disclosure of information that will come. With a 5X rate of suicide attempts vs. placebo the first 12 weeks, sure hope things didn't get any worse or that there wasn't other bad stuff to report. I also hope someone will ask how researchers with huge conflicts of interest decide when patients "get better" from disorders that are by definition subjective.

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