Depression: association between drug safety warning and suicidal behaviour amongst young people

posted 29 Jul 2014, 13:50 by Damian Wood   [ updated 29 Jul 2014, 13:52 ]
Christine Lu and colleagues writing in the BMJ examined changes in antidepressant use by young people and associated suicidal behaviour after drug safety warnings and media coverage in the USA. They found that the widely publicized warnings in 2003 from the US Food and Drug Administration about a possible increased risk of suicidality with antidepressant use in young people were associated with abrupt changes in antidepressant use and poisonings after the warnings. In the second year after the warnings, relative changes in antidepressant use were −31.0% (95% confidence interval −33.0% to −29.0%) among adolescents, −24.3% (−25.4% to −23.2%) among young adults, and −14.5% (−16.0% to −12.9%) among adults. These reflected absolute reductions of 696, 1216, and 1621 dispensings per 100 000 people among adolescents, young adults, and adults, respectively. Simultaneously, there were significant, relative increases in psychotropic drug poisonings in adolescents (21.7%, 95% confidence interval 4.9% to 38.5%) and young adults (33.7%, 26.9% to 40.4%) but not among adults (5.2%, −6.5% to 16.9%). These reflected absolute increases of 2 and 4 poisonings per 100 000 people among adolescents and young adults, respectively (approximately 77 additional poisonings in our cohort of 2.5 million young people). Completed suicides did not change for any age group. They conclude that safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. They assert it is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting.