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On February 7, 2004, the body of Traci Johnson, a 19-year-old college student, was found hanging by a scarf from a shower rod in a drug company laboratory. Johnson had no apparent signs of depression, and the reason she killed herself was a mystery. What made her death different from other such tragedies is that she was a subject in a trial of an experimental antidepressant. The company, Eli Lilly, noted that four other patients given the drug in earlier trials had also committed suicide. Not long afterward, prompted by Johnson's death and others, the Food and Drug Administration warned doctors that antidepressants might increase the risk of suicide in children and adolescents.
Johnson's death and the FDA's warning underscored the difficulty of treating depression in children. Was the cure worse than the disease? Nearly two decades after doctors began giving antidepressants to children, it is a question they still cannot answer definitively.
Graham Emslie, a psychiatrist at the University of Texas Southwestern Medical Center at Dallas, was one of the first psychiatrists to treat kids with antidepressants. His patients—children and teenagers—were in the grip of life-threatening depression. He wanted something more for them than the talk therapy that at the time was the only option.
Prozac and a growing number of similar successors were just then proving to be effective in treating depression in adults. But the drugs had not been tested in the supple young brains of children. Frustrated by the lack of alternatives, Emslie and others began to prescribe them anyway. They hoped the benefit would outweigh the risks—although there was no evidence to support that.
Despite the unknowns, the use of antidepressants in children and teens exploded during the 1990s. According to Julie M. Zito, a researcher at the University of Maryland who has studied antidepressant use in children, about 1.5 million kids younger than 18 are taking the medications in the U.S. (This figure comes from insurance industry and Medicaid data.)
Now, however, research suggests that suicide is only one of the potential risks. Studies have found that Prozac-like drugs might interfere with normal patterns of growth in children's still developing brains. Although the research is not conclusive, it is possible that kids on antidepressants are trading one psychiatric diagnosis for another. Children who take these drugs—in some instances starting in the preschool years—could find short-term relief and then grow up into edgy, anxious, dysfunctional adults.
Shaping the Wiring?
Amir Raz, a professor of clinical neuroscience in the psychiatry department at McGill University, is one of a handful of researchers raising concerns over the continued use of antidepressants in children and teens. "The human brain is developing exponentially when we are very young," he says. "And exposure to antidepressants may affect or influence the wiring of the brain, especially when it comes to certain elements that have to do with stress, emotion and the regulation of these."
The drugs in question, Prozac and its relatives—including Celexa, Paxil, Zoloft and others—affect brain levels of the neurotransmitter serotonin, which helps to transmit signals between neurons. The drugs are known as selective serotonin reuptake inhibitors, or SSRIs, because they inhibit the removal of serotonin from the synaptic cleft (the space between neurons), leaving more of the transmitter available to exert its effects through neuronal receptors.
Drugs that affect serotonin during developmental years could alter brain function in unpredictable ways.
Raz thinks messing with serotonin in kids is a bad idea. In addition to serving as a chemical messenger, serotonin acts as a growth factor during the first years of life. It encourages the formation of connections, or synapses, between neurons, and it is crucial for the acquisition of a normal response to anxiety-producing events in adulthood. It is also found elsewhere in the body, where it performs a variety of other functions. Drugs that alter serotonin during these critical developmental years could alter brain function in unpredictable ways, Raz says.
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5 Comments
Add CommentIs there endogenous depression in childhood. Are not disorder such as bipolar and unipolar depression diseases with an onset around or after teenage years. I ask because such young children may be better treated with behaviour therapy, simple cognitive therapy and family therapy. When i first started studying neurology i asked if there was a relationship between depression and irritable bowel syndrome and migraine all of which can be positively affected with SSRI's and mty neurology teacher said that they had thought this might be the case but a syndrome uniting the disorders could not be shown. if this is the case then the SSRI's in young people should not a problem. on the other hand are there site specific SSRI's that thet only influence the brain? (not the stomach)
Reply | Report Abuse | Link to thisanti depressants are not good - nor the idea that their use is a solution - this is child sacrifice - decade after decade - until we work out that culture is the issue - adult and child and dangerous labels - a young mind can be verg rigid [though able to change in certain environs] an old mind can be very flexible and still evolving - science needs to realise that alot of this brain stuff aint science [yet] - it is philosophy
Reply | Report Abuse | Link to thiswe are in built racist - we believe no one knows better or ever did on any issue - systems are never questioned - but the bankers are a marker for a corrupt culture
all head pills are shit - always were - any in the field are deply worried - that realise that pharma and society memes themselves allow and disallow such that we believe they [pills] are good - and eventually it is clear to all - they are a torture of a band aid to fix something a band may aid better - music is life :) - and herb if you have serotonin issues
Reply | Report Abuse | Link to thisbut of course if you are sensitive and society says you are wicked to express yourself and take herb
you may be adversely affected
and similarly if told pills should work
you may change adversely
and not know it or report it
or children cant report it
etc
tranquiliser cocktail of abuse anyone :)
dat rape anyone :(
list goes on - but shhhhhhh
everyone keep working as if economic systems are gods
and spiritual systems have to be old enough or stupid enough for idiocy to control
etc
etc
i digress
rant
rant
rant
any one
:)
There may be problems with antidepressants in children, but your badly composed rant isn't doing anyone any favors, least of which the cause you are trying to support.
Reply | Report Abuse | Link to thisThe drug companies list suicide as only a side effect of these antidepressants. That is very scary and is sending the wrong message to children. There is so much doubt about these meds and people still give them to their children. It is a growing trend now among young children. The outcome of these meds prescribed for kids will not truly come out until these children have grown up and its too late. I would hate to be one of these doctors who prescribe these meds to these kids and know I was responsible for it . These parents put the responsibiltiy on the doctors b/c they aren't responsible enough themselves. They want someone else to take the responsibility.
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