FDA Ponders New Antidepressant Warnings

Can antidepressants really drive some people to commit suicide? That is a question the FDA has had to wrestle with for nearly two decades.
For most of that time the agency has insisted that SSRI-type antidepressants such as Prozac or Paxil are life savers that prevent suicide. When someone taking one of these medications considered or even committed suicide, this tragedy was frequently explained as the result of the underlying illness, not the medicine.
After years of denying any link, however, a panel for the FDA has recommended a warning be added to the official label. It will warn physicians and patients that the risk of suicide is almost twice as high among young adults taking such medicines.
This caution comes too late for many. Over the years we have heard from distraught family members who reported that a loved one committed suicide shortly after starting on one of the SSRI antidepressants. We’ll never forget the father who reported that his son, a graduate student, shot himself less than three weeks after starting Paxil. The father blamed the FDA and the drug manufacturer for failing to warn of this danger.
Lest we demonize these drugs, however, it is important to recognize that many people do experience benefit. One wrote, “I was very sad to hear of the young man who committed suicide after taking Paxil for 17 days. Since I have had good results with Paxil, I am disturbed when I hear of someone’s tragic results.
“After a year of counseling and resisting taking antidepressants, I gave it a try. I’ll never forget how I felt on the ninth day of taking it. I felt alive for the first time in my life, at age 27.
“After ten years of taking Paxil, I noticed a change when I tried to increase the dosage. I thought it would make me feel better, but it had the opposite effect. I was very moody and miserable for a month before going back to the previous dosage.
“I think Paxil is an incredible breakthrough for the treatment of chronic depression, but more studies need to be done on the effects on different mental illnesses and different dosages.”
Antidepressant medications such as Paxil (paroxetine), Prozac (fluoxetine) and Zoloft (sertraline) help many people overcome depression and may prevent suicides. But not everyone experiences the same benefit. Some people become agitated, irritable, hostile and cannot get a good night’s sleep. For them, such drugs can be a hazard, especially if they begin to think about suicide.
For a deeper understanding of the benefits and risks of antidepressants and many non-drug approaches to dealing with depression, we offer our new book, Best Choices From The People’s Pharmacy (Rodale Books). It is available at booksellers or on the Internet.
After dragging its feet for years, the FDA seems poised to admit that SSRI antidepressants may pose a suicide risk for some people. It is considering expanding the “black box” warning that alerts doctors and patients to this danger.
Family, friends and health professionals should now be more vigilant when patients with depression start, stop or change the dose of these powerful medications. If this awareness can prevent just one needless death it will be worthwhile.