Common antidepressant medications used today, referred to as third generation antidepressants, have caused some frustration over the last 20 years. Most are considered to be selective serotonin re-uptake inhibitors (SSRI’s), and are a large improvement over preceding antidepressants, which were significantly more dangerous. Today, SSRIs are taken daily by 10% of the population, 12 years old and up. Although SSRI’s are sometimes remarkable at treating depression, medical professionals continue to question whether they are safe.
Third generation antidepressants treat depression by increasing the amount of serotonin in the body, a neurotransmitter that causes feelings of happiness. SSRIs works by inhibiting the bodies natural collection process, called re-uptake, after serotonin is released. Unfortunately the drugs are not perfect and can cause withdrawal, sexual dysfunction, emotional blunting, insomnia, and increased risk of suicide.
A number of drugs on the market cause unwanted effects, but it’s not typical for a drug to increase risk of suicide. As a result, the US Food and Drug Administration (FDA) decided to require a “black box” warning on all antidepressants in 2004. The black box, included in every medication, provides information on suicidal risks associated with the medication. After the change, the use of antidepressants dropped, and adolescent suicide attempt rate increased 22%.
Outrage surrounded the FDAs decision, claiming the black box warning lead to more deaths. To improve and validate the FDA’s study, The National Institute of Health (NIH) conducted a similar study on children and adolescents. Patients were provided with proper guidance for all treatment options and different types of antidepressants and patients with various duration of use were considered.
A treatment option included in the study was mindfulness based interventions (MBI), which was available for people who prefer not to take an antidepressant. MBI is a form of psychiatric therapy, which has been found to improve and prevent relapse of depression by 50%. The goal of MBI therapy is to learn how to accept all thoughts, not reacting to them.
The improved test found a 5% greater chance of suicide while taking antidepressants. Due to the risk of taking SSRIs, the NIH concluded their study by agreeing with the FDAs decision to require a black box warning.
References:
Dingman, Marc. “Antidepressants and Mood Stabilizers.” Nov 20. PowerPoint presentation.
S, Schneeweiss. “Comparative Safety of Antidepressant Agents for Children and Adolescents Regarding Suicidal Acts”. National Institute of Health. May 2011. Web. 29 Nov 2014.