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The "Real World" Effectiveness
Antidepressants Not Great
The following article includes
research conducted by Mentor Research Institute (MRI) using StepOne
For Parents.
www.StepOneForParents.Org. The article reports research by
Michael Conner, PsyD, that according to parents, antidepressants do
not significantly improve the behavior of children.
By LIDIA
WASOWICZ
UPI Senior Science Writer
Author, “Suffer the Child: How the Healthcare System Is Failing Our
Future,” (Capital Books, 2007)
Reproduced under the Fair Use
exception of
17
USC § 107 for noncommercial, nonprofit, and educational use
SAN FRANCISCO, June
17, 2006 (UPI) -- When it comes to treating depression,
it’s a matter of different strokes for different folks, specialists
say.
No remedy will
suit all patients, and no patient will gain benefits from all
therapies, they note.
“We know 60
percent of people will respond to the initial medication, including
children and adolescents, and a significant percentage will respond
ultimately to a different medication, but always there is a group
that doesn’t respond to any medication,” said child psychiatrist Dr.
David Fassler, a trustee of the American Psychiatric Association.
“General
research has identified genetic markers for 10 percent of people
with depression who seem resistant to treatment with medication.”
Ultimately,
scientists may develop genetic screening and imaging tests to help
physicians gauge which patients will react and how, Fassler said.
For now, the best guide is no less tenuous than the child’s family
history, he said.
Also in need of
further exploration is the drugs’ long-term impact on brains and
bodies still under development, Fassler said.
Because their
effects on growing, aging and child bearing are largely unknown,
psychotropic medications should be used with extra caution in
treating children, the elderly and pregnant and nursing women,
psychologists urge.
"The routine use
of these medications creates the illusion that their safety and
efficacy are known quantities," said Daniel Breslau, associate
professor of science and technology in society at Virginia Tech in
Blacksburg,
Va.
Indeed, that’s
the image with which millions of Americans gushingly welcomed the
antidepressant Prozac into their medicine cabinets within months of
the drug’s December 1987 market debut.
In the
beginning, reports of the medicine’s near-magical transforming of
anguished hermits into “better than well” socialites had visions of
custom-ordered psychological makeovers dancing in some scientists’
heads.
But the
widespread euphoria that greeted the arrival of Eli Lilly’s
green-and-white capsule and the generation of drugs -- called selective
serotonin reuptake inhibitors --
it heralded appears to be waning.
While many credit
the boosters of the brain chemical serotonin with reversing their
mental misfortunes, for others, the initial thrill is gone.
“Only
a very few children benefit from these medications. The benefit is
usually not long-lasting," said psychologist
Michael Conner,
director of the non-profit Mentor Research Institute in Oregon, which has screened more than 3,000
adolescents and their families for a “real-world” review of the
drugs’ effectiveness.
“From
the perspective of parents, antidepressants do not significantly
improve the behavior of children,” he said.
“Interestingly, many children
on antidepressants are still delinquent, oppositional, defiant,
aggressive, suicidal, violent, failing school, skipping school,
promiscuous and using drugs and alcohol. Many are still depressed
and anxious despite medications."
As with numerous
favored treatments before them, these latest showstoppers appear to
have sailed into some rough seas.
Some estimates
indicates a plunge of up to 20 percent in prescriptions of the
medicines dispensed to pediatric patients since the Food and Drug
Administration lowered its suicide warning boom.
Antidepressant
labels now carry alerts of their potential to increase the risk of
suicidal behavior in some users.
Whether the
decline in prescriptions represents a long-term trend or just a blip
in an otherwise meteoric rise in usage or even to what degree the
amassed statistics offer a true reflection of day-to-day clinical
practice remains to be determined.
“Are people
scared off good medicines that can help them?” wondered Dr. Cynthia
Pfeffer.
She is professor
of psychiatry and founding director of the Childhood Bereavement
Program at Weill Medical College of Cornell University, attending
psychiatrist at NewYork-Presbyterian Hospital, a noted authority on
childhood bereavement and child and adolescent suicidal behavior
and author of “The Suicidal Child” (Gilford Press, 1986), and
“Severe Stress and Mental Disturbance in Children” (American
Psychiatric Publishing, Inc., 2003). She served on the FDA’s
advisory committee that recommended the strong “black-box” warning
for antidepressants.
“Concern about
the fear factor (is) all hypothetical,” she said.
“We don’t know
(what the ultimate effect will be),” she added. “ My feeling is
patients (who see) a well-trained, competent psychiatrist who knows
how to treat diagnosed children and adolescents, who has a careful
discussion with the family and child about any medicine that’s
prescribed, (who) can utilize medication and (provide the child)
with careful monitoring hopefully will not refuse if a treatment is
indicated.”
Medco Health
Solutions, a pharmacy benefit manager whose figures cover privately
insured families, noted a more than 19 percent decline in the number
of children taking antidepressants in the third quarter of 2004,
compared to a year earlier.
By the fourth
quarter, however, the decrease was whittled down to a 16 percent
difference from the same period in 2003, still below previous rates
but at least to a lesser degree.
In the latest
survey, reported in May 2006, an analysis of the prescription claims
of 2.5 million Americans showed a decrease of less than 13 percent
from 2004 to 2005 in the number of antidepressant-taking minors 19
and younger, said Erin Drelick of Medco.
(Editors’ Note: This series on depression is based on a review of
hundreds of reports and a survey of more than 200 specialists.)
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Mentor Research Institute is an
Oregon 501c3 non-profit research and educational organization with a
focus on mental health for youth and families including
homelessness, effective intervention, public and professional
education. For further information visit www.StepOneForParents.Org
StepOne for Parents is trademarked
by InCrisis, LLC. All other company and product names may be
trademarked by their respective owners.
Mentor Research
Institute
Contact Kevin Rea: 541 390-9848
Mentor Research Institute
818 NW 17th Ave. Suite 2
Portland, OR 97209-2327
503 227-2027
501 c 3 Non-Profit
Tax Id# 91-1777183
www.InCrisis.Org
www.MentorResearch.Org
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