When Janna Tennant's 13-year-old son was hospitalized for depression last spring, the news media already were rife with stories about a possible link between antidepressant use in youths and an increased risk of suicide.
"I remember questioning the psychiatrist at the time about the safety of starting him on Zoloft," an antidepressant, says Tennant, who lives in Mission Viejo. "The doctors didn't think it would be a problem whatsoever."
For a time, the teenager's mood disorder appeared to improve. But after he stopped taking the medication for five days, then resumed it, he became irritable, aggressive and stubborn, Tennant says. She took him off the medication and instead sent her son to counseling, encouraging him to exercise more and eat a healthier diet.
The experience not only made her question her doctor's advice, she says, but also "gave me pause about the safety of the drugs."
Like Tennant, a growing number of parents, and some doctors, appear increasingly uneasy with antidepressants for treating childhood depression. Six months ago, the Food and Drug Administration voted to affix a black box warning -- the most stringent safety warning -- to SSRI antidepressants prescribed for children based on studies linking the drugs to a slight increase in suicidal behavior. SSRIs (or serotonin reuptake inhibitors) are a class of medications that include Prozac, Zoloft, Paxil and others.
The number of prescriptions for antidepressants for children younger than 18 dropped 10% last year, according to data from Medco Health Solutions, a national firm that manages pharmacy benefit programs for employers. The decline is striking considering that antidepressant use by children had been rising sharply. From 1998 to 2002, prescriptions for kids had increased by 49%.
Some health officials express concern that the public has overreacted to the FDA decision and that some children who might benefit from antidepressants will not use them. Several mental health organizations have been revamping their websites and publishing brochures and guides to help families sort out the facts on treatment for childhood depression.
"Parents and physicians are being particularly cautious about the use of these medications, which in many cases is entirely appropriate," says Dr. David Fassler, a child and adolescent psychiatrist in Burlington, Vt., and a spokesman for the American Psychiatric Assn. "But I do worry that some parents may be frightened and confused by the numerous media reports and may be reluctant to seek help for their children with psychiatric disorders. There are very significant risks of not treating an illness like depression."
