Antidepressant Warnings Had Unintended Impact on Youth Mental Health

WEDNESDAY, Oct. 9, 2024 (HealthDay News) -- Youth antidepressant warnings had a detrimental unintended effect: significant reductions in mental health care, according to a report published in the October issue of Health Affairs.

Noting that since 2003 the U.S. Food and Drug Administration has warned that antidepressants may be associated with suicidal thoughts and behaviors among youth, Stephen B. Soumerai, Sc.D., from Harvard University and the Harvard Pilgrim Health Care Institute in Boston, and colleagues conducted a systematic review to examine suicide-related outcomes after these warnings.

Thirty-four studies of depression and suicide-related outcomes were identified; 11 of these met research design criteria established to reduce biases. Eleven studies assessed monitoring for suicidal thoughts and behaviors, physician visits for depression, depression diagnoses, psychotherapy visits, antidepressant treatment and use, and psychotropic drug poisonings (a proxy for suicide attempts) and suicide deaths. Possible spillover to adults not targeted by the warnings was also examined. The researchers observed significant unintended reductions in mental health care after the warnings in multiple studies. Following these reductions, marked increases in psychotropic drug poisonings and suicide deaths were seen.

"Rigorous evidence suggests that the FDA's most serious ongoing youth antidepressant warnings have not had the intended outcome of increased monitoring for suicidal thoughts and behaviors," the authors write. "Instead, the warnings were associated with unintended reductions in physician visits for depression, depression diagnoses, antidepressant treatment and use, and psychotherapy visits, as well as increases in psychotropic drug poisonings and increased suicide deaths."

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