Impact of the 2004 Food and Drug Administration Pediatric Suicidality Warning on Antidepressant and Psychotherapy Treatment for New-Onset Depression

Abstract

The FDA suicidality warning was associated with an overall decrease in antidepressant treatment for youth with a clinician-reported diagnosis of depression, but not for those with MDD. Also, following the warning, psychotherapy without medication increased.

The Pharmacoepidemiology of Antipsychotic Medications for Canadian Children and Adolescents: 2005–2009

“…This supports the findings of Valluri et al (2010), who found that children with major depression disorder did not experience a decrease in antidepressant treatment between 2003 and 2006. An important difference in prescribing patterns for these three types of medications is the diversity of indications in which the antipsychotics are being recommended for, in comparison to psychostimulants, which are almost exclusively used for ADHD and SSRIs, which are mainly used for mood and anxiety disorders.…”

The FDA and ABCs: Unintended Consequences of Antidepressant Warnings on Human Capital

“…In recent years, multiple studies have documented large declines in pediatric antidepressant use coincident with the 2004 FDA advisories and warnings, with most estimates suggesting that antidepressant use fell by 20 percent to 30 percent relative to the peak levels of antidepressant use in the 12 to 24 months surrounding the warnings (Busch et al 2010; Busch et al 2011; Gibbons et al 2007; Kurian et al 2007; Libby et al 2007; Nemeroff et al 2007; Olfson, Marcus and Druss 2008; Valluri et al 2010). The most-often cited of these studies are summarized briefly in Appendix Table I.…”

“…The literature is mixed on whether or not the receipt of psychotherapy increased after the warnings. One study suggests there was a slight increase in receipt of any psychotherapy – among treated adolescents, the percent receiving at least one psychotherapy visit rose less than 5 percent in the period after the warnings (Valluri et al 2010). In contrast, other studies found no such increase (Busch et al 2010; Libby et al 2007).…”

Suicide and Suicide Attempts in Adolescents

“…74 Most of the reductions in diagnosing and prescribing were related to substantial reductions by primary care providers, with these reductions persisting through 2007. 75 Studies differed as to whether there was 76 or was not 73,74 a compensatory increase of psychotherapy treatment during the same time period.…”