A decade ago, the U.S. Food and Drug Administration (FDA) warned that children and adolescents taking a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) could result in elevated risks for suicidal thoughts. These drugs include both Zoloft and Paxil.

The FDA required manufacturers to have a black box warning on their labels to inform doctors and consumers about the suicidal risks associated with the use of the medications. The warning has apparently led to a reduction in the usage of antidepressants in the U.S. However, it also seemed to have worsened the situation. The number of suicide attempts among young people has gone up and the black box warning on antidepressants has something to do with it, a new study suggests.

In the study published in the British Medical Journal on June 18, Christine Lu, from the Department of Population Medicine at the Harvard Medical School, and colleagues examined the medical claims data from 11 health plans of the U.S Mental Health Research Network covering the period 2000 to 2010, which include the records of about 1.1 million adolescents, 1.4 million young adults and around 5 million adults, to determine if the 2003 FDA warnings on the dangers of antidepressants were linked with changes in antidepressant use as well as attempted and completed suicides among young people.

Lu and colleagues looked at records of nonfatal overdoses involving mind-altering drugs such as amphetamines, tranquilizers, ecstasy and marijuana, and used this as a measure of suicide attempts. The researchers found that following FDA's warning, use of antidepressants dropped by 24.3 percent among young adult and 14.5 percent among adults albeit they were not included in the warning. They also observed that while the use of antidepressants dropped, the number of attempted suicide rose by 22 percent among adolescents and 34 percent among young adults.

"Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people," Lu and colleagues concluded.

The researchers said that doctors and patients who were frightened by the exaggerated media coverage of the risks of using antidepressants turned away from treatment that could have prevented suicide attempts.

"This study is a one of the first to directly measure a health outcome driven by the interaction of public policy and mass media," Lu said. "The FDA, the media and physicians need to find better ways to work together to ensure that patients get the medication that they need, while still being protected from potential risks."

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