The Food and Drug Administration has recently instructedantidepressant manufacturers to add warning signs of suicide to thedrugs’ caution labels. However, the question of whethertaking the medications can in fact cause suicide has been asked formany years.
“I hate the word ‘causal,” said RobertHampson, associate professor of psychology at SMU. He said thatwhile determining a cause-and-effect relationship betweenantidepressants and suicide is problematic, there are cases inwhich the drugs seem to contribute to the suicidal actions.
Psychiatrists on staff at SMU declined to comment on this topic.While prescribing antidepressants is not Hampson’s mainexpertise, he does teach about depression and its medications. Heshows his classes a “20/20” segment from a few yearsago that discusses potential side effects of antidepressants,including akathisia, an emotional blunting or fearlessness, andsevere agitation and anxiety that can lead to suicide.
The FDA suggests that it could be the depression, not theantidepressant, causing the suicide.
“The debate still rages about whether it’s thedepression or the chemical reaction [to the medication],”Hampson said.
Sophomore psychology and religious studies major Luci Liddellsaid it would be difficult to determine if antidepressants wereresponsible for suicides.
“It isn’t really a cause-effect relationship; thereare far too many outside factors,” she said.
Many doctors who advocate the use of antidepressants, and thecompanies that make them, say that when used and monitoredproperly, antidepressants can be very effective. Liddell andHampson agree.
“Antidepressants help more than they hurt,” Liddellsaid.
“I think they can be very useful drugs,” Hampsonsaid. “For most people that take them, they can be verybeneficial.”
The problem, Hampson said, is that people react to medicationsdifferently, and it is difficult to know beforehand the possibleeffects in each individual case.
In most cases drug treatments need to be combined with cognitivebehavioral therapy, Hampson said. Many people who suffer fromdepression experience self-blame, and they “internalize theirfailures and externalize their successes.”
“The drug doesn’t change that,” he said, buttherapy can help in challenging failing belief systems and offeringemotional support.
The FDA’s decision to warn against suicide followed ameeting with parents of adolescents who committed suicide afterbriefly taking antidepressants, according to an Associated Pressarticle from March 22.
The article also said that Prozac is the only drug proven toalleviate pediatric depression, although others are oftenprescribed for youth.
“We’re just in a medication era,” Hampsonsaid. He discussed the trends that exist regarding new medicationsand the frequency of current psychological diagnoses.
In the 1950s and 1960s, the most frequent diagnosis wasschizophrenia. This was at the same time that anti-psychoticmedications were introduced.
Now, mood disorders like depression are the highest diagnoses,during a time when many anti-depressants have been developed.
Hampson described this as a sort of chicken-and-egg situation.It is difficult to establish whether the conditions led to thecreation of medications, or if the emerging medications encouragedspecific diagnoses.
In recent years, medicating children and youth has increasedsignificantly, for conditions ranging from Attention DeficitDisorder to depression. Hampson said he supports further researchand additional warnings of the potential side effects ofantidepressants, especially when they are being given to youth.
“It makes sense at least to have someone in achild’s life or environment looking out [for thechild],” he said.
Liddell was unsure if adding the extra caution would help theproblem.
“I don’t know how much weight it will really pullwith people given that none of the other complications ofantidepressants seem to faze them,” she said. “But, ifit slows one person from popping a pill they might not necessarilyneed, then I think it is a good thing.”
Hampson and Liddell both agreed that medicating youth fordepression should be “the absolute last resort,”because potential side effects in youth are still unknown.
“I get knots in my stomach every time I think aboutchildren and, in most cases, teenagers takingantidepressants,” Liddell said.
“I have a major problem with teaching teenagers that youcan fix problems with a pill so early in their life. I think thiscan easily guide kids into various lifelong addictions anddependency problems. I just think it would be far more beneficialto teens if talking about their issues and learning productivecoping skills were stressed more so than antidepressants,”she said.
