Ten years ago, the Food and Drug Administration mandated that all antidepressants carry a prominent “black box” warning to alert prescribers of the potential danger in children and adolescents of these medications leading to new suicidal thoughts or actions. The warning came in the midst of passionate debate about the potential risks and benefits of using and not using these drugs. A decade later, this discussion has largely disappeared from the public eye and evaded media headlines. Nevertheless, antidepressants continue to be prescribed and research into their use has continued.
What have we learned since then? I offer my take on some key conclusions.
Overall, it appears that the amount of risk and benefit of this class of medications is less than many believed a decade ago. Antidepressants can be useful for many youth but need to be considered only as part of an overall treatment strategy that addresses the entire family environment and potential causes of the symptoms.
@copyright by David Rettew, MD
David Rettew is author of Child Temperament: New Thinking About the Boundary Between Traits and Illness and a child psychiatrist in the psychiatry and pediatrics departments at the University of Vermont College of Medicine.