CHICAGO (Reuters) - Suicides among children and young adults rose by an alarming 8 percent in 2004, a year when concerns about the dangers of antidepressants triggering suicides were widely publicized, federal researchers reported on Thursday.
Regulators said they would check into whether the rise may have occurred when some people stopped taking antidepressants -- ironically because of links between use of the drugs and suicidal thoughts.
In 2004, 4,599 children and adults aged 10 to 24 committed suicide, the biggest rise in suicides in 15 years. Suicide was the third-leading cause of death in that age group, the U.S. Centers for Disease Control and Prevention said.
The increase was seen mostly in girls aged 10 to 19 and boys 15 to 19. The biggest increase was among girls aged 10 to 14, where rates rose nearly 80 percent.
The CDC noted a sharp rise in hanging or suffocation suicides among girls in this age group.
“Our news today is sobering,” Dr. Ileana Arias, director of CDC’s National Center for Injury Prevention and Control, said in a telephone briefing. “We don’t yet know if this is a short-lived increase or if it’s the beginning of a trend.”
In 2004, the U.S. Food and Drug Administration required a “black box” warning that antidepressant drugs, taken by millions of Americans, could increase the chances of suicidal thoughts or actions in children and teen-agers.
Many psychiatrists have criticized the warnings, saying they scare people away from effective treatment and may have contributed to an increase in suicides in recent years.
“It is true that antidepressant prescriptions in pediatric patients has come down and that coincides with this one-year uptick in adolescent suicides. Obviously, that is a concern for us,” the FDA’s Dr. Tom Laughren said during the briefing.
CHANGE IN DIRECTION
The suicide rate among youth aged 10 to 24 had fallen by 28.5 percent over a 13-year period that ended in 2003, the CDC said.
“You cannot reach causal conclusions from this kind of data. We are going to have to look at the data over time,” Laughren said.
But a second report, published in the American Journal of Psychiatry, makes a clear connection between the warnings and the suicide rate.
Robert Gibbons of the University of Illinois at Chicago found that youth antidepressant prescriptions fell 22 percent among children aged 0 to 19 in the United States and the Netherlands after the warnings were issued.
In the Netherlands, the youth suicide rate rose 49 percent between 2003 and 2005. Youth suicide rates in the United States rose 14 percent between 2003 and 2004.
The American Foundation for Suicide Prevention said the FDA black box warnings and the drop in antidepressant prescriptions are the most likely cause of the higher suicide rates.
Dr. Carolyn Robinowitz, president of the American Psychiatric Association, agreed. “I’m hoping the FDA will reconsider this black box language in light of these findings,” she said in a telephone interview.
Arias said the CDC plans to start a suicide database to track the circumstances behind these suicides and to understand the role that alcohol, drug abuse or prior mental health problems plays in these deaths.
“It is important for parents, health care professionals, and educators to recognize the warning signs of suicide in youth,” said Dr. Keri Lubell, who led the CDC study.
These include talking about suicide and signs the child is feeling sad or hopeless. Parents should also look for changes in eating or sleeping habits and loss of interest in favorite activities.
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