Fwd: [drugawareness] Boston Globe: Can a popular antidepressant cause teenage suicide?

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Thu, 7 Aug 2003 03:19:00 EDT

[drugawareness] Boston Globe: Can a popular antidepressant cause

teenage suicide?

 

 

 

 

PLEASE NOTE: Before you follow my previous advice and take the New York Times

article you just received from us to your local newspaper reporters PLEASE

correct the order number for " Prozac: Panacea or Pandora? - Our Serotonin

Nightmare " and the tape on safe withdrawal " Help! I Can't Get Off My

Antidepressant! "

 

If someone needs help getting off these drugs the correct number could save

their life as well as the lives of those around them. The number should have

read 1-800-280-0730.

 

Thank you,

 

Dr. Tracy

_____________________

 

The Boston Globe interviewed our New Jersey director, Lisa Van Syckel on her

daughter's horrible experience on Paxil and her case against Paxil's

manufacturers GlaxoSmithKline.

 

''I never felt helpless prior to Michelle being on medication,'' said her

mother, Lisa Van Syckel.

 

''My advice to parents is, when you take your child to a psychiatrist and

their first suggestion to you is, `We've got this new medication,' run for the

hills,'' said Lisa Van Syckel. ''Because they have no desire to help a child;

only to medicate them and get them out of their hair.''

 

The article backs up Lisa's statement by pointing out that:

 

" Not long before the FDA's announcement [warning of the use of Paxil in

children due to the increase in suicide], its British counterpart took a strong

stance against Paxil, advising doctors not to prescribe it to children after

reviewing clinical trial data of about 1,000 children on the drug who had a 1

1/2

to three times greater risk of having suicidal thoughts. "

 

BUT even though these studies show up to THREE TIMES greater risk of suicide

.. . .

 

" Some psychiatrists, however, say the side effects, while serious, are not

reason enough to stop prescribing SSRIs to children. "

 

So, if chemically inducing suicide at a rate THREE times greater is not

reason enough to stop prescribing SSRIs to children what on earth is enough to

get

them to stop drugging our children?!!!! Who would take their child to a doctor

knowing this?!

 

Dr. Ann Blake Tracy,

Executive Director, International Coalition For Drug Awareness

& author of Prozac: Panacea or Pandora? - Our Serotonin Nightmare

& tape on safe withdrawal " Help! I Can't Get Off My Antidepressant! "

 

Order Number: 1-800-280-0730

Website: www.drugawareness.org

 

 

 

http://www.boston.com:80/dailyglobe2/217/science/Can_a_popular_antidepressant_

cause_teenage_suicide_+.shtml

 

Can a popular antidepressant cause teenage suicide?

 

By Katherine Lutz, Globe Correspondent,

 

8/5/2003

 

ichelle Van Syckel was one of those teenagers who did everything -- played

the clarinet and basketball, loved to travel, was an honor-roll student for five

years. But, after moving to a new town, Van Syckel had trouble making

friends, became irritable, and eventually stopped eating.

 

Doctors diagnosed her with anorexia and depression, eventually prescribing

Paxil, a close relative of Prozac and one of the most popular antidepressants on

the market. Rather than improving, though, Van Syckel became suicidal, at one

point cutting ''DIE'' into her abdomen with a razor.

 

''I wasn't always this insane,'' Van Syckel wrote in a poem. ''I don't see an

end to this long and winding road. . . . Tomorrow doesn't look too great but

maybe I'll be happier.''

 

Now, Van Syckel's family is suing both her doctors and GlaxoSmithKline, the

maker of Paxil, charging that her downward spiral into depression was made

dramatically worse by the very medication prescribed to treat it. The case, part

of a growing body of evidence linking Paxil to suicidial thoughts and actions

in a small percentage of the children who take it, could have far-reaching

implications for the treatment of depression in adolescents.

 

''I never felt helpless prior to Michelle being on medication,'' said her

mother, Lisa Van Syckel.

 

GlaxoSmithKline's head of clinical development and medical affairs, Dr. Alan

Metz, said ''we have some evidence'' that Paxil is effective in children.

Children on Paxil who experience suicidal thoughts ''is a relatively small

number

of patients,'' said Mary Anne Rhyne, a spokeswoman for GlaxoSmithKline. ''We

think there is more research that needs to be done.''

 

But the Van Syckel case and others like it have prompted regulators to act.

In June, the US Food and Drug Administration, in an unprecedented decision,

recommended that doctors stop prescribing Paxil to new patients under the age of

18 and advised parents to consult a doctor if their children are currently

taking Paxil.

 

Not long before the FDA's announcement, its British counterpart took a strong

stance against Paxil, advising doctors not to prescribe it to children after

reviewing clinical trial data of about 1,000 children on the drug who had a 1

1/2 to three times greater risk of having suicidal thoughts. But the FDA is

more equivocal, waiting to deliver the final word on Paxil while it reviews the

data, leaving parents and doctors agonizing over what to do next.

 

''This is something we are actively working on,'' said an FDA spokesperson.

''Until we finish our review, we won't have a final decision on this issue.''

 

But psychiatrists fear the controversy surrounding Paxil could scare families

from getting what is sometimes the best possible treatment.

 

''This just puts families in a difficult spot,'' said Dr. William Beardslee,

chairman of the department of psychiatry at Children's Hospital Boston.

 

Doctors may become more reluctant to prescribe Paxil to children as well,

knowing that it could cost them personally if something goes wrong. A Wyoming

family won a $6.4 million dollar lawsuit against GlaxoSmithKline in 2000 after a

man taking Paxil shot his wife, daughter, and grandaughter. The jury found

there was enough scientific evidence to find Paxil primarily responsible for the

violence.

 

''Doctors I know felt more vulnerable [after FDA action],'' Beardslee said.

''We're prescribing medications for a terrible disease and suddenly the

approval was withdrawn. It left us as physicians feeling very puzzled. If we

can't

trust the FDA, what can we trust? No physician alone has resources to look at

all medications. That's what we have the FDA for.''

 

The controversy occurs at a time when Paxil has emerged as the drug of choice

to treat teenage depression. Although the company says national figures are

not available, in Massachusetts, about 1,000 children under MassHealth, the

state's Medicaid insurer for low-income people, are currently taking Paxil, out

of about 3,700 children on Zoloft, Paxil, and Prozac.

 

''It seems like over the last few years I've encountered more and more kids

coming into our practice that are on Paxil,'' said Dr. Bruce Black, director of

Comprehensive Psychiatric Associates in Wellesley and a paid speaker for

GlaxoSmithKline five years ago. ''I'm sure [the FDA's decision] is going to put

a

significant damper on this. It will pretty much shut it down.''

 

Paxil, a selective serotonin reuptake inhibitor, or SSRI, from the same

family as Prozac and Zoloft, works by boosting concentrations in the brain of

serotonin, a chemical that is key to mood regulation. Some doctors prefer it

over

Prozac because the body metabolizes it more quickly.

 

Paxil was celebrated upon its FDA approval in 1992, like other SSRIs, as the

cure-all for depression, a debilitating disease affecting 18.8 million

Americans, up to 2.5 percent of children and 8.3 percent of adolescents. It was

one

of the biggest sellers last year for GlaxoSmithKline with $2.5 billion in sales

and the second most commonly prescribed antidepressant in the United States.

 

But drugs that boost serotonin levels in the brain could actually encourage

the behaviors they are supposed to prevent. Soon after Prozac's approval in

1987, doctors noticed their Prozac patients feeling so uncomfortable they wanted

to jump out of their skins. This excessive physical and emotional agitation,

called akathisia, some doctors believe could lead some patients to act on

suicidal thoughts. In 1991, an FDA advisory panel decided there was no link

between

antidepressants like Prozac and suicide tendencies in adults.

 

Dr. Christopher Lamb, director of child psychopharmacology at Cambridge

Health Alliance, said these side effects can happen with drugs like Prozac and

Paxil early on in treatment or when the dosage is changed, although ''it's hard

to

separate what is the side effect and what is just the illness.''

 

Some psychiatrists, however, say the side effects, while serious, are not

reason enough to stop prescribing SSRIs to children.

 

''Medication can be extremely helpful and even lifesaving for some

children,'' said Dr. David Fassler, a child and adolescent psychiatrist in

Burlington,

Vt.

 

Far from saving Michelle Van Syckel's life, however, the drug, her family

said, nearly killed her. Within days of taking Paxil, Van Syckel felt

''extremely

nervous and anxious,'' according to court documents. Instead of withdrawing

the medication, her doctors increased the dosage and within weeks Van Syckel

became confrontational, verbally abusive, and started cutting herself. Her

mother said the most striking change in the normally tolerant teenager was her

rabid racism, ''calling kids s---s and using the n word.''

 

Understanding why youths like Van Syckel could be more susceptible to these

side effects requires more data, doctors say, but companies rarely conduct

clinical trials on children, leaving doctors to guess what drugs work best for

you

ng people.

 

In fact, Prozac is the only antidepressant approved for children, with

studies demonstrating its effectiveness in young people. But even without

approval,

a drug like Paxil can still be prescribed to children. Once the FDA approves a

drug for a certain group of patients with particular condition, doctors are

free to prescribe it to whomever they feel might benefit, including children

and conditions the FDA did not consider.

 

Parents should not take their children off Paxil or other antidepressants,

according to the FDA, since patients can sustain severe withdrawal symptoms if

the drugs are stopped abruptly. Psychiatrists have fielded more calls from

concerned parents since the announcement, but Black sees this as medical

progress.

 

''This is going to push people to be a little more thoughtful, and that's a

good thing,'' Black said.

 

Doctors eventually took Van Syckel off Paxil. Three years later, her mother

said she is almost completely back to normal and will be off to college soon.

 

But the scars remain. Van Syckel may not remember threatening her mother with

an axe or screaming racial slurs, but the cuts on her body will not

disappear.

 

''My advice to parents is, when you take your child to a psychiatrist and

their first suggestion to you is, `We've got this new medication,' run for the

hills,'' said Lisa Van Syckel. ''Because they have no desire to help a child;

only to medicate them and get them out of their hair.''

 

Katherine Lutz can be reached at lutz.

 

This story ran on page D1 of the Boston Globe on 8/5/2003.

 

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Globe Newspaper Company.