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Depression diagnoses drop after FDA warning

A persistent decline in new diagnoses of depression has followed FDA warnings in 2003 about the related risks of suicide among American children and young adults, a study suggests

A persistent decline in new diagnoses of depression has followed FDA warnings in 2003 about the related risks of suicide among American children and young adults, a study suggests.

The findings published in the Archives of General Psychiatry noted that the warning may have helped reverse a five-year trend of rising rates of diagnosis for depression, but that "policy actions are required to counter the unintended consequences of reduced depression treatment."

The analysis examined eight years of data from nearly 100 managed care plans and more than 55 million patients. It showed that the rate of diagnoses climbed from 3.3 per 1,000 patients in 1999 to 5.2 in 2004, and subsequently fell to 3.5 by 2007.

Lead author of the study, Anne Libby of the University of Colorado, said: "We don't know why [fewer cases of depression have been diagnosed]. What we can say is that the warnings definitely changed behaviour [and that the FDA] should reopen its discussion about the boxed warning on anti-depressants."

US and European regulators sent out a series of public health warnings surrounding the use of anti-depressant drugs beginning in 2003 after clinical trials showed they increased the risk of suicidal thoughts and behaviours in children and teens.

In February 2005, the FDA added its most serious warning, the 'black box', on the use of all antidepressants in children and teens to draw attention to the possible risks of these medications. In May 2007, it extended warnings to young adults aged 18 to 24.

Many psychiatrists have criticised the warnings saying they scare people away from effective treatments for depression, the leading cause of suicide. 

2nd June 2009

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