Long before the New York Times reported in September that youth suicides were up 8% from 2003 to 2004 and experts indict black box warnings on antidepressants which the FDA imposed in 2004, pharma has been trying to plant a favorable antidepressants/suicide story.
Last year an article in the June PLoS Medicine by lead author Dr. Julio Licinio, a paid consultant to Eli Lilly, maker of the popular selective serotonin reuptake inhibitor (SSRI) antidepressant Prozac, found the US suicide rate "dropped steadily over 14 years as sales of the antidepressant [Prosac] rose."
In April, eight authors including four from the private "drug development services" company Quintiles Transnational wrote in an article in the Archives of General Psychiatry ("Impact of Publicity Concerning Pediatric Suicidality Data on Physician Practice Patterns in the United States") that "the number of children and teenagers who were prescribed antidepressants has decreased significantly" underlining "the importance of presenting a fair balance within the media."
And in February a MedPage Today article based on statistics in the February issue of Pediatrics and reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine actually scooped the New York Times with the headline Teen Suicide Spike Linked to SSRI Black Box.
Black box warnings create a barrier to treatment "by scaring young people and parents away from care," said David Shern, Ph.D., president of Mental Health America, reported to have accepted $3.8 million from pharmaceutical companies in 2005, in a statement.
"The concerns about antidepressant use in children and adolescents have paradoxically resulted in a reduction in their use, and this has contributed to increased suicide rates," Charles Nemeroff M.D., Ph.D., of Emory University School of Medicine told reporters. Dr. Nemeroff has financial ties to Eli Lilly, AstraZeneca, Pfizer, Bristol-Myers Squibb, Forest Laboratories, Pharmacia-Upjohn, SmithKline Beecham and Wyeth-Ayerst according to published reports.
But when the New York Times did finally break the story it had a short shelf life.
The Centers for Disease Control and Prevention statistics of a rise in suicides among ages 10 to 24 in 2003 to 2004 stood. But the allegation cited in an article in the September American Journal of Psychiatry--that the suicide rise was due to SSRI prescription drop-offs--promptly fell on its head and forced a follow-up story.
The drop in SSRI prescriptions that "caused" the suicide rise, it turned out, occurred the following year; from July 31, 2003 through March 31, 2004, SSRI prescriptions for those 18 and under actually "rose an average of just over 10 percent," according to Psychiatric News and "the number of prescriptions peaked in March 2004."
Meanwhile preliminary CDC statistics from the year that would have been influenced by a drop in SSRI prescription that occurred--2005--do not show deaths up, though they have not been broken into category.
Asked about the 180% turnaround in facts which meant the suicide rise was not caused by SSRI prescription drop-offs and possibly caused by SSRIs themselves, vindicating the FDA's black boxes, lead author Robert D. Gibbons, Ph.D., a professor of biostatistics and psychiatry at the University of Illinois at Chicago did not sound the statistician.
"This study was suggestive, that's what we're saying," Dr. Gibbons told the Times--it was titled "Early Evidence on the Effects of Regulators' Suicidality Warnings on SSRI Prescriptions and Suicide in Children and Adolescents"--and should piggyback off previous studies that showed the links... better.
Then why publish it?
There were other question marks about the study too--not counting Pfizer's financial contribution and Dr. Gibbons link to Wyeth Pharmaceuticals.
What if the suicides aren't about SSRIs at all but the growing popularity of treating children with antipsychotic drugs?
"I would be absolutely certain that the increase is not because kids are not being treated," says David Healy, M.D. a British psychiatrist at the University of Cardiff and early critic of SSRIs "They may not be getting SSRIs, but they are getting psychotropics," he says and, "the antipsychotic 'mood stabilizers' have just as great an increase in suicide risk as antidepressants--if not greater."
