Featured Research

from universities, journals, and other organizations

FDA Warnings Led To Unintended Changes In Depression Diagnosis, New Report Finds

Date:
June 16, 2009
Source:
JAMA and Archives Journals
Summary:
Government warnings about suicidality among children taking antidepressants appear to be associated with unintended and persistent changes in the diagnosis and treatment of depression in children and adults, according to a new report.

Government warnings about suicidality among children taking antidepressants appear to be associated with unintended and persistent changes in the diagnosis and treatment of depression in children and adults, according to a new report.

"In October 2003 the Food and Drug Administration (FDA) issued a Public Health Advisory about the risk of suicidality for pediatric patients taking antidepressants; a boxed warning, package insert and medication guide were implemented in February 2005," the authors write as background information in the article. "The warning was extended to young adults aged 18 to 24 years in May 2007. Immediately following the 2003 advisory, unintended declines in case finding and non–selective serotonin reuptake inhibitor substitute treatment were shown for pediatric patients, and spillover effects were seen in adult patients, who were not targeted by the warnings."

To determine whether these unintentional consequences have persisted, Anne M. Libby, Ph.D., and colleagues at the University of Colorado Denver's School of Medicine analyzed patterns in a national integrated managed care claims database from July 1999 through June 2007. During this time period, 91,748 children (ages 5 to 18), 70,311 young adults (ages 19 to 24) and 630,748 adults (ages 25 to 89) were diagnosed with depression.

Between 1999 and 2004, the rate of diagnosed episodes of depression increased steadily among each group. "After 2004 the observed national rate of pediatric case-finding fell significantly, with the post-advisory decline persisting such that the rate per 1,000 enrollees in 2007 (3.5) approached the 1999 level (3.2)," the authors write. "Based on the historical trend established in the five years prior to the advisory, the 2007 rate per 1,000 enrollees would have been 15.6 for young adults and 20.3 for adults; the actual observed rate was 9.6 for young adults and 12.4 for adults."

In addition, primary care clinicians specifically continued to diagnose fewer cases of depression, with a 44 percent lower rate of diagnosis among pediatric patients, 37 percent lower among young adults and 29 percent lower among adults. This trend is particularly important because the general medical sector sees the largest proportion of patients seeking mental health care in the United States, the authors note.

"Substitution of other forms of treatment might have been an expected outcome of a decrease in first-line treatment for the acute phase of depression," they write. "There was a small but significant increase in the proportion of new depression cases that received at least one visit for psychotherapy within 180 days of diagnosis for adults only. Antidepressant alternatives—atypical antipsychotics and anxiolytics—did not increase statistically or in clinically meaningful ways from their very low base rates in the pre-advisory period."

The findings suggest that initial unintended consequences of the FDA warnings have continued through 2007, the authors conclude. "Diagnosing decreases persist," they write. "Substitute care did not compensate in pediatric and young adult groups, and spillover to adults continued, suggesting that unintended effects are nontransitory, substantial and diffuse in a large national population. Policy actions are required to counter the unintended consequences of reduced depression treatment."

Dr. Libby and co-authors Dr. Orton and Dr. Valuck report unrestricted investigator-initiated research grants from Eli Lilly and Company, Forest Pharmaceuticals, Lundbeck and the American Foundation for Suicide Prevention.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Anne M. Libby, PhD; Heather D. Orton, PhD; Robert J. Valuck, PhD, RPh. Persisting Decline in Depression Treatment After FDA Warnings. Arch Gen Psychiatry, 2009;66(6):633-639 [link]

Cite This Page:

JAMA and Archives Journals. "FDA Warnings Led To Unintended Changes In Depression Diagnosis, New Report Finds." ScienceDaily. ScienceDaily, 16 June 2009. <www.sciencedaily.com/releases/2009/06/090601182818.htm>.
JAMA and Archives Journals. (2009, June 16). FDA Warnings Led To Unintended Changes In Depression Diagnosis, New Report Finds. ScienceDaily. Retrieved August 20, 2014 from www.sciencedaily.com/releases/2009/06/090601182818.htm
JAMA and Archives Journals. "FDA Warnings Led To Unintended Changes In Depression Diagnosis, New Report Finds." ScienceDaily. www.sciencedaily.com/releases/2009/06/090601182818.htm (accessed August 20, 2014).

Share This




More Mind & Brain News

Wednesday, August 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Charter Schools Alter Post-Katrina Landscape

Charter Schools Alter Post-Katrina Landscape

AP (Aug. 20, 2014) Nine years after Hurricane Katrina, charter schools are the new reality of public education in New Orleans. The state of Louisiana took over most of the city's public schools after the killer storm in 2005. (Aug. 20) Video provided by AP
Powered by NewsLook.com
Researcher Testing on-Field Concussion Scanners

Researcher Testing on-Field Concussion Scanners

AP (Aug. 19, 2014) Four Texas high school football programs are trying out an experimental system designed to diagnose concussions on the field. The technology is in response to growing concern over head trauma in America's most watched sport. (Aug. 19) Video provided by AP
Powered by NewsLook.com
Kids' Drawings At Age 4 Linked To Intelligence At Age 14

Kids' Drawings At Age 4 Linked To Intelligence At Age 14

Newsy (Aug. 19, 2014) A study by King's College London says there's a link between how well kids draw at age 4 and how intelligent they are later in life. Video provided by Newsy
Powered by NewsLook.com
Mental, Neurological Disabilities Up 21% Among Kids

Mental, Neurological Disabilities Up 21% Among Kids

Newsy (Aug. 18, 2014) New numbers show a decade's worth of changes in the number of kids with disabilities. They suggest mental disabilities are up; physical ones are down. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins