Duty to Warn: Antidepressants in Children and Adolescents

For nearly 17 years, since the FDA black box warning about suicidality with antidepressants, our community has been quoting data that downplays this concern. We were wrong. We were deceived. Antidepressants can be lifesaving, but there really is a duty to warn. In this episode, Doctors Martha Ignaszewski and Glen Spielmans talk with us about what went on and how to talk about it with our families.

Listen to my Carlat Psychiatry podcast

https://www.thecarlatreport.com/podcast/duty-to-warn-antidepressants-in-children-and-adolescents/

Guests:

Dr. Glen Spielmans, professor of psychology at Metropolitan State University in Saint Paul, Minnesota
Dr. Martha Ignaszewski, staff psychiatrist at BC Children’s Hospital and a clinical instructor at the University of British Columbia

Published On: 3/1/2021

Duration: 24 minutes, 36 seconds

“Duty to Warn? Debating Antidepressant Suicidality,” The Carlat Child Psychiatry Report, Oct/Nov/Dec 2020
Spielmans GI, Spence-Sing T, Parry P. Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Front Psychiatry. 2020 Feb 13;11:18. doi: 10.3389/fpsyt.2020.00018. PMID: 32116839; PMCID: PMC7031767.
Ignaszewski MJ, Waslick B. Update on Randomized Placebo-Controlled Trials in the Past Decade for Treatment of Major Depressive Disorder in Child and Adolescent Patients: A Systematic Review. J Child Adolesc Psychopharmacol. 2018 Dec;28(10):668-675. doi: 10.1089/cap.2017.0174. Epub 2018 Jul 31. PMID: 30063169.

References:

Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Erkens JA, Herings RM, Mann JJ. Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry. 2007 Sep;164(9):1356-63.
Gibbons RD, Brown CH, Hur K, Davis J, Mann JJ. Suicidal thoughts and behavior with antidepressant treatment: reanalysis of the randomized placebo-controlled studies of fluoxetine and venlafaxine. Arch Gen Psychiatry. 2012 Jun;69(6):580-7. doi: 10.1001/archgenpsychiatry.2011.2048. Erratum in: Arch Gen Psychiatry.2013 Aug;70(8):881. PMID: 22309973; PMCID: PMC3367101.
Findling RL, Robb A, Bose A. Escitalopram in the treatment of adolescent depression: a randomized, double-blind, placebo-controlled extension trial. J Child Adolesc Psychopharmacol. 2013 Sep;23(7):468-80. doi: 10.1089/cap.2012.0023. PMID: 24041408; PMCID: PMC3779002.
Healy D, Cattell D. Interface between authorship, industry and science in the domain of therapeutics. Br J Psychiatry. 2003 Jul;183:22-7. PMID: 12835239.
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