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FDA warning on antidepressants have depressed depression diagnoses

June 1, 2009 |  1:00 pm

After five years of steady growth, diagnoses of depression in patients of all ages dropped like a rock in 2004, the year after the Food and Drug Administration warned that the current generation of antidepressant medications increased the risk of suicide and suicidal thinking in children.

By 2007, according to a study published today in the Archives of General Psychiatry, depression diagnoses had begun creeping back up. But physicians were still less inclined than they had been before the FDA's warning to diagnose a patient of any age with depression and to offer medication.

The new wariness was particularly pronounced among primary care physicians -- the doctors to whom most patients with mental health problems tend to turn first, wrote the authors. And the reluctance to diagnose and treat depression affected populations not even covered by the warnings that the FDA issued on selective serotonin reuptake inhibitors (SSRIs) in October 2003. During the three subsequent years, primary-care physicians diagnosed depression in adults 29% less often than would have been expected and 37% less often in young adults (a population that in May 2007 was included in the FDA's warning about SSRIs and increased suicidal thinking). The drop in depression diagnoses was sharpest for children -- 44%.

The study is the latest to suggest that the FDA's warning -- and the media coverage surrounding the issue of SSRIs and suicide -- have set back progress in treating depression, a condition that the mental health profession believes is seriously underdiagnosed.

While fewer prescriptions were written, patients who did get a diagnosis of depression were slightly more likely to receive at least one psychotherapy visit over the next six months. But the authors said that, overall, the use of psychotherapy as an alternative to medications appeared lower than would have been expected if doctors were routinely proposing talk therapy as a substitute for antidepressants.

Anne M. Libby and a team of researchers at the University of Colorado Denver's School of Medicine called the trends the "unintended consequences" of the FDA's first "black box" warning -- the agency's strongest safety alert to patients using a drug. The effect has been substantial, persistent and spread over a broad population of patients. If the trend of "reduced depression treatment" is to be reversed, Libby added, "policy actions are required."

For more patient information on the signs and consequences of and the range of treatments for depression, go here.

-- Melissa Healy

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Comments (5)

But how many patients are now being diagnosed instead as bipolar spectrum disorder or bipolar - not otherwise specified and does this make up the difference. Remember NIMH has been saying that many people diagnosed with depression really have these two disorders, and the diagnosis for them has been rising over the past several years. Consequently these patients may be being treated with antipsychotics instead of antidepressants, which is even more dangerous.

BRAVO!!! BRAVO!! BRAVO!!! More spared what patients have long called antidepressant hell!!!

Initial studies (hidden by manufacturers for two decades) show antidepressants have no more benefit than placebo, yet they have listed side effects as deadly as "suicidal and homicidal ideation." Their risk to benefit ratio should be classified as "down the toilet." So, technically these drugs should be off the market, not just have strong warnings.

It is of little importance to drug manufacturers though because antidepressants have long been the gateway drugs to their new high priced atypical antipsychotic medications that have brought in far more than the antidepressants did. I know of no faster way to get a diagnosis of Bipolar Disorder than to begin the use of an antidepressant, switch brands of an antidepressant, or attempt to stop taking an antidepressant too rapidly.

The drug makers only concern would be that these warnings may have caused them to lose some patients taking antidepressants which would in turn lead them into mania or psychosis so that they could sell more of these antipsychotics. The antipsychotics bring in more because they are still under patent. Most antidepressants are no longer under patent and do not bring in as much. Money is the name of the game here, not anyone's health and well being. Senator Charles Grassley's investigation into these drugs and payoffs have clearly demonstrated that.

After having spent the past 20 years gathering the dead and damaged left behind in the wake of these deadly antidepressant drugs I would warn anyone taking them to keep our web address ( because they WILL need it. They will especially need it to learn how to get off an antidepressant safely.

Research is clear in supporting that fact that the hypothesis behind the antidepressants is backwards! They CAUSE depression and anxiety, they do not cure it! So is it any wonder that they produce a higher suicide rate even in those who took the drugs for something other than depression such as something as simple as warts, or becoming nervous about taking a test? Yes, those are real cases. Check out a LONG list of more cases at

The purpose of this current news story about a drop in antidepressant use is to bury the news out of Japan days ago. The Japanese Health Ministries warned that antidepressants have a CAUSAL connection to violence. Not that these drugs are just associated with violence, but that they cause it. That is the bad press the drug makers would like to bury with this news story about sales being down.

Antidepressants work by impairing one's ability to metabolize serotonin even though research has shown for decades that impairing one's ability to metabolize serotonin produces impulsive violence including murder and suicide. So why are we surprised to see such incredible violence in our society since the widespread use of these SSRI antidepressants which are designed to selectively target serotonin metabolism?

It is long past time to wake up America because the warnings from the FDA have not even begun to touch the surface yet when it comes to the dangers of these so called "antidepressants." These are drugs that should be classed as "dissociative anesthetics" like PCP or ketamine and include warnings that they also produce LSD flashbacks. None of this should be a surprise since those old medications (Patents: LSD-Eli Lilly & PCP-Parke Davis, now Pfizer), now classed as illegal drugs, produce their hallucinogic effects via serotonin as well.

Ann Blake-Tracy, PhD, Executive Director,
International Coalition for Drug Awareness &

Depression Diagnoses Dropped After FDA Antidepressant Warnings:

My 19 yr old niece killed herself, probably because she was not on antidepressants. She self medicated with drugs and alcohol to stop her panic and depression. Because of her, and the depresion that runs in our family, my 3 children do take antidepressants and so do Il. It has saved our lives. Unless you have been there you have no idea what mental pain can do to a person. As long as you are being carfully watched by your physicoan and family there can be life-saving. Depression is a chemical imbalance of the brain. You would never tell some one with diabetes not to take their insulin, why don't people understand that depression is a REAL illness that needs REAL medicaiton.

I agree. You need medication to control depression. Otherwise people walk blindly not knowing what to do. As a mom you also feel helpless to take care of your kids.


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