The suicide rate among young Americans ages 10 to 24 increased significantly in 2004 for the first time in ten years, a reaction many prominent mental health professionals blame on the ‘black box’ rule enforced by the FDA beginning that same year.  The ‘Black box’ rule  requires that antidepressant medications, a common treatment for depression among teens and young adults, contain a warning label stating that taking the medication could increase suicidal thoughts, much the same way cigarette packages are required to warn of the perils of smoking.  Several prominent psychiatrists stand against this rule, saying that it might cause nervous parents to shy away from the most effective treatments for their children out of fear.

The same year that the ‘black box’ rule went into effect, antidepressant prescriptions in patients younger than age twenty took a 22 percent dive, and suicide rates among children in this age group experienced the most pronounced increase in suicide rate of any age group, according to a Reuters news report.  Most alarming was the increase in suicide rate in girls ages 10 to 14, which increased 80 percent in a single year. The overall increase in patients between ages 10 and 24 was eight percent.

Medical professionals and parents are quick to point fingers and assign blame for this frightening trend.  During the briefing during which the data for 2004 were released, the FDA’s Dr. Tom Laughrehn stated that “obviously, [the increase] is a concern for us…You cannot reach causal conclusions from this kind of data. We are going to have to look at the data over time.”   Dr. Ilena Arias, director of the Center of Disease Control’s National Center for Injury Prevention and Control, described the increase as “sobering” and reiterated that “We don’t yet know if this is a short-lived increase or if it’s the beginning of a trend.”

On the other side of the fence, such formidable forces as the American Foundation for Suicide Prevention have already blamed the ‘black box’ rule and subsequent drop in prescriptions for the increase, a view shared by Dr. Carolyn Robinowitz, president of the American Psychiatric Association. Dr. Robinowitz stated in an interview with Reuters that she “hop(es) the FDA will reconsider this black box language in light of these findings.”  Time will tell what, if any, effect this new data will have on the ‘black box’ rule, or on the way that psychiatric treatments are administered to depressed young adults.

Nick Mildebrath can be contacted at Please put ‘BNN’ in the subject line.

The Reuters news story, which contains more data regarding suicide rates among teens in other countries, can be found here.

Data used in this story was also taken from the 2006 NAHIC Fact Sheet on Suicide, which can be read in pdf format here.

You can read the American Foundation for Suicide Prevention’s statement regarding this story here.

If you are a parent or concerned friend of someone you think may be suicidal, click here.

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