Following the Food and Drug Administration's warning about the possible risk of suicide among teens when they're treated with antidepressant drugs known as SSRIs, the rates of diagnosis and treatment of depression among adults have declined significantly, according to a new report.
"While some degree of decline in antidepressant prescribing was not unexpected after the black box warning was issued, few if any had predicted diagnosing to decline, or that other modes of treatment (psychotherapy or other medications) would remain relatively unchanged," Dr. Robert J. Valuck told Reuters Health. "It was thought that the latter two may increase to compensate for fewer antidepressant prescriptions being written."
Valuck, from the University of Colorado at Denver, and colleagues examined data relating to depression among 400,000 adult patients enrolled in managed care plans.
In the five years before the SSRI warning about teen suicide, the rate of diagnosed episodes of depression increased steadily from 6 to 11 per 1000 enrollees, the investigators report in the American Journal of Psychiatry.
In 2005, when the black box warning was ordered on the drugs, the depression diagnosis rate decreased significantly, from 8 to 5.8 per 1000 men and from 17.4 to 12.4 per 1,000 women.
While 53 percent of episodes of depression were treated with SSRIs before the advisory, this dropped to only 22 percent after the advisory. Other types of antidepressants saw similar, albeit more modest, prescription declines after the advisory.
The percentage of patients who had at least one psychotherapy session, and the percentage of depressive episodes for which possible alternatives to antidepressants were prescribed, did not change significantly after the advisory, the researchers found.
"We believe that there are likely to be many factors involved in the changes that we observed, and that they are very deserving of further study," Valuck said. "Physicians and policy makers should be aware of the power of these regulatory tools, both for the intended and unintended consequences that they may cause."