Turning agony into advocacy — (Philadelphia Inquirer)

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Philadelphia Inquirer

July 22, 2003

By John Grogan, Inquirer Columnist

Since their daughter’s suicide 14 months ago, Kathy and Tom Woodward have had little to celebrate.  Devastated by the loss of 17-year-old Julie, the North Wales couple turned their grief into advocacy, speaking passionately to anyone who would listen about what they are convinced pushed their daughter to take her own life: antidepressant medication.

Last Monday Tom Woodward took Julie’s story to Washington, testifying before an advisory panel to the Food and Drug Administration.

The next day, the expert panel, composed of psychiatrists and pediatricians, issued a stinging ruling that found a direct link between certain antidepressants and increased suicide risk in young people.

It was what the Woodwards had been saying all along, even as the FDA maintained its long-held position that youth suicide was the result of depression, not medication.

The panel cited studies showing teenagers who took the antidepressants, known as selective serotonin reuptake inhibitors, were twice as likely to become suicidal as teens who took a placebo. It concluded that two or three out of every 100 youths taking SSRI drugs would become suicidal as a result of the medication.

That number might sound small until you consider that doctors wrote about 11 million antidepressant prescriptions to minors last year.

Raising a red flag

The panel urged the FDA to require that the drugs, which include brand names such as Prozac, Zoloft, Paxil and Effexor, carry prominent warnings of suicide risk in minors. The “black box warning” would appear at the top of drug-package inserts and in advertisements for the drugs.

If the FDA accepts the recommendation as expected, it would be the strongest action it could take short of banning the drugs for youngsters.

The Woodwards consider the panel’s findings a bittersweet victory.

Sweet because the couple believe the warning will save the lives of other children. Bitter because it came too late to save their own.

Julie, who was about to begin her senior year at North Penn High School, hanged herself on July 22, 2003, seven days after she began taking Zoloft.

No one will ever know whether it was an adverse reaction to the medication or her depression that spurred Julie’s final act. But her parents have no doubts.

Julie had been unhappy and withdrawn after transferring from a small private school to sprawling North Penn High. “She was going through a rough patch, but she was sorting through it,” Tom Woodward told me.

But after the parents took her to a mental-health clinic where Zoloft was prescribed, Julie’s personality changed abruptly, they said.

No dots to connect

Having received no warning of increased suicide risk, the Woodwards missed signs in Julie’s final days. “We did not know to collect the dots, much less connect them,” the father said.

Now he and his wife are convinced the drug killed their daughter. And the FDA panel’s ruling adds significant weight to their contention. The panel not only found the link between SSRI drugs and suicide real – a “fatal side effect” one panelist called it – but that the drugs can be largely ineffective in treating young people.

The Woodwards are angry at revelations that some drug companies buried studies pointing to increased suicide risk. “Tell me how that isn’t criminal.” Tom Woodward asked. “This is a classic example of putting profits above the lives of children.”

Kathy Woodward said last week’s ruling won’t bring Julie back, but it helps her deal with her own feelings of inadequacy as a mother.

“I’ve been feeling extreme guilt this whole year because I was the one who suggested she go for help, and I believed the doctors when they said the drug was safe and mild,” the mother said. “I felt, why couldn’t I have been more careful with my child?”

Now she realizes she could not protect against what she did not know.

“It’s like backing out of your driveway after someone tells you the road is all clear, and then you run over your own child,” she explained. “It’s just a terrible, terrible thing to live with.”

Contact John Grogan at 610-313-8132 or jgrogan@phillynews.com. Read his recent work at http://go.philly.com/grogan.