Original article no longer available
The Winchester Star
By Robyn Taylor, The Winchester Star
Published July 23, 2003
Just weeks after graduating from high school last year, Matthew Steubing killed himself.
His family knew the 18-year-old had been depressed, but they were quick to find him help. But the antidepressant Matthew faithfully took each day came with a life-threatening risk, a risk the Steubings were never told about.
“I believe that if he had not been on that medicine he would still be alive today,” said his mother Celeste Steubing, sitting on the sun porch of her Frederick County home. “My son came to me. He trusted me to help him. And the help that we got killed him.”
Last month, an advisory panel to the Food and Drug Administration recommended that the agency require drug companies place “black box” warning labels on antidepressants because of the risk of suicide in children. It is the strongest warning the FDA can require.
The bittersweet victory is an important step, said Steubing, one of a number of parents who testified at the Sept. 13 Congressional hearing that led to the recommendation.
But even if the FDA requires the warning, it comes too late to help Matthew, said Steubing, whose shock over her son?s death has gradually turned to anger.
She’s mad at the drug companies for possibly knowing the risks and not reporting them, at the medical profession for being too quick to prescribe antidepressants, and at the FDA for minimizing the risks and doing a poor job of regulating the drugs.
“They make it sound like the lives that were lost were dispensable because of the benefits to others,” she said of a recent news story reporting the risk was “low” because only two to three young people out of 100 were likely to have suicidal thoughts or actions.
But with physicians writing nearly 11 million antidepressant prescriptions a year for children, according to the FDA, 2 or 3 percent is a lot of children, Steubing said.
“It’s not a rare risk. It’s a very real risk,” she said. “And my big, big fight here … where my anger is coming from is that we were not told of the risks.”
Born April 25, 1985, Matthew Sean Steubing was the youngest of Celeste and Daniel Steubing’s six children.
He worked out, held a job, attended James Wood High School and Sacred Heart of Jesus Catholic Church.
He was thinking about college. Maybe joining the Air Force like his older brother.
But during his senior year, he became depressed.
“He had a couple of disappointments and took a couple of things hard,” Steubing said.
The Steubings had weathered such difficult life lessons with their older children, but these setbacks seemed to keep Matthew down longer than normal.
He lost interest in school, working out, and playing basketball, all things he usually enjoyed.
By early spring of 2003, it was clear Matthew wasn’t getting any better.
The counselor they consulted told them depression was caused by a chemical imbalance in the brain and that Matthew might benefit from taking an antidepressant, a prescription he would need to get from a medical doctor.
Not familiar with any psychiatrists, the Steubings consulted a general practitioner, who asked Matthew a few questions, Steubing said.
Twenty minutes later, they left the doctor’s office with a sample pack of pills and a prescription for Lexapro.
“When I asked about side effects, I was told about things like dizziness and insomnia,” Steubing said.
The full dosage left Matthew lethargic, sleepy all the time but unable to sleep. His doctor suggested they cut the pill in half, and for three weeks he took a half dose.
Life progressed. He managed to graduate from high school.
“Everything seemed to be going OK. Not great, but OK.”
The doctor said Matthew could start taking the full dosage again.
Matthew soon became anxious, nervous, and restless. When he did sleep, he had nightmares.
And every day there I was asking, “Matt, did you take your medicine? Matt, did you take your medicine?”
On July 18, 2003, seven weeks after he started the full dose, Matthew killed himself.
The note he left his family said, “Things just got worse.”
In the weeks immediately following Matthew’s death, Steubing and her family had no idea how things could had gotten so much worse for Matthew.
He was going to counseling, taking an antidepressant. That Matthew would take his own life was simply unfathomable.
“The bottom line is I know my son. I was closely involved with him,” Steubing said. “He was not suicidal. He wanted help, and he went willingly to find help.”
It wasn’t until her husband ran across an article on the suicide/antidepressant connection in a February issue of Time magazine that things began to make sense.
“I looked at it, and I was just sick.”
Frightened, too. One of her daughters had started taking Zoloft to deal with the shock and grief of Matthew’s death.
Steubing herself had been prescribed Paxil, but hadn’t stayed on it long because of alarming side effects.
“I felt like I had a bug zapper in my head,” Steubing said. “I thought I was having a stroke.”
Her daughter was having a hard time metabolizing the Zoloft, leaving Steubing to wonder: If they all had adverse reactions to antidepressants doesn’t that mean their body chemistry doesn’t mix well with the drugs?
“Who cares if it costs money for a test?,” she said. “I would have paid anything to know this drug would do this to my son.”
“Unfortunately, there is no test to determine if a patient will have an adverse reaction,” said Dr. Don Lee, a child and adolescent psychiatrist in Winchester.
Just as cold medicine can make one person drowsy and another hyper, patients react differently to antidepressants.
Patients on these drugs should be closely monitored with frequent follow-up visits to their physician, said Lee, who in recent weeks has received many calls from teachers, pediatricians, counselors, and parents worried about the risk to young people who take antidepressants.
Every year, about 3,000 young people, ages 5 to 20, commit suicide, he said. Most are suffering from depression.
Antidepressants are an important tool in the fight against depression, said Lee, who has prescribed a variety of drugs for his patients, including Lexapro.
Ideally, only a specialist would prescribe psychiatric medications to children, Lee said. But with only two full-time child psychologists in Winchester, pediatricians and family practitioners see many young patients who need help. He hopes the recent scare won’t keep other physicians from prescribing potentially helpful drugs.
Making the issue more complicated, Lee said, is that there’s not a definite cause and effect relationship between antidepressants and suicide.
Just because the patient was prescribed the medication doesn?t mean they were taking it. And depressed people who are feeling better, often as a result of medication, commit suicide because they finally have the energy to carry through on their suicidal thoughts.
Even so, Lee supports the advisory panel?s recommendation for a black-box warning. As with any medication, there are risks. A warning would put physicians and parents on alert.
“It doesn’t hurt,” he said. “And it may help.”
After reading the Time article, Steubing got on the Internet to find out more about akathisia, an adverse reaction to antidepressants that can cause aggressive behavior, increased irritability, and suicidal thoughts.
She called authors of books critical of antidepressants. She found other parents suffering the same guilt and anger.
And she started speaking out.
“I’m not going to sit here with my grief and let these people get away with murder.”
Congress continues to investigate whether the drug companies or the FDA improperly reported or underestimated the risk of antidepressants to children.
So Steubing spends a lot of time on Capitol Hill these days, testifying when she’s allowed, taking notes when she’s not.
Carrying a handmade poster of more than a dozen photos of Matthew, this woman who never took a public speaking class tells complete strangers? physicians, drug company executives, Congressmen, FDA regulators ? the most intimate details of her boy’s pain.
Steubing won’t go so far as to say the drugs should be banned. Millions of young people may feel better because of antidepressants, she said.
But by telling her story – Matthew’s story – maybe she can get physicians to try other options before writing a prescription, get parents to vigilantly watch their children on antidepressants, get the drug companies to come clean about negative results of their testing, and get the FDA to ferociously protect the public’s health.
“I have prayed every day for God to show me what to do with this pain,” she said, gently touching a photo of Matthew. “I’m not supposed to be quiet.”