To view original article click here
The Adelaide Advertiser
Sue Dunlevy, National Health Correspondent News Corp Australia Network
CHILDREN as young as two are being prescribed antidepressants linked to deaths despite warnings from the world’s medicine regulators, shocking new data reveals.
A News Corp investigation found there are 1022 children aged two to six years using the medications, an increase of 16 per cent since 2008-09.
And data from the Department of Human Services shows a further 26,000 children under the age of 16 were using antidepressants in 2012-13.
This is despite no antidepressant medicine being recommended for use in children and the drugs being linked to suicidal behaviour in young people.
The use of medications in children is highly contentious with University of Adelaide child psychiatrist Professor Jon Jureidini saying he can’t understand the rise in their use.
However, Dr Kenneth Nunn from the Children’s Hospital at Westmead defends their use. He says the drugs are not being used to treat depression but autism, intellectual disability, child abuse and neglect and self injurious behaviour.
Professor Peter Gotszche, a co-founder of the acclaimed Cochrane Collaboration which independently assesses medical studies, claims antidepressants are killing more than 500,000 Americans and Europeans a year. In a new book [Deadly Psychiatry and Organised Denial] he says the drugs are the third leading cause of death after heart disease and cancer because they can lead to obesity, diabetes and heart disease.
In 2004 drug regulators worldwide including the US Food and Drug Administration (FDA) and our medicines regulator the Therapeutic Goods Administration (TGA) issued warnings about the use of these drugs in adolescents after they were linked to suicidal thoughts and actions in teenagers.
A spokesman for the TGA says no antidepressant medicines are recommended for use in children for the treatment of depression in Australia.
“While the product information of some antidepressants specifically exclude use in children and adolescents with depression, others do not specifically recommend against use in children and adolescents with depression,” he said.
But despite these warnings the use of antidepressants is rising rapidly in this age group.
The number of children aged under 16 on the drugs leapt 42 per cent in the four years to 2012-13, according to the Department of Human Services data.
And in 2013-14, Australian Institute Health and Welfare figures showed 95,425 kids under the age of 15 were using some type of mental health drug.
Recent University of Sydney research found between 2000 and 2011, antidepressant dispensing for all age groups in Australia increased by 95.3 per cent.
We had the second highest rate of antidepressant use in the OECD in 2013.
The most rapid percentage increases in antidepressant and antipsychotic dispensing occurred in children aged 10 to 14 (35.5 per cent and 49.1 per cent respectively) between 2009 and 2012 Professor Iain McGregor found in his study.
Professor Jureidini revealed in September the antidepressant Aropax found safe for teenagers could be harming them, an outcome he said “scares me”.
His investigation showed the original 2001 drug company study hid results about dangerous suicidal behaviour.
“You can’t trust what is written in medical journals unless the individual patient data and the protocols of the study are made publicly available,” he said.
Another new study published in PLOS medicine found a modest association between use of anti depressants like Paroxetine, Prozac and Zoloft and violent crime in people aged 15 to 24.
Professor Jureidini says he can’t think of a reason why the rapid rise in the use of antidepressants in young people “is a good prescribing decision”.
“It might be justified in rare circumstances but in my clinical experience some doctors have a low threshold for prescribing,” he said.
“There might be a role for drugs but it needs to be carefully assessed,” he said.
Dr Nunn, who defends the use of the medications in young people, says academics like Peter Gotszche have never been faced with the real life situation of trying to treat severely traumatised children.
Anti-depressants are not used to treat depression in children aged 2 to 6 but are used off label to help children with autism, intellectual disability, child abuse and neglect and self injurious behaviour, he says.
Some of these children bite themselves, bang their heads against the wall or engage in repetitive behaviours and antidepressants are used as part of a wider management plan to help control their behaviour, he says.
“No-one is using these medications with the idea that they are the single solution,” he says.
“We are dealing with individuals and having to come up with the best we can do in the circumstances,” he says.
He says it is true there is evidence antidepressants can spark suicidal thoughts in teenagers, this is more likely to occur when they begin to recover and come out of the shut down and withdrawal phase, he says.
“When they are really depressed they are too depressed to do anything,” he says.
“As they get better they are more likely to act on their thoughts,” he says.
[This is not correct, it is an “urban myth” in the same vein as “suicidailty is due to underlying depression” – Ed]
However, he says Scandinavian studies show long term depressed teenagers are more likely to harm themselves if doctors don’t do something than if they do.
Suicide has been around for ages and modern treatments have made a phenomenal difference, he says.
The only real message of those opposed to medication use is “a third world message of go back to nature”, he said.
Last year the federal government’s Drug Utilisation Subcommittee found the prescription of some atypical antipsychotics had more than doubled and more than more than 12,600 kids aged under 19 were now using the powerful medications.
These drugs have terrible side effects including weight gain, diabetes, metabolic syndrome, increased cholesterol and high blood pressure.
“Of particular concern is the increasing use in younger patients,” the report says. More than 2,000 patients under the age of nine, and 110 children under age four, have been prescribed antipsychotic drugs approved to treat autism, schizophrenia and acute mania, the report found.