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Depression Diagnoses Drop After 2003 Suicide Warning

Policy actions urged to help counteract fallout of reduced depression treatment

MONDAY, June 1 (HealthDay News) -- In the wake of a 2003 U.S. Food and Drug Administration (FDA) warning about potential suicide among pediatric patients on antidepressants, the projected rate of depression diagnosis dropped sharply, according to a study in the June issue of the Archives of General Psychiatry.

Anne M. Libby, Ph.D., of the University of Colorado in Denver, and colleagues analyzed trends in new depression diagnoses using data from the PHARMetrics Patient Centric Database, including 91,748 pediatric diagnoses, 70,311 young adult diagnoses, and 630,748 adult diagnoses. The study sought to determine the impact of an October 2003 Public Health Advisory from the FDA about the risk of suicide for pediatric patients on antidepressants. Diagnosis and practice trends before and after the advisory were compared (July 1999 through June 2007).

There were declines in depression diagnoses and the use of selective serotonin reuptake inhibitors in pediatric cases immediately following the 2003 advisory, which also carried over into adults. By 2007, the previously increasing rate of depression diagnosis dropped to 1999 levels for pediatrics and to below 2004 levels for adults. Compared to 1999 projections, new depression diagnoses by primary care providers were down 44 percent for pediatrics, 37 percent for young adults, and 29 percent for adults.

"Diagnosing decreases persist. Substitute care did not compensate in pediatric and young adult groups, and spillover to adults continued, suggesting that unintended effects are nontransitory, substantial, and diffuse in a large national population. Policy actions are required to counter the unintended consequences of reduced depression treatment," the authors conclude.

Three study authors reported receiving research grants from Eli Lilly and Company, Forest Pharmaceuticals, Lundbeck, and the American Foundation for Suicide Prevention.

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