Prozac Benefits Children With Depression, Study Finds
Prozac treats children with depression "far better" than talk therapy with a psychologist, but a combination of the two provides the most effective treatment, according to a study sponsored by the National Institute of Mental Health and presented Tuesday at a meeting of psychiatric drug researchers, the New York Times reports. According to the Times, the results of the study, the first to compare drug treatment with psychotherapy for children with depression, "are likely to reassure psychiatrists, pediatricians and others who increasingly prescribe antidepressants to teenagers and children." In the $17 million study, called the Treatment for Adolescents with Depression Study, 439 children between ages 12 and 17 with moderate to severe depression were randomly assigned to receive 36 weeks of treatment with Prozac, an antidepressant manufactured by Eli Lilly; a form of talk therapy called cognitive behavioral therapy; a combination of the two treatments; or a placebo. Researchers, led by Dr. John March, a professor of psychiatry at Duke University, collected data on participants for 12 months but have currently analyzed only information from the first 12 weeks; 378 of the 439 participants have completed the first 12 weeks of tests.
Researchers used several psychological scales to measure their results. Under one measure, the study found that after 12 weeks, 71% of participants who received Prozac and talk therapy experienced improvement in their conditions, compared with 61% of those who received Prozac only, 43% of those who received talk therapy and 35% of those who received a placebo. However, according to the study, the risk of suicide attempts among participants who received Prozac was twice that of those who did not receive the medication; five participants who received Prozac attempted suicide, compared with one of those who did not receive the medication (Harris, New York Times, 6/2). FDA in March issued an advisory that asked several companies that manufacture 10 different antidepressants to revise product labels to include detailed warnings about the potential risk of suicidal tendencies in children and adults who take the medications. In addition, the advisory asked physicians, families and caregivers to monitor patients who take antidepressants for a number of symptoms that could indicate more serious risks (California Healthline, 5/25). March said that the results of the NIMH study indicate that the benefits of Prozac for children with depression outweigh the risks. He added, "The take-home message is that these adverse events are extremely rare."
Mental health experts said that the study was "notable" because of the number of participants and the lack of funds received from pharmaceutical companies, the Times reports. NIMH Director Thomas Insel said, "The most striking thing about the study is that, in all groups, there was a dramatic decrease in the amount of suicidal thinking." However, according to the Times, the results of the study are "unlikely to resolve the controversy over whether Prozac and similar drugs" can lead to suicidal behavior in children. Researchers plan to publish the preliminary results of the study this summer (New York Times, 6/2).
USA Today in a cover story on Wednesday examined the "badly frayed and even torn open" safety net for children with mental illnesses, a problem that has left "many kids untreated or in a dangerous free-fall on treatments that don't work." According to USA Today, children are "just about as likely as adults to have mental illness, but much less is known about childhood disorders and safe, effective treatments for them." In addition, a lack of research, failure to provide children with proven treatments, limits on health coverage and a lack of child and adolescent psychiatrists have contributed to the problem (Elias , USA Today, 6/2). A second USA Today feature article on Wednesday examined the increased use of psychiatric medications in children with mental illnesses (Elias , USA Today, 6/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.