By Dr. Mercola
The use of antidepressants is rarely more controversial than when they’re prescribed to children and adolescents.
In 2004, the U.S. Food and Drug Administration (FDA) issued a black-box warning on antidepressants, indicating that they were associated with an increased risk of suicidal thinking and behavior in young people.
In 2007, the FDA directed manufacturers to update the warning to include increased risks of suicidal thinking and behavior, known as suicidality, in young adults aged 18 to 24 during initial treatment (generally the first one to two months).1
For about two years following the initial 2004 warning, substantial reductions in antidepressant use were observed among youth, but it was unknown whether those reductions had continued.
Now, a new study published in European Neuropsychopharmacology shows that not only did antidepressant use continue after the FDA warnings, but it also markedly increased.2
Antidepressant Use Among Youth Increased Significantly From 2005 to 2012
The study revealed significant increases in antidepressant prescriptions to youth in five Western countries included in the study. In Denmark, for instance, there was a 60 percent increase in youth antidepressant prescriptions from 2005 to 2012.
The rate increased 54 percent in the U.K., 49 percent in Germany, 26 percent in the U.S. and 17 percent in the Netherlands during the same period.3
In response to the study, the World Health Organization (WHO) called the increase a “matter of concern.” Dr. Shekhar Saxena, WHO director of Mental Health, told BBC News:4
"Anti-depressant use amongst young people is and has been a matter of concern because of two reasons … One, are more people being prescribed anti-depressants without sufficient reason? And second, can anti-depressants do any major harm?”
Saxena also noted concerns about off-label usage of the drugs, as many antidepressants have not been tested in people under the age of 18. He continued:5
"These are medicines which have not been tried amongst young people, have no justification for being used widely in young people …
There are legal regulations and professional guidelines and off-label use of drugs many times crosses both of them. That's something the World Health Organization is very concerned about.
… There is no reason for many years of prescriptions being continuously given … Adolescents and young people are in the phase of development they develop out of everything, including their own depression.”
National Institute for Health and Care Excellence (NICE) clinical guidelines, for instance, state antidepressants should not be offered as a first-line treatment for symptoms of mild depression in children. And even when they’re prescribed for more serious cases, it’s supposed to be along with psychological therapy.
Fatal Anxiety Drug Overdoses on the Rise
The rise of antidepressant use among children mirrors another concerning rise in psychotropic drugs, this time for anxiety drugs called benzodiazepines (brand names include Xanax, Ativan and Valium).
Prescriptions for such drugs tripled from 1996 to 2013, but this doesn’t fully account for the uptick in overdoses, which quadrupled during that time period.
Researchers from the Albert Einstein College of Medicine in New York used data from the Medical Expenditure Panel Survey and multiple-cause-of-death data from the U.S. Centers for Disease Control and Prevention (CDC) to describe trends in benzodiazepine prescriptions and overdose deaths.
They found that the number of U.S. prescriptions for the drugs rose from 4.1 percent in 1996 to 5.6 percent in 2013 — a 37 percent increase.
Further, the rate of overdose deaths increased from 0.58 per 100,000 adults at the start of the study to about 3 per 100,000 adults at the end, which represented a more than 500 percent increase.
As for why the rate of overdose deaths rose faster than the rate of prescriptions, Dr. Chinazo Cunningham, one of the study’s authors, told STAT News, “Our guess is that people are using these prescriptions in a riskier way.”6
The number of pills prescribed to each adult increased over the study period, for instance, which suggests Americans may be taking higher doses or taking the drugs for longer periods, both of which increase the risk of overdose.
Combining the drugs, which act as sedatives and are often prescribed not only for anxiety but also for insomnia, with alcohol is also risky, as is using the drugs along with opioids.
Even Children Are Overdosing on Anxiety Drugs
About 9,500 children younger than 6 are hospitalized each year after ingesting family members’ medications.
Among them, three-quarters are between the ages of 1 and 2. Likely echoing the sharp rise in adults’ use of opioids and benzodiazepines, both opioid painkillers and benzos topped the list of medications most often responsible for young children’s hospitalizations. 7 According to the study:8
“Emergency department visits and subsequent hospitalizations of young children after unsupervised ingestions of prescription medications are increasing despite widespread use of child-resistant packaging and caregiver education efforts …
Opioids (17.6 percent) and benzodiazepines (10.1 percent) were the most commonly implicated medication classes.”
Yet, not all of the children consuming these powerful, mind-altering drugs are doing so accidentally. Millions of children are taking such drugs, often before they're even old enough to attend school.
In the U.S. alone, nearly 5 million children have been labeled with some type of serious mental disorder.9 In any given year, 20 percent of children will be diagnosed with a mental illness.
The most common diagnosis for kids ages 3 to 17 is ADHD (attention deficit hyperactivity disorder), followed by behavioral problems, anxiety and depression,10 and many of these children are being prescribed powerful and potentially dangerous psychiatric drugs as a result.
The long-term effects of psychotropic drugs on children are largely unknown, while serious short-term side effects are unfortunately common and include seizures, suicidal ideation, violent behavior and more.
How Are Children Diagnosed With a Mental Illness?
This video may not be available in all countries.
The diagnosis of mental illness in children is far from an exact science. Modern psychiatry has expanded its reach to the point that even the most normal of emotions and mental states are now labeled as one "disorder" or another.
In many cases, a child is labeled with a "disorder" such as ADHD based on subjective observations of behaviors that nearly all children exhibit at some time or another, such as excessive fidgeting or becoming angry after losing a game.
Ironically, many of these behaviors are a result of forcing children into unhealthy patterns like sitting in a chair at their school desk for six to eight hours a day.
Journalist Louis Theroux, in the BBC documentary “America's Medicated Kids” (above), identified a fine line between ordinary “bad behavior” and pathology and posed the question of whether the latest drugs are taking the place of "good old-fashioned parenting."11
What happens to children when they are medicated at a very young age, during key formative years? Do they grow up never knowing who they really are? What passions might they have developed were it not for the drug's influence? Psychotropic agents can influence a child's brain development, and chronic drug exposure during sensitive periods can produce alterations to a child’s nervous system that have unpredictable and potentially harmful effects.
Behavioral problems in children (and also many mental challenges in adults) — including what might appear to be serious mental disorders — are frequently related to improper diet, emotional upset and exposure to toxins. These underlying issues should be resolved before suppressing symptoms with potentially dangerous medications.
Do Antidepressants Even Work for Most People?
Antidepressants are the most commonly prescribed class of medication other than antibiotics, taken by more than 1 in 10 Americans (and 1 in 4 among women aged 50 to 64).12 Many assume that such pills are the best available treatment for symptoms of depression, but in fact the difference between antidepressants and placebo pills is very small — and both are ineffective for most depressed patients.13
If you or your child is diagnosed with depression, be aware that there are many treatment options available, including cognitive behavioral therapy (CBT). In a systematic review of 11 studies, no statistically significant difference in effectiveness was found between second-generation antidepressants and CBT.14
Further, in a meta-analysis published in PLOS Medicine, only the most severely depressed showed any response to antidepressants at all and that response was quite minimal.15 This lack of effectiveness must be taken into consideration along with the drugs’ side effects — of which there are many.
Serious Side Effects Demand That Antidepressants Be Used With Caution
Antidepressants called serotonin reuptake inhibitors (SSRIs) may leave you with a new set of mental challenges, as they’ve been linked to a slightly increased risk of mania or bipolar disorder.16 In addition, research suggests taking an SSRI may double your risk of bone fractures.17
This is because serotonin is also involved in the physiology of bone. If you alter serotonin levels with a drug, it can result in low bone density, boosting fracture risk. A large study of post-menopausal women also found that those taking tricyclic antidepressants or SSRIs were 45 percent more likely to suffer a fatal stroke.18
Meanwhile, overall death rates were 32 percent higher in women on the drugs, while other research linked antidepressant use to thicker arteries, which could contribute to your risk of heart disease and stroke.19 Among the most concerning side effects, however, especially to society as a whole, are suicidal thoughts and violent behavior, which are well known side effects, particularly in youth.
At SSRIStories.org, you can browse through a collection of more than 6,000 stories in which prescription drugs, primarily SSRIs, were potentially linked to serious side effects including violent behavior. Categories include murder-suicide, postpartum reactions, road rage, school and other mass shootings, workplace violence and more.
Try This Before Mind-Altering Drugs for Depression or Anxiety
If you are experiencing severe depression or anxiety, please seek help from a professional. For milder cases, and in addition to professional treatment for severe cases, the place to start is to return balance — to your body and your life. If you’re currently taking antidepressants and wish to stop, you should wean off them gradually under the care of a knowledgeable health care provider.
Abrupt withdrawal from these drugs can lead to severe psychiatric or physical problems. You have nothing to lose, and everything to gain, by applying lifestyle modifications before trying medication, especially in children. You may be surprised by how much such changes lessen symptoms naturally.
In addition to the creation of new neurons, including those that release the calming neurotransmitter GABA, exercise boosts levels of potent brain chemicals like serotonin, dopamine, and norepinephrine, which may help buffer some of the effects of stress.
Many avid exercisers also feel a sense of euphoria after a workout, sometimes known as the "runner's high." It can be quite addictive, in a good way, once you experience just how good it feels to get your heart rate up and your body moving.
The Emotional Freedom Techniques (EFT)
EFT can be very effective by helping you to actually reprogram your body's reactions to the unavoidable stressors of everyday life. This includes both real and imagined stressors, which can be significant sources of anxiety. In the following video, EFT therapist Julie Schiffman discusses EFT for depression relief.
Please keep in mind that while anyone can learn to do EFT at home, self-treatment for serious issues like persistent anxiety or depression is dangerous and NOT recommended, and you should consult with an EFT professional to get the relief you need.
Optimize Your Gut Flora
Your gut and brain actually work in tandem, each influencing the other. This is why your intestinal health can have such a profound influence on your mental health and vice versa. It’s also the reason why your diet is so closely linked to your mental health.
Prior research has shown that the probiotic Lactobacillus rhamnosus had a marked effect on GABA levels in certain brain regions and lowered the stress-induced hormone corticosterone, resulting in reduced anxiety- and depression-related behavior.20 The probiotic known as Bifidobacterium longum NCC3001 has also been shown to normalize anxiety-like behavior in mice with infectious colitis.21
So optimizing your gut flora with beneficial bacteria is a highly useful strategy. This is done by eliminating sugars and processed foods and eating plenty of non-starchy vegetables, avoiding processed vegetable oils, and using healthy fats. Additionally, eating plenty of fermented vegetables or taking a high-potency probiotic would be useful to reestablish a healthy gut flora.
Your diet should include a high-quality source of animal-based omega-3 fats, like krill oil. The omega-3 fats EPA and DHA play an important role in your emotional well-being, and research has shown a dramatic 20 percent reduction in anxiety among med students taking omega-3s.22
Dr. Andrew Stoll, a Harvard psychiatrist, was one of the early leaders in compiling the evidence supporting the use of animal based omega-3 fats for the treatment of depression. He wrote an excellent book that details his experience in this area called “The Omega-3 Connection.”
Optimize your vitamin D levels, ideally through regular sun exposure. Vitamin D is very important for your mood. In one study, people with the lowest levels of vitamin D were found to be 11 times more prone to depression than those who had normal levels.23
The best way to get vitamin D is through sun exposure. A vitamin D3 supplement can be used if these aren’t possible, but you’ll need to monitor your levels regularly.
Lower Your Intake of Sugar and Processed Foods
In addition to being high in sugar and grains, processed foods also contain a variety of additives that can affect your brain function and mental state, such as monosodium glutamate (MSG) and artificial sweeteners. There's a great book on this subject, “The Sugar Blues,” written by William Dufty more than 30 years ago, that delves into the topic of sugar and mental health in great detail.
Get adequate amounts of sleep. You can have the best diet and exercise program possible, but if you aren't sleeping well you can easily become depressed. Sleep and depression are so intimately linked that a sleep disorder is actually part of the definition of the symptom complex that gives the label depression.
Anxiety drugs are also often prescribed for sleep troubles. I suggest first reading my “Guide to a Good Night's Sleep” on improving your sleep. Small adjustments to your daily routine and sleeping area can go a long way to ensure uninterrupted, restful sleep (which may further help with anxiety symptoms as well).