In a news story released one week ago (3/22/04), the Food and Drug Administration (FDA) said that patients taking antidepressant medication needed to be watched because they were at risk to commit suicide. The warning comes after a panel of experts last month called on the FDA to issue stronger warnings about the possible risks of suicidal behavior among children and teenagers taking antidepressant drugs.

The FDA called on doctors to closely monitor patients for signs of hostility, anxiety, insomnia, and other behaviors that could signal worsening depression and suicidal thoughts.

Regulators first alerted physicians to carefully watch children or teenagers taking antidepressants last fall. These stronger warnings call for closer monitoring and urges patients, families and caregivers to look for behavioral changes. Patients should alert their doctors, who may consider lowering the dose or ending use of the drug, the FDA said.

The agency also asked manufacturers to change the labels of 10 drugs to include larger and more prominent warnings about patient monitoring. The 10 drugs targeted were: Prozac (fluoxetine); Zoloft (sertraline); Paxil (paroxetine); Luvox (fluvoxamine); Celexa (citalopram); Lexapro (escitalopram); Wellbutrin (bupropion); Effexor (venlafaxine); Serzone (nefazodone); and Remeron (mirtazapine).

“Because antidepressants are believed to have the potential for inducing manic episodes in patients with bipolar disorder, there is a concern about using anti- depressants alone in this population. Patients should be adequately screened to determine if they are at risk for bipolar disorder before initiating antidepressant treatment so that they can be appropriately monitored during treatment. Such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.

In Britain, health authorities have advised doctors not to prescribe most SSRI drugs, or selective serotonin re-uptake inhibitors, to anyone under 18.