"Active treatment with an SSRI of at least 8 weeks duration" followed by abrupt discontinuation leads to SSRI withdrawal syndrome, including suicidality for teens with moderate to significant depression.
These pharma-sponsored researchers have the evidence right in front of their eyes that SSRI, or SSRI withdrawal, leads to suicidality, but they absolutely fail to put their finger on this horrible phenomenon (just to get you started, Google "SSRI" and "suicide", or cf.:
The study is in the April edition of the American Journal of Psychiatry (v. 4, pp. 418-426). "Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study."
Lead author is Brent, who in the COI section seems to have no COI. However, other authoers pretty much cover the landscape of pharmaceutical funding.
OK- there has recently been a few notbale comments indicating that talk therapy is valuable and critical for depressed teens. Never mind all that. "Failed" treatment means that a teen did not get better on SSRI, which in other reseaerch has been shown to be modestly effective, and largely due to non-specific factors including placebo response.
Now, withdrawal from SSRI has been extensively noted by many to lead to suicidality. Thoughts and acts.
So, for the kids who did not respond to SSRI, the authors stopped the SSRI, and assesssed level of suicidality.
Level was shocking, at least to me: 20%.
Uh, folks, hang on - maybe we should go to plan B: talk therapy.
Another recently emergent study, the TADS study (John March, found similar results:
15% of depressed kids treated with SSRI had suicidal thoughts; of those treated just with talk therapy, only 6%. Less than half.
Nonetheless, the Brent study has no indication that the suicidality may have been provoked by the "treatment." It possibly reverses the causal relation and indicates that the suicidality has something to do with the subsequent poor treatment response.
Their solution? Keep family conflict and illicit drug use from interfering with the SSRI effect.
How about if we simply do what we can to get these kids into talk therapy, and heed the black box warning that SSRI leads to suicidality in teens?
right in front of our faces, and they totally re-interpret this result to sell more pills. Shameful.