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Weekend House Call

Aired January 31, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


JEFF FLOCK, CNN ANCHOR: And Weekend House Call begins right now.
HOLLY FIRFER, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.

I'm Holly Firfer.

We're glad you're here.

More than a million American children are on some kind of prescription drug to treat major depression. But, could anti- depressants actually increase the risk of suicide in children?

The FDA is looking into that possibility and opens public hearings on the issue on Monday.

CNN medical correspondent Christy Feig takes a closer look at the debate and possible dangers of prescribing anti-depressants to children. We'll have that package in a minute.

But first, I wanted to give you some information about anti- depressants. Prescribing anti-depressants to kids is a polarizing issue and in our next half hour, we are not going to draw conclusions. We're only going to try to answer your questions and your e-mails.

Now, depression occurs in about 10 percent of American children and depression can also lead to suicide. As we mentioned, about a million children are currently taking some form of anti-depressant. But Prozac is the only type of anti-depressant approved by the FDA for kids. Now, according to drug regulators, it is the only one that is proven to alleviate pediatric depression.

Now, anti-depressants are not approved for children, but are still being prescribed by doctors, and those include Paxil, Zoloft, Effexor, Remeron, Celexa, Luvox and Serzone. Now, those drugs can be prescribed legally off label to children by doctors because they are approved for adults.

The FDA issued a recommendation to doctors this past summer not to prescribe Paxil for kids under 18 years old because of the possible rise in suicide risk. The FDA also set up a task force to study the suicide link further, but no defensive conclusions have been made so far. These public hearings on Monday are only one step in the long process to find answers.

Right now we want to take you back to that story we told you about, Christy Feig, about anti-depressants. (BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Kelie Schwindt was diagnosed with depression at 15, after she attempted suicide. Four months ago at 19, she tried again.

KELIE SCHWINT: I felt useless, like, I felt like I didn't belong here. I felt like, you know, nobody cared.

FEIG: It was only after that second attempt that she started taking her anti-depressants regularly. Kelie and her mother believe those pills definitely make her better. But some British experts believe certain anti-depressants actually can be dangerous in depressed teens.

Kelie's mom sees how that could happen.

MRS. SCHWINT: I think if the medication isn't taken right, if the support system isn't there, if they're not seeing their counselors like they should be, I think a lot of that is what leads up to problems that they have later.

FEIG (on camera): The issue came to a head in December when the British government sent doctors there a warning that some anti- depressants might actually increase a child's risk of attempting suicide.

(voice-over): That warning came after one pharmaceutical company released study results of their anti-depressant Paxil on more than 1,000 children. The rate of suicidal thinking and attempts on the drug was 3.7 percent; on the dummy pill or placebo, 2.5 percent.

But some U.S. doctors say the British warning misses a crucial detail.

DR. ADELAIDE RIDE-ON BUS, CHILDREN'S NATIONAL MEDICAL CENTER: In untreated depression in teenagers, the rate of suicide can be as high as 10 percent. So if kids don't get help, whether it's therapy or medication, the risk for suicide is 10 percent.

FEIG: Now, the issue rests with an advisory committee to the U.S. Food and Drug Administration, which will have the final word on what this means for U.S. patients.

Christy Feig, CNN, Washington.

(END VIDEOTAPE)

FIRFER: Now, as we said, prescribing anti-depressants to kids is a tough issue and we're going to take your questions by e-mail and by phone today. You can call us at 1-800-807-2620 or go ahead and e-mail us at housecall@cnn.com.

We are now joined by Dr. Alvin Poussaint from Boston.

He's a child psychiatrist and a professor of psychiatry at Harvard.

Now, we have a lot of e-mails and phone calls lined up, so let's go ahead and get started.

Welcome, Dr. Poussaint.

DR. ALVIN POUSSAINT, HARVARD UNIVERSITY: Thank you.

FIRFER: First up, an e-mail from Paula in Vermont.

And she says -- oh, I'm sorry.

Let's do the phone call.

Vanessa in New York, I'm sorry, on the phone.

Vanessa, go ahead.

What's your question?

VANESSA: Hi.

Good morning, Dr. Poussaint.

POUSSAINT: Good morning.

VANESSA: I'm having an issue with my 19-year-old son. He's sleeping all day. He doesn't have any incentive. He doesn't get up if there's no school. He doesn't have, he doesn't want to go to school and he doesn't want to do anything. He doesn't want to return to college, nothing.

I'd like to know what can I do when he's sleeping all day, he doesn't clean up, he -- is it possible that this is a sign of depression and what can I do?

POUSSAINT: Yes, I think it's possible that that's a sign of depression. Many people with depression withdraw. They are fatigued. They're tired. They don't want to get up in the morning. They can't do their work. So, yes, it could be a sign of depression. Getting him to see someone, I think, is probably the issue and the problem.

I think you should talk to him and say that his behavior is not normal and perhaps you should consult with someone, a health care professional, a mental health professional, psychiatrist/psychologist, just to get an evaluation to see if someone can be of some help to him. Because he certainly is not satisfied with what's happening to him and having trouble and difficulty doing his work and tending to college.

FIRFER: Dr. Poussaint, we now have an e-mail from Jane in Pennsylvania.

She asks, "What is the minimum age for which it's appropriate to prescribe anti-depressants for young people, if or when they might be needed, and how long is the general treatment?" Good question.

POUSSAINT: Well, that depends, of course, on the severity of the depression. But I think in general, even in clinical trials of children using drugs to treat their depression, they don't usually go below the age of six. Six is kind of a cutoff point. I'm sure probably in particular situations they may go lower than that. But I think no one's about to start prescribing these anti-depressants to preschool children and younger children, who also may suffer from depression.

FIRFER: Another phone call. This one is from Dean in Florida.

Dean, go ahead with your question.

DEAN: Yes, good morning, folks.

A healthy body leads to a healthy mind. My question for the doctor is when it comes to lack of physical education, the school lunch programs and basically childhood obesity on the rise, what can parents do to look at other options and perhaps even environment when it comes to looking to educate and not medicate so quickly, like we do today?

POUSSAINT: Io think that's a very good point. I think the environment plays a very important role in depression, particularly in children and adolescents. And I think the first attempt in treating it should be talk therapies, play therapy, group therapies, working with the parents, family therapy, because many of these children will improve from changes in the environment and supportive types of therapy for them.

In fact, even in the drug studies, a high proportion of the children improve when they're on this sugar pill and not on the real anti-depressant. So I think we should turn a little bit back, not to over medicate, but to help support children with good practices, good parenting and good mental health services.

FIRFER: Some great questions this morning. Keep them coming into us.

More answers to those questions about kids and anti-depressants is straight ahead. Plus, a closer look at a teenager who has endured the pain of depression and she even attempted suicide. Kelie's powerful story when we come back.

And like I said, we're still taking your phone calls, 1-800-807- 2620, or go ahead and e-mail us at housecall@cnn.com.

Back in a minute.

COMMERCIAL

FIRFER: Welcome back to Weekend House Call.

A link between the use of certain anti-depressants and an increased risk of suicide in kids has not been proven, but suicide is a very real problem among America's young people. About 4,000 children and adolescents commit suicide every year and experts estimate for every actual suicide, there are 10 to 20 attempts. Suicide is the third leading cause of death for young people ages 15 to 24.

Now, perhaps the most startling, the suicide rate among children 10 to 14 years old has more than doubled since 1980.

Now, as we know, depression can lead to suicide, whether you're young or old. There is always a risk. In the last segment, medical correspondent Christy Feig introduced us to a young woman who has experience with depression, medication and, yes, even attempted suicide.

Here now is more of Kelie's story.

(BEGIN VIDEOTAPE)

SCHWINT: I would just kind of all of a sudden just hit bottom.

FEIG (voice-over): Early in her teens, Kelie Schwindt was battling depression but she never let anyone know until one night.

SCHWINT: I took a bunch of pills. It was Excedrin. I didn't want to live anymore. And so I just kept on popping them one after another.

FEIG: She was 15. At the hospital, she was diagnosed and put on anti-depressants. She says she, like many teens, didn't take the diagnosis or her medicine seriously.

SCHWINT: I didn't want to be labeled so it just kind of went over my head. I was just like yes, right, you know? Nothing's wrong with me. I'm cool.

UNIDENTIFIED MALE: Kelie Schwindt, Mrs. Garden City.

FEIG: The summer after high school, she won Miss. Teen South Dakota International. Her issue? Preventing teen suicide. Just two months later, she hit rock bottom again.

SCHWINT: I thought I was fine. I mean I wasn't on top of the world or anything like I used to be, but, you know, I felt like -- I thought I was fine.

FEIG: But she hadn't been taking her anti-depressants. One evening, she took the entire bottle.

SCHWINT: You know, I felt useless. Like, I felt like I didn't belong here. I felt like, you know, nobody cared.

FEIG: She says that was her wake up call that depression is a real disease.

SCHWINT: I was given a second chance at life and there's a reason for that.

FEIG: Now at 19, Kelie's focus is keeping other teens from going through what she's been through.

Christy Feig, CNN, Garden City, Kansas.

(END VIDEOTAPE)

FIRFER: And as you can see, depression is a real disease for Keeley and anti-depressants were the answer. We're happy to report she's doing well today.

Now, we're joined again by Dr. Alvin Poussaint from Boston, so let's get some more of our viewer e-mails.

Helen in Florida is asking, "My daughter has been prescribed an anti-depressant recently to treat her depression and her anxiety. It has done wonders for her. But can somebody build up a tolerance to a particular medication? Her doctor indicated she needs to be on anti- depressants long-term."

Is this a concern?

POUSSAINT: Not usually. After you reach the correct dosage, usually the patient is stabilized and do quite well on that dose. Now, things may happen that change in a person's life that might make them more depressed, more stressed. You might have to up the dose. And sometimes, after they're stabilized, you may be able to lower the dose.

But you don't develop a tolerance to the medication like you would a narcotic, no. That doesn't happen. But the doses may vary with the severity of the symptoms.

FIRFER: Bruce in Wisconsin is asking, "What affects will anti- depressants have on the developmental process when someone starts taking them during their teenage years?"

And, Dr. Poussaint, we know that kids are growing. They're very different than adults. Could this have an impact on that growing process?

POUSSAINT: The answer to that question is we really don't know. They've been using these drugs now for about 15 years. That is the more modern anti-depressants. And there have been no reports of interference with the development or the development of the brain or the neurological system of these young people who have been on the anti-depressants.

But they, we should continue to follow that and look at it and so I think we have a responsibility to do research in that area.

FIRFER: Olivia joins us now on the phone from Kentucky.

Good morning, Olivia.

What's your question for Dr. Poussaint?

OLIVIA: Doctor, I'm concerned that other doctors don't necessarily check into the nutrition of the adolescents to see if that could also be improving their state of depression, if they have sufficient minerals and vitamins for a growing body and to handle their emotional and mental problems.

POUSSAINT: Well, I think a healthy, good balanced diet is very important to your sense of well-being. If you eat too much and become obese, that's going to contribute to feelings of depression. If you eat too little, of course, and become skinny and anorexic, that also will help lead to depressive feelings.

So I think having a sound body helps to keep a sound mind. So I think a balanced kind of a holistic approach to teenagers with depression and other problems is the best one.

FIRFER: Another e-mail we have is from Denise in Georgia. She's asking, "My 10-year-old son was prescribed Zoloft by our physician after observing his behavior over the course of a couple of years. Is it safe for children of this age and should a child be evaluated by the mental health expert before taking this type of medication?"

I know you touched on that earlier, but reiterate. Ten years old, is that OK? And are there certain steps you should take before you actually put a child on anti-depressants?

POUSSAINT: Well, considering the current controversy over the use of some of these medications and the fact that they're not approved -- Zoloft is not approved by the FDA at this point for use in children -- I think physicians should exercise caution for the benefit of the patients and also their own liability.

But Zoloft has been used. Some people, experts, have found it to be effective, particularly in depression, if her son has depression. And the question of how long he should be on the medication is one that's open. It depends on the severity of his symptoms. But I think the mother and the physician should have an open discussion with the risks and benefits being laid out to the parent so that they can be involved in the decision around taking Zoloft.

FIRFER: OK. And we know parents are a very important part of this. Being a parent of a child who may be depressed is extremely difficult. So coming up, some tips for parents to make sure they are protecting their children and asking the right questions.

But first, a look at how some kids are feeling fit.

(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN CORRESPONDENT (voice-over): For these kids, losing weight has been an uphill struggle. Rock climbing class is one step in their battle against the bulge. They're in a program called Kidshape and it's putting a fun spin on fitness.

CHRISTIANNE RIVARD, KIDSHAPE PROGRAM DIRECTOR: We've done everything from kick boxing to salsa dancing, tae kwon do, soccer, volleyball. And our goal is to make physical activity fun.

GUPTA: This group of teens and pre-teens meets every Saturday, and not just to rock climb, but participate in a program of nutrition counseling with their parents and, of course, to exercise.

RIVARD: For the kids that participate in Kidshape, 87 percent of those kids lose weight. But, also, the parents start to eat healthier, move more.

GUPTA: For Feeling Fit, I'm Dr. Sanjay Gupta.

(END VIDEOTAPE)

COMMERCIAL

FIRFER: If your doctor is recommending that your child be put on medication to treat depression, make sure you're asking the right questions. And most of all, remember you are the parent. Trust your instincts.

If medicating does not feel right, don't do it. Know the risks and the benefits of the drug your child is being prescribed and keep the communications open between you and your doctor. Report any unusual reactions or side effects of the medication and always ask questions. For example, how do I know the medication is helping? What are the possible side effects I should look for? And how long should my child take this medication?

We're joined this morning again by Dr. Alvin Poussaint in Boston.

And Dr. Poussaint, do you have any other tips for parents of children who might be prescribed anti-depressants so that they can make sure that their children get the best care?

POUSSAINT: Well, I think often a lot of parents may be seeing regular doctors and they're prescribed these very strong medications. I think whenever possible that parents should have their child evaluated by a mental health professional to make sure that they have the correct diagnosis and that the medications are being prescribed for the particular symptoms that the child has. And I think they should ask questions and I think that the psychiatrists/psychologists have to be open with the parents on many of the issues surrounding these drugs.

FIRFER: OK. We have another phone call.

Tina is on the phone from Virginia.

Good morning, Tina.

TINA: Good morning.

I'm calling in, I have a question about my 10-year-old daughter. She's been seeing since she was two years old, she was diagnosed as bipolar and she's being treated with Seroquel, Lithium and Clonidine. And I'm just curious as to is this something that kids normally outgrow?

POUSSAINT: Bipolar?

TINA: Yes.

POUSSAINT: No, they, I don't think they usually outgrow bipolar disorder. That's a severe chemical imbalance of the brain and probably connected with genetics or often many of these children have to stay on some type of medication over a long period of time, perhaps, we're not sure, but perhaps even for the rest of their life, to maintain them in a stable kind of position.

So I think being off the medications there's some risk that your daughter would relapse. Perhaps at some point psychiatrists or other mental health professionals might want to try withdrawal, but I think it's iffy. It depends on the severity of her symptoms and how much particularly of a family history she has for bipolar.

But bipolar is a brain disorder that needs correction through medication, usually, and doesn't always respond well to just changes in the environment, but that also should be part of the treatment and therapy. That is, good, again, good parenting, talk therapy, because these children have to learn how to interact with other people and learn how to avoid the stresses that might precipitate some of their disorder.

FIRFER: Some great information here. Some much needed information, Dr. Poussaint. And for everyone, if we haven't had a chance to get to your phone call or your e-mail, don't go away because after the break, we're going to give you some good Web sites to click on to get the questions answered that you might have.

But first, let's look at some of the other health stories making news this week.

(BEGIN VIDEOTAPE)

FIRFER (voice-over): A University of Maryland study shows that parents of children with Attention Deficit Hyperactivity Disorder, or ADHD, are 24 times more likely to have the disorder themselves. The study suggested that treatment for children with ADHD should include treatment for their parents, as well.

Also, a study in the "Journal of the American Medical Association" this week shows that mammograms may not be as effective in patients with breast implants. The study was careful to point out that having breast implants does not increase your risk of breast cancer, simply that the tests may be less effective.

(END VIDEOTAPE)

COMMERCIAL

FIRFER: For more information on anti-depressants, kids and suicide and Monday's public hearings, check out the FDA Web site at www.fda.gov. And, as always, check out cnn.com for the latest news to come out on anti-depressants and kids.

I'd like to thank our guest this morning, Dr. Alvin Poussaint, for some great insight, we appreciate it, on a serious topic.

Thank you for joining us.

POUSSAINT: Thank you.

FIRFER: And that's all we have time for on this morning's Weekend House Call.

Tomorrow, Super Bowl Sunday, we'll talk all about the low carb craze.

Hope to see you then.

I'm Holly Firfer.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired January 31, 2004 - 08:30   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JEFF FLOCK, CNN ANCHOR: And Weekend House Call begins right now.
HOLLY FIRFER, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.

I'm Holly Firfer.

We're glad you're here.

More than a million American children are on some kind of prescription drug to treat major depression. But, could anti- depressants actually increase the risk of suicide in children?

The FDA is looking into that possibility and opens public hearings on the issue on Monday.

CNN medical correspondent Christy Feig takes a closer look at the debate and possible dangers of prescribing anti-depressants to children. We'll have that package in a minute.

But first, I wanted to give you some information about anti- depressants. Prescribing anti-depressants to kids is a polarizing issue and in our next half hour, we are not going to draw conclusions. We're only going to try to answer your questions and your e-mails.

Now, depression occurs in about 10 percent of American children and depression can also lead to suicide. As we mentioned, about a million children are currently taking some form of anti-depressant. But Prozac is the only type of anti-depressant approved by the FDA for kids. Now, according to drug regulators, it is the only one that is proven to alleviate pediatric depression.

Now, anti-depressants are not approved for children, but are still being prescribed by doctors, and those include Paxil, Zoloft, Effexor, Remeron, Celexa, Luvox and Serzone. Now, those drugs can be prescribed legally off label to children by doctors because they are approved for adults.

The FDA issued a recommendation to doctors this past summer not to prescribe Paxil for kids under 18 years old because of the possible rise in suicide risk. The FDA also set up a task force to study the suicide link further, but no defensive conclusions have been made so far. These public hearings on Monday are only one step in the long process to find answers.

Right now we want to take you back to that story we told you about, Christy Feig, about anti-depressants. (BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Kelie Schwindt was diagnosed with depression at 15, after she attempted suicide. Four months ago at 19, she tried again.

KELIE SCHWINT: I felt useless, like, I felt like I didn't belong here. I felt like, you know, nobody cared.

FEIG: It was only after that second attempt that she started taking her anti-depressants regularly. Kelie and her mother believe those pills definitely make her better. But some British experts believe certain anti-depressants actually can be dangerous in depressed teens.

Kelie's mom sees how that could happen.

MRS. SCHWINT: I think if the medication isn't taken right, if the support system isn't there, if they're not seeing their counselors like they should be, I think a lot of that is what leads up to problems that they have later.

FEIG (on camera): The issue came to a head in December when the British government sent doctors there a warning that some anti- depressants might actually increase a child's risk of attempting suicide.

(voice-over): That warning came after one pharmaceutical company released study results of their anti-depressant Paxil on more than 1,000 children. The rate of suicidal thinking and attempts on the drug was 3.7 percent; on the dummy pill or placebo, 2.5 percent.

But some U.S. doctors say the British warning misses a crucial detail.

DR. ADELAIDE RIDE-ON BUS, CHILDREN'S NATIONAL MEDICAL CENTER: In untreated depression in teenagers, the rate of suicide can be as high as 10 percent. So if kids don't get help, whether it's therapy or medication, the risk for suicide is 10 percent.

FEIG: Now, the issue rests with an advisory committee to the U.S. Food and Drug Administration, which will have the final word on what this means for U.S. patients.

Christy Feig, CNN, Washington.

(END VIDEOTAPE)

FIRFER: Now, as we said, prescribing anti-depressants to kids is a tough issue and we're going to take your questions by e-mail and by phone today. You can call us at 1-800-807-2620 or go ahead and e-mail us at housecall@cnn.com.

We are now joined by Dr. Alvin Poussaint from Boston.

He's a child psychiatrist and a professor of psychiatry at Harvard.

Now, we have a lot of e-mails and phone calls lined up, so let's go ahead and get started.

Welcome, Dr. Poussaint.

DR. ALVIN POUSSAINT, HARVARD UNIVERSITY: Thank you.

FIRFER: First up, an e-mail from Paula in Vermont.

And she says -- oh, I'm sorry.

Let's do the phone call.

Vanessa in New York, I'm sorry, on the phone.

Vanessa, go ahead.

What's your question?

VANESSA: Hi.

Good morning, Dr. Poussaint.

POUSSAINT: Good morning.

VANESSA: I'm having an issue with my 19-year-old son. He's sleeping all day. He doesn't have any incentive. He doesn't get up if there's no school. He doesn't have, he doesn't want to go to school and he doesn't want to do anything. He doesn't want to return to college, nothing.

I'd like to know what can I do when he's sleeping all day, he doesn't clean up, he -- is it possible that this is a sign of depression and what can I do?

POUSSAINT: Yes, I think it's possible that that's a sign of depression. Many people with depression withdraw. They are fatigued. They're tired. They don't want to get up in the morning. They can't do their work. So, yes, it could be a sign of depression. Getting him to see someone, I think, is probably the issue and the problem.

I think you should talk to him and say that his behavior is not normal and perhaps you should consult with someone, a health care professional, a mental health professional, psychiatrist/psychologist, just to get an evaluation to see if someone can be of some help to him. Because he certainly is not satisfied with what's happening to him and having trouble and difficulty doing his work and tending to college.

FIRFER: Dr. Poussaint, we now have an e-mail from Jane in Pennsylvania.

She asks, "What is the minimum age for which it's appropriate to prescribe anti-depressants for young people, if or when they might be needed, and how long is the general treatment?" Good question.

POUSSAINT: Well, that depends, of course, on the severity of the depression. But I think in general, even in clinical trials of children using drugs to treat their depression, they don't usually go below the age of six. Six is kind of a cutoff point. I'm sure probably in particular situations they may go lower than that. But I think no one's about to start prescribing these anti-depressants to preschool children and younger children, who also may suffer from depression.

FIRFER: Another phone call. This one is from Dean in Florida.

Dean, go ahead with your question.

DEAN: Yes, good morning, folks.

A healthy body leads to a healthy mind. My question for the doctor is when it comes to lack of physical education, the school lunch programs and basically childhood obesity on the rise, what can parents do to look at other options and perhaps even environment when it comes to looking to educate and not medicate so quickly, like we do today?

POUSSAINT: Io think that's a very good point. I think the environment plays a very important role in depression, particularly in children and adolescents. And I think the first attempt in treating it should be talk therapies, play therapy, group therapies, working with the parents, family therapy, because many of these children will improve from changes in the environment and supportive types of therapy for them.

In fact, even in the drug studies, a high proportion of the children improve when they're on this sugar pill and not on the real anti-depressant. So I think we should turn a little bit back, not to over medicate, but to help support children with good practices, good parenting and good mental health services.

FIRFER: Some great questions this morning. Keep them coming into us.

More answers to those questions about kids and anti-depressants is straight ahead. Plus, a closer look at a teenager who has endured the pain of depression and she even attempted suicide. Kelie's powerful story when we come back.

And like I said, we're still taking your phone calls, 1-800-807- 2620, or go ahead and e-mail us at housecall@cnn.com.

Back in a minute.

COMMERCIAL

FIRFER: Welcome back to Weekend House Call.

A link between the use of certain anti-depressants and an increased risk of suicide in kids has not been proven, but suicide is a very real problem among America's young people. About 4,000 children and adolescents commit suicide every year and experts estimate for every actual suicide, there are 10 to 20 attempts. Suicide is the third leading cause of death for young people ages 15 to 24.

Now, perhaps the most startling, the suicide rate among children 10 to 14 years old has more than doubled since 1980.

Now, as we know, depression can lead to suicide, whether you're young or old. There is always a risk. In the last segment, medical correspondent Christy Feig introduced us to a young woman who has experience with depression, medication and, yes, even attempted suicide.

Here now is more of Kelie's story.

(BEGIN VIDEOTAPE)

SCHWINT: I would just kind of all of a sudden just hit bottom.

FEIG (voice-over): Early in her teens, Kelie Schwindt was battling depression but she never let anyone know until one night.

SCHWINT: I took a bunch of pills. It was Excedrin. I didn't want to live anymore. And so I just kept on popping them one after another.

FEIG: She was 15. At the hospital, she was diagnosed and put on anti-depressants. She says she, like many teens, didn't take the diagnosis or her medicine seriously.

SCHWINT: I didn't want to be labeled so it just kind of went over my head. I was just like yes, right, you know? Nothing's wrong with me. I'm cool.

UNIDENTIFIED MALE: Kelie Schwindt, Mrs. Garden City.

FEIG: The summer after high school, she won Miss. Teen South Dakota International. Her issue? Preventing teen suicide. Just two months later, she hit rock bottom again.

SCHWINT: I thought I was fine. I mean I wasn't on top of the world or anything like I used to be, but, you know, I felt like -- I thought I was fine.

FEIG: But she hadn't been taking her anti-depressants. One evening, she took the entire bottle.

SCHWINT: You know, I felt useless. Like, I felt like I didn't belong here. I felt like, you know, nobody cared.

FEIG: She says that was her wake up call that depression is a real disease.

SCHWINT: I was given a second chance at life and there's a reason for that.

FEIG: Now at 19, Kelie's focus is keeping other teens from going through what she's been through.

Christy Feig, CNN, Garden City, Kansas.

(END VIDEOTAPE)

FIRFER: And as you can see, depression is a real disease for Keeley and anti-depressants were the answer. We're happy to report she's doing well today.

Now, we're joined again by Dr. Alvin Poussaint from Boston, so let's get some more of our viewer e-mails.

Helen in Florida is asking, "My daughter has been prescribed an anti-depressant recently to treat her depression and her anxiety. It has done wonders for her. But can somebody build up a tolerance to a particular medication? Her doctor indicated she needs to be on anti- depressants long-term."

Is this a concern?

POUSSAINT: Not usually. After you reach the correct dosage, usually the patient is stabilized and do quite well on that dose. Now, things may happen that change in a person's life that might make them more depressed, more stressed. You might have to up the dose. And sometimes, after they're stabilized, you may be able to lower the dose.

But you don't develop a tolerance to the medication like you would a narcotic, no. That doesn't happen. But the doses may vary with the severity of the symptoms.

FIRFER: Bruce in Wisconsin is asking, "What affects will anti- depressants have on the developmental process when someone starts taking them during their teenage years?"

And, Dr. Poussaint, we know that kids are growing. They're very different than adults. Could this have an impact on that growing process?

POUSSAINT: The answer to that question is we really don't know. They've been using these drugs now for about 15 years. That is the more modern anti-depressants. And there have been no reports of interference with the development or the development of the brain or the neurological system of these young people who have been on the anti-depressants.

But they, we should continue to follow that and look at it and so I think we have a responsibility to do research in that area.

FIRFER: Olivia joins us now on the phone from Kentucky.

Good morning, Olivia.

What's your question for Dr. Poussaint?

OLIVIA: Doctor, I'm concerned that other doctors don't necessarily check into the nutrition of the adolescents to see if that could also be improving their state of depression, if they have sufficient minerals and vitamins for a growing body and to handle their emotional and mental problems.

POUSSAINT: Well, I think a healthy, good balanced diet is very important to your sense of well-being. If you eat too much and become obese, that's going to contribute to feelings of depression. If you eat too little, of course, and become skinny and anorexic, that also will help lead to depressive feelings.

So I think having a sound body helps to keep a sound mind. So I think a balanced kind of a holistic approach to teenagers with depression and other problems is the best one.

FIRFER: Another e-mail we have is from Denise in Georgia. She's asking, "My 10-year-old son was prescribed Zoloft by our physician after observing his behavior over the course of a couple of years. Is it safe for children of this age and should a child be evaluated by the mental health expert before taking this type of medication?"

I know you touched on that earlier, but reiterate. Ten years old, is that OK? And are there certain steps you should take before you actually put a child on anti-depressants?

POUSSAINT: Well, considering the current controversy over the use of some of these medications and the fact that they're not approved -- Zoloft is not approved by the FDA at this point for use in children -- I think physicians should exercise caution for the benefit of the patients and also their own liability.

But Zoloft has been used. Some people, experts, have found it to be effective, particularly in depression, if her son has depression. And the question of how long he should be on the medication is one that's open. It depends on the severity of his symptoms. But I think the mother and the physician should have an open discussion with the risks and benefits being laid out to the parent so that they can be involved in the decision around taking Zoloft.

FIRFER: OK. And we know parents are a very important part of this. Being a parent of a child who may be depressed is extremely difficult. So coming up, some tips for parents to make sure they are protecting their children and asking the right questions.

But first, a look at how some kids are feeling fit.

(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN CORRESPONDENT (voice-over): For these kids, losing weight has been an uphill struggle. Rock climbing class is one step in their battle against the bulge. They're in a program called Kidshape and it's putting a fun spin on fitness.

CHRISTIANNE RIVARD, KIDSHAPE PROGRAM DIRECTOR: We've done everything from kick boxing to salsa dancing, tae kwon do, soccer, volleyball. And our goal is to make physical activity fun.

GUPTA: This group of teens and pre-teens meets every Saturday, and not just to rock climb, but participate in a program of nutrition counseling with their parents and, of course, to exercise.

RIVARD: For the kids that participate in Kidshape, 87 percent of those kids lose weight. But, also, the parents start to eat healthier, move more.

GUPTA: For Feeling Fit, I'm Dr. Sanjay Gupta.

(END VIDEOTAPE)

COMMERCIAL

FIRFER: If your doctor is recommending that your child be put on medication to treat depression, make sure you're asking the right questions. And most of all, remember you are the parent. Trust your instincts.

If medicating does not feel right, don't do it. Know the risks and the benefits of the drug your child is being prescribed and keep the communications open between you and your doctor. Report any unusual reactions or side effects of the medication and always ask questions. For example, how do I know the medication is helping? What are the possible side effects I should look for? And how long should my child take this medication?

We're joined this morning again by Dr. Alvin Poussaint in Boston.

And Dr. Poussaint, do you have any other tips for parents of children who might be prescribed anti-depressants so that they can make sure that their children get the best care?

POUSSAINT: Well, I think often a lot of parents may be seeing regular doctors and they're prescribed these very strong medications. I think whenever possible that parents should have their child evaluated by a mental health professional to make sure that they have the correct diagnosis and that the medications are being prescribed for the particular symptoms that the child has. And I think they should ask questions and I think that the psychiatrists/psychologists have to be open with the parents on many of the issues surrounding these drugs.

FIRFER: OK. We have another phone call.

Tina is on the phone from Virginia.

Good morning, Tina.

TINA: Good morning.

I'm calling in, I have a question about my 10-year-old daughter. She's been seeing since she was two years old, she was diagnosed as bipolar and she's being treated with Seroquel, Lithium and Clonidine. And I'm just curious as to is this something that kids normally outgrow?

POUSSAINT: Bipolar?

TINA: Yes.

POUSSAINT: No, they, I don't think they usually outgrow bipolar disorder. That's a severe chemical imbalance of the brain and probably connected with genetics or often many of these children have to stay on some type of medication over a long period of time, perhaps, we're not sure, but perhaps even for the rest of their life, to maintain them in a stable kind of position.

So I think being off the medications there's some risk that your daughter would relapse. Perhaps at some point psychiatrists or other mental health professionals might want to try withdrawal, but I think it's iffy. It depends on the severity of her symptoms and how much particularly of a family history she has for bipolar.

But bipolar is a brain disorder that needs correction through medication, usually, and doesn't always respond well to just changes in the environment, but that also should be part of the treatment and therapy. That is, good, again, good parenting, talk therapy, because these children have to learn how to interact with other people and learn how to avoid the stresses that might precipitate some of their disorder.

FIRFER: Some great information here. Some much needed information, Dr. Poussaint. And for everyone, if we haven't had a chance to get to your phone call or your e-mail, don't go away because after the break, we're going to give you some good Web sites to click on to get the questions answered that you might have.

But first, let's look at some of the other health stories making news this week.

(BEGIN VIDEOTAPE)

FIRFER (voice-over): A University of Maryland study shows that parents of children with Attention Deficit Hyperactivity Disorder, or ADHD, are 24 times more likely to have the disorder themselves. The study suggested that treatment for children with ADHD should include treatment for their parents, as well.

Also, a study in the "Journal of the American Medical Association" this week shows that mammograms may not be as effective in patients with breast implants. The study was careful to point out that having breast implants does not increase your risk of breast cancer, simply that the tests may be less effective.

(END VIDEOTAPE)

COMMERCIAL

FIRFER: For more information on anti-depressants, kids and suicide and Monday's public hearings, check out the FDA Web site at www.fda.gov. And, as always, check out cnn.com for the latest news to come out on anti-depressants and kids.

I'd like to thank our guest this morning, Dr. Alvin Poussaint, for some great insight, we appreciate it, on a serious topic.

Thank you for joining us.

POUSSAINT: Thank you.

FIRFER: And that's all we have time for on this morning's Weekend House Call.

Tomorrow, Super Bowl Sunday, we'll talk all about the low carb craze.

Hope to see you then.

I'm Holly Firfer.

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