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Daily Dose: Kids and Antidepressants

Aired February 02, 2004 - 11:40   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.


DARYN KAGAN, CNN ANCHOR: As many as 10 percent of children and adolescents in the U.S. may suffer from depression. An FDA panel today examines whether some adult antidepressants might increase the risk of suicide when given to children.
Dr. Adelaide Robb is a psychologist and researcher at the Children's National Medical Center in Washington, and she's with us for our "Daily Dose" of health news.

Good morning, Dr. Robb.

DR. ADELAIDE ROBB, CHILDREN'S NATIONAL MEDICAL CENTER: Good morning, Daryn.

KAGAN: First, off the top, how do you know if your teenager is truly depressed or just dealing with that regular teenager stuff?

ROBB: Well, one of the things that you should look for as a parent is any comments about wanting to be dead or wishing they were not alive. A second one is a marked or a dramatic change in their behavior from the way they usually are. So, if they stop going to the mall with friends, stop talking on the telephone, their grades go from A's down to D's, a parent needs to be worried it's more than just normal adolescent behavior.

KAGAN: And so many of these drugs are being prescribed for teenagers. Do we know for a fact that chemically they work different in children and teenagers than they do in adults?

ROBB: We know that the older antidepressants did not work in the treatment of teenage depression. That includes the tricyclics, the monoamine oxidase inhibitors, and the dopaminergic anti-depressants. Only the serotonin selective reuptake inhibitors have been shown to be effective in some of the pediatric depression trials.

KAGAN: Do you give any credence to these studies that show that it might lead to an increase in suicide in teenagers?

ROBB: I think first you need to remember that the overall rate of suicide in untreated teenage depression is 10 percent. None of the studies, either in the placebo arm or in the active medicine arm, have had a rate as high as that. The rates, in fact, have been much lower, as low as 2 to 3 percent on placebo and 3 to 5 percent on active medication.

KAGAN: OK. So, the answer here is not, don't do anything. No. 1, if you have a teenager who you think is in trouble, you've got to go get help.

ROBB: Absolutely. You need to go see your pediatrician first, if that's the person you have access to, and then ask for a referral to a mental health care provider such as a social worker, a psychologist or a child psychiatrist.

KAGAN: And so, as the FDA holds these hearings on these drugs and hears from different camps, would you imagine you're going to hear a variety of different stories, you're going to hear some parents who say this was a nightmare for my child, but then some who say hold on, don't do anything, because these drugs were literally lifesavers for my kids?

ROBB: You're certainly going to hear a variety of opinions. And for kids who have gotten better on medication, it's like getting your life back again. They go from being sad and dysfunctional to being able to concentrate at school and join their activities and hanging out with their friends again, which is just an amazing thing for a child who is truly suffering.

KAGAN: But are these medications that teenagers can expect to be on for a long time, or is there a limited amount of time that they should be used as a help?

ROBB: Normally, what we do when we prescribe antidepressants for a child is put them on for six months. That's the amount of time that it is thought to be necessary to treat a single episode of depression. And at the end of those six months, the medicine is slowly tapered, and the child is monitored closely to make sure that symptoms don't come back.

KAGAN: Ideally, if a teenager has a problem, if a parent thinks a teenager has a problem, not just get help, but get to a mental health professional.

ROBB: Absolutely. We're the ones that are trained to look for and treat the signs and symptoms of depression, and also to monitor response to medication and change the dose or change the medicine if the child seems to be having difficulty on a specific medicine.

KAGAN: Dr. Adelaide Robb, thank you for giving us some answers to a very difficult situation for a lot of teenagers and parents out there. Appreciate it, Dr. Robb.

ROBB: Thank you for having me.

KAGAN: And for your "Daily Dose" of health news online, you can log on to our Web site. You'll find the latest medical news making headlines. There's also head-to-toe health information from CNN and the Mayo Clinic. The address is CNN.com/health.

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 February 2, 2004 - 11:40   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, CNN ANCHOR: As many as 10 percent of children and adolescents in the U.S. may suffer from depression. An FDA panel today examines whether some adult antidepressants might increase the risk of suicide when given to children.
Dr. Adelaide Robb is a psychologist and researcher at the Children's National Medical Center in Washington, and she's with us for our "Daily Dose" of health news.

Good morning, Dr. Robb.

DR. ADELAIDE ROBB, CHILDREN'S NATIONAL MEDICAL CENTER: Good morning, Daryn.

KAGAN: First, off the top, how do you know if your teenager is truly depressed or just dealing with that regular teenager stuff?

ROBB: Well, one of the things that you should look for as a parent is any comments about wanting to be dead or wishing they were not alive. A second one is a marked or a dramatic change in their behavior from the way they usually are. So, if they stop going to the mall with friends, stop talking on the telephone, their grades go from A's down to D's, a parent needs to be worried it's more than just normal adolescent behavior.

KAGAN: And so many of these drugs are being prescribed for teenagers. Do we know for a fact that chemically they work different in children and teenagers than they do in adults?

ROBB: We know that the older antidepressants did not work in the treatment of teenage depression. That includes the tricyclics, the monoamine oxidase inhibitors, and the dopaminergic anti-depressants. Only the serotonin selective reuptake inhibitors have been shown to be effective in some of the pediatric depression trials.

KAGAN: Do you give any credence to these studies that show that it might lead to an increase in suicide in teenagers?

ROBB: I think first you need to remember that the overall rate of suicide in untreated teenage depression is 10 percent. None of the studies, either in the placebo arm or in the active medicine arm, have had a rate as high as that. The rates, in fact, have been much lower, as low as 2 to 3 percent on placebo and 3 to 5 percent on active medication.

KAGAN: OK. So, the answer here is not, don't do anything. No. 1, if you have a teenager who you think is in trouble, you've got to go get help.

ROBB: Absolutely. You need to go see your pediatrician first, if that's the person you have access to, and then ask for a referral to a mental health care provider such as a social worker, a psychologist or a child psychiatrist.

KAGAN: And so, as the FDA holds these hearings on these drugs and hears from different camps, would you imagine you're going to hear a variety of different stories, you're going to hear some parents who say this was a nightmare for my child, but then some who say hold on, don't do anything, because these drugs were literally lifesavers for my kids?

ROBB: You're certainly going to hear a variety of opinions. And for kids who have gotten better on medication, it's like getting your life back again. They go from being sad and dysfunctional to being able to concentrate at school and join their activities and hanging out with their friends again, which is just an amazing thing for a child who is truly suffering.

KAGAN: But are these medications that teenagers can expect to be on for a long time, or is there a limited amount of time that they should be used as a help?

ROBB: Normally, what we do when we prescribe antidepressants for a child is put them on for six months. That's the amount of time that it is thought to be necessary to treat a single episode of depression. And at the end of those six months, the medicine is slowly tapered, and the child is monitored closely to make sure that symptoms don't come back.

KAGAN: Ideally, if a teenager has a problem, if a parent thinks a teenager has a problem, not just get help, but get to a mental health professional.

ROBB: Absolutely. We're the ones that are trained to look for and treat the signs and symptoms of depression, and also to monitor response to medication and change the dose or change the medicine if the child seems to be having difficulty on a specific medicine.

KAGAN: Dr. Adelaide Robb, thank you for giving us some answers to a very difficult situation for a lot of teenagers and parents out there. Appreciate it, Dr. Robb.

ROBB: Thank you for having me.

KAGAN: And for your "Daily Dose" of health news online, you can log on to our Web site. You'll find the latest medical news making headlines. There's also head-to-toe health information from CNN and the Mayo Clinic. The address is CNN.com/health.

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