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Antidepressants May Be linked to Suicide, FDA Warns

Doctors who prescribe popular antidepressants and patients who take them should watch closely for warning signs of suicide and other mental health problems, federal health officials cautioned Monday.

Makers of the drugs, which include Paxil, Prozac and Zoloft, are also being asked to step up suicide warnings on their package labels.

The cautions from the Food and Drug Administration do not tell people taking the medications to stop using them. But they do urge doctors and patients to watch for any unusual reactions, especially when the drugs are first started or the dose has been changed, so that patients can get prompt medical help.

Patients, doctors and other caregivers should be especially watchful for suicidal thoughts or worsening of depression. Signs of increased anxiety, agitation, hostility, insomnia or other conditions should also be noted and reported to a physician. Such reactions to antidepressants are not common, but occur often enough to merit a watchful eye, doctors said.

"I think this recommendation is very reasonable,'' said Dr. Glen Elliott, a specialist in pediatric psychiatry and director of the children's division of Langley Porter Psychiatric Institute at the University of California-San Francisco. "These are potent medications. They have many benefits, but you have to keep on monitoring.''

The warnings will affect millions of Americans of all ages. Newer types of antidepressants were the third most commonly prescribed class of drug in 2003, pulling in $10.9 billion for their makers, and their use is growing in adults and children alike.

The 10 medications covered by the FDA's warning include Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro, Wellbutrin, Effexor, Serzone and Remeron. Such drugs are most commonly prescribed for depression, but may also be used to treat other conditions such as panic or obsessive-compulsive disorders.

Patients who notice any unusual effects from the drugs or have questions about their use should not abruptly stop taking them, FDA officials and doctors stressed. Instead, patients should talk with their physicians before making any decisions about their medication.

"It's very good to be aware and informed,'' said Dr. Tiffany Ho, medical director of the Santa Clara County Health Department. "But people shouldn't be overly alarmed. These medications have helped millions of people. It's worth seeking out help.''

To read the complete FDA advisory on antidepressants, go to www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273.



For information about alternative treatments to antidepressant medication go to www.alternativementalhealth.com. Always make an informed decision and consider all options when deciding to take a psychotropic medication. Consult a qualified practitioner such as a psychiatrist or licensed psychologist for expert psychiatric evaluation and medication.



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