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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Anti Depressant Medications and Suicide Risk Warnings

Allan N. Schwartz, LCSW, Ph.D. Updated: Apr 10th 2007

The media has emphasized the suicide risk for children and adolescents who take anti derpessant medications, particularly the SSRIs, such as Prozac among others. The result of all the media exposure is that there is a significant decrease in the numbers of children and adolescents being prescribed these medicines. Is this a good thing or not?

We are a very media oriented society, allowing our choices and preferences for clothes, vacation spots, foods and life styles to be influenced by what is depicted and praised by the media. When the SSRI medications first hit the market many years ago they were praised as a major step towards resolving depression. In the same way the media insisted that psychoanalysis was useless and turned instead to cognitive-behavioral therapy as the panacea for depression and anxiety. Now the media states that there is a risk of suicide among children and teenagers who are prescribed anti depressant medications and the numbers of children beint prescribed this is reduced.

What is concerning to me is that many health decisions are being made by the public based on media information rather than trust in the medical professionals. The fact is that the evidence for suicide among children and adolescents who are taking anti depressants is extremely small. In addition, it is not clear how many of those patients were in psychotherapy at the time suicide became an issue.

From my point of view as a mental health practitioner is that psychiatric medications are not a cureall for depression, anxiety and the other mental illnesses. It is vital that people on psychiatric medications be in psychotherapy for several reasons.

Reasons for being in psychotherapy when on psychiatric medications:

1) Psychotherapy provides an opportunity for people to learn new coping behaviors that can help them prevent a resurgence of depression.

2) With medication many people become more open to learning about their illness and how to control it.

3) By learning how to control their symptoms it becomes possible for some people to look forward to the day when they can, with their doctor's guidance, get off of the medicines.

4) There are times when a few patients may be at increased risk of a suicide attempt because they have started to take medication, feel somewhat better but remain depressed with the energy to make an attempt.

5) Attending weekly psychotherapy sessions, the therapist has an opportunity to observe, listen to and monitor his patient for symptoms of suicide or any other dangerous problems that could emerge and prevented from becoming more serious.

I work with many patients who take psychiatric medicines. In all cases the prescribing psychiatist and I have regular contact in order to review the progress of the patient and for the psychiatrist to see the patient sooner than the next appointment if medications need to be adjusted. Working in psychiatry is a teem effort in which patients are not allowed to flounder alone in the outside world.

In no way am I suggesting that anti depressant medications are safe for anyone to use. On the contrary, it is the job of the psychiatrist to recommend what is safe and most likely to succeed.

On the other hand, we know that both the rate of suicide attempts and successful suicides has significantly decreased as a result of medications treatment.

It is important that we not "throw out the baby with the bath water" but measure with great care whether a child is in greater danger without rather than with medications.

Always consult seek medical advice from your psychiatrist about medication decisions for your self or for your children and teenagers.

What are your opinions?

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

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