New doubts about medicating kids

Diller says he spoke in his testimony about his "loss of faith in my academic colleagues to generate accurate information and opinions that I feel I can trust because of the extremely intimate link between researchers and the drug industry."

After such revelations, he says, one might expect closer regulation of the medical profession. But "we don't have to worry about regulation of doctors because the government has been bought off and so has the public by the drug industry," he says. "The ads directed to consumers convince everyone that life is simply, you know, neurotransmitter bubbles going from one set of synapses to another. The lobbying of the drug industry is legendary - and this is a doctor speaking."

Another testifier, David Antonuccio, a psychologist at the University of Nevada Medical School in Reno, was part of a team that analyzed 12 studies (published and unpublished) on antidepressants and children. "Our conclusions were that the advantages of the antidepressants in children were so small and so trivial as to be clinically insignificant," Dr. Antonuccio said by telephone after the hearing. They certainly do not "warrant any increased risk, let alone increased risk for suicidal behavior.

"We don't think the benefits warrant [even] some of the [lesser] side effects, which are quite common, including agitation, insomnia, and gastrointestinal problems."

His team's preliminary analysis of available studies shows that "placebos duplicate 90 percent of the drug response," which suggests that the drugs' benefit is primarily psychological. Less risky strategies such as "exercise, cognitive-behavior therapy, depression-management skills, sports, or just good parenting" should be considered first, he says, adding that, speaking as a father of a 5-year-old, "this is a really important issue when it comes to protecting our children."

Britain cited health risks when it banned six brands of antidepressants for children under 18. In the United States, only Prozac has been deemed effective by the FDA in treating children for depression, but doctors are legally free to prescribe other antidepressants and have been doing so routinely.

In October the FDA alerted doctors to reports of suicidal tendencies found among children participating in clinical tests of antidepressant drugs. Wyeth, the pharmaceutical company that makes the antidepressant Effexor, had warned doctors in August that its drug caused an increased risk of suicidal behavior in children.

Antidepressants are heavily advertised by drug companies to the general public and are used to treat depression, obsessive-compulsive disorder, social phobias, and anxiety disorders.

The drugs are classed as SSRIs or selective serotonin reuptake inhibitors. Millions of prescriptions for them are written each year. The FDA says that more than 10 million children and teens 17 and under took antidepressants in 2002. The drugs under review by the FDA are known by the brand names Remeron, Serzone, Effexor, Wellbutrin, Celexa, Luvox, Paxil, Zoloft, and Prozac.

The Pediatric Research Equity Act of 2003, signed into law last November by President Bush, provides the FDA with authority to require studies of the effects of pharmaceutical products specifically on children to ensure that they are both safe and effective.

• Material from wire services was used in this report.

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